Homeless in Toronto Emergency Wards FWD
Tom Boland (wgcp@earthlink.net)
Wed, 10 Dec 1997 03:52:37 -0800 (PST)
FWD
VICTIMS OF "HARRIS-MENT:
Homeless end up on the street, then the emergency wards
By John Richmond, richmond@smh.toronto.on.ca
http://www.policyalternatives.ca/articles/article113.html
The results of a study (to be published elsewhere) conducted
during the winter of 1996 in a downtown Toronto hospital indicate
that the Harris government's massive cuts in welfare and social
services have greatly increased the numbers of homeless people in
the city. The government's failure to tackle the underlying
causes of homelessness, such as the lack of affordable housing,
has resulted in many of these victims ending up in the emergency
departments of hospitals.
The study involved screening patients at one hospital for a wide
variety of social problems. The study was confined to patients
who came (or were carried) to the emergency department between 3
p.m. and 11 p.m. over the course of 60 days between January 1 and
April 30, 1996.
Of the 1,622 patients screened during the study, 31% were found
to have at least one serious social problem. Only 29%, for
example, had jobs, and over 400 had no source of income at all.
Whether these 1,622 people were representative of the population
in Toronto's inner city may be debatable, but the findings
clearly suggest that thousands of people must be falling through
the holes in the province's disintegrating social safety
net--including the growing numbers of homeless people on the
city's streets.
Of the patients in this survey, a dozen without any source of
income were elderly. One other man, aged 79, was employed as a
tradesman in the underground economy, but was not making enough
to pay rent. He was living in a van.
The study found that 278 of the patients had no place to live,
not even with families or friends, and that nearly half of them
had no source of income. Even though it was the middle of winter
at the time of the survey, only 90--or less than 30%--of these
homeless people had any kind of shelter.
While this study was being done, 2,362 people were cut from the
welfare rolls in Toronto. No one seems to know for certain where
these people went, but the study's findings suggest that many of
them ended up on the street, and a significant number in hospital
emergency wards.
Lack of income, however, is not the only cause of homelessness.
Canadian experts, such as Prof. David Hulchanski of the
University of Toronto, also argue that many of the working poor
are being squeezed out of the rental market. No longer able to
afford rental housing, the very poor have come to rely on
friends, family, and the state (through social housing).
Considering the 21.6% cut in welfare rates inflicted just two
months prior to this study, the harsh measures taken since to
reduce "welfare dependency," the lack of new social housing
starts since 1995, and the abolition of rent control, even those
on some form of income assistance are finding it increasingly
difficult to hold on to their homes or to cope with rising rents.
More and more people are being forced to seek refuge temporarily
in public shelters (use of which has increased dramatically in
recent years) and eventually onto the street.
Once on the street, even healthy people are more prone to
illness, and for needed health care people with no fixed address
inevitably go (or are taken) to a general hospital's emergency
department. The emergency department which provided the locale
for this study is also the source of many other hard-to-access
resources for the homeless: food, clothing, bus and subway
tokens, and even taxis for those unable to walk.
But hospitals are expensive sources of care for the homeless. A
visit to the emergency department may cost several hundred
dollars, while a stay in the hospital for a relatively minor
ailment (which would normally be treated at home for those with
homes) will cost thousands of dollars. Hardly an effective and
efficient use of a province's resources.
Unfortunately, the ideologically-driven conservative politicians
who now govern Ontario seem to have forgotten the infamous law of
unintended consequences, which serves to remind us that simple
policy "solutions" to complex social problems never work.
Laissez-faire social policies, such as those favoured in Ontario
and other parts of Canada (and in the United States), don't
alleviate social problems; they make them worse. So we see higher
prison incarceration rates, higher rates of illiteracy, extended
family breakdowns, and of course growing number of homeless
people begging in the streets.
All these social problems, left to fester, cost society far more
in the long run, in terms of increased social, medical and legal
services, than would have been the case had steps been taken to
prevent or moderate them.
The Harris government has not only failed to create jobs, but has
also gutted the programs and services that were designed to help
those denied jobs. The only steps the government has taken have
been negative ones, and the result has been to leave many more
people dependent--not on low-cost social programs such as co-op
or social housing, but on expensive services such as ambulances
and hospital emergency departments.
This is a policy disaster of monumental proportions, one that is
not being mitigated by the government's most recent attempt to
download responsibility for social services onto the
municipalities. The cynical hope seems to be that, when the whole
system falls apart, the city and town councils will be blamed
rather than the chief architects of the disaster at Queen's Park.
In these times of globalization and growing corporate power,
social policy has become a mine-field. No level of government in
Canada has had the foresight or courage to devise even a
sensible--never mind a progressive--approach to social policy
reform. Instead, most governments, driven by a right-wing
ideology, have tried to change social programs in ways that move
them away from being a collective responsibility to forcing
people to fend for themselves. Associated with these damaging
"reforms" have been tax cuts for the well-to-do, subsidies to
inflate business profits, and wage restraints and other measures
to reduce the incomes of working people.
This study of homelessness in Ontario's largest city is but one
indicator of the abject failure of right-wing social
policies--failure, at least, in terms of the larger public
interest. The Harris government's corporate backers apparently
remain quite happy with such an approach.
The Tories now plan to extend and enforce workfare, to
fingerprint welfare recipients, and make it even harder for the
poor to access social assistance. These additional harsh measures
are bound to put more homeless people on the streets, and
increase the number who succumb to serious illness and even death
during the coming winter.
With food banks and other charities already stretched to the
limit of their resources, more homeless people will end up
needing expensive services such as emergency departments, thus
offsetting any "savings" that might be made by the deeper cuts in
social services.
There is no escaping the cost of modern cutthroat capitalism.
Either we pay up front for the welfare state, or we pay later for
the unwell-fare state in the form of more unemployment, more
crime, more illness, and more homelessness.
...........................................
(John Richmond, MSW, CSW, is a clinical social worker and researcher
with the Inner City Health Program at the Department of Emergency
Medicine, St. Michael's Hospital, Toronto.)
Taken from The CCPA Monitor, November 1997.
http://www.policyalternatives.ca/articles/
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