Sept 2002


Philip Topham is part of the T.H.O.M.A.S. team.

Our Mentoring Co-ordinator, Pam, recently had a visit from a young man referred to her from the local Probation Service. He had several problems which included being homeless and a drug user. Whilst she was speaking to him, it became clear that it was fruitless trying to sort out any of these difficulties first, because the poor man was suffering from a raging toothache which he had had for four days. Over that period, he had been trying without success to get dental treatment.

Pam herself then spent a considerable amount of time trying to help him get emergency dental treatment. Her efforts degenerated at one point almost into farce. After numerous phone calls, she was given the number of NHS Direct and explained to the voice at the other end that she was trying to get emergency treatment for someone. The voice then asked her if she was the patient. When she reiterated that she was enquiring for someone else, the voice asked her whether the patient was still breathing! Pam's efforts culminated in her paying his bus fare to the Emergency Dental Suite, which is the Hospital in the next town. Because he had no address and no appointment, she advised him to demand treatment and sit there until he received it.

In our work with drug users and recovering addicts, we have come across instances of a reluctance on the part of some, but not all, NHS staff to give short shrift to such people - usually because they regard them as problematic and suffering the effects of 'self-inflicted' illness. But many patients such as smokers, heavy drinkers of alcohol, those with anorexia and bulimia to name but a few, could be said to be suffering from conditions which they have induced by their own decisions or state of mind. But do they suffer the same level of discrimination as drug users or addicts? We think probably not. This is where we would appreciate feedback from our readers.

It is now generally recognised that our state of health and ill health is largely governed by many factors, most of which are rooted in the social conditions and environment in which we find ourselves including social, domestic and family pressures; work-related stress, housing and working conditions.

When people use drugs, it is often the result of preexisting problems and pressures. When people are homeless, it is frequently the culmination of the abovementioned adverse social and domestic factors. Consequently, to discriminate against and to stigmatize drug users and homeless people purely on the basis of their most obvious problem is unfair and represents a failure to accept a person as a whole. We recognize that many health care workers carry out their duties to an irreproachable standard and we are not seeking to make any blanket condemnation of all NHS staff, but we have sufficient direct experience to lead us to question whether such discrimination is common and widespread.

As a Charity, one of the Objectives of THOMAS is to campaign and this subject is an area where we feel some campaigning might be called for. In particular, we would welcome your views on:-

. Instances of good practice, treatment and care of homeless people and drug users by health care workers and especially attempts to solve common problems associated with dealing with them;

. Examples and/or statistics of the incidence of: discrimination against drug users and the homeless.

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