'You can judge them on how they look…': Homelessness officers, medical evidence and decision-making in England

Unusually in the international context, in England the landmark Housing (Homeless Persons) Act 1977 provided a set of justiciable rights to homeless people. Local authorities have a duty to assist homeless people who meet a set of eligibility criteria set out in the Act. One of the criteria, ‘vulnerability’, often requires consideration of medical evidence. Homelessness officers are the key actors in deciding whether or not an applicant is ‘vulnerable’. Previous research has often contended that there is both bias against some high need groups and inconsistency in the decisions made by local authorities in relation to vulnerability under English homelessness law. This paper builds on those critiques by examining decision-making in relation to the use of medical evidence in homelessness cases in England. It explores how homelessness officers assess the ‘expert’ medical evidence that is put to them, how far they rely on their own intuition and judgement, and the other factors that influence their ultimate decision. The study was able to investigate the intersection between law, administration, and medicine and add to the evidence base in the operation of English homelessness legislation.