Homeless and hospitalised: The deadly impact of sleeping rough

Hospitalisations of homeless people have doubled in six years.

One frontline doctor is warning of the deadly impact of sleeping rough, saying it is the sickest population he has ever worked with.

Meanwhile, the minister responsible says every New Zealander should have confidence that support is available for rough sleepers who need it.

Lauren Crimp reports.

Dr Bruce Arroll - a GP at Auckland City Mission's Calder Centre - was getting ready for bed about 10pm last Thursday when the phone rang.

It was the clinic's lab, telling him one of his patients, who is homeless, had a very low blood count - about a third of what it should be.

The woman was not answering her phone. Rough sleepers are hard to get hold of, regularly switching up their phones because they get stolen, Arroll said.

"She could be bleeding to death. So I get in my car, and I go down to the CBD," he said.

With a stroke of luck he managed to find her, and put her in an Uber to get to the hospital for blood transfusions.

It is quicker than an ambulance at that time of night.

"I could have said, 'oh well, I'll see you tomorrow, she's probably stable'. Fortunately, she was stable, but if she actually had a bleeding ulcer in her stomach, she could literally bleed to death overnight."

This one hit hard, Arroll said.

"When I saw the patient during the day, and I got her story, I felt like crying," he said.

"I don't always cry about patients, but it was just such a harrowing story."

Arroll's former clinic in Manurewa had about 5000 patients, and a person would die every three or four months.

The Calder Centre has 2300 patients on the books, most of whom are homeless, or formerly rough sleepers.

They record a death a fortnight, and the average age of those who die is 55 for men, and 54 for women.

"That's the stress of being homeless," Arroll said.

"It's the sickest population I've ever worked with."

Hospitalisations of homeless people double

Health New Zealand data showed there were 1954 hospitalisations of homeless people in 2024/25, up from 971 in 2018/19.

The figures represent counts of hospitalisations rather than individuals, meaning patients who were admitted more than once are counted each time.

In the most recent year, seven of those hospitalised were babies under four. And 25 people were discharged from maternity.

Arroll was not surprised by rising hospitalisations, saying more rough sleepers were seeking help at Calder Centre.

"We're also getting people who come to us in the middle of the night, they get discharged from hospital and they get sent to the Mission. Well, the Mission doesn't have facilities for providing places for people overnight."

He said hospitals did their best, and in some cases surgical teams would take patients in without appointments because they knew how difficult arranging that appointment would be for them.

Arroll called emergency housing a lifeline.

He said the government tightening access to it has left more people on the street, making it difficult to keep track of them and get them the healthcare they need.

"Let's say they're diabetic and they're on insulin, you need to have a fridge.

"If you're taking pills, you need to be able to go and get a glass of water, and if, of course, you're sleeping rough, you won't have access to a tap."

Some seek shelter at ED

She put that down to a big increase in social housing, which had helped keep many people off the street, and out of hospital.

For those who did show up - often just-released prisoners - staff would always offer more than just medical treatment, Logan said.

Some rough sleepers came in just to stay warm.

"It's like trying to be a wraparound support. There's nowhere else for them to go, so for us to be able to do that, that does help them, and try to keep them off the streets, if we can."

But it takes a toll on an already heavy workload, with hospitals across the country bursting at the seams.

Further south, Hutt-based ED doctor Dr Tanya Wilton - speaking as an Association of Salaried Medical Specialists executive member - said about one patient a week was there, at least in part due to their housing insecurity.

"It's definitely something new that I've noticed, and I would say more particularly in the last 12 months," Wilton said.

It was difficult to help those people outside of their medical needs, with the social worker only available during regular office hours, she said.

"After hours, our hands are really tied. We have a list of low-cost accommodation options that are nearby, but where I am from, there's no emergency shelter or housing that's available after hours."

Huge complexity behind hospitalisation figures, minister says

Associate Housing Minister Tama Potaka said it would not be appropriate to attribute the hospitalisation figures to any single cause or policy position.

In a statement, he said recent data showed a slight decline in hospitalisations where homelessness had contributed.

RNZ asked for that data, but did not get a response.

"We know many New Zealanders continue to experience homelessness alongside complex health and mental health needs," Potaka said.

"That is why our focus is on helping people into stable, long-term housing, improving wellbeing, and reducing pressure on public services over time."

He pointed to investment in transitional housing, Housing First and social housing, as well as homelessness outreach services - some of which recently received a share of $14.5 million government funding.

"This will see services extended so more people can access help before they reach crisis point," Potaka said.

Emergency housing alone would not end homelessness - though it was available for people in "genuine need", he said.

"Our focus is on helping people move into stable housing as quickly as possible, because long-term reliance on emergency accommodation is not a good outcome for individuals, whānau, communities or taxpayers."

A vicious cycle

Labour's housing spokesperson Kieran McAnulty agreed emergency housing would not solve the housing crisis.

But it would prevent more people sleeping rough, he said.

"If they end up on the street, they are significantly more likely [to] need hospital care, and it is a vicious cycle once that starts," said McAnulty.

"We've got to find a temporary solution for the people on the street whilst we build houses for the medium to longer term, if you don't do either of them, like this government, the problem is only going to get worse."

McAnulty acknowledged the hospitalisation numbers had also grown while his party was in power.

"We're not trying to portray this as a problem created by this government, but the facts stack [up] that it is a problem that has been made worse by this government," he said, referring to the emergency housing changes.

Labour would change the emergency housing entry criteria to open it up to more people in need, and build more social homes, said McAnulty.