What do I do? 

"Don't give up the day job," said the Provincial at my ordination.  So, during the day, I work as a GP for homeless people in Westminster.  This is an open access drop-in medical service for homeless people in London.  It was started about 20 years ago by Dr Mary Hickey, a sister of the 'Daughters of Mary and Joseph' on her return from a mission doing gynaecology in Africa.

She noticed there were rather a lot of homeless people in Central London who didn't have much access to medical services and thought that God would like her to do something about that.  So, being that kind of person, she begged an office, borrowed a prescription pad, “acquired” a desk and chair and started work.  Twenty years on, some things have changed for the better: we now have a bright spanking newly refurbished suite of offices with reception area, treatment room and even a fully equipped disabled loo!

But quite a lot of things have not changed.  Homeless people in London have an average age at death of 42; homeless IV drug users have an average age at death of 34.  As Mary is wont to say, "Some of the poorest people in the world live half way between the palaces of Buckingham and Westminster."

Some things have also changed for the worse.  The price of crack cocaine is now a fifth of what it was six years ago; so consumption is expanding exponentially - doubling every eighteen months.

Try a brain teaser: fifteen years ago, what other disease reduced people's average age at death to the middle-thirties and was doubling every eighteen months? (Clue: think sub-Saharan Africa.)
Without wishing to press the analogy too much (the epidemiology of the two diseases is not the same), it is quite possible that substance misuse will do to the next generation of British young people what AIDS has done for the current youth of Africa.

Whatever the future may bring, the present reality is of a large and increasing homeless underclass who are typically multiply addicted to drugs and alcohol; frequently mentally ill (as both cause and consequence of their substance misuse); commonly in and out of prison; are typically socially isolated, with no other family or friends in this country; usually have multiple medical and psychiatric problems and generally could use the services of a doctor.

Why do I do it? 

If I am right, the challenge of working with the homeless underclass is the central justice challenge of modern Britain.  All the most pressing social issues occur here: drugs, alcohol, crime, violence, 'care in the community', the destitution of refused refugees; one could go on but it would begin to sound like a homily.

It is here that the response of the Church must be seen by the nation, heard by the poor and felt by those who need it the most.  Which is why we believe we need to be here.  Even, perhaps especially at a time of diminishment, the Church must not give up on the day job.