Homeless people are turning to accident and emergency services because they have difficulty registering with GPs, according to a study by The Big Issue in the North.

A survey of 212 Big Issue vendors in Manchester, Liverpool and Leeds found that 29 per cent were not registered with a GP.

Almost a third said this was because they had problems registering, 19 per cent said they moved around too much and 13 per cent said they had been taken off GP lists. Just 13 per cent said they had no need of a GP or 'could not be bothered' to register.

Half the vendors surveyed had used an A&E unit in the past 12 months, mostly because of accident, injury or drug problems.

But in Liverpool, 30 per cent of those who used A&E services had done so because of illness. The city had the lowest number of vendors registered with a GP, at

63 per cent.

In Manchester, where 78 per cent of vendors were registered with a GP, 17 per cent had attended A&E because of illness.

In Leeds, where 70 per cent were registered with a GP, 7 per cent of vendors had been to A&E for this reason.

'A lack of GP registration is encouraging vendors to make use of other less appropriate health care services,' the survey report concludes.

Many of the vendors polled believed that health service staff 'discouraged' take-up of services and did not treat homeless people 'with respect'.

Access to drug treatment also varied dramatically. Almost 60 per cent of those Manchester vendors who used drugs were receiving treatment, compared with 19 per cent in Leeds.

Magazine joint proprietor Anne McNamara called for health organisations to 'look again at their responsibilities' to homeless people.

'This study clearly shows that some homeless people do not give priority to their health needs, but it's also the case that many have been turned away from accessing services,' she said.

A Primary Health Care Study of Vendors of The Big Issue in the North. 0161-834 6300. Free.