Contemporary health promotion emphasises the concepts of lifestyle, risk, and preventive health behaviour alongside the broader societal concerns of the environment, public policy, and culture.1 The recent green paper Our Healthier Nation stresses a more coordinated approach to health promotion for people who are socially excluded, emphasising behavioural change through targeted interventions at the level of the community. 2There have been extensive reviews of homelessness and health, 3 4 along with calls for urgent action, 5-7 but little attention has been paid to the health promotion needs of homeless people, and there is no firm evidence base for practice. One challenge for health promotion is to develop and deliver appropriate initiatives to a heterogeneous population that is not always easy to categorise but has a wide range of needs. The healthcare priorities of a young man sleeping on the streets differ from those of a single mother in temporary accommodation. To be homeless means more than just the absence of secure accommodation. Homelessness has as much to do with social exclusion as with bricks and mortar, and demands a range of health promotion strategies.

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The system of departmentally-related select committees which was introduced in the House of Commons in 1979 has, in the decade of its existence, seen committee activity grow significantly, both in the public consciousness and in the influence which backbenchers exert over government policy. However, attempts to measure influence, whether through quantitative or qualitative approaches, inevitably meet problems with those outcomes which are unacknowledged or delayed, unanticipated or simply unannounced; identifying modifications of policy where the ability to trace origins back to a committee report are minimal, can rely heavily on the intuitive and interpretive insights of those directly involved. In this paper an attempt is made to examine examples of policy recommendations made in select committee reports which were initially rejected by government but produced subsequent policy change, and others where the very fact of a committee investigation appears to stimulate action or change difficult to establish through formal measuring techniques.

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