As news breaks of the scarily high numbers of homeless people arriving in British hospitals with diseases we thought we’d left in the past, such as tuberculosis, there’s yet more soul-searching about what can be done to help. So what do homeless people really need? It sounds naive, and obvious, but the answer is: housing. They need homes more than anything else. Rough sleepers especially urgently need a permanent roof over their head, as of right.

Recently, I have been sofa surfing. It was more difficult than I can really explain: I endured daily insecurity, often not knowing where I would stay that night. I applied successfully to be housed and have now been offered a home. Because that is what I needed; it doesn’t take a genius to work out that homeless people need some sort of a home.

Some years ago I lived in social housing in Manchester. One day I encountered the gruff, no-nonsense caretaker who was in a state of distress. He told me of an abandoned flat previously occupied by a former rough sleeper, the door left open. Inside he found nothing: no carpets, furniture or possessions. All that remained was a letter from the former occupant’s mum, wishing him all the best, hoping he stayed warm and “clean” (that is, drug-free). He’d been housed there without support and, unable to cope, had walked out back on to the streets.

It’s appalling to see the threat of cuts to vital homeless services supporting those who self-medicate and are physically damaged by rough sleeping. I hope as a human being to be for ever shocked by the sight of people sleeping in tents in a country as wealthy as the UK. But homeless people are not all roofless. Thankfully, homelessness is now more accurately and widely defined to include sofa surfing.

‘I hope as a human being to be for ever shocked by the sight of people sleeping in tents in a country as wealthy as the UK.’ Photograph: Leon Neal/Getty Images

And the solution is more straightforward than politicians – especially the Conservatives, who have overseen the booming numbers of homeless people – would like to admit. Mend the fractured private rented sector. Next, provide housing as a basic right, like clean water. Obviously build more homes, priced at social rents; none of that 80% market rent rubbish, as extortionate private-sector rates can devour over half of people’s earnings. The working homeless are rarely rich but they don’t necessarily require assistance for the chaotic lives they are believed to lead.

While temporarily housed, I received a letter from a charity working with people with “complex social needs”. They assumed that I would welcome them calling round without my asking. My needs were not complex; I simply needed (yes, once more with feeling) a home. I told them not to come. I was perhaps not your usual homeless person: I know my way around the system. But like most homeless people, I was a victim of the broken rental housing system. We don’t all need this compulsory “support”, and we can’t afford to pay for it either (costs are added to rent in supported accommodation, especially galling when my council, Glasgow, had caused my homelessness). At every turn I was spoken down to as if I were stupid. I was even offered “help maximising my income”. Alas, they had no contacts in the media to help me get more.

It is routinely assumed we have needs such as addiction and mental health issues. Councils charge extra for this support: in Glasgow as much as £150 per month, which you can’t decline. This help is desperately needed by some, especially recent rough sleepers, care-leavers and those who do have mental health issues. But it is utterly pointless for others. Of course, proper skilled help should be offered to anyone who has experienced homelessness, which is routinely disorientating and destabilising. But we must be able to decline it so as to redirect it to those who genuinely need it.

Help should be targeted at people without recent experience of settled life, because inevitably some people struggle. Troubled lifestyles complicate the ability to stay in a house. In Finland, the policy is simply housing first – help next. Scotland is in the early stages of pursuing similar objectives. Don’t assume all homeless people are architects of their own misfortune, their troubles caused by lifestyle choices. “Housing first” should be the mantra.

Evicting a tenant should be a difficult, restricted process with in-built delays for mediation and strict rules on actual evictions, such as a winter break. If housing is to be a basic, incontrovertible human right, evictions must become the very last resort. Governments must provide a roof over everybody’s head – we should have no more time for excuses.

• Penny Anderson is a writer and artist