And the health of the homeless people arriving at the hospital is usually extremely poor.

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People experiencing homelessness have many more health problems and die earlier than the general population.

Musculoskeletal disorders, respiratory tract and skin infections, poor oral and foot health, and blood-borne viruses (such as Hep B and C) are common. They also exhibit higher rates of mental illness, alcohol and drug use and trauma.

Australian studies show one-third of chronically homeless people have asthma (compared with one-in-10 in general Australian population); one-in-five are diabetic (compared with one-in-20 in general Australian population); while one-third have heart disease.

Among chronically homeless men in Sydney the rate of post-traumatic stress disorder is four times higher than the general population. Of the same group, almost three-quarters have a functional disability; and more than half have lost consciousness following a head injury.

The homeless people we help don’t have a GP. They don’t keep medical appointments because of their chaotic lives. The stigma of being homeless also keeps many away from medical help.

For most, the absolute basics of life – food, shelter, a place to sleep safely – take precedence. Health often falls down the list of priorities until an illness becomes so bad it drives them to our Emergency Department for relief.

The sad irony is that an unmanaged illness is often the factor that makes it difficult for them to leave homelessness behind.

When I look around and see the volume of homeless people the hospital cares for, see the extent of their illnesses and injuries, I’m proud of our work, but it’s hard not to be pessimistic.

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Homelessness in Sydney increased by close to 50 per cent in the five years between 2011 and 2016.

Less than 1 per cent of private rental properties are affordable for people on low incomes.

And now, on the eve of a byelection some are calling the most important since Federation – covering an area where many of St Vincent’s homeless patients live – I have to ask, "Where do the candidates stand?"

Demand for our help is as high as ever.

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St Vincent’s Sydney’s homeless health outreach services provided almost 3500 occasions of care in the last six months of 2017.

In the electorate of Wentworth alone, 387 people are homeless. Close to 5,500 households are living in rental stress and 25,000 households face rental insecurity.

What’s Canberra been doing for the past decade?

Are the Wentworth candidates willing to speak on behalf of homeless people who are being denied their most basic need: shelter?

Four of Australia’s 10 wealthiest postcodes are found within Wentworth but whoever becomes the new MP needs to represent all their constituents, including homeless people.

Will they commit to trying to make a real difference in the lives of this vulnerable group by championing the issue of homelessness when they take their seat in Parliament?

There’s no question the political stakes in this byelection are high. But that only makes it more important the candidates speak up about this issue.

Their win, and the platform on which they stand, could influence an entire government.

Cameron French is the manager of St Vincent’s Hospital Sydney’s Tierney House.