Health experts urge MPs to back decriminalisation of prostitution

BMJ 2016; 354 doi: (Published 18 July 2016) Cite this as: BMJ 2016;354:i3927
  1. Adrian O’Dowd
  1. London

Public health experts have backed a recent call from MPs for changes to the law over prostitution, and have urged them to consider full decriminalisation of sex work.

MPs on the home affairs committee recently published a report1 that recommended that the Home Office change existing legislation so that soliciting is no longer an offence and brothel keeping provisions allow sex workers to share premises, without losing the ability to prosecute those who use brothels to control or exploit sex workers.

The report said that treating soliciting as an offence was having an adverse impact in terms of stopping sex workers from seeking help to exit prostitution because having a criminal record for prostitution related offences could create barriers to moving into regular work. It also exposed sex workers to abuse and violence, damaging other areas of their lives, such as access to health and welfare benefits.

MPs also said there should be zero tolerance of organised criminal exploitation of sex workers and that the Home Office should legislate for the deletion of previous convictions and cautions for prostitution by amending the Rehabilitation of Offenders Act.

Currently, in England and Wales, the sale and purchase of sexual services between consenting adults is legal, but various activities related to prostitution, such as soliciting, kerb crawling, brothel keeping, and various forms of exploitation, are illegal.

It is estimated that there are between 60 000 and 80 000 sex workers in the UK—mostly women—and that around 11% of British men aged 16-74 have paid for sex on at least one occasion.

Public health experts such as Lucy Platt, senior lecturer in public health epidemiology at the London School of Hygiene and Tropical Medicine, have welcomed many of the report’s recommendations.

Platt told The BMJ: “The committee recommendations show a welcome step forward in their approach to sex work legislation, offering a real opportunity to address the harms caused by criminalisation.

“It is encouraging that the committee has considered the public health evidence in making their recommendations. Research across diverse settings consistently shows how criminalisation of sex work increases the risk of violence, HIV, and sexually transmitted infections, and reduces access to health and social care services.”

Pippa Grenfell, a research fellow in public health sociology also at the London School of Hygiene and Tropical Medicine, added: “We urge the committee to recommend the full decriminalisation of sex work, avoiding the ‘Swedish model’ that criminalises the purchase of sex.

“In New Zealand, full decriminalisation has led to better working conditions for sex workers, including improved capacity to negotiate condom use and refuse clients.”

Recent research2 estimated that this model could stop 33-46% of HIV infections among female sex workers and their clients over the next 10 years, she added.

“Evidence from Sweden and Canada, on the other hand, shows how criminalising the purchase of sex exacerbates sex workers’ existing vulnerabilities and health risks, and reduces access to harm reduction services, undermining existing public health interventions.”

MPs on the home affairs committee also said that they were dismayed at the poor quality of information available about the extent and nature of prostitution in England and Wales.

They recommended that the Home Office commission an in-depth study to help develop better understanding of the current extent and nature of prostitution in these countries, which should report back to Parliament by June 2017.


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