At a focus group on street sex workers’ health, Angelica is a natural orator. She is funny and passionate, and shares her life’s successes and struggles with hard-won conviction. At almost 60 years old, she has experienced homelessness and addiction, as well as physical and mental health problems. She spent eight years on the streets of Hackney as a sex worker.
Like many others in the room, Angelica says she owes her life to Open Doors, a pioneering NHS sex worker support service, regarded as among the best in the country. Where she feels other services have judged her, or have been insensitive to her trauma, she says of Open Doors: “They understand me.”
Many credit the service as a lifeline: “I’ve got my house, I’m clean six years”; “Open Doors harmonised me”; “I would have died without Open Doors.” And the high praise is substantiated by outcomes. Open Doors has significantly reduced ill health and deaths, and improved wellbeing and safety.
Unlike many other services, says manager Georgina Perry, Open Doors does not simply offer clinical assistance or “tea and sympathy,” but adopts an integrated case management approach, informed by evidence-based public health measures.
“We may be presented with a very unwell person,” says Perry, “ but there are countless things going on in their lives that influence their health: whether they’re homeless, have undiagnosed mental health, use drugs, in domestic violence relationships, experienced violence and abuse as children, have a grasp of the language, are excluded from mainstream society.”
Despite the accolades at the focus group, many are on the brink of tears. Open Doors’ future is uncertain.
Its funding has been cut substantially and, “more importantly,” adds Perry, “the local authority has “completely, without consultation or discussion with the service that understands the issues best, changed their whole approach to supporting sex workers.”
In a statement released this week, National Ugly Mugs (NUM), a multi-award winning sex worker safety charity formally supported by the Home Office and the National Police Chiefs Council, has expressed “grave concern for the safety of sex workers in Hackney,” describing the changes as a “seismic shift towards criminalisation … recklessly compromising [sex workers’] safety and ignoring national guidelines.”
Until 2014, Hackney authorities worked in partnership with Open Doors to keep street sex workers out of the criminal justice system. “Sex workers in the borough were considered complex individuals with a magnitude of health and social care needs,” say NUM, rather than targets for arrest.
As a result, sex workers had more trust in the police. “For the first time in London we had violent offenders who attack sex workers being convicted because women would report to the police,” says Perry.
The picture now is very different. NUM data shows a “startling decrease in the numbers of Hackney sex workers willing to report crimes to the police,” says Alex Feis-Bryce, Chief Executive of NUM and a member of the National Police Working Group on sex work. Sex workers are increasingly subject to enforcement by the police and local authorities in the form of dispersal orders, fines and even prosecution.
Dispersal orders require sex workers to leave a given area for 48 hours. This is usually the area they live, work and have established support systems, so exclusion can place individuals at increased risk.
Furthermore, Kirstie Douse, head of legal services at the charity Release, has expressed concern that sex workers are being criminalised simply “on the basis that their behaviour is likely to contribute to Anti-Social Behaviour, without anything having actually occurred.” In turn, local authorities have asked Open Doors to hand over their clients’ names to an ‘enforcement panel’, and have stopped referring sex workers in need of safeguarding to the service – instead signposting them to religious groups or cafes.
A Hackney Council spokesperson said: “Enforcement action is only ever taken as a last resort if there are cases of anti-social behaviour that are having an impact on the lives of local residents.”
The spokesperson added that the council hosts Street Users Outreach Meetings (SUOM) to support sex workers. However, Perry is quick to respond that these meetings have enforcement – not integrated support – at their core and that “the people leading these meetings have no analytical or clinical understanding of sex workers’ complex health and safeguarding needs.”
The council says that enforcement measures have been successful, claiming that the number of street sex workers has reduced, but Perry and NUM reject this claim. “Sex workers may not be as visible, says Perry, “but that is because they are afraid of the police and are working in more hidden, dangerous places as a result.”
The borough’s enforcement-heavy approach contradicts the 2016 National Police Sex Work Guidance, which states: “enforcement does not produce sustainable outcomes and can actually increase the vulnerability of sex workers to violent attack”.
As a result, says Feis-Bryce, “violent, sexual offenders, who are a danger to us all, simply get away with their crimes.”
Feis-Bryce warns that Hackney’s current approach is reminiscent of that which has historically increased the vulnerability of sex workers to violence.
“Metropolitan Police Officers should not need to be reminded,” he says, “that the tragic murder of Mariana Popov in Redbridge in 2013 came at a time when enforcement was so aggressive that women were actually running to hide from the police. At the time, Mariana was working alone to avoid police detection and working later than usual to pay off a fine.”
And the sex workers in the focus group are all too aware of the frightening realities. “It’s going to get even more dangerous,” says one woman. “I’m scared to go outside sometimes.”
Perry, Open Doors’ manager of 13 years, has announced her resignation. “I am disgusted at the way institutions that used to work in partnership with us to safeguard the lives of vulnerable sex workers are now prioritising enforcement over impartial support,” says Perry. “ I do not believe an NHS service should be complicit in this.”
Meanwhile in an interim report published last week, Friday 1 July, the Home Affairs Select Committee (HASC) said that soliciting by sex workers, and sex workers sharing premises, should be decriminalised.
The Committee says the Home Office should immediately change existing legislation so that soliciting is no longer an offence and brothel-keeping laws allow sex workers to share premises, without losing the ability to prosecute those who use brothels to control or exploit sex workers.
There must be zero tolerance of the organised criminal exploitation of sex workers. The Home Office should also legislate to delete previous convictions and cautions for prostitution from the record of sex workers, as these records make it much more difficult for people to move out of prostitution into other forms of work if they wish to.
The Rt Hon Keith Vaz MP, chair of the committee, said: “This is the first time that Parliament has considered the issue of prostitution in the round for decades. It is a polarising subject with strong views on all sides. This interim report will be followed by final recommendations, when we consider other options, including the different approaches adopted by other countries.
“As a first step, there has been universal agreement that elements of the present law are unsatisfactory. Treating soliciting as a criminal offence is having an adverse effect, and it is wrong that sex workers, who are predominantly women, should be penalised and stigmatised in this way. The criminalisation of sex workers should therefore end.”