"YouTube still"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, she has experienced homelessness and addiction, as well as physical and mental health problems. She spent eight years working 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.”
Person after person credits 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 – among the thousands of sex workers they’ve supported.
Unlike many other services, says its 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, whether they have undiagnosed mental health, whether they use drugs, whether they’re in domestic violence relationships, whether they’ve experienced violence and abuse as children, whether they have a grasp of the language, whether they are excluded from mainstream society.” Open Doors addresses all of these factors.
But among 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.” This would seem particularly concerning as the English Collective of Prostitutes has told the Hackney Citizen that local sex workers say there is “a serial rapist” in the area.
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.”
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