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Life-saving sex worker support service Open Doors is under threat

Posted at 17:28 on 3 Aug 2016 by Pandora / Blake

Tags: Hackney, intersectionality, law enforcement, marginalisation, migration, Open Doors, police, racism, sex worker rights, stigma

The other day I attended the sexual health clinic at Homerton University Hospital. I was impressed. The clinic was clean, modern and well staffed; I was seen quickly, and the care I received was non-judgemental, helpful and thorough. In fact it was probably the best experience of attending a sexual health clinic I've ever had in London. During the short time I was sitting in the waiting room, I saw posters and leaflets advertising the other free services Homerton University Hospital offers to the public, including Out There, the walk-in center for bisexual and gay men, and Open Doors, a free and confidential advice service for people working in the sex industry.

If you look at the Open Doors website (there are three other Open Doors NHS clinics in London, but I think the Homerton one is the longest running) their mission statement is clear:

Open Doors work with sex workers in East London regardless of legal or immigration status in the UK.  We are not connected to the police and we do not need to pass information about you, or the place in which you work, to other parties.

As a result of this non-judgemental, confidential policy, Open Doors is regarded as one of the best sex worker support services in the country. Some sex workers who have worked on the streets in Hackney say they would have died without Open Doors; and it has improved the lives of too many others to count. But thanks to the actions of Hackney Council, this invaluable service is now under threat.

I heard about what was happening when Georgina Perry spoke at an event I attended at Kings College London in June. She has been the service manager of the clinic for thirteen years, and pioneered an integrated multi-dimensional approach, responding to each case with an understanding of the individual's intersecting and complex needs. Although the service was initially set up by the NHS to offer sexual health support, Perry and her team took the radical approach of listening to sex workers and finding out what they needed - and ended up offering support on issues from homelessness to mental health, drug use, domestic violence, sexual violence, language skills, immigration and stigma. Many will testify to the positive impact Open Doors has had on those living and working in Hackney; it has helped service users find stable housing, recover from addiction, and it has saved lives.

Despite this glowing legacy, Open Doors has had its health funding slashed by Hackney council, and is now forced to operate on 40% of its former budget. But that's not the worst of it. Without consulting those working at the clinic, the remaining funding contract was transferred from the health budget to the local law enforcement budget. This means that Open Doors is now dependent on Hackney police for their meagre remaining funds; and with this shift in contract, the terms of engagement have been changed without their consent. The local authorities are now insisting that Open Doors share the names of its service users with law enforcement, or face being found in breach of contact for the slim funding that remains. Frankie Mullin reports for Vice,

Sex workers are no longer referred straight to the service but, instead, passed through gatekeepers via a Street Users Outreach Meeting (SUOM). Crucially, SUOMs include police officers, meaning anyone discussed will now be known to the authorities. Until recently, Open Doors refused to be part of the SUOM group but the service has now been told its participation is not optional. Essentially the line is that, to ensure continued funding, Open Doors must enmesh itself with the criminal justice system.

This is a shocking violation of a public contract for a social service that exists to provide support for the borough's most marginalised people. The principle of confidentiality lies at the heart of the service Open Doors provides. The website states it time and time again: "We are not connected to the police and we do not need to pass information about you, or the place in which you work, to other parties." It's the first item on their Sex Worker Services Outreach Charter: "We will NEVER visit you with the police or give information about you and where you work to the Police."

Six weeks ago, unable in good conscience to comply with the terms of the new contract, Georgina Perry handed in her resignation so she could challenge the NHS with integrity. This after over a decade helping vulnerable people in need of understanding, material help, and informed, non-judgemental, integrated support.

"The health and human rights of sex workers are being breached," she said when I heard her speak, mere days after announcing her resignation. Her rage and frustration were palpable as she told us how this policy compromises the privacy and safety of those who come to Open Doors: people who need the help and protection of the authorities, rather than to live in fear of them.

Her voice shaking with disbelief and righteous anger, Perry laid out the consequences in the clearest possible terms: "With all this civil enforcement, people will be dying on the streets when they really, really don't need to be." 

It's not hard to understand why this isn't an exaggeration. Open Doors saves lives. People struggling with addiction, poverty, mental health issues, homelessness, sexual violence and domestic abuse all come to the service for help. Confidentiality is crucial to providing adequate support. Drug users, sex workers and migrants are all prime targets for police harassment, and all fear arrest if their identities are revealed to enforcement officials. 

Until recently, local police co-operated with Open Doors to keep street-based sex workers out of the criminal justice system. As a result, sex workers felt liberated to report instances of crime, robberies, stalking and violence to the police without fearing that they themselves would be arrested under brothel-keeping or soliciting laws. But this change in the Open Doors funding contract reflects a wider shift in attitudes towards enforcement in Hackney. Sex workers are finding themselves increasingly targeted by law enforcement, and as a result are much less likely to go to the police when they need help. Hiding from the police makes people more vulnerable to crime. And now, they can't even go to a vital support service like Open Doors without their details being shared with law enforcement. For some, this might mean the difference between life and death.

This isn't happening in isolation. The new Prime Minister of the UK Theresa May pledged to create a "hostile environment" for migrants which has resulted in an explosion of over 500 instances of racist abuse since the EU referendum. A recent Independent article states that "police have said that reported hate crime rose by 57 per cent in the four days following the referendum, and that 42 per cent more hate crime was reported to them in the last two weeks of June than there had been in the corresponding period of 2015."

If the work Georgina Perry has done via Open Doors teaches us anything, it is that social precarity is rarely straightforward, and many street sex workers who end up seeking support are living at the intersection of multiple marginalisations. Many people living in poverty, trying to feed their children or escape an abusive partner, end up attempting to improve their circumstances by traveling to another country to work. The UK is increasingly unwelcoming towards economic migrants; and so unstable migration status, racism and language barriers become part of the web of intersecting barriers that make it harder for people to survive.

Imagine you traveled across the EU and found yourself needing to work illegally, either to survive until your visa was confirmed, or to send money home to your family in the meantime. If things got desperate and you needed help, would you seek help from a support service that you knew was affiliated with the police? No; you would stay well clear, for fear of being arrested and deported. And so the people who could most benefit from the help Open Doors offers - the people it was, in fact, set up to help - are forced to stay away, even if a condom has broken at work, or a client has been violent, or they have nowhere else to go.

Alongside all this, the increasingly gentrified borough of Hackney is embarking on a wider move to relocate marginalised people. Last year, Hackney council announced plans to punish the homeless with court action and fines of up to £1000; these plans were quashed last year only after a hard-fought campaign. Now, authorities are handing out 'dispersal orders' to vulnerable people, rough sleepers and outdoor sex workers deemed to be "at risk" of "anti-social behaviour". Ordered to disappear from a given area for 48 hours, these individuals are forced away from their support networks, sources of income and familiar, safe spaces - and of course, health and support services like Open Doors. Refusal to comply with a dispersal order carries a risk of arrest, court action, and potentially a fine - or if the fine cannot be paid, imprisonment.

The damaging effects of criminalisation and enforcement on socially excluded people are clear. Alex Feis-Bryce of sex worker support organisation National Ugly Mugs, which has worked closely with Open Doors over the years, has drawn parallels between the "hostile environment" being created in Hackney towards people precariously living and working on the streets, and the aggressive atmosphere of enforcement at the time of the Ipswich sex worker murders in 2013. As he told Sophie Hemery for the Hackney Citizen,

"Metropolitan Police Officers should not need to be reminded 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."

As Hemery points out, Hackney's heavy-handed approach directly 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".

Prostitution law in the UK desperately needs bringing up to date in line with recommendations by Amnesty International and the UK Home Affairs Select Committee that the full decriminalisation of sex work is the best way to improve the health, safety and human rights of marginalised individuals. But regardless of the law around sex work, local authorities have the power to choose whether to prioritise law enforcement, or public health and community support. Policies like the shift in the Open Doors funding contract, and the increased use of dispersal orders, have a real and damaging impact on the lives of people living and working in precarious conditions in the borough. "Legislation starts at home with local authorities," Georgina Perry said, "and law enforcement undeniably increases the morbidity and mortality of sex workers". Hackney Council have a choice to make. 

If you want to support Open Doors and help keep life-saving public services open, and help protect street-based sex workers and other socially excluded people in Hackney from police crackdowns and aggressive law enforcement, here are some things you can do:

  • Sign this petition to Hackney Council, demanding they stop criminalising the borough's most vulnerable people; and get your friends to sign it too.
  • Attend this protest against Public Space Protection Orders in Hackney this Sunday from midday-2pm 
  • Write to the Hackney health and wellbeing board (you can address your letter to any of the board members; or even better, copy it to all of them) urging them to reverse the changes made to Open Doors' contract, and help keep the clinic open
  • Get involved with Sisters Uncut - particularly the East London branch, who have occupied an empty council flat in Hackney to highlight the need for social housing for survivors of domestic violence.
  • Spread the word. Share this post on social media to raise awareness about what's happening; write about it in your own blog; and if you're a journalist, pitch an article to a newspaper or magazine about the threat to Open Doors, and the scandalous rise of law enforcement against Hackneys most marginalised individuals.


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