What nurses need to know about the RCN motion to decriminalise prostitution

The first item on the agenda at the annual Royal College of Nursing (RCN) Congress in Liverpool on 19 – 23 May 2019 is a motion calling for the decriminalisation of prostitution:

“1. Decriminalisation of prostitution

That this meeting of Congress calls upon Council to lobby governments across the UK to decriminalise prostitution. Proposed by the RCN Greater Bristol Branch. (R)”

At a recent RCN branch meeting to discuss this, there was bewilderment and disbelief that “decriminalisation of prostitution” could actually mean the decriminalisation of the entire sex trade – pimps, brothel keepers and punters (sex buyers) – as well as the (mostly) women and girls directly involved. But make no mistake, this is what you would be voting for if you vote for this motion.

One of the nurses explained that the Nordic Model is a better approach. First pioneered in Sweden, it decriminalises those engaged in prostitution and provides them with high-quality services, including routes out and genuine alternatives, while making buying sex a criminal offence, and cracking down on pimps and brothel keepers.

The aim is not to fill our prisons with the approximately 10% of the adult male population who admit to paying for prostitution. Rather, it’s to make it clear that society does not condone the purchase of sexual access to other human beings, and to change men’s behaviour and reduce the driving force behind sex trafficking.

One woman said, “Maybe the motion means the Nordic Model?” But surely, others said, if that’s what it means, they would have made it clear.

Another said, “But everyone will think ‘decriminalisation of prostitution’ means just decriminalising the women involved. And everyone wants that.”

Exactly. The motion is misleading.

Juno Mac and Molly Smith are two ‘sex worker’ activists who campaign for the “decriminalisation of prostitution.” This is how they define it in their book, Revolting Prostitutes:

“Decriminalising prostitution is a process of overturning criminal laws (for example, soliciting) and administrative or civil orders (for examples, ASBOs) that punitively target street workers, collective work, employed work, advertising, and so on. These are the laws designed to punish workers and eradicate workplaces. In a decriminalised system, the sale, purchase, and facilitation of commercial sex has largely been shifted out of the realm of the criminal law and into the framework of commercial and labour law. The purchase and facilitation of sexual services remain subject to the same reasonable laws on coercion, exploitation, bullying, assault, and rape that apply in other contexts.”

But even this is steeped in obscure language.

What does ‘facilitation of commercial sex’ really mean?

It means pimping – procuring and profiteering.

What does ‘collective work’ and ‘employed work’ mean in relation to prostitution?

Brothels, small and large.

What does making prostitution come under standard commercial and labour law look like in practice?

It means that prostitution is treated like any other business, like hair dressing, food distribution, or factories, and there’s no recognition of its specific harms.

Comparison of full decriminalisation and the Nordic Model

So before we look in more detail at what full decriminalisation means in practice, let’s compare it with the Nordic Model. Renaming pimping to ‘facilitation of commercial sex’ does not alter its nature, and no amount of obfuscation can change the fact that pimping becomes legal under full decriminalisation.

Using down-to-earth and unambiguous language, the following table provides a summary of the key measures of both the Nordic Model and full decriminalisation.

Check List Nordic Model Full decrim
Decriminalises prostituted people? Yes Yes
Provides services, including routes out and genuine alternatives? Yes No
Decriminalises pimping? No Yes
Decriminalises purchasing sexual services? No Yes
Large brothels subject to planning? No Yes
Unrestricted smaller brothels? No Yes


When prostitution is decriminalised, larger brothels come under standard planning and zoning laws just like other large businesses, while smaller brothels don’t need to register and are free to set up anywhere.

In practice, large multi-storey brothels spring up in business districts. In England, we could expect to see these in every city and larger town, much like the four-storey Artemis brothel in Berlin, which can cater to 600 punters simultaneously.

Artemis brothel, Berlin, Germany. Photo: Fridolin freudenfett (Peter Kuley)

The owners of the big brothels will make fortunes and become regular business men and lobby politicians and policy makers to ensure their business interests are prioritised. But their business success relies on a steady stream of girls and young women to exploit.

If it’s now considered a regular business, they’ll be able to advertise on all the normal job sites and the ads will make it clear that no experience or qualifications are required. To unemployed young women with few prospects in our post-industrial world, it will seem like a lucky break, just as it seemed to Olivia when she was a vulnerable teenager in New Zealand:

“The adverts in the papers for strip clubs and brothels […] all boasted that it was EASY, that there was lots of MONEY, and that the men were FRIENDLY.”

We know that once women get embedded in prostitution, it becomes increasingly hard to get out. One study found that 75% of women in escort prostitution were so desperate and despairing of finding a way out that they’d attempted suicide. Under full decriminalisation, prostitution is considered a regular job, so there’s no public funding for the specialised services that women embedded in prostitution generally need to successfully exit and rebuild their lives.

Just as large brothels colonise the business districts, small brothels spring up in residential areas. Small brothels are outside all regulations and so if one opens up in your block of flats or next door in your terraced housing, there’s not much you can do – even if punters get the address wrong and knock on your door at all hours of the day and night, and dodgy looking men walking up your communal stairwell make you worry for your children’s safety.

Because the industry is legal, the police have little or no oversight and illegal practices invariably proliferate. Coercion and trafficking may technically be illegal, but they’re notoriously hard to prove and this becomes more or less impossible when police are not allowed to step foot inside a brothel without compelling evidence that the law is being broken.

Health & Safety

One of the arguments for decriminalisation is that prostitution would then come under Health & Safety regulations. Nurses are more aware than most of the importance of the regulations around bodily fluids. Let’s think this though. Here are some excerpts of safety instructions from the UK Health & Safety Executive (HSE) for workers who are exposed to bodily fluids:

  • Avoid contact with blood or body fluids.
  • Take all necessary precautions to prevent puncture wounds, cuts and abrasions in the presence of blood and body fluids.
  • Protect all breaks in exposed skin by means of waterproof dressings and/or gloves.
  • Protect the eyes and mouth by means of a visor or goggles/safety spectacles and a mask when splashing is a possibility.
  • Avoid contamination of the person or clothing by use of waterproof/water resistant protective clothing, plastic apron, etc.
  • Wear rubber boots or plastic disposable overshoes when the floor or ground is likely to be contaminated.
Dentist and assistant in HSE-compliant protective gear

Before we consider whether it is possible for prostitution to be compatible with these working practices, let’s remember its actual nature. Andrea Dworkin, who was herself in prostitution, describes it like this:

“Prostitution is the mouth, the vagina, the rectum, penetrated usually by a penis, sometimes hands, sometimes objects, by one man and then another and then another and then another.”

It is not surprising therefore to find that women in prostitution suffer from frequent abrasions and tears in their vagina, mouth, anus and rectum caused by friction and the punter’s heavy pounding. Punters not only ejaculate in women’s orifices, but also on their faces and bodies, and some want to piss (or even shit) on her, leading to risk of infectious agents contaminating her eyes, mouth and anywhere her mucous membranes are exposed or her skin is broken. Some punters may want her to penetrate his anus and rectum with dildos and similar objects, which can lead to faecal matter being sprayed over a wide area.

How is it possible for this to conform to HSE safe practices? Condoms hardly provide even basic protection, and it’s well-known that punters often refuse to wear them and/or take them off midway.

Is it ethical to expect vulnerable young women in brothels to be exposed to serious health risks that all other workers have a legal right to be protected from? And what would be the implications for other workers of normalising such unsafe practices?

Health & Safety guidelines also give employers a responsibility to take measures to minimise workplace psychological risks. Research has found that prostitution has a profoundly negative impact on women’s mental health. For example, one study of 193 women involved in prostitution found a high rate of psychological and mental ill-health and concluded that prostitution is itself a major public health problem. This applies to prostitution per se – regardless of the setting or legal framework in which it occurs.

But the risks don’t end there. Punter violence is commonplace and women involved in prostitution have the highest risk of murder of any social group. Most of these murders are by pimps and punters.

Women who’ve had first-hand experience in the legalised brothels in Australia and the decriminalised brothels in New Zealand testify that the health and psychological risks remain intolerably high.

Nurses need to think hard about whether they want to vote for a motion that promotes an approach that legitimises and normalises an industry that is incompatible with standard Heath & Safety norms and that causes serious, long-term physical and mental health problems.

Impact on wider society

We are currently witnessing an epidemic of male violence against women and girls. Last year 1.3 million women were victims of domestic abuse in England and Wales and more than half a million women and girls were raped or sexually assaulted.105 women were killed by men they knew, 82 in the home they shared with him, 58 involving violence many times greater than was required to kill her – one had been stabbed 175 times, another “battered beyond recognition.” In our schools, boys’ sexual harassment of girls is ubiquitous and at unprecedented levels.

How did this happen? This is breakdown of the social order. Why have things gone backwards for women and girls so rapidly?

Can there be any question but that it is connected with the unprecedented availability of pornography – the majority of which is imbued with extreme misogyny and violence?

Pornography is a form of prostitution and, like prostitution, it positions women and girls as objects to be consumed, implying they are second class, not fully human. Is it any wonder then that the current epidemic of male violence against women and girls is not considered a priority, let alone a national emergency?

In prostitution, men can rent women by the hour or half hour for sexual use and abuse. Research is clear it makes men more prone to violence against women and girls and less likely to have empathy with them. In one study, punters were eight times more likely than other men to say they’d rape if they thought they could get away with it.

Whenever there’s an increase in the amount of prostitution that takes place, we can therefore expect to see an increase in the amount of male violence against women and girls in the community.

And when prostitution is decriminalised, there’s always a huge increase in the amount that happens. This isn’t surprising when you consider that it broadcasts the message to men that there’s nothing wrong with prostitution-buying, and men respond by doing it more often and in increasing numbers. And this leads to even more male violence – against the increased numbers of women and girls drawn into the industry and against women and girls in the wider community.

Can we really afford to recommend an approach to the sex trade that will inevitably lead to its increase when male violence against women and girls is already at emergency levels?


Those who promote the full decriminalisation of the sex trade claim that it makes women safer. But the truth is that nothing can make prostitution safe.

The ethical response is therefore to take measures to reduce the numbers of (mostly) women and girls being drawn into it and provide them with viable alternatives, while discouraging prostitution-buying and all forms of profiteering. This is exactly what the Nordic Model aims to do.

Another justification for full decriminalisation is that all ‘sex workers’ are in favour of it. But this is simply not true. We know this because we are in touch with many women who have lived experience of the sex trade, including those still trapped in it.

I have experience within the sex industry – both ‘choice’ and forced. There are many of us. I have friends I used to ‘work’ with on the streets and in brothels who are still stuck and none of them want full decriminalisation. It would mean the end of exit opportunities.” – British woman who contacted us on social media.

Before voting or asking your RCN representative to vote on your behalf, consider what kind of world you want. Do you want a world where women and girls are on sale as commodities in an industry that is rife with abuse and violence, that can never conform to standard Health & Safety norms, and that inevitably leads to more male violence against women and girls and the worsening of the status of all women?

We strongly advise voting against Motion 1.

Further reading


We’ve produced some flyers to help nurses understand the practical implications of the motion. If you would like some to distribute to nurses you know or in your local hospital, see Flyers explaining what the RCN motion for “decriminalisation of prostitution” REALLY means.

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