Dr. Derek Freedman:

Absolutely not.

One aspect we should consider is the reason people look for sex workers. Sometimes they are just seeking comfort. I do not know if any of the members of the committee has seen the Visconti film, "The Leopard", in which the prince deals with social change in Italy - Sicily - at the time of Garibaldi. In his family there is complete coldness.

At the end of the film, he walks down town to a woman whom he obviously visits frequently and who actually talks to him and gives him comfort in times of stress. We must appreciate that many people do receive comfort. Many of the girls and men say much of what they do is not just providing sex but actually giving comfort to people.

There is a social stigma and a barrier associated with the use of sex workers. People do not feel it is the right thing to do, but when they break that barrier, there is the potential to be hooked. We are probably most interested in the public health consequences. The reality is that sexually transmitted infections are rare among the thousands of clients of sex workers I have seen during the years, particularly those who use sex workers from western Europe, North America and Australia. One is safer with a professional than a gifted amateur.

Where there has been contact in South-East Asia, eastern Europe or Africa, in particular, there are substantial risks. The consequences in practice are anxiety, stress, guilt, remorse and a great fear of infecting a spouse or partner. This can be overwhelming or disabling. On occasion, we have had to have patients admitted for psychiatric care because the stress, anxiety and remorse was so overwhelming.

When a patient comes to us, our aim is not just the elimination of infection. The WHO has a much wider perspective on sexual health that involves the enhancement of the expectation of a good and full sex life. Our aim in checking for infection is merely the technical one; the real aim is the preservation of the marriage, relationship or family unit. What we never want to happen is for a stupid drunken night out to destroy a family unit. We try to identify underlying causes such as addiction, sociopathy, inadequacy and alcohol, but we do not want to destroy the family.

In that context, one of the subjects of debate is the concept of criminalising the client. One must think extremely carefully before doing so. It would certainly make our rehabilitation work much more difficult. If people are not only fearful of infection but also of a criminal charge, the consequences for their health, particularly their psychological and psychiatric well-being, could be immense, especially since there are inadequate health service resources to deal with the actual problems we face rather than anything else. We all like solutions, but we sometimes like simple solutions and believe certain approaches are obvious. However, at the hard end of an STD clinic life is much more like a scrambled egg. There are many things going on and the simplistic solution does not work.

We need to set boundaries for both the client and the sex worker to protect both. We must protect the client from the pushers and the sex worker from the serpents, the pimps. That is the context in which we should examine this problem and the surrounding legislation. We must seek to protect people from harm, be it caused by oneself or others. It is well recognised that trying to eliminate sex work or prostitution, irrespective of how broadly one defines it, is really trying to take away something that has always been part of society.