UK NHS national policy on circumcision - rite or wrong ?

4 More News last night had a fascinating piece about male circumcision in the UK .NHS Direct (in page Last updated on 27 November 2007 ) says "In the UK, circumcision is only carried out on the NHS in cases where it is medically necessary. It is usually performed as a last resort when other types of treatment have been unsuccessful." Some fascinating pictures of the whole process here.

The policy is extremely clear ..."In England, ritual circumcisions are not carried out by the NHS. Primary Care Trusts (PCT) only perform circumcisions for medical reasons, as recommended by The British Medical Association (BMA).(There is no discussion on NHS Direct on female circumcision)

Which is clear enough .. quite where when and how this universal policy was established is a little unlcear - in the 40's and 50's circumcision of boys ran at about 30%. It is now recognised as medically unecessary - unlike for example in the US where male circumcision is prevalent.

In March 2007 the Center for Disease Control and Prevention stated that a National Health and Social Life Survey in 1992 revealed that 77% of men reported being circumcised including 81% of white men, 65% of black men, and 54% of Hispanic men. Since 1999, 16 states have eliminated Medicaid payments for circumcisions that were not deemed medically necessary. In 2006, two states—Hawaii and Vermont—introduced resolutions questioning the need for public funding of male circumcision. More here and here and the CDC have a current fact sheet here including discussion on HIV transmission in vaginal sex by circumcised / non-circumcised men.

Since 1975, the American Academy of Pediatrics' position on circumcision is that "there is no absolute medical indication for routine circumcision of the newborn." a position now supported the American College of Obstetricians and Gynecologists. Many groups both in the US and the UK regard the operation as a form of sexual assault on children.

4 More News has however discovered however that some Health Trust in areas with high levels of Muslims in the local population are now providing circumcisions free where it was undertaken simply for religious or "cultural" reasons.

The reasons and authority for the local change in a national policy are unclear, but the practice is defended ( and was defended by an embarassed NHS manager on the program) , as the refusal to perform the operation without requiring payment, would lead to "back street" circumcisions which might result in injury, disease and complications requiring orthodox medical treatment and NHS intervention .

We have just unearthed the bizarre finding (More Clostridium difficile deaths and infections in Northern Ireland but outbreak over (?) )that there is no national UK policy on rules for hospital visitors .Despite 8 years spent focussing on Hospital Acquired Infections, which unlike the choice for circumcision YES/NO ,is actually killing some 20,000 people a year. Every year.

Perhaps 4MoreNews ,this might have a slightly higher priority for further investigation.