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→Reduction of practice: Wikify.
==Reduction of practice==
A national election was held in the United Kingdom at the end of World War II. The Labour Party gained a majority of the seats in Parliament and its leader, Clement Atlee, became prime minister. The party leaned to the left and supported social welfare. Aneurin Bevan was Minister of Health. [https://www.nhs.uk/ The National Health Service] (NHS) was created in 1948 to provide free medical treatment for all. Services were provided based on clinical need, not ability to pay. The NHS did not provide non-therapeutic [[circumcision]], so the incidence of circumcision dropped to a very low level.<ref name="gollaher1994">{{GollaherDL 1994}}</ref>
Sir James Spence, a prominent senior British paediatrician, urged his younger colleague, [[Douglas Gairdner]], to produce a paper on infant circumcision. The now famous classic paper, ''The fate of the foreskin: a study of circumcision'', was published in the ''British Medical Journal'' on Christmas Eve, 1949. The paper reported 16 deaths per year from non-therapeutic infant circumcision and concluded in part: "'''The prepuce of the young infant should therefore be left in its natural state.'''"<ref name="gairdner1949">{{GairdnerDM 1949}}</ref>
}}</ref>
The ''British Medical Journal'', the house organ of the [https://www.bma.org.uk British Medical Association], in an unsigned editorial in 1979, slammed the practice of child circumcision, calling it unnecessary, and citing the danger of contracting staphylococcal [[infection ]] in the newborn nursery.<ref>{{REFjournal
|last=Van Howe
|first=Robert S.
Fewer boys were being [[circumcised]] so there were more [[intact]] boys. The general practitioners (GPs) in the UK seemed to be unable to distinguish between true [[phimosis]] and developmentally non-retractile healthy [[foreskin]] and were referring numerous boys for unnecessary [[circumcision]].
Rickwood et al. (1980) had provided guidance on diagnosis of [[phimosis]]. According to Rickwood et al. true [[phimosis]] occurs when the [[foreskin]] has been attacked by [[balanitis xerotica obliterans]] (BXO) (also known as lichen sclerosis). If BXO is not present then true phimosis does not exist.<ref name="rickwood1980">{{REFjournal
|last=Rickwood
|first=
|DOI=10.1136/bmj.306.6869.1
|accessdate=2021-09-05
}}</ref> Williams et al. (1993) complained that most of the 30,000 circumcisions that were being done in the UK were on boys under 15. They reported that of 69 boys referred by GPs, 29 had a healthy retractile [[foreskin]], 30 had a healthy non-retractile foreskin, and only 9 had a phimosis requiring circumcision.<ref name="williams1993"> {{REFjournal
|last=Williams
|first=Nigel
Rickwood & Walker (1989) reported that 21,000 circumcision were done annually on boys under 15 years of age,<ref name="rickwood1989" /> so Cathcart et al. (2006) are finding a reduction of 53 percent,<ref name="cathcart2006" /> although still much higher than it should be. It should be noted that manual [[stretching]] of the [[foreskin]] with the aid of topical steroid ointment to relieve [[phimosis]] had not yet entered general use.
The 2000 British ''National Survey of Sexual Attitudes and Lifestyles'' (Natsal 2000) found that 15.8 percent of British males aged 16 to 44 reported being [[circumcised]]. The incidence of circumcision was highest in the men aged 40-44 at 19.6 percent [born 1956-60] and lowest in the group aged 16-19 [born 1981-84] at 11.7 percent. Men of ethnic minorities (except black Caribbeans) were significantly more likely to circumcised than those described as "white". Jews were 98.7 percent circumcised and Sikhs, Hindus, and Buddhists were only 9.8 percent circumcised.<ref>{{REFjournal
|last=Dave
|first=
}}</ref>
Quaba & MacKindlay (2004) reported a 33.7% decline in the incidence of [[circumcision ]] in Scotland from 1990 to 2000. This occurred because medical doctors were better trained in the recognition of healthy non-retractile foreskin in boys.<ref name="quaba2004">{{REFjournal
|last=Quaba
|first=