Articles on Shifting Sands
FGM: People have moved on. Why don’t campaigners?
Although families and communities who may have or used to practice FGM have moved on, ‘we still don’t trust you’ is the message they continue to hear from campaigners, the state and its representatives. That’s despite there being little if any evidence to back up their views, they continue to believe girls will be forced to undergo it, given half a chance.
So hardly an eye is being raised in regard to a plethora of new FGM prevention initiatives soon to be introduced. They include a new NHS – Information Sharing (NHS-IS) system where an indicator to a child’s electronic record will be added if her mother has had FGM; the addition of FGM Protection Orders to the 1989 Children Act; and making FGM part of the new Relationship and Sex Education (RSE) curriculum for secondary schools. These are in addition to the existing initiatives which form the scaffolding that supports Britain’s FGM industry.
Yet there’s no data, reliable or otherwise, about the number of British born girls who are subjected to FGM, or that many are ‘at risk’ here. But the industry that has grown exponentially in direct contrast to the decline of the practice, has convinced policy makers and politicians that the situation remains critical and of the need to remain über-vigilant.
New initiatives include:
By 31 March 2020 (recently deferred from March 2019) an alert will be added to a girl’s NHS electronic record in England if there is a family history of FGM. Specific healthcare professionals will add the alert where they consider a girl to be at risk of FGM, and it could last until she is 18 years old.
Concerns were raised in regard to this development after it was first proposed by the DH and NHS England at the Girl Summit in July 2014. After discussion with providers and system suppliers, NHS Digital requested the extension to the conformance date. But no changes are allowed to the standard.
This Information Sharing is formally justified on the basis that it will help strengthen local safeguarding frameworks and processes. Access to it will be controlled and viewable by authorised, healthcare professionals anywhere in England because it is part of the NHS Spine.
Is this measures necessary?
This was promised five years ago at the height of concerns about an FGM epidemic. Despite that the epidemic has not materialised, it is nevertheless still to be implemented.
The NHS-IT is additional to the controversial mandatory data that professionals have had to collect and centralise to NHS Digital since 2015. Concerns about breaching confidentiality, threatening the therapeutic relationship and putting patient/client engagement with services at risk have often been raised in regard to it. There’s also the hugely concerning and problematic mandatory reporting of under 18’s with verified or observed FGM direct to the police, that registered professionals are obliged to do.
It is evident from data compiled at a population level that very low numbers of girls, living in countries of the UK, have undergone FGM either recently or in the past, especially among girls born in the UK. Good practice suggests risks to girls should be assessed through contacts with individual mothers and families. It should never be assumed.
Nevertheless, the Department of Health expects that a girl’s name will be added to a Register soon after birth. This is wrong because its based on little more than deterministic assumptions about parental heritage. And it will put a huge burden on primary care professionals in particular who, almost on a daily basis, will have to deal with the fall out from it. Repeated questioning about parental intentions may run the risk of stigmatising the child/mother and possibly deter them from seeking future healthcare.
I expect that some professionals will exercise their professional judgement and ignore it as others have with mandatory recording. I certainly hope so.
The Children Act 1989 (amendment) FGM
A controversial private member’s bill that will enable family courts to make Protection Orders under the Children Act 1989, in cases relating to FGM, is currently working its way through the parliamentary process, to become law. This is designed to close a perceived legal gap in regard to children considered at risk of FGM.
Sir Christopher Chope’s twice raised objections to the Bill being nodded through without Parliamentary scrutiny and debate, and ordinarily that would have been the end of the legislative process. But Prime Minister May intervened: “It is only right that we find time for this bill, and the Government will find time to deliver it”. “We have strengthened the law on FGM, leading to that first conviction.”
The Bill is being scrutinised by a Public Bill Committee and is expected to report this month.
Is this measure necessary?
The barrister who suggested the need for the amendment to Lord Berkley referenced a single case where police applied for an FGM Protection Order to prevent a child at risk being removed from the country. But as Dr Brenda Kelly wrote, there are already powers in law to protect children at risk of FGM. What seemed likely in the instance cited was that safeguarding provisions may have been inadequate, and that was the problem that needed addressing. She thought the case for new FGM-specific laws and amendments had been inadequately made in that instance. And as we know, hard cases make bad law.
In the Committee reading that followed, the scrutiny and debate that Lord Chope had wanted didn’t happen. None of the MP’s raised a critical voice about the need for the Bill or questioned anything in regard to the dominant FGM narrative. Instead, they chose to grandstand and suggested the proposal was ‘no panacea for the widespread practice of FGM in the UK’, that ‘much more needs to be done to eradicate it’ and ‘to supplement the existing legal powers.’ It appears that while MP’s may differ hugely on many issues, Brexit being a good example, they are united in occupying the FGM moral high ground. So, without a hint of irony, they unanimously approved the ‘small, uncontroversial but important amendment to the law’.
This development will help fuel the belief that legislation will lead to fewer instances of FGM. But as they are already few, it begs the question as to the need for more laws.
RSE for secondary schools to include FGM
The guidance for the school curriculum subject, Personal, Social, Health and Economic (PSHE) Education has just been updated and renamed Relationship and Sexuality Education (RSE). It is scheduled for implementation by 2020.
During RSE classes, secondary schools will now be expected to cover a number of new aspects including the physical and emotional damage caused by FGM in addition to honour-based abuse, grooming, forced marriage and domestic abuse. Although parents may still withdraw children from the classes, from the age of 15 years children will be able to opt into sex education classes even if it goes against the wishes of their parents.
The Welsh government are consulting on new school guidance on sexual education, which includes FGM. Neither Scotland or Northern Ireland include FGM in the curriculum.
Is this measure necessary?
This development puts another nail in the coffin of the educative role of schools in favour of state formulated morality and propaganda. And crucially may help drive a wedge between parents and pupils.
As Joanna Williams, Head of Education at Policy Exchange said ‘For some youngsters, the proposed curriculum will sit happily alongside the attitudes of their parents and home environment. For others, the moral disjuncture will rapidly become apparent. These children will be taught that the values held by members of their family are not only wrong but perhaps founded on ignorance or prejudice. This is a harsh lesson for adolescents and quite possibly an even harsher lesson for their parents.’
Some parents are already up in arms about practices they disagree with being normalised without consultation via the primary school curriculum as illustrated here, and view it as undermining of their rights. Imagine how some will feel when they learn that FGM is about to be included in SRE in secondary schools? Who will convince them that children must learn to protect themselves from a practice their parents are giving up on? There is not a good justification..
But every cloud has a silver lining for the parts of the FGM industry with vested interests and a keen eye on funding opportunities. Some even think SRE doesn’t go far enough and are recommending that safeguarding training for primary school students as young as four should include FGM so that it is part of a range of risks and not ‘othered’.
People move on, why don’t the FGM crusaders?
These developments are happening in the context of little existing evidence to suggest that FGM is taking place in the UK or that girls are being taken abroad to undergo it. Fortunately, some are beginning to appreciate that UK communities who may have practised FGM in the past are no longer doing so. But this isn’t generally acknowledged. A Newsnight programme and a BBC Wales article have also demonstrated how families and children in those communities are being harmed by well-intentioned but damaging official measures.
The assumption that girls are automatically at risk because their mothers had childhood FGM is unjustified and stigmatising. Less, not more intervention would appear to be a far better way forward. As well as congratulating families for what they have already achieved.
A new network of NHS ‘one stop shop’ FGM clinics was launched in September 2019.
‘More than 1,300 women over 18 are expected to benefit from the highly specialised FGM support being rolled out to eight new centres across England’. ‘The new network of FGM support clinics – opening in Birmingham, Bristol, London and Leeds – will aim to reach women before they are pregnant, providing those over the age of 18 with a range of services all under one roof.’
The ‘research’ basis for the clinics was a report that I critiqued here: London’s Mayor pays half a million to do women with FGM a dis-service.
About the Author - Bríd Hehir
Bríd is a retired health professional. She started her career as a nurse and midwife in Africa where she worked for almost four years. She encountered FGM/C in Ethiopia. She then moved to London where she worked in the National Health Service as a midwife, community nurse, health visitor, reproductive and sexual health nurse and manager over a period of 30 years. She did not encounter FGM/C during that time despite working with immigrant communities who are reported to practice it still. She is puzzled by the current reported prevalence of the practice, the official response and associated activism. And is worried that they might cause more harm than good.