Articles on Shifting Sands
Police disappointment at few FGM referrals
A London Metropolitan Police Service’s Project Azure representative has expressed disappointment at the low number of FGM referrals being received from professionals since the introduction of a new Mandatory Reporting Duty.
This happened at an International Day of Zero Tolerance for FGM conference in London. The disappointment was compounded by the perceived low number of FGM Protection Orders also being requested and issued nationally. Despite supportive evidence, the police believe that FGM remains an ongoing and hidden practice in Britain.
Project Azure, which became active in 2006, is one of the ways in which the Metropolitan Police Service (MPS) responds to FGM ‘through training, prevention work, pro-activity and community partnerships.’ Its mission is to identify and prosecute offenders, identify and protect victims from harm and work with partners to prevent FGM.
In a Government attempt to help address the problem through legislation, the 2003 FGM Act was amended in 2015 by sections 70-75 of the Serious Crime Act. Consequently, since 31 October 2015, regulated health and social care professionals and teachers have been mandated to notify the police if FGM, in under 18’s, is visually identified or verbally disclosed to them in the course of their work.
Confusions persists in regard to the status of consensual female genital cosmetic surgery (FGCS) like piercings and labiaplasty. The Royal College of Obstetricians & Gynaecologists advises ‘FGCS may be prohibited unless it is necessary for the patient’s physical or mental health. All surgeons who undertake FGCS must take appropriate measures to ensure compliance with the FGM Acts.’ Gateshead Council e.g. has advised Body Piercing Practitioners there: ‘the (85) Act does not allow females to consent to any procedure that could be defined as female circumcision. This is enforced by the Police.’
Who has a duty to report?
Professionals who have to report include those regulated by a body which is overseen by the Professional Standards Authority for Health and Social Care. This includes the General Chiropractic Council, General Dental Council, General Medical Council, General Optical Council, General Osteopathic Council, General Pharmaceutical Council, Health and Care Professions Council and Nursing and Midwifery Council.
Educators include qualified teachers or persons who are employed or engaged to carry out teaching work in schools and other institutions, and, in Wales, education practitioners regulated by the Education Workforce Council. Social Care workers in Wales are also included.
How many referrals have been made?
The MPS, admitting a priority interest in securing an FGM related prosecution leading to a conviction, was surprised to receive fewer referrals than expected. That is probably because the Service, the Government and Campaigners, are all working under the assumption that 60,000 girls are ‘at risk’ of FGM in the UK, just because they were born to mothers who’ve undergone it.
So the 23 referrals received by the police was perceived to be disappointingly low. And of these, three were immediately discounted as inappropriate, reducing the actual number to 20.
The police were however pleasantly surprised to have received the highest number from health service professionals -17, bearing in mind that direct reporting to the police is a new and worrying development for them. The others were made by educators -2 and social care -1.
Following investigations, the MPS learned that none of the young people had undergone FGM in the UK. They’d all had it elsewhere. None could therefore be registered as a UK crime so became crime-related incidents instead. This means that police action could not be taken although the 20 are now on their ‘radar’.
They were then referred to social care, to be investigated as potential safeguarding incidents, and maybe to have multidisciplinary agencies consider what help and support was needed and could be offered e.g. surgical, psychological.
Problems with the Mandatory Reporting Duty
Though early days in regard to the Duty, questions about it must be asked. Those 20 referrals would almost certainly have been dealt with adequately under the previous system, without the involvement of the MPS, thus making 100 per cent of the referrals to them unnecessary.
Some may not even have become safeguarding referrals. Prior to the hype around FGM and the suspicion engendered, professionals were able to exercise judgement in regard to how they dealt with an FGM case and how best to manage any associated problems. With MR, that ability has been overridden by the imperative of referring to the Police.
The MR duty for professionals is a personal one; the responsibility cannot be delegated. So they neglect making referrals at their peril. Fear of being disciplined, or even de-registered, is uppermost in their minds, remembering their colleague’s 2015 FGM showtrial. So they refer to cover their backs, irrespective of private reservations. That is almost certainly what happened here.
As I wrote recently ‘A girl who underwent FGM in her or her family’s country of origin as a child, should be of no interest to the police or even healthcare professionals except where it impacts negatively on her health. Many will have undergone less severe types of FGM/C that do not lead to health problems despite scary and sensational headlines to the contrary.’
Without the MR duty, communities might not have lost trust in professionals to the extent they now have. Many now approach health professionals like family doctors (GP’s) with trepidation, considering them an extension of the Criminal Justice System, not the trusted people they’d believed them to be and would like them to remain.
I know that some under 18’s even defer/delay approaching health care providers, irrespective of whether their problem is related to their FGM status, knowing they will be questioned and reported. They also fear the consequences of a disclosure for themselves and their families. Some are even resorting to going abroad to seek health care rather than approach a health professional.
The police have also come to understand that despite saying ‘one day we’ll get that conviction and prosecution’, it cannot be all about criminal justice; they recognise the importance of dealing with the issue in other ways. They want professionals and communities to develop faith in their services and systems. They also realise that their track record with black and minority ethnic (BME) communities is not good. In another conference, and in response to a question from a BME professional about how they could be reassured that working with police was now for the better, she was told ‘We are your police service. Trust us!’
I suspect that whatever trust there was, has been further undermined by MR. Life experience has taught migrant communities to fear the law, the courts and what they represent. Even a visit from a friendly police officer, in or out of uniform, is feared. Imagine what the families of those 20 children went through? And for what?
FGM Protection Orders
Jane Ellison, Parliamentary Under-Secretary of State for Public Health, in her keynote address to the multi-professional conference, expressed disappointment that few of the other tools in the criminal justice armoury; FGM Protection Orders (FGM PO’s), were being requested or issued.
These PO’s have been in operation since 17 July 2015 and apply in England, Wales and Northern Ireland. The 2015 Serious Crime Act inserted a new section into the 2003 FGM Act, with the intent to protect girls and women considered to be at risk or victims of FGM. Applications for PO’s are made to the High or Family Courts as happened in Bedfordshire on the first day the law came into force.
But fewer than 40 have been issued in the intervening months and 18 only in the first quarter. Many have been issued to families with more than one child as was the case in Bristol recently. But because of a widespread, if false, belief in the existing of a ‘cutting season’, and the suspicion that female children are being taken to be cut to a country where FGM is practiced, the expectation that more should be sought is becoming widespread among the police, campaigners and some professionals.
This misconception is fuelled by professionals like midwife, Celia Jeffreys, head of the National FGM Centre. In December 15, she called on professionals in contact with girls ‘at risk’ to use the PO’s. “We need to be a bit braver as professionals and a bit clearer about how we can protect our girls,” she said. “We’re just starting to get to grips with how we use the orders and how useful they can be. Professionals need more support to enable them to do this and it’s something the centre is working on. But I would say be brave, use them.”
Once issued, prohibitions, requirements and restrictions (to protect the girl or woman at risk) are then usually applied. These may included the surrender of passports and travel documents, and would state that family members, or other named individuals, should not aid, abet, counsel, procure, encourage or assist another person to commit or conspire to commit FGM.
Though likely to be time bound, FGM PO’s can be kept for as long as a Judge considers necessary. They are lifted when the risk is no longer present. Families/young people as well as professionals can request this.
There is anecdotal evidence that PO’s are being sought and issued despite any intent by families to have their daughter(s) cut, but solely on professional suspicion. The knock-on effects, in addition to financial loss, inability to travel overseas, flights cancelled, out of date visas, as well as ongoing surveillance are all deemed acceptable inconveniences by the authorities. Families fear speaking publicly about PO’s out of fear of reprisals.
Repeal the Law
FGM is a complex and challenging issue and one we should be far more sceptical about attempting to address through legislation. The extension of the law into professional practice is a retrograde step for professionals and communities. That it’s been introduced to the detriment of the relationships of trust that should exist between professionals, girls/young women who’ve undergone FGM, their families and communities should be of major concern to us all. The law should be repealed before it does further damage. The cost of not doing this is too great for all concerned.
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.