42.Since 31 October 2015 healthcare professionals, social care workers and teachers in England and Wales have been required to report cases of FGM in under-18s to the police. Some clinicians have raised concerns that mandatory reporting breaches fundamental principles of patient confidentiality which might result in women being less likely to speak with doctors openly. We heard that some healthcare professionals just did not accept that mandatory reporting should be their responsibility. Janet Fyle, Professional Policy Advisor at the Royal College of Midwives, said that mandatory reporting “had not worked” because some healthcare professionals believed they did not have to do it and had “franchised it out to some community groups”.
43.Our predecessor Committee was concerned that it was unclear what would happen if a professional failed to report a case of FGM to the police and recommended that the Government set out the sanctions that might apply if a professional failed to comply. It suggested that sanctions should range from “compulsory training to a criminal offence for intentional or repeated failures.” In its response to the Committee’s report, the Government rejected the recommendation and said that failure to comply with the mandatory reporting duty would be dealt with in accordance with existing disciplinary procedures.
44.The police rely on professionals in the education, health and social care sectors to identify signs that FGM has taken place. Prosecutions will not be possible if we wait for daughters to report their parents to the police, which is unlikely to happen. On that basis, we believe the Government was right to introduce mandatory reporting. If a health professional, social worker or teacher saw someone who had been the victim of another crime, they would be expected to report it. In the same way, they must report FGM, which is equally a crime.
45.Existing disciplinary procedures for professionals who ignore the duty on mandatory reporting are insufficient and ineffective and it is unacceptable that some clinicians appear to refuse to accept it as their responsibility. The duty to report must not be seen as optional. A decision not to report puts children’s lives at risk and is complicit in a crime being committed. We repeat our predecessor Committee’s recommendation that the Government introduce stronger sanctions for failure to meet the mandatory reporting responsibility, beyond the relevant professions’ own general disciplinary procedures.
46.Dr Judy Shakespeare, Clinical lead for FGM at the Royal College of GPs, told us that statistics showing the rate of mandatory reporting were not available and that neither the Home Office, the Department of Health nor the Office for National Statistics (ONS) were collecting figures. In response to an FOI request for the number of cases of FGM reported to the police between 21 October 2014 and 10 January 2016 sent to the Home Office, Department for Health, NHS England and the ONS, the first three organisations were unable to provide any information The ONS said that FGM statistics were collected under category ‘8N Assault with injury’ but that category included incidences of other offences so it was not possible to extract data on FGM only. The majority of police forces declined to provide the information.
47.Detective Chief Superintendent Gerry Campbell was able to provide some figures on mandatory reporting. He said that since 31 October 2015 there had been in excess of 152 referrals from regulated professionals, notably from health, education and from children’s social care. However, those figures were not comprehensive as some forces had not yet returned data. He noted that one police force in particular (not named) had received a significant number of reports from professionals which could offer lessons for other force areas in maximising reporting.
48.The then Minister acknowledged that data collection had been a problem but suggested the absence of available statistics was the result of health and social care professionals being unaware of the reporting duty rather than recognising that it was the responsibility of Government to manage the data:
We know that data collection has been a problem. That is why the NHS has started to collect this data. It is disappointing to hear that, because we contacted all GPs—about 8,000 practices across the country—and sent them FGM packs. Health Education England has delivered 22,000 training sessions in an e-learning session. There has been significant work. The Department of Health has put over £4 million into outreach to medical professionals to help them understand what FGM looks like, how to find the signs of it, how to identify it, and the mandatory reporting duty. It is disappointing to hear that, but it is clearly something that we need to look at.
Janet Fyle of the Royal College of Midwives said the absence of feedback from the police on reports might lead some healthcare professionals not to report in future. She suggested that the police should disseminate a report with a breakdown of figures along with an explanation of progress that had been made on cases.
49.We were surprised and disappointed that there still appears to be no central Government office collating data on the mandatory reporting of FGM. One way to encourage reporting would be to publish readily available statistics so that those reporting can see the results of their diligence as well as that of their colleagues across the health, social care and education sectors. A centralised system for pooling reports of FGM would also be a positive step and would aid data analysis from which examples of best practice could be drawn. We recommend that the FGM Unit publish quarterly reports showing high-level results, progress in police investigations and examples of best practice that should then be disseminated to all professionals with a mandatory duty to report FGM. Ideally those reports should incorporate the data collated by the Health and Social Care Information Centre to encourage the standard of that data also to be improved.
50.FGM has been a crime since 1985 but there has still not been a successful prosecution for the offence. In February 2015, Dr Dhanuson Dharmasena (along with another defendant) was found not guilty of performing FGM on a patient at the Whittington Hospital in north London. He was alleged to have performed reinfibulation on a woman after she had given birth. He performed a single suture to stop postpartum bleeding. The woman herself made no request for the doctor to be prosecuted. The prosecution resulted in acquittal. Campaigners said that the publicity generated from the prosecution sent out a strong message to the practising community that the UK takes FGM seriously, but given it was the only prosecution to date, some felt that the outcome of the case could discourage survivors from coming forward if they thought a conviction was unlikely.
51.There have been no further FGM-related prosecutions since, despite recent legislative changes to expand the range of offences. Since 2010, only 29 cases of FGM offences have been referred to the CPS and a number of those cases are still live. In comparison, there have been 40 FGM-related trials in France, and European Commission figures to January 2012 show that there had been six in Spain; two in Italy and Sweden; and one each in the Netherlands and Denmark.
52.We were told during our roundtable discussion that one of the main barriers to gathering evidence on FGM offences is the difficulty in getting testimony from survivors. FGM is often arranged by close family members, including parents, whom children will rarely want to implicate. A child might have no memory of the act if it took place at a young age, as is common, or they might not know who was responsible. Crucially, a child is unlikely to know that FGM is illegal. It is often practised by families because they believe that it is in the best interests of the child, so even where a child does know that FGM is a crime, there might be an unwillingness to inform on others within a community and to do so might result in being ostracised.
53.The Government has expanded support for survivors and has sought to make FGM more difficult to inflict, particularly since the implementation of the Serious Crime Act 2015. Extra-territorial offences contained in the Female Genital Mutilation Act 2003 have been extended, life-long anonymity has been granted to survivors, and new civil FGM Protection Orders (FGMPOs) have been created. There is also a new offence of failing to protect a girl from FGM. As we have discussed, the Act also introduced a mandatory reporting duty on healthcare professionals, social care workers and teachers.
54.In France, FGM was defined as a crime in 1983 with the threat of 10 years in prison, or up to 20 years for cutting a girl under the age of 15. There have been about 40 trials which have led to approximately 100 convictions since. Unlike in the UK, there is no specific French legislation banning FGM but it is a crime under articles of the Penal Code which deal with mutilation and abuse of minors. Linda Weil-Curiel, a Paris-based lawyer, (who attended our roundtable discussion) has said the French legal system makes it easier to bring FGM trials than in other countries because a young victim does not herself pursue her own parents through the justice system. She can be represented by a person named as her guardian by the judge. Neil Moore, Principal Legal Advisor to the Director of Public Prosecutions, pointed out that the UK has a very different legal tradition and history of case law which would make adopting elements of the French system problematic. However, the expansion of the law to prosecute parents for failing to protect daughters from FGM has gone some way to moving the UK closer to the strict liability approach which operates in France.
55.France has an excellent record on securing prosecutions for FGM offences but the UK’s distinct legal tradition makes the adoption of similar practices unlikely and possibly unworkable. We welcome the introduction under the Serious Crime Act 2015 of the new offence of failing to protect a girl from FGM, which is similar to provisions in French law for prosecuting parents as abetters of the crime. The UK could learn a great deal from identifying the methods used in other countries, particularly France, to support girls who are prepared to give evidence against perpetrators. The Home Office should take steps to investigate additional legislative measures which might be successful in securing more prosecutions and in supporting victims who wish to contribute to legal proceedings, despite the obvious difficulties and conflicts this presents for young women.
56.It is beyond belief that there still has not been a successful prosecution for an FGM offence since it was made illegal over 30 years ago. That is a lamentable record and the failure to identify cases, to prosecute and to achieve convictions can only have negative consequences for those who are brave enough to come forward to highlight this crime. In the absence of successful prosecutions, FGM remains a national scandal that is continuing to result in the preventable mutilation of thousands of girls. We welcome the measures that the Government has introduced in recent years to deter parents and others from attempting to inflict FGM on girls and to bring those to justice who succeed in this. When we next review FGM the new laws will have had longer to ‘bed in’ and we will expect to see a number of successful and ongoing prosecutions, in line with other countries in Europe.
57.We recommend that the Government reconvenes its FGM Summit of June 2014 within the next year, to bring together the leaders of other European countries dealing with this problem and those from ‘home’ countries where girls living in the UK are taken in order for FGM to be carried out. The current Prime Minister took action to tackle FGM when she was the Home Secretary and she should take the opportunity to provide global leadership in tackling this form of child abuse.
58.When our predecessors published their report on FGM last year, they were so appalled by the lack of progress that they announced their intention to revisit this matter again. We will continue to draw attention to this horrific crime until prosecutions and convictions are achieved and we are able to turn the tide of violence against girls and women.
47 The Serious Crime Act 2015 amended the Female Genital Mutilation Act 2003 for the purposes of introducing a mandatory reporting responsibility
48 BMJ, Views and Reviews: , 12 November 2015
49 Home Affairs Select Committee, , Q12
50 Home Affairs Select Committee, , July 2015, para 22
51 Home Office, , 22 July 2015
52 Home Affairs Select Committee, , Q12
53 BMJ, Letters: , 20 May 2016
54 Home Affairs Select Committee, , Q21
56 Home Affairs Select Committee, , Q12
57 Letter from Sarah Newton to the Chair of the Committee,
58 European Commission, , 25 November 2013
59 Home Affairs Select Committee, , Q28
60 College of Policing,
61 Home Affairs Select Committee, , Q34
62 Home Affairs Select Committee, , Q32
63 Home Affairs Select Committee, , Q41
13 September 2016