Oral Answers to Questions

Debate between Valerie Vaz and Jane Ellison

Tuesday 21st October 2014 Commons Chamber

[Jane Ellison]

My hon. Friend is right to highlight this important issue. As he knows, the Department is negotiating with the manufacturer to purchase the vaccine at a cost-effective price, and he will understand that we need to ensure that NHS funds are used as effectively as possible. We are keen to see a positive conclusion to the negotiations as soon as possible so that plans for the Men B immunisation programme can be finalised.

[Valerie Vaz (Walsall South) (Lab)]

Will the Secretary of State explain why NHS England has entered into a contract with a company based in Kent to provide GP services, when my constituents have just seen a string of locum GPs at a higher cost to the NHS?

Tobacco Products (Standardised Packaging)

Debate between Valerie Vaz and Jane Ellison

Thursday 3rd April 2014 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

I obviously welcome the Minister’s statement, but given the evidence from Sir Cyril, from Australia and Canada and from the Health Committee, will she update the House on a possible time frame? “Before 2015” is too vague.

[Jane Ellison]

As I said, I want to publish the draft regulations alongside the short final consultation to look at any final points people want to make about the wider aspects of the policy. It is important that we do that to move forward in a way that is robust and sensible and that shows that we have considered everything in the round. I want to do that this month; then, if we decide to proceed, we will move to give the House a final decision before the summer recess. There is no reason why the legislation could not be brought before the House before the end of this Parliament.

Oral Answers to Questions

Debate between Valerie Vaz and Jane Ellison

Tuesday 14th January 2014 Commons Chamber

[Jane Ellison]

Obviously, health is a devolved matter, but research goes across the United Kingdom. In 2012-13, we spent £2.3 million on research into this disease through the National Institute for Health Research. The hon. Gentleman may be aware that during the passage of the Mesothelioma Bill, which has recently passed through this House, ministerial colleagues agreed to write to the Association of British Insurers. The Department of Health is seeking to set up meetings with the ABI and the British Lung Foundation to explore how insurers can individually sponsor specific mesothelioma research.

[Valerie Vaz (Walsall South) (Lab)]

4. How much has been spent on medical locums in accident and emergency departments in each year since 2009-10.

Female Genital Mutilation

Debate between Valerie Vaz and Jane Ellison

Thursday 3rd November 2011 Commons Chamber

[Jane Ellison (Battersea) (Con)]

I am grateful for the opportunity to raise this important issue again in the House. Female genital mutilation—FGM—affects millions of girls and women around the world, including here in the UK. My remarks this evening are focused on FGM in the UK, and what we can do to prevent it.

FGM is a gross violation of girls’ human rights, and is nearly always carried out on minors. In the UK, the girls most at risk are usually aged between eight and 12, but are often much younger. We should therefore be clear from the outset that FGM is a form of child abuse. FGM is defined by the World Health Organisation as the full or partial removal of, or injury to, the external female genitalia for non-medical reasons. Although it occurs in countries across the world, it is particularly prevalent in sub-Saharan Africa. There are no benefits to FGM. Indeed, quite the opposite is true. The girl’s health is damaged for ever.

There are various types of FGM, but the most extreme, which is the most common in larger FGM-practising communities settled in this country, is type 3. That is total removal of the victim’s external genitalia. The girl is then infibulated—effectively sewn up. I am sure that hon. Members can imagine the dreadful impact of that on the quality of life and the health of those girls in childhood, and the long-term damage to their sexual and mental well-being.

It is a source of great frustration to those who campaigned against FGM for many years that the UK has in place everything that might reasonably be expected to be needed to end FGM in this country, yet it continues and is apparently a growing problem. The necessary legislation is already on the statute book. FGM has been illegal in the UK for more than a quarter of a century under the Prohibition of Female Circumcision Act 1985, which was strengthened in the Female Genital Mutilation Act 2003 by making it illegal to take a girl abroad for cutting, as FGM is often referred to colloquially. Indeed, new guidelines for prosecuting the perpetrators of FGM were published here only this autumn.

As well as having the right legislation, the UK has a solid child protection framework in place which, on the whole, does a good job of protecting vulnerable children from other forms of abuse. The Government have recently published fresh multi-agency guidelines to aid professionals —for example, teachers, social workers and health workers—to identify children at risk and what steps must be taken to assist them. Despite that, all the anecdotal and medical evidence suggests that FGM is a growing, not a diminishing problem here. Why is it proving so difficult to right this wrong?

First, to meet the challenge, we need to know its scale. As part of the Mayor of London’s strategy to tackle all forms of violence against girls and women, the Greater London authority will shortly publish a policy document on addressing harmful practices in London. It will focus on, among other things, FGM. That report and others identify the fact that the lack of up-to-date figures is a significant stumbling block in efforts to tackle the problem.

Most of the FGM data for the UK that inform most parliamentary speeches, media articles and reports, including that from the Greater London authority, comes from a respected 2007 study by the charity FORWARD—the Foundation for Women’s Health, Research and Development. This report extrapolated data from the 2001 UK census, and its finding were startling, even then. Over 174,000 women residents in the UK had been born in an FGM-practising country. The estimated number of maternities in England and Wales in women with FGM stood at just over 6,000 in 2001 and had increased by 44% to just over 9,000 in 2004. FORWARD estimated that by 2009, that figure would be around 7,000 in London alone. Those are astonishing figures. That study is sound, but it is based on decade-old data.

As the Minister will know, with the trends in migration to this country over the last decade, especially from countries with a high prevalence of FGM, such as Somalia and Ethiopia, one can only conclude that those figures dramatically understate the extent of female genital mutilation in the UK today. We urgently need to update the evidence base.

Another reason the evidence base needs to be updated is that FGM is adding to existing health inequalities for these girls and women. How many women are not attending routine cervical smear testing because they do not want to alert the authorities to what has happened to them? How many parents do not take their children to the local GP when they are unwell because they fear that an examination will reveal that the girls have been cut? If, as the evidence suggests, FGM is a growing problem in the UK, the burden that it puts on the NHS in the long run will grow to match it.

[Valerie Vaz (Walsall South) (Lab)]

I thank the hon. Lady for bringing this debate to the Chamber. It is an extremely important subject, and she should be congratulated on the stance she has taken nationally and internationally. She is right when she points to the effects on the NHS. A midwife has shown me a video of the effects that FGM will have and what she needs to do when the women and young girls who have, in effect, been abused have to be cut again in order for them to give birth. It is having a huge effect, not only physically but on their mental state.

[Jane Ellison]

I thank the hon. Lady for that intervention. She is doing marvellous work to highlight this problem as well, and I know that she has seen recent evidence that was quite shocking and brought the problem into stark relief. I ask the Minister to consider, perhaps on a cross-departmental basis, supporting research to update the evidence base better to inform public policy in health, which the hon. Lady mentions, and in other areas. I understand that the FORWARD study cost about £30,000 to put together and that a more in-depth and qualitative report would cost in the region of £120,000.

Another area of major concern is that some professionals, especially teachers, are not confident enough of their role in protecting and supporting girls who are at risk. Although the multi-agency guidelines are excellent and we have a robust child protection framework in place, FGM remains under-reported. Recent feedback from a focus group with young women who had been affected suggested that not all professionals who deal with at-risk girls are clear about what they should do. Perhaps they do not feel that they can rely on the support of senior colleagues or that they have the political cover to step into what they perceive to be a cultural minefield. I very much welcome the current inquiry by the Select Committee on Education into how the child protection framework might be improved. I am pleased that the Committee identified FGM as a particular problem, and I have submitted evidence to its inquiry.

Since I have been speaking about this subject in the media over the past year—including on Radio 4’s “Woman’s Hour” in August—I have received a steady stream of letters and e-mails from around the country, many of them from retired teachers, telling me of their frustrations in reporting their suspicions about a girl who was at risk or had already suffered this abuse, but then finding that their information was not taken any further. This is child abuse, as the hon. Member for Walsall South (Valerie Vaz) says, and our professionals must feel that they can, and indeed must, speak up when they see the signs, and that once reported this information will be followed up swiftly by the relevant authorities.

Members will perhaps be astonished, as I was, to learn that one child who asked her teacher for help, saying that she was frightened that she was to be taken on holiday to be cut, was advised by her teacher to write a letter to an FGM charity. Perhaps some professionals feel that they cannot speak out because they fear that an accusation of racism would damage their career; I think that we, as politicians, can understand that fear. However, my argument is that by not protecting girls at risk of FGM, we are treating these girls less equally. If this abhorrent practice were happening routinely to little white, middle-class girls from long-settled parts of the community, would there not be a greater outcry among professionals, politicians and the media? There would be headlines every week.

While reflecting on the leadership role that we as politicians have, it is incumbent on all of us, as Members, to ask the difficult questions of our contacts in all communities and not to allow issues to be swept under the carpet, because some community leaders have issues that they do not want to talk about. I hope that when the Minister responds she will comment on whether information from front-line workers is being gathered and reviewed centrally to build up a clearer picture of patterns of behaviour—for example, recording school absences of at-risk girls.

On the subject of gathering evidence, I understand that the Crown Prosecution Service is in the process of collecting data on the FGM cases considered for charge. Everyone campaigning on this issue recognises the deterrent impact that just one successful prosecution would have. It remains a source of astonishment that there has not been one prosecution in the UK in the past 25 years, even though, throughout that time, a growing number of African and other European countries have secured convictions.

If we accept that FGM is child abuse, why do we not treat it as such? In other cases of child abuse, arrests are made, people are charged and convictions are secured. It is very difficult territory, but elsewhere, even when witnesses are very young or unwilling to testify, convictions have been secured and vulnerable siblings have been identified and registered as being at risk. Are we really doing enough to protect girls from abuse? Does it make a difference to the police that those girls are overwhelmingly from immigrant communities? In France, compulsory physical checks make the job of the prosecutors easier. That is not part of our tradition here in the UK, but is that hampering the police? Should we at least be challenging and discussing that received wisdom?

Will the Minister tell us more about the work that the Crown Prosecution Service is doing, and whether she feels that a prosecution under FGM legislation is becoming more likely? What does she feel are the main sticking points for the police when it comes to pursuing cases?

Of course, for the girls involved prevention is much better than prosecution, so as well as considering the action that we can take in this country, we have to take more effective action to prevent families from taking girls overseas to be cut. I have learned a lot about FGM over the past year or so from one of the world’s leading experts, Efua Dorkenoo, who is advocacy director on FGM for the charity Equality Now. She has been looking around the world for ideas that work. The Dutch and French Governments use what they call a “health passport” for girls who are at risk. That simple document, carried with them overseas, states clearly that FGM is a criminal offence in the country of residence and a form of child abuse. It details the appropriate criminal penalties, and in the case of Dutch residents, explains that if convicted of having their daughters cut, parents could lose the right to remain in the country if they are not citizens. The parents are then asked to sign the document before they travel to show that they have understood, and accept, their responsibilities.

I believe that such a document could be a powerful tool here. It would send a strong message to families that FGM is not to be tolerated and would empower girls to assert their own human rights. It may also empower parents who have their doubts about FGM. There is some evidence that some parents, perhaps those who have grown up in this country, are having doubts about whether they want it to happen to their daughters. They could show such a document to relatives from the extended family who were putting pressure on them to have a girl cut, and say, “Look, we can’t do it, we’ll be prosecuted.”

[Valerie Vaz]

Another problem is that the cutters abroad see such things as a loss of their income, so one solution could be that any aid sent out to relevant countries could be linked to retraining the cutters for a somewhat more useful job.

[Jane Ellison]

That is a very powerful intervention. That is a Department for International Development responsibility, as the hon. Lady knows, and DFID is being urged to do more on the matter. It is doing things, and astonishing grass-roots movements are growing up all over sub-Saharan Africa, with women in the lead. They are going from village to village urging people to stop the practice, and re-educating the cutters to do something else. She is absolutely right to highlight that as one way in which we can help. There is an extraordinary link on this issue between communities in the UK and the diaspora communities around the world.

Does the Minister think the health passport could help prevent FGM from happening to British girls when they are taken overseas? Should we consider whether it could work here?

I do not believe there is any argument about the fact that female genital mutilation is a terrible thing, yet for too long the issue has been talked about at the margins of public life, if at all. If we are to send a clear signal to the girls affected by this abhorrent practice that they are not at the margins of our national life, we in this Parliament must take every opportunity to address the issue. I am grateful for the opportunity to do so this evening, and I thank colleagues for their support and pay tribute to those campaigning outside the House. I very much look forward to hearing from the Minister, who I know has been very supportive of us and feels very strongly about the issue. We must aim to stop FGM in this generation and break the cycle of abuse that blights the lives of so many girls and women in the UK.