Female Genital Mutilation

Baroness Cox Excerpts

Wednesday 4th December 2013 Lords Chamber

Asked by

[Baroness Cox]

To ask Her Majesty’s Government how they are addressing issues relating to female genital mutilation.

[Baroness Cox (CB)]

My Lords, I am deeply grateful to all noble Lords contributing to this debate on a subject which is of the utmost gravity in its implications for appalling and avoidable suffering of millions of girls and women today. I am delighted that the noble Baroness, Lady Rendell, is speaking, as her tireless endeavours to address that barbaric practice are widely appreciated.

My deep concern originated when I was working as a nurse, implementing an immunisation programme in a remote desert area in Sudan in the 1980s. I will never forget my horror when I first saw FGM—the extent of mutilation and the unbelievable legacy of the remaining tiny aperture with complications of utmost severity for micturition, menstruation, sexual intercourse, risks of haemorrhage, increased risks to mother and baby during childbirth, depression, post-traumatic stress and other mental health problems. I will never forget the screams of young girls in the village when they were taken into the bush at night to undergo the excruciating cutting, often with a rusty knife or broken glass, with thorns for sutures.

Together with my noble friend Lady Masham, who regrets that she is unable to take part in this debate, we supported the late Lady Jeger and Lord Winstanley in the introduction of the first Bill to outlaw FGM in this country in 1985. Earlier this year, when I re-engaged with the issue, I was profoundly shocked to learn that FGM has continued unabated, with an estimated 100 million to 140 million girls and women globally who have undergone FGM; and approximately 3 million girls are currently at risk of undergoing FGM each year in Africa.

In England and Wales, despite the 1985 Act, extended in 2003, in 2001 approximately 66,000 women had undergone FGM and 24,000 British girls under the age of 18 were at risk. That number is doubtless below the real figure, because many go to secret clinics or suffer in silence.

FGM is a very severe form of violence against girls and women, and of child abuse. Despite commendable actions by police forces—for example, Project Azure by the Metropolitan Police and Operation Sentinel by the West Midlands Police—and the action plan launched by the CPS in November 2012, there have still been no prosecutions for FGM in this country.

I pay tribute to anti-FGM campaigners such as Daughters of Eve, Equality Now and 28 Too Many for pressing for urgent remedial policies. Media coverage, including news reports, documentaries and the BBC television “Casualty” series have raised levels of public concern. FGM survivors, such as the brave young women speaking out in the recent TV documentary “The Cruel Cut” on Channel 4, are calling for those responsible for FGM to be held to account to protect future generations of girls.

I highlight the excellent report by an intercollegiate group comprising the RCM, the RCN, the RCOG, the Community Practitioners’ and Health Visitors’ Association and Equality Now, which makes important recommendations for Her Majesty’s Government and other stakeholders to develop a long-term strategy for treating FGM as a crime, with systematic and co-ordinated policies using health, social care, education and the police.

Protection requires early identification of baby girls, especially those born to mothers who have undergone FGM, as high-risk cases; their referral by health professionals as a child-safeguarding obligation to social care; and a follow-up plan to include education, counselling and support for parents. Sadly, the joined-up work needed to track such girls at risk is not happening. Except for emergency one-off cases where a girl is identified as being at risk of imminent FGM, referrals to social services are often dropped as they are deemed not to meet the threshold for assessment, and a care plan is not put into place.

Another weak link is in the education system. Most FGM occurs during a girl’s time at primary school. Teachers are expected to play a key role in protecting children from abuse, as they are able to detect warning signs and pupils may turn to them before contacting the police or social services. But in a recent YouGov survey for the NSPCC, 83% of the 1,000 teachers surveyed said they had not been given any training about FGM. Education about FGM should also be a compulsory element of personal, social, health and economic education, starting with primary-age children, because girls at risk need to be aware of the danger before they reach the most vulnerable age, which is between eight and 14 years old, to enable them to seek help, protection and prevention. FGM is a form of brutal child abuse and a crime, but the police cannot build a case for prosecution if they are not informed and there is currently widespread failure to refer.

I turn briefly to the crucial issue of support for survivors. As the number of people from countries where FGM is practised increases in the UK, there is an urgent need for policies to ensure access to support services and referral protocols between health, social care and other key services. This requires mandatory training and reporting requirements as well as a fundamental change of attitudes towards so-called cultural sensitivity and multiculturalism. There are far too many deeply disturbing cases where victims who have looked for help have been refused protection and support because of respect for local cultural traditions. We surely should never have allowed tenets of multiculturalism to take precedence over the law of the land, especially when the cultural practices being condoned are manifestly forms of torture, permanent injury and child abuse. We must move beyond this distorted priority and reassert the fundamental principle that culture cannot take precedence over the law of our land.

In your Lordships’ House last Thursday, I asked whether the Minister was aware that women who have had FGM and whose daughters are likely to be at risk of subjection to this abhorrent practice are not currently tracked through the National Health Service or social care systems, so that no preventive measures could be implemented; and why girls at school who show signs of having had FGM have not been referred to social services or the police for follow-up action. I also asked what Her Majesty’s Government are doing to ensure that robust information-sharing protocols are developed between health, social care and education agencies and the police so that appropriate actions can be taken to support victims and bring perpetrators to account. The Minister responded that on Monday—I believe it was Monday this week—the Health Minister, Jane Ellison, would be meeting healthcare professionals and stakeholders to develop policies on sharing information and data. I take this opportunity to commend Jane Ellison on all her endeavours to address this subject. Can the Minister give an account of the results of that meeting?

In conclusion, all experienced advocates agree that the time is long overdue for the implementation of comprehensive, joined-up policies of early identification, protection and support, procedures to bring perpetrators to account—as has been achieved in other European countries such as France, Sweden and the Netherlands—and an end to a culture of impunity which allows this mutilation to continue.

I finish by quoting Nimco Ali, a young British woman who lives in this country and is the co-founder of Daughters of Eve. She wishes her voice to speak for all those voices, either in far-away places or on our own doorsteps, that we cannot here hear tonight:

“There is a child somewhere today in this country, in school, in a hospital A and E Department or on a bus, who has had FGM or is at risk of this torture, who is counting on us to help her with her physical or emotional trauma—or crying out to stop it happening. That child’s protection is our responsibility. For over 25 years such children have suffered this appalling practice in this country. For how many more years will we allow this extreme child abuse to continue with impunity? The UK is laughing stock of Europe”.

She also said that girls are sent to the UK because we are seen as a soft touch. Those are not my words but those of a very articulate British woman who has endured the agony, humiliation and psychological trauma of FGM. I hope that the Minister’s reply tonight will bring substantial hope to victims, and to those living in terror of becoming victims, of this indescribable horror of FGM.