Female Genital Mutilation

Jane Ellison Excerpts

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.

[The Minister for Equalities (Lynne Featherstone)]

I thank my hon. Friend the Member for Battersea (Jane Ellison) and congratulate her on securing this debate on an incredibly important topic for women and girls both in the United Kingdom and internationally. We have to protect girls from this abuse, and we have to ensure that all those living with the consequences of female genital mutilation are given the care and support they deserve.

I want to answer my hon. Friend’s specific points first, so that if time runs out I do not miss answering them. On updating the statistical and quantitative evidence base, she made a powerful point about the fact that the records are outdated. We shall certainly look at what the Greater London authority comes up with. Although £120,000 is small in governmental terms, it is not easy to come by, but we can commit to considering it. I am happy to give her that commitment.

My hon. Friend also mentioned health inequalities, the tackling of which is a Government priority, as part of our wider focus on fairness and social justice. In the Health and Social Care Bill we are proposing the first ever duties, on the Secretary of State, the NHS commissioning board and clinical commissioning groups, to have regard to the need to reduce health inequalities—and of course, victims and survivors of female genital mutilation would fall into that category. We expect there to be action, therefore, under that banner.

My hon. Friend raised the important point that everyone works with the best of intentions, but that perhaps teachers are uncomfortable or do not use the multi-agency guidelines that the Government have published, and she asked what feedback the Government are receiving centrally. Currently, we are not receiving or collating feedback resulting from those guidelines, but there will be a review of the use and effectiveness of the guidelines in February 2012, and we will evaluate their success by examining how extensively they have been used. Depending on the review’s findings, we will consider how we might improve or adapt the guidelines. If front-line workers are not using them properly, there must be another barrier that we have not recognised in dealing with victims of FGM.

My hon. Friend raised the possibility of health passports for at-risk girls. I can undertake to explore and investigate the feasibility of such a measure. I do not know enough about the Dutch system to make a commitment, but I can commit to considering the idea.

The Government have recognised the need for a joined-up approach, co-ordinated by several Departments, to tackle FGM. We are trying to raise awareness of that barbaric practice. We have made progress, but I want to make it clear that the long-term and systemic eradication of FGM in the UK also requires communities affected by the practice to abandon it themselves. I cannot emphasise that point too strongly. We all work hard and are committed, but the pace is slow.

Our key focus is on prevention, and we have undertaken considerable work in the past year, across nine Departments, to take forward our efforts to prevent and tackle FGM. In February, I was pleased to launch the multi-agency practice guidelines for front-line professionals at the Manor Gardens centre, with which my hon. Friend and the hon. Member for Walsall South (Valerie Vaz), who has also contributed to the debate, will be familiar. Both are committed to that agenda. I spoke there to committed and dedicated community practitioners, and I want to commend and thank them publicly for their work.

As I said, the guidelines aim to raise awareness of FGM, highlight the risks of the practice and set out clearly the steps that should be taken to safeguard women and children from this abuse. I remember reading the guidelines myself. We talk about guidelines, and I sometimes wonder whether people know what they are like. I shall give an example for a teacher: if a girl spends half an hour going to the toilet, which is an inordinately long time, the teacher, if it happens more than once, should be alert, because it might be a signal that the girl has been cut, and so signpost and refer it on. The guidance focuses in particular on ensuring a co-ordinated response from all agencies, which is key to ensuring that professionals are able and confident to intervene to protect girls at risk. That is the objective. In addition, we continue to distribute leaflets and posters about FGM, which are key to bringing the issue to more people’s attention. More than 40,000 leaflets and posters have been circulated to schools, health services, charities and community groups around the country. In July, the Metropolitan Police Service’s Project Azure worked alongside Kids Taskforce to produce a film for secondary schools to raise awareness of FGM, which is now available for download on the Kids Taskforce website. Last summer the project also worked at Heathrow airport, talking to families with young girls going to countries where FGM is practised.

[Jane Ellison]

I watched the film, and I was astonished to see the young teenagers who made it say towards the end, “We want girls to have an informed choice about this.” No one can have an informed choice about a crime that is committed against them. However, those involved in campaigning on the issue are often forced to make such compromises in their language, essentially because of concerns about how they will be dealt with in their communities, which goes exactly to what the Minister said about changing attitudes in communities.

[Lynne Featherstone]

My hon. Friend makes a powerful point. Some of the attitudes and sensitivities—or perhaps over-sensitivities—associated with this issue have sometimes meant that what needs to be said is not said as directly as it should be.

The Government are frustrated by the lack of prosecutions in the 25 years since the practice became a criminal offence. Indeed, as a Minister, I am intensely frustrated by that, as I stand at the Dispatch Box at Question Time and am asked why there have been no prosecutions under Labour, Conservative or coalition Governments. We have worked to strengthen the current legislation and we keep trying to encourage prosecutions. As my hon. Friend said, in September the Crown Prosecution Service launched FGM legal guidance so that prosecutors can better understand the background of FGM-affected communities and identify evidential challenges, so that they do not work in a vacuum, but understand the issue.

Research suggests that the most likely barrier to prosecution is pressure from the family or wider community, which makes it difficult for girls and women to come forward and notify police about what has happened to them. Victims may be too young, vulnerable or afraid at the time of mutilation to report offences to the police or give evidence in court. There could be other evidential difficulties if cases are reported many years after the event. I had not heard about the compulsory examinations that take place in France, which my hon. Friend mentioned. That is not the way we do things here, but one does sometimes think, “What other way is there to know whether a girl has been cut?”

The aim of the legal guidance is to provide prosecutors with advice on building stronger cases to bring to court. Prosecutors will now work closely with the police to investigate cases and consider evidence from social services, schools or local authorities, which may have crucial information to help build a case. The guidance has not been launched in isolation, but is part of a concerted approach to building prosecutions. The CPS will be monitoring and reviewing every case referred to it by the police for 12 months. That will allow the CPS to identify why cases are failing to proceed to court and what issues need to be addressed in building a successful case. That reflects the CPS’s commitment to taking positive action to address the problem.

I want to talk about abandonment. I recently met representatives from the Orchid project, who introduced me to Tostan, a non-governmental organisation whose mission is to empower African communities to bring about sustainable development and positive social transformation based on respect for human rights. It takes a respectful approach that allows villagers to make their own conclusions about FGM and to lead their own movements for change. By helping to foster collective abandonment, Tostan’s programme allows community members to share the knowledge. Through this process, entire villages and communities—men and women—have decided together to end FGM. This is incredible work, and I am looking into it. I do not know whether it is directly transferrable, because, geographically, such villages are quite different from the communities here, in the midlands or wherever. There must, however, be something to be said for a community making a decision about the value being put on women being cut. If the whole community accedes to that decision, it will be something that has been done collectively.

A couple of months ago, at the conference on FGM at Manor Gardens, religious leaders met for a forum on female cutting. They represented all the religions, although the Jewish representatives could not come, but did send a message of support. What was so amazing was that all the speakers made it clear that religion played no part in FGM. Afterwards, 80% of the people who had attended said that that was beginning to break the link. Somewhere in all this, there is something that we need to look at that is more than all the things that we have been trying to do for so long.