Female Genital Mutilation - Question for Short Debate

– in the House of Lords at 6:12 pm on 9 June 2016.

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Photo of Lord Berkeley of Knighton Lord Berkeley of Knighton Crossbench 6:12, 9 June 2016

To ask Her Majesty’s Government what steps they intend to take in the light of NHS statistics showing that in 2015 over 1,000 cases of female genital mutilation were reported every three months and the lack of any successful prosecutions to date.

Photo of Lord Berkeley of Knighton Lord Berkeley of Knighton Crossbench

My Lords, in 2003 the late Ruth Rendell, Baroness Rendell of Babergh, introduced the Bill making female genital mutilation illegal. To date, there has not been a single successful prosecution—a fact made all the more shocking, seemingly, by NHS statistics showing that, in 2015, over 1,000 cases were reported in each three-month period. Are the Government surprised by these figures and how are they reacting to them?

I say “seemingly”, because NGOs have told me that they are not surprised; it is what they have known for some time. Furthermore, the figures revealed some worrying facts: there was some evidence of girls mutilated here in the UK and GPs do not appear to have been involved with the issue as much as they might be in some areas. They could do more to advertise the dangers as, for example, they do in their surgeries about diabetes or heart disease.

The need for a national action plan is paramount. What has happened to the 2014 draft? We are behind practically every other EU country; even countries with far less widespread problems have implemented action plans, including Ireland and Scotland. The NGOs are there and they would love to work more closely with the Government. Of course, progress has been made. The mere fact that we have these NHS statistics, appalling though they are, is a huge leap forward.

There has also been a strong emphasis on education. This has to be the way to secure a change of attitude within these communities, where FGM is normally not to be questioned. This issue is almost always spoken of in terms of women but, vitally, we must target men as well for it is in their name that FGM continues. This is an area to which we could usefully devote more time and resources. Girls are told that men will not want to marry them if they cannot be seen to be pure or if they are in danger of realising sexual desire. Obviously, men need to take a lead in this area.

Of course, prosecution is important, and I will come on to this, but prevention is even more important. The UK is starting to provide a talking point for young girls who are beginning to say no. I have been deeply moved by the testimony of women who have been cut, speaking of their experience—for example, on “Woman’s Hour” and at the University of Warwick—with great dignity, telling not only of their medical and psychological wounds but of their hope and determination not to allow their daughters to go through this ordeal.

Several charities are doing sterling work in sub-Saharan Africa to get men and women talking about and questioning FGM. Here in the UK, local government, in the form of the National FGM Centre, has had considerable success in places such as Newham and Bristol in getting skilled and dedicated social workers to shift attitudes in areas where women and girls are vulnerable. The charity FORWARD is an African diaspora women’s campaign and support organisation. It has been working tirelessly to end FGM in the UK for more than 20 years. I pay tribute to it, to Men Speak Out, which works throughout Europe to engage men in the process of ending FGM, and Equality Now, which attempts to bypass the cultural barriers by framing them within the context of violence done to women and girls. So there is hope, and another reason for securing this debate is to keep the subject aired and current. Many experts and victims believe it is crucial that the word of mouth is that FGM is no longer acceptable and that girls and mothers in this country can and should resist it. It will take time. Deep-seated cultural traditions are not changed overnight.

There are in the Chamber today distinguished members of the medical profession who can attest to the effects of FGM with far more authority than I can. But FGM is child abuse and its implementation is torturous, causing lifelong grievous bodily harm. That is reflected in sentences that the courts could hand out if they were ever to get to deal with a conviction; 14 years in prison awaits anyone convicted of carrying out FGM.

These mutilations are frequently performed by people with no medical training in unhygienic surroundings, using old razor blades or broken glass. My noble friend Lady Cox deeply regrets that she cannot be in her seat. She has witnessed examples of this terrible damage on her journeys around the world. As she says, there is no anaesthetic and the results often lead to sepsis. The actual degree of cutting varies but it can range from the attempted excision of the clitoris to deny the victim sexual pleasure or desire to the cutting off of the labia, both minor and major, and the sewing up of the skin across the vaginal opening, leaving only a tiny hole for natural functions. I apologise to noble Lords for the graphic nature of this but it is important that we never lose sight of the quite terrible pain and damage inflicted.

In the UK, 60,000 girls are thought to be at risk. I have a few more statistics: 137,000 girls and women in the United Kingdom are living with the consequences of FGM. Many of these, it must be said, were cut outside the UK before arriving here. More than 130 million girls and women worldwide have undergone FGM. It is practised in more than 29 countries.

Religious leaders all over the world and of virtually every persuasion have continually stated that there are no doctrinal reasons whatever to justify or encourage FGM. So it is worrying that an Indian Muslim sect, Dawoodi Bohra, which has several thousand followers in the UK, has been encouraged to practise its form of FGM—khatna—by its leader, Mufaddal Saifuddin. His senior representative, a Mr Vaziri, has just been sentenced to 11 months in prison by an Australian court for his part in trying to cover up acts of FGM. The mother of the girls in question has been sentenced to 11 months’ home detention for allowing her two daughters to be harmed, as has the midwife who mutilated the girls. The judge made it clear that Australia was sending a message that it simply would not tolerate this abhorrent practice. If Australia can achieve success in prosecution, why cannot we?

Will the Minister make it absolutely clear, as set out in law, that should anyone encourage others to practise FGM they would be committing a criminal offence? We need to fire this shot across the bows of groups such as Dawoodi Bohra, so that their members are in absolutely no doubt about the grievous consequences of such actions. The one recent prosecution which the CPS mounted sadly failed—or perhaps not sadly, because it was regarded by many in the legal and medical professions as flawed from the outset.

The Government have made it clear on previous occasions that they do not believe in mandatory examination as in France, where many successful prosecutions have been obtained. The Minister will probably repeat this view but, on the other hand, we simply cannot avoid the issue of prosecution while girls in this country are being cut and in danger of being cut. I have a suggestion involving limited and targeted examination, given the 2015 NHS reports of FGM, which have to be reported to the police. I would be grateful if the Minister could give us, if he knows, an indication of what steps the police have already taken as a result of these cases. Among the many thousands of referrals, there must be some leads on which they could act, so here surely is an opportunity to gain convictions. After all, if the police have reports of drug dealing, for example, they get a search warrant. They will question or observe known acquaintances and build up a case. Might not these NHS reports provide fertile ground for the Government to consider targeted mandatory examinations, where reports reveal a hotspot of activity? We know that there are such, for example in London.

I am deeply grateful to the noble Lords who are taking the trouble to speak in this debate. I believe passionately that it is our duty to keep this awful practice under scrutiny and make it clear that in this country, we will pursue with the full force of the law those who encourage or practise the mutilation of young girls, thus damaging their capacity to lead their lives as young women to the full and to hamper seriously their prospects of conceiving and giving birth to healthy children.

Photo of Lord Smith of Hindhead Lord Smith of Hindhead Conservative 6:22, 9 June 2016

My Lords, I am grateful to the noble Lord, Lord Berkeley of Knighton, for raising this important matter as a Question for Short Debate. I appreciate that FGM has been the subject of previous Oral Questions but this debate provides an opportunity for further consideration to be given to a matter that, for the vast majority, appears so barbaric that we cannot understand how or why it can continue to be practised. As he pointed out, it is estimated that 137,000 women and girls are living with FGM in the UK. The report Prevalence of FGM in England and Wales: National and Local Estimates confirmed in 2015 that every local authority in the UK has FGM occurring within its jurisdiction. In London, it is estimated that 2.5% of the female population has been subjected to FGM.

FGM has been illegal now in the UK for 31 years and in all that time there has not been a single prosecution—not one—with a parent, guardian, aunt or cutter being brought to justice. In 2014, almost 16,500 parents in England were prosecuted for failing to ensure that their children were sent to school, which is about 45 prosecutions a day in one year alone. I wonder what a young British woman who has been subject to FGM, possibly when she was much younger, would think about that statistic since clearly we care passionately about the welfare of our children. Equally clearly, there is something here that we are still not completely getting right in respect of dealing with and, importantly, preventing this offence.

We understand that due to the secretive world in which FGM exists, the victims are vulnerable and the perpetrators manipulative. It involves pressures from mothers, fathers, grandparents, aunts, uncles and so-called leaders of communities that are often closed and therefore difficult to investigate. The main problem of course is that the perpetrators of this crime are usually the victim’s parents—the very people with the first duty to protect the child from harm.

Despite these rather depressing statistics, there has been success in raising awareness through national guidelines for front-line workers, the introduction of the duty to report cases of suspected FGM and the introduction of lifelong anonymity for victims, together with the criminal offence of failing to protect a girl at risk of FGM. There have also been national campaigns such as Not in Religion’s Name and Not in my Name, and the Girl Summit in 2014, to name some of the positive work in this area. Yet according to the statistics from the Health and Social Care Information Centre, a case of FGM is reported in the UK every 109 minutes. Based on that estimate, one report will have occurred in the space of this debate. If we are going to be successful in stopping this practice, we have to break the cycle. For every woman we are able to protect, there is a better chance of breaking the link so that this is not inflicted on the next generation.

Will my noble and learned friend update the House as to how the measures of the Serious Crime Act 2015 aimed at strengthening the law on FGM are affecting the landscape? Specifically, how many FGM protection orders have been issued since their introduction, and does he know whether they have been successful in protecting the children involved? The lack of police referrals is often cited in reports, such as that of the House of Commons Home Affairs Committee, as a serious contributing factor to the lack of prosecutions. Can my noble and learned friend tell the House whether police referral numbers have increased since the introduction of the mandatory reporting duty last October?

Can my noble and learned friend also give some thought to including the equally barbaric and dangerous act of breast ironing into the Serious Crime Act? Again, this is child abuse, violating the most intimate areas of young girls under the thinly veiled disguise of being a religious and cultural practice. Does he also agree with me that breast ironing should be included in the ongoing work on raising awareness and educating girls about the dangers of FGM?

We know France has had some success in securing prosecutions for FGM. Up to 2014, it had had 43 prosecutions, resulting in the punishment of more than 100 parents and cutters. French prosecution success has been partly due to regular medical examinations of girls from an early age—although it is not mandatory, receipt of social security is dependent on participation. The Minister in another place has made her feelings clear about the introduction of these sorts of early examinations and does not feel it would be appropriate—nor does the House of Commons Home Affairs Committee. I of course accept their view, and understand that different levels of evidence are required for prosecutions in France, but can my noble and learned friend say whether any discussions have taken place between UK officials and their counterparts in France and other countries which have secured successful prosecutions, to see whether there is anything else we can learn from their processes?

I end by congratulating my noble and learned friend and his department on the work that has been done so far in recognising the incidents of FGM that are practised in the name of religion and tradition but which are nothing short of abuse of young British girls and women. I look forward to his thoughts in summing up.

Photo of Baroness Finlay of Llandaff Baroness Finlay of Llandaff Crossbench 6:28, 9 June 2016

My Lords, I congratulate my noble friend Lord Berkeley of Knighton on having secured this debate and the timely nature of it given that we are coming up to the summer holidays, when prevention must be a critical aspect of the way that we behave towards young girls who are at risk. We know, as has already been said, that the estimates are that between 60,000 and 65,000 young girls under the age of 17 are at risk in the UK. At the outset, I give credit to two junior doctors, Dr Erna Bayar and Dr Jessica Gubbin, who are trying to investigate the level of knowledge among healthcare workers here in London. They are both junior doctors at St Mary’s, and they are here to listen to the debate today.

With regard to the report from the House of Commons and the figure of 137,000 victims in the UK, which has already been alluded to, it is worrying to note that only one-third of the cases referred to the Metropolitan Police—although there were no prosecutions—came from health and education. The Serious Crime Act 2015 has already been referred to, but it is worth noting that there seems to be enormous ignorance about the Act itself and the extraterritorial offences, as well as exactly what the duty of care is—in particular, the offence of failing to protect a girl from the risk of FGM.

A study from Birmingham, conducted through members of the Royal College of Obstetricians and Gynaecologists, was the first UK-wide survey of its nature. It revealed that one-fifth of respondents were not aware of the FGM Act, although over 93% knew that it was illegal in the UK—but there is a difference between it being illegal in the UK and the extraterritorial offence created in the Serious Crime Act. Appallingly, fewer than 10% of respondents were aware of the psychiatric morbidity in the victims of FGM. There did not seem to be any difference in the knowledge scores among different grades of staff, but it was worrying to read that there were lower knowledge scores overall among those who had been in obstetrics and gynaecology for more than 15 years. In other words, the younger generation had a greater level of awareness than the older generation, although it does not seem to feature in the curricula of all medical schools, which I suggest that it should.

In 2010, the Royal College of Midwives published a report in which it found that 70% of midwives were aware of UK law and one-fifth stated that it was illegal to resuture after birth, but there was little knowledge of where to refer a victim to, and only 15% of midwives reported having any training. To date, I have not been able to find a survey of paediatricians. There needs to be education across all levels, in medicine, nursing, midwifery, social work, physiotherapy and so on. There are some very useful educational tools out there. Health Education England has produced one, and there are e-learning modules that healthcare professionals can sign up to. But there seems to be an ignorance about how to report within a trust, whether to go to the police, and exactly where the interface is with safeguarding and domestic violence.

The worrying figure from the literature is the large number who do not even know how to ask about FGM, do not know what to look for, do not know how to document it, and certainly do not know the complexities of the law. However, we are looking at children under the age of 17, in general, as victims, and we know that over 80% come from the populations of Somalia, Eritrea, Ethiopia, Yemen, Sierra Leone, Egypt, Mali and Sudan, even though, in some of those countries, FGM is deemed to be illegal. There is good WHO guidance out there, but it is not being accessed, and it was worrying to find a study of a small number of UK victims suggesting that, of 27 victims who had been mutilated to a varying degree, the majority of them severely, for 71% it had happened in some kind of medical setting, where it had actually been performed by a doctor.

Teachers in primary schools—and in secondary schools particularly teachers of the lower age groups—have spoken about recognising girls who come back after the summer holiday who are completely different to the lively, bright and happy child who they saw before the summer holiday started. They are pretty sure that these girls have been taken away. They are never the same again. They remain inhibited, depressed and mistrustful within the class. These are girls who will have been at risk.

Much has already been said about obstetrics, and in a previous debate I have spoken about some of the obstetric disasters that can happen to these women. They are at risk of HIV and hepatitis B as well as of pelvic infections and so on. There is another pointer that is often missed, and that is where girls fail to attend GP appointments and when mothers fail to take their daughters along for routine checks, even when they are babies. This failure to engage with the NHS and the general practice system seems to be linked to later becoming victims of FGM.

It is about time that the Government changed gear on this. I know there have been a lot of campaigns to raise awareness, that there are so-called cultural sensitivities around this and that there is a fear of being branded somehow racist or discriminatory. However, these are children, and this is child abuse. It is abhorrent, and we have a duty to protect the victims. We have those who are already victims, but we have to protect the victims of the future. Have the Government considered using Section 75 of the Serious Crime Act to produce further statutory guidance before the summer holidays to go to schools to require them to engage with the parents of children who are in the at-risk population, to open up the subject and the discussion and let it be known that this is an offence here and extraterritorially? There is a duty of care that rests on teachers as well as on healthcare professionals. That must be done before the summer holidays, otherwise we will have another cohort of girls who have been terribly damaged by this deeply abhorrent practice.

Photo of The Bishop of Derby The Bishop of Derby Bishop 6:37, 9 June 2016

My Lords, I, too, thank the noble Lord, Lord Berkeley, for introducing this vital debate and making the point that we need to keep this subject in the public domain to raise awareness and challenge people.

I want to offer some perspectives from my experience in Derby, where I operate as a bishop at grassroots level, to try to help understand why we are in this position and how we might best tackle things. Your Lordships will know that FGM is a very ancient practice going back to at least the fifth century BC. It was mentioned by Herodotus, especially in Egypt and Ethiopia, all that time ago. I remind noble Lords that FGM was practised until the 1950s in western countries as part of dealing with what was then called “female deviancy”. Things such as hysteria, epilepsy and lesbianism were dealt with by this horrific practice as an enlightened medical approach to those conditions. We have to recognise that it is not only deeply embedded in ancient culture, but until quite recently in the west, we have been implicated in using this barbaric method for medical reasons.

The noble Baroness, Lady Finlay, and the noble Lord, Lord Berkeley, have been very clear about the physical and psychological damage that FGM causes and about the sheer scale. I think I am right in saying that even today in Egypt, 90% of girls are cut between the age of five and 14, and in Yemen 75% of girls are cut before they are two weeks old. I mention those statistics because that shows how, as people move into Europe and our country, the culture is reinforced by new recruits who inhabit it. So it is not simply a matter of having a law and fighting back; the problem comes from all over the world into our midst as we speak.

There are four “reasons” in the background why FGM is and has been prevalent. One, as we have heard, is to do with culture and faith frameworks; one is to do with the idea of a rite of passage; one is to do with concepts of purity and virginity; and one is to do with the control of female sexuality. Of course the Government must take a lead in their policy and legal framework but, as someone who was involved in the legislation against slavery, I would observe that it is very difficult to express in law something that can work effectively. With slavery, as with this issue, prosecutions are very low. Therefore, besides the Government giving out a proper signal and benchmark that this is unacceptable and barbaric, we have to work at all kinds of other levels, especially the cultural and faith ones, if we are going to really try to turn the tide.

In the work I have been involved in with colleagues in Derby, there are a number of methods of trying to enable an enlightened discussion. We have much to learn because the areas concerned—gender, the role of women and sexuality—are ones that we in the West struggle with too. We have to be careful about saying that we have all the answers and other people just need to jump to our solutions; we can have fruitful discussions with friends and neighbours from all kinds of cultures about gender, female sexuality and the role of women in society.

From my experience, there are four issues which I invite the Government to think about in terms of their own investment and encouragement. The first is appropriate spaces for conversations, the sharing of stories and the sharing of cultural faith hinterlands. How do we create the kind of space that is safe? Secondly, there is a very challenging issue which we in politics ought to know about: pace. There is a great danger of moving on to the offensive, which will cause a defensive reaction. We need a conversation and debate that is paced so that people can get into it, be influenced by it, participate in it and be changed by it. We have to be very careful about wagging a big finger, so that people do not just think, “Well, that’s western liberal culture, and we have something precious to preserve against it”.

The third thing that we have learned is that the official agencies—the law, safeguarding and local authorities—have limited resources and are regarded by people in a limited way. Therefore, although they must do the policing and act out the standards, they need the support of the informal grass-roots sector, where friends and neighbours can have conversations, listen to each other, share stories and raise aspirations of what is possible, right and desirable. Fourthly, we had a day conference in Derby and did all sorts of informal work with other churches, faith groups and community groups. As a result, we now have 10 community champions, providing community support and signposting at grass-roots level, looking out for the opportunities for those conversations, encouraging them and getting people in the circle, so that there can be genuine change that people have signed up for and committed to, rather than jumping to an abstract law that is thundering towards them.

So my simple question to the Minister is: how might the Government take seriously that important grass-roots work, which requires a particular kind of space, pace, community champions and informality, and which will have an enormous effect in reinforcing the formal law and systems? How might the Government encourage and invest in that work, which would achieve real change and pushback? How might that be part of the action plan that, as has rightly been said, needs to be put on the table?

Photo of Lord Patel Lord Patel Chair, Long-Term Sustainability of the NHS Committee, Chair, Long-Term Sustainability of the NHS Committee 6:44, 9 June 2016

My Lords, I too thank the noble Lord, Lord Berkeley, for obtaining this debate, which concerns an important issue. As everybody knows, my background is in obstetrics. Because of that, I am involved in a charity that trains doctors and nurses in parts of Africa and the Far East to treat women with fistulas. I have seen the results of this barbaric and cruel procedure, which is sometimes carried out on young children. It results in not only immediate consequences but long-term consequences during childbirth, and it is horrendous to see, even at that stage.

I can talk about the medical consequences but I shall try to look at the legal side. I do so with some trepidation as a doctor taking on a lawyer of the distinction of the noble and learned Lord, Lord Keen of Elie. He is well known for his incisive dissection of the law and for trying to defend what cannot be defended.

As has already been mentioned, France is a European country that has been successful in getting the maximum number of convictions and prosecutions—to date, about 50. The reason given is that it has a policy of regularly examining children at risk and children at school. Children at risk have more regular follow-up examinations. Examination is not mandatory, as the noble Lord, Lord Smith of Hindhead, said, but refusal involves a penalty involving social security benefits. That is the key reason that France has been successful, although other countries in Europe have also achieved certain levels of prosecutions and convictions.

I looked at a study of female genital mutilation in Europe and an analysis of a sample of cases. Considering that some 500,000 women have probably gone through this procedure, Europe has not achieved the levels of prosecutions and convictions that it ought to have done. None the less, some countries have been successful. The study that I looked at developed a comparative overview of recent FGM court cases within the EU, as well as making an exploratory survey of transnational movements in relation to FGM. The legal aspects of the court cases in Europe were analysed, and evidence of transnational movement to have FGM performed was also assessed. The data included court decisions, the migration background of groups from FGM-practising countries in the host countries, the process of FGM reporting, and stakeholders’ proposals and opinions regarding FGM.

The report addressed the general legal context or framework for fighting FGM in the 11 countries that were looked at, including the United Kingdom and Switzerland, although of course Switzerland is not an EU country. It analysed the impact that the embracing of the due diligence standard could have as a consequence of signing the Istanbul convention, to which the United Kingdom is a party—albeit a more recent party.

Findings of FGM are modelled by disparities of public prosecution systems in Europe. Calling on state parties to apply the Istanbul convention and, accordingly, to modify existing provisions that limit their jurisdiction over FGM cases could have an impact on such procedural disparities. I have no doubt that the noble and learned Lord, Lord Keen of Elie, will challenge what I have just said—maybe not—but I am eager to hear his views on whether this disparity is in any way related to the laws and framework that we have.

The review of existing court cases shows the legal concepts of “error of prohibition” and “neglect of care” as novel approaches for both prosecution and prevention of FGM in Europe. As a consequence, the report points out that these aspects of due diligence, neglect of care and error of prohibition ought to be further explored in future discussions—not primarily for their potential to result in more criminal court cases resulting in conviction but because of their potential power as preventive tools.

We know from the statistics we heard from several speakers that this crime is committed on a daily basis in the United Kingdom. We also know that the number of these cases is increasing. What we seem to be lacking is the evidence necessary to bring about prosecution, and therefore conviction. We made a mistake with the first case that we brought for prosecution and conviction, which was the wrong case of a doctor who was merely repairing the damage done at birth. In many cases, I have done that, and I am sure on occasions it was for women who have had FGM carried out on them. We need to examine whether there is an issue with our law as it operates or with the way we go about collecting the evidence, knowing, as I just said, that this crime is committed on a daily basis.

In all 11 countries, FGM is legally banned either through specific criminal provisions, as we have, or provisions in the penal code that penalise bodily injury and mutilation. Will the noble and learned Lord, Lord Keen of Elie, comment on whether our legislation complies with that? As I said, the most atypical prosecution occurred in the United Kingdom, but something similar happened in the Netherlands in the case of a father, originally from Morocco, which is not an FGM-practising country, who was accused of having performed FGM on his daughter.

The other question is whether the noble and learned Lord thinks that creating a unified European legal framework might help in detecting more cases and bringing about prosecution. The common framework is established by the Istanbul convention, which originates not from EU law but from the Council of Europe. The system of protection is, on paper, rather standardised, but the practice in different countries varies. As I said, the disparities detected in the procedure for reporting or not reporting, as well as for prosecuting or not prosecuting, would decrease if all countries adopted the Istanbul convention into legislation. Perhaps the noble and learned Lord might comment on that.

Why can we not get the evidence required? What is the nature of the evidence that is lacking and means that prosecution, and therefore conviction, is not brought about? As has been mentioned, if we could successfully prosecute a case and get a conviction, that would be the biggest deterrent to reducing further cases.

Photo of Lord Rosser Lord Rosser Shadow Spokesperson (Home Affairs), Shadow Spokesperson (Transport) 6:52, 9 June 2016

The noble Lord, Lord Berkeley of Knighton, has raised a seemingly simple and straightforward issue: namely, the contrast between the number of reported cases of female genital mutilation and the lack of successful prosecutions. The reason for that cannot be a lack of legislation—although how effective it is proving may be another matter—with the Prohibition of Female Circumcision Act 1985, the Female Genital Mutilation Act 2003 and, finally, the Serious Crime Act 2015, which extended the reach of the previous Acts including through mandatory reporting and enabling authorities, in respect of future offences, to prosecute parents for failing to protect their daughters regardless of whether the daughters have named them as complicit in their FGM. We await to see whether the Government agree that there is a problem and, if so, to what they attribute that difficulty.

Others have already highlighted potential reasons for the lack of successful prosecutions, including the National FGM Centre, which is a partnership between Barnardo’s and the Local Government Association. In the past year, the centre has provided specialist social care provision in six local authorities considered to have “low prevalence” of FGM. Despite this, the centre worked on 71 cases involving 70 women and 95 girls at risk of or affected by FGM. The centre says that a significant barrier to successful prosecutions is insufficient communication between professionals, particularly those working in health and social care. Although health professionals are under a duty to record cases of FGM, the centre says that the data show that only 17 GP practices produced any records at all in the last quarter of 2015.

The National FGM Centre goes on to say that low confidence among education professionals in asking sensitive questions and assessing risk also results in limited referrals to social care from education, and that when they do happen they often contain insufficient information to be processed by social care. It goes on to say that a number of social care professionals still feel uncomfortable in assessing FGM risk or using the tools available to them such as medical checks or FGM protection orders, with this being especially the case, once again, in “low prevalence areas”.

Barnardo’s has set out a number of recommendations for increasing the number of successful prosecutions, including more specialist training for front-line professionals, better information systems between key agencies, compliance with recording and reporting requirements by all professionals, specialist social care provision and lesson plans on FGM in schools.

The Local Government Association has also sent a briefing, setting out its views on the issue of prosecutions raised in this debate. It says that more than 125,000 women in England and Wales are estimated to be living with the consequences of FGM, and there are 60,000 girls born in England and Wales to mothers who have undergone FGM. Another analysis has said that approximately 10,000 girls aged under 15 who have migrated to England and Wales are likely to have undergone, or are likely to undergo, FGM.

The key points made by the Local Government Association on the lack of successful prosecutions are that FGM is often carried out on young girls who may not understand what is being done to them, or if they are, may be unwilling to testify against close family members; and that, in the overwhelming majority of cases in the UK, the FGM has been carried out before the women and girls arrived in this country.

The Local Government Association says that FGM will be eradicated in the longer term only by changing practice and custom in communities where it happens. It says that through the National FGM Centre programmes are being rolled out across the country to shift attitudes and behaviour towards better prevention of FGM. As has been said, FGM is most often claimed to be carried out in accordance with religious beliefs, but it is not actually supported by any religious doctrine.

There is a rather different emphasis on the reasons for the lack of successful prosecutions between the National FGM Centre and the Local Government Association, and we wait to hear the Government’s views on this issue. There is no doubt, however, that encouraging and promoting change in practice and customs will be crucial, and it is far better to succeed in preventing the offence happening in the first place than it is to prosecute after it has happened. Equally, in the light of the law of the land, action needs to be taken that will help in the shorter term to address the issue of FGM, which is a serious crime, and the lack of successful prosecutions. The lack of successful prosecutions hardly acts as a disincentive to those who commit or aid and abet this serious crime.

The Local Government Association has referred to the work of the Bristol FGM Community Development project, which has led to the development of appropriate services in the community and to an increase in referrals to the police, with a 400% increase in potential FGM referrals from 2009 to 2014. Does the Minister have any information on the outcome of this increase in referrals to the police, based on the work done in Bristol?

In its report last year on FGM, the House of Commons Home Affairs Committee was quite blunt in its comments, saying that,

“it is still the case that there have been no successful prosecutions for FGM in the United Kingdom in the last 20 years. This record is lamentable”.

Further on in the report, the committee said:

“There seems to be a chasm between the amount of reported cases and the lack of prosecutions. Someone, somewhere is not doing their job effectively. The DPP informed the Committee that she could only prosecute on the basis of evidence, the police said that they could only investigate on the basis of referral, and the health professionals told us that they could not refer cases because their members were not fully trained and aware of the procedure. While agencies played pass the parcel of responsibility, young girls are being mutilated every hour of the day. This is deplorable. We wish to see more prosecutions brought and convictions secured. This barbaric crime which is committed daily on such a huge scale across the UK cannot continue to go unpunished”.

The Home Office Minister in the Commons has said that lead FGM prosecutors have been appointed for each Crown Prosecution Service area and have agreed joint FGM investigation and prosecution protocols with their local police forces. Have any of these lead FGM prosecutors yet authorised a prosecution for FGM? The same Minister also said last month that the Government accepted that tackling FGM needed a co-ordinated response from a range of professionals, including teachers, health professionals, social workers and police, and that updated multiagency guidance on FGM had been published to support compliance. The Minister also said that free FGM e-learning had been made available for all professionals; that the Department of Health’s FGM prevention programme was seeking to improve the response of the NHS to FGM; and that the Department for Education was funding the Local Government Association and Barnardo’s to develop a centre of excellence and outreach to support local authorities. On the face of it, that all sounds good.

However, how much co-ordination is there at government level, bearing in mind the number of different departments involved, each with their own programme or projects for their own specific areas? What is the total amount of additional money that is now being made available, and to whom, to address the incidence of FGM and the lack of successful prosecutions? As far as the police are concerned, is it ultimately a matter for a chief constable or a police and crime commissioner to decide what resources and priority will be directed to pursuing FGM referrals within their force? Do the Government agree with the recommendations of Barnardo’s for increasing the number of successful prosecutions for FGM, to which I referred earlier? If so, are the Government saying that the steps they have taken already will deliver those recommendations? When do the Government anticipate seeing a reduction in the incidence of FGM? When do they expect to see successful prosecutions in the light of the legislative and other steps that have been taken? Finally, is there any hard evidence yet that the legislative changes in respect of FGM introduced under the Serious Crime Act 2015 are beginning to have an impact?

Photo of Lord Keen of Elie Lord Keen of Elie The Advocate-General for Scotland, Lords Spokesperson (Home Office) 7:03, 9 June 2016

My Lords, I thank the noble Lord, Lord Berkeley, for securing today’s debate on this important subject.

FGM is an extremely serious and harmful crime. Its victims deserve to receive support and legal redress. Offenders should be punished and potential perpetrators must be deterred from committing this appalling offence. A conviction for FGM would send a strong message. It would demonstrate unequivocally this country’s absolute intolerance of the practice.

Before I turn to the issue of prosecution and convictions, I wish to say something about the prevalence of FGM in the United Kingdom. The collection of the statistics to which the noble Lord referred was introduced as part of the Department of Health FGM prevention programme and represents the first time these data have been collected across the NHS in England.

As the noble Lord noted, these statistics are providing important information about the prevalence of FGM which can be used to inform the commissioning of services to ensure that victims receive the support they need. The latest figures published on Tuesday show that 1,242 women with FGM were seen by the NHS between January and March of this year. In the detail we can see that the vast majority of these cases are in adults who were both born and underwent FGM overseas. This is consistent with previous reports. As noble Lords will recognise, that means that these crimes are unlikely to be eligible for prosecution under the law in England and Wales. While this may mean that the perpetrators of these acts cannot be brought to justice here, the statistics are helping to ensure that those who have undergone FGM both receive the care they deserve and are educated on the legality and health consequences of FGM.

Of course it is abhorrent that any woman or girl should undergo FGM. Any UK national or resident who carries out, facilitates or allows FGM to happen should be punished accordingly. Indeed, whether or not encouraging FGM could be a criminal offence was mentioned. Of course it could be under the Serious Crime Act. However, we must not underestimate the difficulties in obtaining a conviction. FGM is a hidden crime that is carried out within families and where the victims are often young children. These young girls are understandably reluctant to speak out for fear of the impact that this could have on their family. Even when the crime does come to light, professionals may hesitate to make a report, fearing what the consequences may be for the patient or pupil. There may also be challenges for the police and prosecutors in ensuring sufficient evidence for a crime that may have been carried out many years ago. These are significant barriers but we must do everything we can to overcome them.

To help to do this, last year we strengthened the law through the Serious Crime Act 2015, based on learning from cases referred to the police and the Crown Prosecution Service. Last October we introduced a new mandatory reporting duty which requires regulated health and social care professionals and teachers in England and Wales who identify cases of FGM in girls aged under 18 to report these to the police. This duty gives professionals the confidence to report FGM without hesitation. It should therefore ensure that more cases reach the police so that they can be investigated and ultimately prosecuted.

Fear of reprisal can be a significant barrier, making victims extremely reluctant to engage in the legal process. This is why we have introduced lifelong anonymity for the victims of FGM. We have also widened the scope of the legislation so that extraterritorial jurisdiction extends to habitual as well as permanent UK residents. Furthermore, we have introduced a new offence of failing to protect a girl from the risk of FGM which extends the reach of the law to cover parents or guardians who do not adequately protect their children from undergoing FGM. The Government’s message could not be clearer: FGM is child abuse. There is no excuse for allowing it to happen or for failure to take action when it is uncovered.

Securing prosecutions is important, but at the heart of any case brought to trial is a victim—a victim who has not been protected from harm. The Government are therefore committed to preventing this crime happening in the first place. That is why we introduced the new FGM protection orders to safeguard those at risk. A question was raised as to the number of those orders that have been secured. From their introduction in July 2015 to December 2015, 32 such protection orders were made to protect girls from harm.

It is also important that professionals know how to identify the risk, share information, and have the knowledge and confidence to take appropriate safeguarding action. We have made significant progress in helping to achieve this. Since 2014, more than 30,000 professionals across all agencies have completed the Government’s free FGM e-learning that was referred to earlier. In April of this year we published new multi- agency guidance which we have placed on a statutory footing for the first time. That guidance provides information on prevention, risk and safeguarding, and sets out the expectations on statutory organisations to adequately prepare and support their staff to tackle FGM. So progress is being made.

To further support the response of health professionals, the Department of Health’s £4 million FGM prevention programme is engaging with healthcare professionals across England through roadshows, e-learning, guidance, and awareness-raising materials. As part of this, a new IT system is being introduced across the NHS to allow clinicians to note on a girl’s record that she is potentially at risk of FGM. To ensure that the social care response is as effective as it can be, the Department for Education’s innovation programme has provided up to £2 million of funding to Barnardo’s and the local government associations for the National FGM Centre which is working to improve the social care response.

Ultimately, we will not stop FGM unless we change attitudes. To do that we have to raise awareness and share good practice. In that regard, the Home Office’s FGM unit is carrying out an ongoing programme of outreach across the country. To date, the unit has spoken at more than 80 events. To dispel the myth that FGM is a religious requirement, the Department for Communities and Local Government has secured the signatures of more than 350 faith leaders to a declaration stating that FGM is not condoned by any faith.

The Government are taking this matter extremely seriously, and we are working right across government to strike at the considerable problem that exists due to ignorance, false religious belief, and so on. The Government have taken significant steps forward in our ambition to end FGM within a generation. We know that more work is needed. For example, last December, Her Majesty’s Inspectorate of Constabulary found that the police response to so-called honour-based violence, including FGM, is not as good as it could be. We are working with the police, CPS and others to address this, including as part of wider work to improve the police response to vulnerable people. Progress is being made. Many more brave women are speaking out against FGM and many more professionals are taking action to safeguard and support those affected. We have seen an increase in referrals to the Crown Prosecution Service. Prior to 2010 it had received no cases but since then 22 have been referred, and we are confident that that trend will continue.

With regard to the number of referrals that may result in prosecution, I can only say that they are under consideration for the purposes of further investigation, but it would not be appropriate to cite particular numbers that are the subject of consideration for actual prosecution at this stage. While our aim is for all these changes to help secure a successful series of prosecutions, it is more essential that we prevent FGM happening in the first place, and work ultimately to end the practice altogether.

I turn to points and questions raised by noble Lords and will deal with them as relatively quickly as I can. Indeed, if there is any question that I do not address, and I am reminded of that fact, I will of course be prepared to write. The noble Lord, Lord Berkeley, asked about the steps the police had been taking with regard to reports of FGM. Indeed, the noble Lord, Lord Rosser, cited the example of Bristol. I do not have the figures in respect of Bristol but I have figures of reports for the West Midlands Police—an area where this is a particularly prevalent problem. We know that there has been an increase in the number of reports to the police in the West Midlands in the period from January to November 2014, from about 25 reports in previous years up to 118, so clearly some progress is being made. Of course, we accept that more progress has to be made. As was noted, there is now a lead FGM prosecutor appointed to each CPS area. They have agreed protocols with local police forces, setting out the arrangements for investigation and ultimately the prosecution of FGM cases.

A reference was made to one prosecution. The noble Lord, Lord Patel, said it was the wrong case—I could not possibly comment. It resulted in a not guilty verdict but that is another matter altogether. Eventually, we are beginning to move the rock; we are beginning to get these cases into court and, of course, a successful prosecution would send an important message. However, prosecution is not an end in itself. The practice has to be rooted out, not the punishment.

Reference was made to the fact that some successful prosecutions had been made in France. My noble friend Lord Smith mentioned, I think, the figure of 43; the noble Lord, Lord Patel—I think referring to the EU report on analysis of court cases in 11 countries—gave the figure of 50. I observe that those cases go back to the 1980s and 1990s, so there is quite a history there. As far as I know, there has been only one recent successful prosecution in France of one cutter, but it involved about 18 different children and their parents. However, in response to points raised by the noble Lord, Lord Patel, France has an entirely different system of prosecution and investigation, and, indeed, entirely different systems and standards of evidence. In addition, it has a more or less mandatory system of examination. When it is said that it is not mandatory, in the event of a refusal there is a withdrawal of benefits; we would not contemplate such a mandatory system. We could not have such a wide-ranging system of mandatory examination for all girls. If we then sought to target it, we would face the issue of discrimination. We do not consider that the way forward.

The noble Lord, Lord Patel, also mentioned the Istanbul convention. We have signed the convention, but we have not yet ratified it. There are certain technical issues that we have to address before we proceed to ratification. The noble Lord, Lord Rosser, mentioned the position of Barnado’s and the local authority organisations. As I indicated, we are supporting them financially and liaising with them.

On the question of learning from other jurisdictions, the Home Office’s FGM unit, set up in 2004, leads the Government’s policy on FGM. That includes approaching officials in other countries to share learning and best practice. Indeed, we hosted an EU learning forum, funded by the European Union Commission earlier this year, to address the issues surrounding FGM. A process is going on in Europe to try to learn from those who are perhaps slightly ahead of us.

My noble friend Lord Smith mentioned other forms of violence against women and girls, such as breast ironing. Clearly, that is a form of child abuse. Our cross-government strategy on violence against women and girls, published on 8 March, sets out our approach to these issues. We continue to be concerned with addressing and dealing with them.

The noble Baroness, Lady Finlay, raised the question of further awareness in the approach to the summer vacation. In fact, we have recently pursued further steps on awareness. To raise awareness, we have been carrying out an ongoing programme of outreach to local areas, professionals, and community groups. That has been made available on the GOV.UK website. Furthermore, on 1 April this year the Government published a statutory multiagency guidance on FGM, setting out the expectations on all professionals, including teachers, regarding prevention of this terrible crime.

I will not detain noble Lords further, as I keep being passed notes with “Time” on them. Time is relative, but time has come. If there are questions I have not answered, I am happy to write to noble Lords. I am obliged to your Lordships.

House adjourned at 7.19 pm.