The document discusses female genital mutilation (FGM), including definitions, prevalence statistics, UK laws prohibiting FGM, and strategies for tackling FGM in the UK such as treating it as child abuse, empowering professionals, and implementing awareness campaigns. It also outlines the mandatory reporting duty for regulated health and social care professionals and teachers to report identified cases of FGM in girls under 18 to the police.
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Female Genital Mutilation
April 2016
Carmel Bagness
RCN Professional Lead Midwifery & Women’s Health
Female Genital Mutilation
WHO (2000) defines FGM as
‘procedures involving partial or total removal of
the external female genitalia or other injury to
the female genital organs whether for cultural,
religious or other non-therapeutic reasons’.
200 million worldwide (UNICEF 2016)
http://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD.pdf
137,000 women and girls living in the UK who
have been affected by FGM Macfarlene (2015)
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UK Law
Acts of Parliament have made it a criminal
offence for anyone to perform, aid, abet,
or counsel to procure FGM in the United
Kingdom.
It is also illegal to take a child out of the
country to perform FGM.
Prohibition of Female Circumcision Act 1985
Female Genital Mutilation Act 2003. The 2003 Act applies to
England Wales and Northern Ireland. Scotland has passed the
Prohibition of Female Genital Mutilation (Scotland) Act 2005.
Serious Crime Act 2015
Tackling FGM in the UK
1. Treat it as Child Abuse
2. Document and collect information
3. Share that information systematically
4. Empower frontline professionals
5. Identify girls at risk and refer them as
part of child safeguarding obligation
Tackling FGM in the UK
6. Report cases of FGM
7. Hold frontline professionals
accountable
8. Empower and support affected girls
and young women (both those at risk
and survivors)
9. Implement awareness campaign
http://www.rcn.org.uk/__data/assets/pdf_file/0004/547996/Tackling_FGM_in_the_
UK_Intercollegiate_recommendations_for_identifying,_recording_and_reporting.p
df
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What is happening in England?
Department of
Education
Department
of Health
Ministry of
Justice /
Home Office
Department of International
Development /Foreign &
Commonwealth Office
Guidance for
teachers
including
nursery schools
National
FGM
Programme
Law enforcement,
including
prosecutions
UK Borders Agency
International Campaign
: £35 million
programme to support
an Africa led movement
to end FGM –
supporting 17 countries
NHS England:
Operational
strategy for
implementation
across Health &
Social Care
Public Health
England –
Safeguarding
Health Education
England – multi
professional e
learning modules
and the rest of the UK…………
Wales
Scotland
Northern Ireland
Royal Colleges
and Professional
Organisations
Doctors, nurses,
midwives, police,
teachers, social
workers
Women and
girls, fathers,
partners families
communities and
support groups
Media & Public
Awareness
Nurses & Midwives
understanding FGM
and the safeguarding
procedures to support
best practice
MESSAGES : Health & Social Care
Professional Curiosity
Understanding the local community
Safeguarding Procedures
Protection of women and girls
Mandatory Reporting
Data Collection and Use
Service Provision – Physical &
Psychological, Psycho sexual Care
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Serious Crime Act (2015) – Changes to FGM Act 2003
– Clause 68: Anonymity for victims
– Clause 69: Offence for failing to protect
– Clause 70: Protection orders
– Clause 74: Mandatory Duty
Serious Crime Act 2015 introduced a new
duty for regulated health, social care and
teaching professionals to report cases of FGM
when identified in a girl under 18 or disclosed
by her to a professional and to the police.
Applies to England and Wales only
Female Genital Mutilation (FGM) is
child abuse and illegal.
Regulated health and social care
professionals and teachers are
required now to report cases of FGM in
girls under 18s which they identify in
the course of their professional work
to the police.
This is a personal duty; it cannot be
transferred to anyone else.
What do I need to do?
Discuss with local safeguarding lead to identify if
there are other safeguarding action required, and
how these will be taken forward
Telephone ‘101’, the non-emergency crime number
Make a record of your actions, and write down the
Police reference number
Make sure that you / someone with access to all
the information is available to discuss further with
the police lead investigator
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Which cases does this cover?
Within scope of DUTY
Girls under 18 who disclose they
have FGM
– Using all accepted terminology
Cut
Circumcised
Sunna
Other words – link to the list
When you see physical signs
appearing to show she has had
FGM
– You have no reason to believe it
was for the girl’s physical or
mental health or for purposes
connected with labour or birth
– Remember this includes genital
piercings and tattoos for non-
medical reasons
Within scope of existing
safeguarding processes
Adult woman (18 and
over) has had FGM
Parent/guardian discloses
that child has had FGM
You believe a girl is at
risk of FGM
You think a girl might
have had FGM but she
has not disclosed, and
you have not seen any
signs/symptoms
What if I don’t make the report?
Failure to comply may be considered
through existing Fitness to Practise
proceedings with your regulator
Regulators will, as with all other matters,
consider professionals ability currently to
practise safely and take into account the
circumstances of the case.
The safety of the girl or other individuals at
risk of harm is paramount.
Mandatory Reporting duty
within Safeguarding context
FGM
happened
Suspected
Risk / sibling /
other types of
harm / other
considerations
FGM MR
Duty
EVERYTHING IS PART OF…
Safeguarding children
and vulnerable adults
from harm
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Enhanced Data Set
Safeguarding of girls and women
To improve Awareness
To enhance Provision of service
To improve management of FGM
Enhanced Data Set
mandatory data collection
General Practitioners, Mental Health Trusts and
Acute Trusts (mandatory since 1 July 2015).
Sexual health and GUM (Genito-Urinary Medicine)
clinics are required to have regard to the FGM
Enhanced dataset standard from October 2015.
The data collected - Health and Social Care
Information Centre (HSCIC), where it is anonymised,
analysed and published in aggregate form.
Ethical decision-making for doctors in the armed
forces: a tool kit
Guidance from the BMA Medical Ethics Committee
and Armed Forces Committee : Core principles
The actions of all military personnel, including medical personnel,
should at all times be both proportionate and just.
The conduct of military doctors should accord with the ethical
standards of civilian practitioners.
Medical care should be delivered according to clinical need,
impartially and without discrimination.
…. should not be involved in or cooperate with torture, or cruel,
inhuman and degrading treatment or punishment, which is illegal
in all circumstances.
…should report violations of ethics and applicable laws, or
practices that interfere with their ability to meet their ethical
duties, to the appropriate chain of command.
… must be able to justify any departure from accepted ethical
principles or guidelines
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Your role……………
Curiosity and Awareness
Encourage individuals to engage
Understand local implementation
Support National Campaigns
Collaboration and Multi agency working
Professional responsibility and duty to
care and protect.
