What practitioners need to know about FGM mandatory reporting

Neil Puffett
Tuesday, March 3, 2015

In a bid to end female genital mutilation, the government plans to introduce legislation before the general election to make reporting of FGM mandatory. But what are the implications for children's professionals?

The government is due to publish a green paper by the end of the year detailing plans to improve children's mental health services. Picture: Shutterstock
The government is due to publish a green paper by the end of the year detailing plans to improve children's mental health services. Picture: Shutterstock

News last month that the government wants to introduce legislation before May's general election to make reporting of female genital mutilation (FGM) mandatory will have far-reaching implications for the children and young people's sector.

Within a matter of months, children's social workers, teachers and health professionals face possibly losing their job if they fail to report cases.

Here, CYP Now answers some of the key questions on the matter.

Why is FGM reporting being introduced?

The government wants to secure more convictions for FGM, pointing to the disparity between prevalence data on FGM and the low number of referrals to the police.

It says the new duty will be an important step forward in tackling FGM, giving professionals the confidence to confront the issue and contact police, ultimately leading to more prosecutions. It says processes around the duty will ensure that for every case reported, there is a "robust and appropriate safeguarding response put in place".

"Ultimately, we believe that, taken together with the wider package of reforms that the government has introduced to end FGM, introducing a new duty will play an important role in deterring perpetrators and preventing this appalling crime from happening," the government says.

Who will have a duty to report?

The new mandatory reporting requirement will apply to all regulated healthcare and social care professionals, and teachers, on the basis that these groups are the most likely to encounter cases of FGM in the course of their work.

The government is keen to stress that the requirement does not mean that there is no responsibility on non-regulated practitioners to report FGM where it is disclosed or visually identified.

Updated multi-agency guidelines, which will be statutory, will identify good safeguarding practice for non-regulated practitioners.

When will professionals have to report?

Professionals will only be required to report "known" cases of FGM - instances which are disclosed by the victim or are visually confirmed - rather than "suspected" cases. The government concedes that teachers and social care staff will be less likely to see visual evidence of FGM than healthcare professionals.

"We are clear that introducing this duty will not mean that there is a new requirement for professionals to look for visual evidence," the government states.

"They will only be expected to report known cases which they encounter in the course of their usual professional duties."

Professionals will still be expected to refer "suspected" or "at risk" cases appropriately, as set out in the updated multi-agency guidelines on FGM, using existing safeguarding procedures.

The reporting requirement will also be limited to victims under the age of 18 due to concerns that extending it to adults could risk deterring women from seeking medical advice and assistance.

Potential for conflict between the duty and patient confidentiality responsibilities were also a concern, but the government has said it will keep the area under review.

Who do professionals have to contact?

Reports will have to be made to police within one month of the initial disclosure or identification. Some respondents to the consultation on the proposals felt that, because there will be safeguarding as well as criminal factors, it would be better to report cases through social care, rather than the police.

However, the government says this is trumped by the need for a "simple reporting duty that professionals can understand" and is "consistent across different sectors".

"We believe that because FGM is a criminal offence, it is most appropriate for reports to be made to the police," the government says.

"When a report is made, the police will then work with the relevant agencies to determine the most appropriate response.

"In preparing to introduce the duty, the government will work with the police to ensure that a clear reporting system, involving specialist teams, is put in place."

In addition, it says the newly formed FGM Unit, which will co-ordinate implementation of the measures, will also work with local communities and professionals "to explain the duty and its primary focus on safeguarding girls and women, thereby managing any anxieties or concerns which could prevent communities from engaging with vital services".

In relation to the one month time limit, the government states that this should be the maximum time frame within which a report should be made, and it expects the vast majority of reports to be made within shorter timescales.

"A longer time frame may be appropriate in exceptional cases where a professional is concerned that a report to the police may result in an immediate safeguarding risk to the child and considers that consultation with colleagues or other agencies is necessary prior to the report being made," the government states.

"The guidance will make clear this expectation and the types of exceptional case where a longer time frame may be warranted."

What if professionals fail to report FGM?

Failure to comply with the new law will not be a criminal act, but could lead to a professional losing their job.

Instead, it will be dealt with via existing disciplinary frameworks.

The government says this will ensure failure to comply with the duty is dealt with appropriately and in accordance with the specifics of the individual case.

"The government will work closely with the bodies responsible for sanctions to ensure that they have due regard to the seriousness of breaches of the duty and take account of all relevant factors when handling cases of failure to report," the government says.

"We will also make clear the expectation that they should have appropriate regard for the importance of transparency in relation to numbers of referrals."

FGM IN NUMBERS

£2m - The amount of money awarded to the Local Government Association and Barnardo's to set up a national network of FGM community outreach services

467 - Number of patients treated at acute NHS hospital trusts in England in one month who were identified as being been victims of FGM

1 - The number of FGM prosecutions brought under 2003 legislation. The defendant was quickly acquitted by a Southwark Crown Court jury last month

Source: Health and Social Care Information Centre

EXPERT VIEW: FGM MANDATORY REPORTING IS UNNECESSARY AND POTENTIALLY DAMAGING

Dr Geoff Debelle, child protection officer for the Royal College of Paediatrics and Child Health

Female genital mutilation (FGM) has been high on the political and media agenda over the past year, not least since the Prime Minister's Girl Summit in July, which pledged a "future free of FGM".

Subsequently, there have been real efforts by the government and other stakeholders - through the Department of Health's FGM Prevention Programme and e-learning resources - to significantly improve the ability of healthcare professionals to identify and respond to FGM.

However, the end of 2014 heralded a government consultation on how mandatory reporting of FGM to the police by healthcare professionals should be implemented.

For those of us working in child protection, this decision to introduce what we feel is a blunt legislative instrument, without sufficient evidence as to its effectiveness, is concerning.

Let's be clear - FGM is gender-based violence and therefore is a form of child abuse. And like every other incidence of child abuse, every effort must be made to stop it. But we have real concerns about mandatory reporting to the police as the solution.

All NHS bodies and all health professionals already have a duty to safeguard children and young people. There is no solid evidence to date which suggests that healthcare staff in the UK are not reporting FGM when they encounter it.

Of course cases can be subsequently followed up by a police investigation, but by referring to the statutory agencies first, it means the individual needs of that child come first and additional support put in place to ensure that continues to be the case.

We also worry that the introduction of mandatory reporting of FGM would undermine a community approach of working together and sharing of risk and responsibility that has been developed in the current system.

And we envisage other unintended consequences. Perhaps most worryingly, this could result in a significant deterrent for young girls accessing health services. They may be discouraged from reporting abuse because of concerns about being catapulted into a criminal investigation - a particular risk given that girls who have undergone FGM are likely to need a range of physical and psychosocial support.

There is a risk that the introduction of mandatory reporting for FGM may also create a hierarchy of abuse, with mandatory reporting for one type of child abuse and not another.

This in turn, could lead to a variation in response and care received by vulnerable children and young people in need of safeguarding.

In our view, there has not been enough research or consideration given to the possible consequences of this proposed legislation on the health seeking behaviours of young girls and their families.

We need to conduct further research into FGM in the UK to fully understand the prevalence and the population group at risk. From that, we need to look at appropriately targeted initiatives - because ultimately, the best interests of the child have to come first.

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