04.11.13
Joined-up action needed against FGM
Health professionals must recognise that female genital mutilation (FGM) is child abuse and not a cultural issue, a group of royal colleges, trade unions and equality groups have urged.
NHS staff must report any suspicions they have of girls at risk, the action group says.
Its new report sets out nine recommendations to develop a comprehensive multi-agency action plan to protect young girls, including tackling the lack of consistent data around FGM in the NHS, and integrating a strategy into all UK child safeguarding procedures.
The government must implement a national FGM awareness campaign, and frontline health professionals must be held accountable for reporting suspicions. Information should be shared systematically to help identify girls at risk and refer them as part of the child safeguarding obligation.
Gaps in the responsiveness of the health and social care system were also criticised by the report, with no joined-up work for early identification or long-term prevention. The system is “failing girls” with an absence of accountability on performance.
Specific legislation has banned FGM in the UK since 1985 but over 24,000 girls under 15 are potentially at risk of the practice.
Public health minister Jane Ellison, said: “Female genital mutilation is illegal and we have to both safeguard girls from this form of child abuse and address the longer-term health needs of those girls and women living with FGM. We are already working actively with the Health and Social Care Information Centre to look at how best the NHS could collect and share data and I am working hard, with colleagues across Government, to protect future generations of girls from this abhorrent practice.”
The Royal College of Midwives chief executive Cathy Warwick welcomed the strategic action and said: “We cannot expect communities or girls and young women tackle this issue by themselves. FGM robs girls of their childhood and it is an abuse of their human rights. This is why we must work collaboratively to ensure that these recommendations, aligned to current policy frameworks, are implemented and monitored. I applaud the coalition for its hard work.
“FGM is a violation of children and women’s human rights, and there is a real need to raise awareness about the damage that FGM can do to young girls and women within the communities that practise it.”
Efua Dorkenoo, OBE, advocacy director of FGM Programme, Equality Now, said: “The UK is well on its way to developing a 'joined-up' response to FGM, which will ensure that existing prevention and prosecution measures are properly implemented in a coordinated way.
“However, we need to re-double our efforts to ensure that the right systems are institutionalised, that the correct data is gathered and shared and that every front-line professional knows what action they need to take to ensure that girls at risk of undergoing FGM are fully protected from the moment they are born”.
Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists (RCOG), said: “FGM is violence against women and we must find ways to eradicate this harmful and unacceptable practice.
“It is the duty of all healthcare professionals to identify the girls whom they believe are at-risk and to share such information in good faith with the local safeguarding networks so these girls can be monitored and protected by social services. Such an approach follows the life-course model of health and social care that the RCOG advocates.”
Dr Deborah Hodes, consultant community paediatrician from the Royal College of Paediatrics and Child Health, said: “It is crucial that all paediatricians have the confidence to talk to parents about the issue and the ability to recognise the signs and respond appropriately when the child is at risk. They must also understand which children are most vulnerable.”
The Royal College of Nursing’s director of nursing Janet Davies said: “All health and social care professionals have a responsibility to do all they can to identify and prevent this abuse. This important guidance makes it clear that nurses, midwives and doctors must work with the police, teachers and social services when they have concerns.
“These intercollegiate recommendations will help create systems that will work to identify and report suspected cases of at risk girls, or where this abuse may have taken place.”
The report’s nine recommendations are:
- Treat it as child abuse: FGM is a severe form of violence against women and girls. It is child abuse and must be integrated into all UK child safeguarding procedures in a systematic way.
- Document and collect information: The NHS should document and collect information on FGM and its associated complications in a consistent and rigorous way.
- Share that information systematically: The NHS should develop protocols for sharing information about girls at risk of – or girls who have already undergone – FGM with other health and social care agencies, the Department for Education and the police.
- Empower frontline professionals: Develop the competence, knowledge and awareness of frontline health professionals to ensure prevention and protection of girls at risk of FGM. Also ensure that health professionals know how to provide quality care for girls and women who suffer complications of FGM.
- Identify girls at risk and refer them as part of child safeguarding obligation: Health professionals should identify girls at risk of FGM as early as possible. All suspected cases should be referred as part of existing child safeguarding obligations. Sustained information and support should be given to families to protect girls at risk.
- Report cases of FGM: All girls and women presenting with FGM within the NHS must be considered as potential victims of crime, and should be referred to the police and support services.
- Hold frontline professionals accountable: The NHS and local authorities should systematically measure the performance of frontline health professionals against agreed standards for addressing FGM and publish outcomes to monitor the progress of implementing these recommendations.
- Empower and support affected girls and young women (both those at risk and survivors): This should be a priority public health consideration; health and education professionals should work together to integrate FGM into prevention messages (especially those focused on avoiding harm, e.g. NSPCC ‘Pants’ Campaign, Personal, Social and Health Education, extracurricular activities for young people).
- Implement awareness campaign: The government should implement a national public health and legal awareness publicity campaign on FGM, similar to previous domestic abuse and HIV campaigns.
Tell us what you think – have your say below, or email us directly at [email protected]
(Image copyright Rufai Ajala, used here under a Creative Commons licence)