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Referrals for female genital mutilation must rise, say MPs

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4447 (Published 07 July 2014) Cite this as: BMJ 2014;349:g4447
  1. Clare Dyer
  1. 1The BMJ

Doctors and other health practitioners are failing girls at risk of female genital mutilation (FGM) and the UK government should make the failure of professionals to report concerns a criminal offence unless reports rise substantially, a committee of MPs has said.1

In a hard hitting report that denounces the practice as an “extreme form of child abuse,” the House of Commons home affairs committee called the UK’s failure to tackle FGM a “national scandal” and urged the adoption of a national action plan.

The report described the record of referrals of cases to social services by healthcare professionals as “extremely poor” and said many cannot even recognise the signs that a child is at risk. “It is unacceptable that those in a position with the most access to evidence of these crimes do nothing to help the victims and those at risk,” the MPs said.

The committee, chaired by the Labour MP Keith Vaz, said that healthcare professionals have a vital role in breaking the intergenerational cycle of FGM. The committee called for high quality training in the area for all professionals, including general practitioners, obstetricians and gynaecologists, midwives, health visitors, and teachers, to make referrals easier.

Unless referrals have risen significantly within 12 months the government should make it a criminal offence for professionals to ignore evidence of the practice, the committee said.

The MPs praised recent recommendations for tackling FGM from an intercollegiate group including the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, and the Royal College of Nursing, but said that the guidelines must be better publicised.2

About 170 000 women living in the UK are thought to have undergone FGM and some 13 000 girls are believed to be at risk, according to the report. But, although FGM has been a crime in the UK since 1985, the first two prosecutions were started only this year.3 This contrasts with the situation in France, where many successful prosecutions have had a key role in discouraging the practice.

If a woman has been mutilated or is from a country where FGM is practised, then her daughters and other young female relatives should be considered at risk, and preventive measures put in place, the report said. The FGM status of the woman and her intentions for her child if the baby is a girl should be a compulsory question at the antenatal booking interview.

When a girl is born to a woman who has undergone FGM or where there is perceived to be a risk to the child, the NHS should make a referral to safeguarding services so an action plan can be developed and implemented, the committee says. Such a plan is about to be piloted in London and the MPs urged a national roll out as soon as possible.

They also recommended that the Royal College of Paediatrics and Child Health amend the “red book,” given to every newborn’s parents and regularly updated by health professionals, to include a reference to FGM and any safeguarding steps. This would allow all those who come into contact with the child to monitor the ongoing level of risk.

Notes

Cite this as: BMJ 2014;349:g4447

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