Seven days in medicine: 28 November to 4 December 2018BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k5126 (Published 06 December 2018) Cite this as: BMJ 2018;363:k5126
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Re: Seven days in medicine: 28 November to 4 December 2018: Corrected figures show that numbers of reports of FGM have decreased rather than doubling
Like the BMJ, the Guardian reported an apparent more than doubling in the numbers of girls in England who experienced or were believed to be at risk of Female Genital Mutilation (FGM). (Guardian, November 30) This was also based on an ‘analysis’ by the Local Government Association. This was based on data in the Department for Education’s publication ’Characteristics of Children in need 2017 to 2018’. This publication reported on children referred to children’s social care and their assessments by children's social services for the year ending 31 March 2018.
It is a pity that the Local Government Association did not look more closely at the data before issuing a warning about a ‘worrying’ rise in numbers of cases of FGM. Its comments were based solely on national headline figures for England as a whole.1
A breakdown by local authority in Table C3 of the Department’s publication showed that while FGM was mentioned in the assessments of 1960 children referred for social care in England in the year ending March 18, 1023 of these reports came from a single authority, Northamptonshire.1 The corresponding table for the year ending March shows 970 children reported overall, with fewer than 5 from Northamptonshire.2
I sent a letter to the Guardian, suggesting that the figure of 1023 was unlikely and copied it to the relevant Department for Education statistical team. The Department’s statisticians asked Northamptonshire to check its data and a coding error was identified. After correcting for this, the revised figure was 8. This brought the total for England down to 940, meaning that far from doubling, numbers had fallen by 30. The Department revised its publication and logged the change.1 The LGA and the Guardian articles were removed and the Guardian published a correction. (Guardian, December 10) Meanwhile, a second Guardian article (December 6) about the work of the National FGM Centre continues to claim a doubling of the numbers. At the time of writing, it has not been removed, nor has my letter been published.
It is important to note that the data in the Department for Education’s publication are not a count of numbers of girls who had been subjected to FGM. Local authorities are asked to report up to five ‘additional needs’ which were mentioned during each child’s social work assessment. This means that it is not in a position to distinguish between children who may have been directly threatened with FGM, children who may have been born elsewhere but undergone it before arriving in England, children who may have actually been taken abroad for FGM or children who were reported just because they were born to mothers with FGM.
In all of this, the main messages of the Department for Education’s publication, relating to children in need seem to have been ignored. It opened by stating that ‘The number of children in need at 31st March has increased this year, from 389,040 in 2017 to 404,710 in 2018, an increase of 4.0%.’1 For 53.2 per cent of these children referred, abuse or neglect was the ‘primary need’. Domestic violence was mentioned as an ‘additional need’ for 51.1 per cent of children and mental health for 42.6 per cent, while children for whom FGM was mentioned accounted for only 0.2 per cent.
Competing interests: No competing interests
This week's BMJ carries news that reported cases of FGM in England more than doubled in a year citing findings from the Local Government Association. This report is problematic on two scores. Firstly, we know from previous NHS Digital reports on FGM prevalence in England that the overwhelming number of women and girls living with FGM underwent the procedure prior to coming to the UK. Such data does not necessarily reflect children who have just undergone FGM. In failing to explain the data behind their headline, the BMJ unwittingly contributes to unhelpful sensationalism around FGM- namely, that there is an epidemic of FGM happening on our shores. There is not. Improved reporting of existing cases of FGM does not equate to increased occurrence of FGM.
The second and perhaps more telling issue is that, since the BMJ went to press, the Local Government Association have withdrawn the report from its website. While there is no explanation for this action on the site, it appears that there was a "fundamental error in the official data on which it was based" (Guardian, December 7th 2018).
Competing interests: No competing interests