From 31st October 2015 it has become a mandatory duty in England and Wales for health and social care professionals and teachers to report any ‘known’ cases of Female Genital Mutilation (FGM) to the police. Those registered with the General Osteopathic Council and the Health and Care Professions Council are specifically mentioned in the list of registering bodies in the government document. In this article we will first of all consider the requirement and then risk factors and identification of FGM followed by some useful resources.
You must make a report if you are either:
- Informed by a girl under 18 that FGM has been carried out on her
- Observe physical signs that an act of FGM has been carried out on a girl under 18 years of age
N.B. the duty applies to the age when the disclosure occurs so if an adult discloses she had FGM when under 18 the duty does not apply.
It is a personal duty for the practitioner to whom the disclosure was made to report. There are no breaches of confidentiality in disclosing FGM in under 18s. In over 18s local safeguarding procedures should be applied.
Reports should be made by the close of the next working day after disclosure or suspicion. The exceptions to this are if disclosure would cause an immediate safeguarding risk to the child. It would be best to discuss the case with your local safeguarding agency and keep clear records.
Reports must be made directly to the police – verbally or written. Keep a record of the reference number for the case and your actions. Dialling 101 will take you through to your local police force.
You will need to inform the child’s family that you are making the report – why and what it means. This must not be done if it will put the child at risk – take advice from your local safeguarding board.
Failure to comply with the duty may be considered through fitness to practice proceedings by the regulator. The General Osteopathic Council has not yet given advice on this issue but it is covered under the Safeguarding duty – C8 3. You must comply with the law to protect children and vulnerable adults
Countries where FGM is high risk
FGM is a cultural practice for specific populations in many African countries and parts of the Middle East and Asia. It is estimated 100 to 140 million girls and women have experienced FGM.
Countries include Iraq, Israel, Oman, the United Arab Emirates, the Occupied Palestinian Territories, India, Indonesia, Malaysia and Pakistan. The highest risk African countries include Egypt, Somalia, Sudan, Ethiopia, Mali, Guinea, Sierra Leone, Burkina Faso, Gambia and Chad.
In the UK FGM is identified amongst migrants from high risk countries.
Risks of FGM
Country of origin – high risk
Girl born to a woman who had FGM
Girl with a sister who has already had FGM
Girls in age bracket 5 – 8 years (although FGM takes place up to age 15 in some communities)
Girls being taken overseas to the country of origin
Indications FGM has already taken place
Girl with difficulty standing, sitting or walking, and looks uncomfortable
Frequent urinary, menstrual or stomach problems
Pelvic pain or discomfort
Pain during intercourse
It is incumbent upon professionals to be able to identify children at risk of FGM and know how to respond. I would highly recommend taking the time to watch this free short training presentation from Health England:
Other key government documents are:
FGM Mandatory Reporting Procedural Information from the Home Office
FGM Multi-agency Practice Guidelines – more indepth information about identifying and responding to FGM disclosure by women and girls.
I would also strongly recommend that you find out the contact details for your local Safeguarding board as is necessary for your general safeguarding duties.
This is an important responsibility placed upon health professionals in the fight against FGM. Take steps now to educate yourself and make sure you are prepared to take action should the need arise.