Female genital mutilation (FGM), also referred to as ‘cutting’ (World Health Organization (WHO), 2018), has become an area of increasing concern in the UK and other developed countries due to migration, particularly from sub-Saharan Africa (Bewley et al, 2010). However, in the 28 countries for which statistics are available, the incidence varies considerably, from less than 1% of the female population in Uganda to almost 98% of women in Somalia (WHO, 2012). It can be assumed therefore, that prevalence in the UK and other Western countries is closely related to patterns of migration and asylum. While FGM has been illegal in the UK since 1985, and taking children abroad for the procedure a criminal offence since 2003, British-born girls are still being cut, with 112 cases reported in 2016-2017 (Moffat, 2017). Altogether, more than 5000 new cases were reported during the same time span, although most of these were in girls and women born outside the UK. Research by City University in 2015 estimated that there were more than 100 000 women between the ages of 15-49 living in the UK who have had FGM (Macfarlane and Dorkenoo, 2015; Cook, 2016). Such statistics demonstrate the importance of ongoing investigation into how and where girls and women are being subjected to FGM, despite legislation prohibiting both the procedure and foreign travel for the purpose of FGM.
This issue is of concern to all health professionals, not just those who may be involved in protecting the health of women and girls. Nevertheless, midwives have a particular responsibility, as they often make the initial contact with women from communities where FGM is prevalent.
Midwives are educated to be skilled communicators and to engage with women empathetically within a framework of cultural, ethnic and religious diversity. What midwives may lack, however, is an understanding of the legal requirements regarding accountability for documenting and/or reporting cases of FGM, or of their safeguarding responsibilities where there are concerns that a family may wish to have an infant, pre-adolescent or adolescent daughter ‘cut’, either by a practitioner in the UK, or while travelling abroad, both of which are illegal under UK law.
This article should interest all health professionals by increasing their understanding of the legal implications of FGM and how UK police authorities have responded to changes in the law. It will be of particular interest to midwives wishing to deepen their understanding of the legal and ethical implications attached to FGM in addition to the physical, social and psychological implications with which they may already be familiar.
Focus of this paper
This paper focuses on data collection for FGM since the introduction of mandatory recording and reporting by the Serious Crime Act 2015, which amended the Female Genital Mutilation Act 2003.
Point 55 from the UK Government Violence against Women and Girls Strategy 2016-2020 action plan (HM Government, 2016) reads as follows:
‘Develop an approach to the collection of data recorded by Police Authorities in relation to Honour Based Violence (HBV), Forced Marriage (FM) and Female Genital Mutilation (FGM) in conjunction with the National Police Chiefs' Council. Consideration will be given to this data being recorded as part of the Annual Data Return.’
Legislation
The Female Genital Mutilation Act 2003 defines FGM as any procedure where a person ‘excises, infibulates or otherwise mutilates the whole or any part of a girl's labia majora, labia minora or clitoris’, consistent with WHO (2018) guidance. Performing such a procedure on a female of any age is a criminal offence, and liability falls on the cutter, accessories and, in rare cases, the female herself. The provisions cover acts performed in England and Wales or overseas (as long as the girl is a UK resident). The change from ‘citizen’ to ‘resident’ in 2014 provided protection for all female children in the UK. There is an exception in the legislation (Sections 1(2) and 1(3)), for operations by approved practitioners as part of childbirth or necessary for her physical or mental health. In the context of what may be necessary, it is immaterial whether she or any other person believes that the operation is required as a matter of custom or ritual. However, if a woman requires cutting in an obstetric setting in order to facilitate childbirth, under the law midwives and obstetricians may not return a woman's vulva to the infibulated state that existed before opening for childbirth (Rashid and Rashid, 2007).
Health consequences of FGM
The immediate health consequences of FGM include severe pain, significant risk of damage to the urinary tract, bleeding, infection, and possible death. Long-term consequences include chronic pain, painful intercourse, urinary incontinence, recurrent urinary tract infections, complications of childbirth, and keloid scar formation (WHO, 2018). Complications of childbirth include obstructed labour, fetal hypoxia, stillbirth, severe perineal tears, infection and haemorrhage (Rashid and Rashid, 2007). For this reason, maternity care providers recommend early identification of women who have undergone FGM so that prenatal de-infibulation can be offered. While this cannot restore the vulva to its original state, it reveals the vaginal and urethral openings, thereby reducing complications during childbirth. This should be done by week 20 of the pregnancy to ensure healing before giving birth (Albert et al, 2015).
Incidence and prevalence of FGM
In 2011, it was estimated that there were 137 000 women and girls affected by FGM living in England and Wales (Macfarlane and Dorkenoo, 2015; HM Government, 2016). More recently, there were 5391 new cases of FGM recorded in England and Wales from April 2016 to March 2017. FGM was most commonly performed when the victim was a child aged between 5 and 9 years old (NHS Digital, 2017), and guidance is to treat FGM as a form of child abuse (National Society for the Prevention of Cruelty to Children (NSPCC), 2018). Investigations have included an unsuccessful prosecution of a medical practitioner (Rogers, 2015).
Mandatory reporting of FGM versus mandatory recording of FGM
Mandatory reporting of FGM
Health and social care professionals and teachers have had a mandatory duty to report FGM cases to the police since October 2015 (Home Office, 2016). Mandatory reporting applies in cases when either a girl informs the professional that FGM has been carried out on her, or when a professional observes physical signs consistent with FGM. The duty only applies when the girl is aged under 18 years of age at the time of disclosure or identification. Following receipt of a report, police should initiate a multi-agency response in line with local safeguarding arrangements. Data are limited as to whether mandatory reporting, in the manner which it is applied, is successfully safeguarding girls and women at risk of FGM in the UK.
Mandatory recording of FGM
Separate from the duty of mandatory reporting to police, there is also a duty of mandatory recording. As of April 2015, all acute NHS Trusts and GPs have a duty to submit details of all diagnosed FGM cases, in girls and women of any age, to the Health and Social Care Information Centre (HSCIC) (NHS England, 2015). The data collected by the HSCIC are comprehensive and include anonymised patient demographic information, the type of FGM identified, the age at presentation and the age at which FGM was done, family history of FGM, and limited obstetric history (NHS Digital, 2017). It also includes whether or not the woman has any daughters. These data have invaluably aided the understanding of the prevalence of FGM in the UK, particularly in locating vulnerable populations and in highlighting the extent of the problem in this country. Since mandatory reporting to the police only applies in relation to girls under the age of 18, it remains to be seen how the HSCIC data of recorded cases of FGM will be used to influence policy and protect all of vulnerable people identified.
In essence, the mandatory reporting duty for individuals is about reporting a crime in relation to a child aged under 18 years of age (Department of Health and NHS England, 2015). The mandatory recording duty for organisations is about collecting and recording data on FGM, including children aged under 18 years of age and adults aged over 18 years of age, many of whom, if they have undergone FGM, will have had this performed as a child.
History of criminal investigations
Where criminal investigations have taken place, barriers to formal charges and/or prosecution have included (Simpson et al, 2012):
Prosecution follows acts of mutilation, so agencies including Amnesty International advocate that the prevention of FGM should be prioritised through a collective approach, which involves raising awareness of women's rights, of the effect of FGM on women and on the community as a whole with the aim of a collective abandonment of the practice (Amnesty International EU Office, 2011).
FGM preventative action
One example of preventive action taken in relation to FGM is Project Azure, a UK-based initiative in which the Metropolitan Police Service (Metropolitan Police Authority, 2010) joined forces with partner agencies to reach out to families from FGM-practising communities. Project Azure aims to educate parents and families about the health and legal implications of FGM while simultaneously empowering children at risk for the practice (Metropolitan Police, 2018).
‘As of April 2015, all acute NHS Trusts and GPs have a duty to submit details of all diagnosed FGM cases, in girls and women of any age’
Why is scientific analysis of FGM data important?
Given that healthcare and human rights experts have raised concerns regarding barriers to its success and alternative strategies, it is imperative that the data on FGM reporting from police authorities in the UK are analysed, as by understanding the impact of mandatory reporting and recording of FGM, the question of whether the incidence of FGM has decreased since mandatory reporting and recording were introduced can be considered, as well as what changes, if any, may be required.
This study was designed to look at the number of FGM cases that were reported to the police prior to the introduction of the mandatory reporting of FGM in the UK in October 2015 and following the introduction of that legislation to try and, initially, ascertain what impact that legislation had had on the reporting of FGM. This was a precursor to using the data supplied to conduct an impact and outcome evaluation of the introduction of the FGM-reporting legislation.
Method
E-mail requests were sent to all 45 UK police authorities (Police.UK, 2018) under the provisions set out in the Freedom of Information Act 2000, asking the following three questions:
Request one
Please supply data on how many cases of Female Genital Mutilation (FGM) were reported to your police force each month between 31 October 2015 and today's date (21 February 2016), stratified, if possible, by age of alleged victim and occupation of person making the report?
Request two
Please can you supply data on how many cases of FGM were reported to your police force each month between 31 October 2014 and 31 October 2015, stratified, if possible, by age of alleged victim and occupation of person making the report?
Request three
Please can you supply data on the age-breakdown, sex-breakdown and total population of your police force area in 2014 and 2015? If it is not possible, or you do not hold this data, please let me know as I would not wish this to detract from the above two requests.
The nature of the above Freedom of Information requests was designed to obtain information about cases of FGM reported to the police under the individual mandatory reporting duty.
Similar requests were also sent to NHS England, the Home Office, the HSCIC and the Department of Health, asking how many cases of FGM had been reported to their organisations within the above timescales. The nature of these requests was to obtain information on FGM which may have been reported under the organisational mandatory recording duty. The Office for National Statistics was asked to supply data on the age-breakdown, sex-breakdown and total population of each local authority area.
Analysis of FGM data from police authorities
Where FGM data was received from police authorities, it was entered into a Microsoft Excel spreadsheet for analysis. Where a rejection notice was given (i.e. no or limited data were supplied) this was saved and an internal appeal lodged under the provisions set out in the Freedom of Information Act 2000. If data were supplied following a successful internal appeal, those data were included in the Excel spreadsheet. If the appeal was rejected, the reasons were saved.
Limitations
Formal requests were made to all 45 UK police authorities under the Freedom of Information Act 2000 and all internal appeal procedures were followed, where necessary, if a negative response was received to the first request. However, there was no escalation to the Office of the Information Commissioner when internal appeal requests were rejected. While such an appeal to the Office of the Information Commissioner may have been legally possible, the focus of enquiries was on the ease, or otherwise, with which such important data could be accessed and analysed. Appeals took on board that the way in which data were collected may contain private data that would require ethical approval to access. This study showed that, for an academic attempting to evaluate the introduction of mandatory reporting of FGM, or for a member of the public with an interest in this subject area—perhaps wishing to express a view on the recent 2016 consultation on generic mandatory reporting of child abuse (Department for Education and Home Office, 2016)—information on FGM was difficult, if not impossible, to obtain.
Results
Organisations providing data
Of the 45 police authorities in the UK, six (13.3%) initially provided data in response to the Freedom of Information request. Of these, three authorities (British Transport Police, Ministry of Defence Police and Civilian Nuclear Constabulary) reported that no cases of FGM had been reported to them between 31 October 2014 and 21 February 2016. The remaining three authorities who disclosed data confirming the number of FGM cases that had been reported to them were the Metropolitan Police Service, Police Scotland and Greater Manchester Police.
Information received from the Metropolitan Police Service
Although the Metropolitan Police Service provided some data, it declined to provide data on FGM reporting that was stratified by month, age of victim, or occupation of person making the report. From the data that were provided with regards to victims of FGM aged over 18 years of age, it was not clear as to whether the FGM was performed when the victim was a child or an adult (Table 1).
| Allegations | Offences | Victims under 18 years of age | |
|---|---|---|---|
| 2014 | 83 | 17 | 10 |
| 2015 | 117 | 17 | 12 |
| Total | 200 | 34 | 22 |
Information received from Police Scotland
Police Scotland provided a detailed response to the Freedom of Information request, including a monthly breakdown of incidents of reported FGM, and a separate breakdown of the ages of the victims overall (Table 2). It could not provide data on the occupations of those reporting FGM. In total, Police Scotland had 33 FGM incidents reported between October 2014 and February 2016, with 3 of these relating to unborn children at risk of FGM, 28 relating to children aged under 18 years of age and 2 relating to adults aged over 18 years of age. It is not clear from the data provided by Police Scotland in relation to those victims of FGM aged over 18 years of age whether the FGM was performed as a child or as an adult.
| Month | Number of incidents reported |
|---|---|
| Oct 2014 | 0 |
| Nov 2014 | 3 |
| Dec 2014 | 0 |
| Jan 2015 | 3 |
| Feb 2015 | 3 |
| Mar 2015 | 1 |
| Apr 2015 | 3 |
| May 2015 | 1 |
| Jun 2015 | 5 |
| Jul 2015 | 2 |
| Aug 2015 | 0 |
| Sep 2015 | 3 |
| Oct 2015 | 0 |
| Nov 2015 | 5 |
| Dec 2015 | 1 |
| Jan 2016 | 1 |
| Feb 2016 | 2 |
| TOTAL | 33 |
Information received from Greater Manchester Police
Greater Manchester Police provided detailed breakdowns of 77 cases of FGM by month, age of victim, and occupation of person reporting (Table 3 and 4).
| Date | Victims aged under 18 years of age | Victims aged over 18 years of age | Incidents where age unknown (or relating to an unborn child) |
|---|---|---|---|
| Oct 2014 | 2 | 2 | 2 |
| Nov 2014 | 1 | 0 | 0 |
| Dec 2014 | 2 | 0 | 0 |
| Jan 2015 | 1 | 0 | 0 |
| Feb 2015 | 0 | 0 | 0 |
| Mar 2015 | 4 | 0 | 0 |
| Apr 2015 | 3 | 0 | 0 |
| May 2015 | 1 | 0 | 0 |
| Jun 2015 | 2 | 0 | 3 |
| Jul 2015 | 8 | 0 | 0 |
| Aug 2015 | 6 | 0 | 0 |
| Sep 2015 | 1 | 0 | 0 |
| Oct 2015 | 10 | 0 | 1 |
| Nov 2015 | 6 | 0 | 2 |
| Dec 2015 | 6 | 0 | 2 |
| Jan 2016 | 6 | 0 | 3 |
| Feb 2016 | 3 | 0 | 0 |
| Total | 62 | 2 | 13 |
| Occupation | Total |
|---|---|
| Midwife | 18 |
| Social worker | 17 |
| School nurse/teacher | 12 |
| Health visitor | 11 |
| Police officer | 8 |
| GP | 4 |
| Charity worker | 3 |
| Nurse | 2 |
| Nursery nurse | 2 |
It was not clear from the data provided by Greater Manchester Police in relation to those victims of FGM aged over 18 years of age whether the FGM was performed as a child or as an adult.
Of the 45 police authorities in the UK, the remaining 39 (86.7%) police authorities supplied only partial information, either on initial request or after an appeal, or refused to supply any information.
Organisations declining to provide information
Of the 45 police authorities, 9 (20%) initially rejected the Freedom of Information request but opted to provide some data, either in an initial response, or on appeal, as part of their stated duty to assist. Although some data were provided, this did not fully respond to the questions asked within the Freedom of Information request.
Norfolk and Suffolk Constabularies
Norfolk Constabulary consented to give only aggregate data on reporting per year. It confirmed that there were 4 incidents of FGM reported to Norfolk Constabulary in 2014, and 13 cases in 2015. Suffolk Constabulary gave identical data. It was not clear if this was pooled data.
North and South Wales Police
North and South Wales police authorities refused to comment on whether there were any cases reported to them between 31 October 2015 and February 2016; however, both forces confirmed that they had no cases of FGM reported between 31 October 2014 and 31 October 2015.
Police Service of Northern Ireland
Police Service of Northern Ireland confirmed that it had no cases of FGM reported during the 2014/2015 financial year.
Northumbria Police
Northumbria Police confirmed only that it had 2 cases that were ‘deemed to be FGM’ in 2015.
Staffordshire Police
Staffordshire Police confirmed only that there were no recorded crimes of FGM from 31 October 2014 to 31 October 2015; however, no mention was given of whether any cases had been reported.
West Yorkshire Police
West Yorkshire Police recorded 11 crimes relating to FGM between 1 March 2004 and 31 December 2015, although no further date-stratification was provided. Of the victims, six were reported to have been under the age of 1 year old, one was reported to have been aged 1 year old, one was reported to have been aged 2 years old, one was reported to have been aged 3 years old and two were reported to have been aged 8 years old. It was unclear whether the ages referred to the age at time of alleged FGM occurring or at time of reporting. The occupations of the people who made the report were not released.
Merseyside Police
Merseyside Police reported that it had recorded no crimes under the Female Genital Mutilation Act 2003 in 2014 or 2015.
Health and Social Care Information Centre
HSCIC data comes from mandatory recording in the NHS. The method of storing and analysing the data on the HSCIC server at NHS Digital was reported to have changed for 2016. It was not therefore possible to see the number of discrete cases of FGM reported by month after December 2015. The numbers of FGM cases reported in the HSCIC data were vastly different from the (limited number) of FGM cases disclosed by the police authorities (Table 5).
| Date | New reports of FGM |
|---|---|
| Oct 2014 | 567 |
| Nov 2014 | 550 |
| Dec 2014 | 608 |
| Jan 2015 | 569 |
| Feb 2015 | 528 |
| Mar 2015 | 578 |
| Apr 2015 | 298 |
| May 2015 | 323 |
| Jun 2015 | 415 |
| Jul 2015 | 471 |
| Aug 2015 | 442 |
| Sep 2015 | 472 |
| Oct 2015 | 436 |
| TOTAL | 6257 |
Office for National Statistics
The Office for National Statistics reported that since April 2012, FGM has been counted under the police recorded offence category of ‘8N—Assault with Injury’, which also includes other types of assault. Therefore specific data for FGM could not be extracted.
The Home Office
Office for National Statistics advised that the Home Office held overall responsibility for police-recorded crime data. Responding to the enquiry for release of data regarding FGM cases, the Home Office stated that FGM was recorded alongside crimes such as ‘assault occasioning actual bodily harm’ as an aggregate under category 8N, and so specific data for FGM was unavailable.
The Home Office did, however, provide data answering Request three (total population, broken down by age and gender) with regard to every local authority in England and Wales. These data are freely available (Office for National Statistics, 2017).
NHS England
NHS England reported that it did not hold any information in relation to FGM cases and advised contact with the Department of Health and Social Care and the HSCIC.
Department of Health and Social Care
The Department of Health and Social Care advised that contact could be made with the HSCIC, but warned that any data provided by the HSCIC would not be analogous to the number of cases reported under the duty for mandatory reporting, as HSCIC data reflected mandatory recording by organisations, not mandatory reporting by individuals.
Organisations declining the Freedom of Information request
In total, 39 (86.7%) of the 45 police authorities did not provide comprehensive data in response to the Freedom of Information request. Police authorities who rejected the request, whether initially or on appeal, were not restricted to one reason as alleged justification of the rejection. Table 6 lists the relevant Sections of the Freedom of Information Act (2000) that were cited by police authorities.
| Section cited as a reason for rejecting the Freedom of Information request | UK Police Authorities citing the Section as a reason for rejecting the Freedom of Information request | |
|---|---|---|
| n | % | |
| Section 12 | 2 | 4.4 |
| Section 30 (1) | 2 | 4.4 |
| Section 30 (2) | 2 | 4.4 |
| Section 30 (3) | 16 | 35.6 |
| Section 31 | 4 | 8.9 |
| Section 31 (1) a | 19 | 42.2 |
| Section 31 (1) b | 5 | 11.1 |
| Section 31 (3) | 30 | 66.7 |
| Section 38 (1) | 1 | 2.2 |
| Section 40 | 2 | 4.4 |
| Section 40 (2) | 5 | 11.1 |
| Section 40 (5) | 5 | 11.1% |
Reasons provided for declining the Freedom of Information request
Overall, 31 (68.9%) police authorities rejected the Freedom of Information request—both on initial request and on appeal. Responses from these 31 police authorities were, generally formulaic with, for example, 23 (51.1%) of the total 45 police authorities who rejected the request citing the same two online news articles from The Telegraph (2015) and The Week (2015) as reasons for declining the request.
Some (n=26; 57.8%) police authorities cited the Authorised Professional Practice guidance on victims and witnesses (College of Policing, 2017), and 29 (64.4%) cited the guidance on information management (College of Policing, 2013), as reason(s) for rejecting the request.
Those police authorities citing Section 31(1) and/or Section 30(3) of the Freedom of Information Act (2000) stated that these sections exempted information from disclosure if such a disclosure would prejudice the prevention/detection of crime, and/or the apprehension/prosecution of offenders. Such provisions would also exempt the authority from the duty to confirm or deny whether any information was held that was subject to criminal investigations. On this basis, police authorities often refused to confirm or deny whether they had any data on mandatory reporting of cases of FGM at all. The logical inference is that if there are a small number of cases, they might fall into this category; however, this does not explain why the HSCIC reports have not progressed to an investigation, nor why the general nature of a report cannot be de-identified.
Those police authorities citing Section 40(2) of the Freedom of Information Act (2000), stated that those provisions meant they could not disclose third party personal information. Appeal requests all reinforced that it was general, anonymous statistical data on number of FGM reports that was being requested, rather than any third party personal identifying information.
South Yorkshire Police and West Midlands Police were distinct from the other Police Authorities in that they declined to comply with the Freedom of Information request using the provisions set out in Section 12 of the Freedom of Information Act (2000) as a reason for rejection, citing that the financial and time cost to retrieve the relevant data on FGM would far exceed the appropriate limit.
Police authorities also cited ‘defense of the public interest’ as a reason to decline the Freedom of Information request. This was loosely defined as ‘protecting alleged victims of FGM’, and subsequently those police authorities outlined a view that the Freedom of Information request itself endangered alleged victims.
That that the publication of FGM data could alert those who suspected they may be under investigation, leading to negative outcomes for the victim, was also cited as a reason for refusing the Freedom of Information request. For example, given the small number of offences recorded by each authority in this area of crime each month, it was suggested that if an offender committed an offence in November 2014 and became aware that the local police had received no report of FGM in November 2014 and December 2014, they could reasonably assume that the victim had not reported the offence to police. Conversely, if the offender had committed an offence in November 2014, it was suggested that the release of any information showing offences recorded in November 2014 or December 2014 would signal that the victim or another person, had reported the incident to police.
Police authorities also suggested that disclosures could give the victim the impression that confidentiality had been broken, and thus affect the likelihood of further witnesses or victims coming forward in the future.
Appeals requests
In the appeals submitted, it was argued that requests for FGM data were not plausibly endangering ongoing investigations or the confidentiality of victims; rather, the public interest lay in the need to evaluate mandatory reporting of FGM before implementing mandatory reporting for other forms of abuse.
Summary of negative responses
In summary, the police authorities declining to provide data argued that law enforcement tactics could be compromised, further crime could be enabled, and victims could be placed at risk or feel that confidentiality had been broken.
Discussion
Transparency
The ability of frontline professionals and policymakers to interpret FGM incidence and prevalence data, and respond to the needs of affected women and children, is affected by the secrecy that surrounds the performance of FGM, the complexities of investigation and the absence of significant number of prosecutions.
It is recognised that requesting data where there are a small number of cases may have caused concern that data would be used for a private investigation into who had reported what, and to put pressure on people not to cooperate with the authorities. However, given that there is very little access to data on FGM investigations, this is an unreasonable barrier to measuring the success of community eradication initiatives. Whether FGM is being tackled, and whether responses are effective, simply cannot be seen.
Lack of consistent, high-quality data
Police forces are not collecting data or responding to requests for information in a consistent fashion. For police authorities who did disclose recorded incidents of FGM, it is unclear whether this referred to all reports or accusations, or those where someone had been formally charged with a crime. Meanwhile, at the national level, if the Office for National Statistics and Home Office aggregate FGM data with other assaults under Category 8N, then the value of recording the data is lost entirely.
Lack of clarity regarding victims' ages
It was not clear from the data obtained in relation to victims of FGM reportedly aged over 18 years of age, whether the FGM was performed as a child or as an adult. This adds to concerns that the data being recorded (either as a result of individual mandatory reporting or organisational mandatory recording) are not in a format that helps policymakers and professionals to target preventative strategies towards particular age groups and their communities.
Mismatch between NHS data and police data
The HSCIC reports that from October 2014 to October 2015, there were, on average, 481 new reports of FGM each month across England. By comparison, there were 145 cases of FGM reported by Police Scotland, Greater Manchester Police, and the Metropolitan Police Service combined for the entire 12-month period of October 2014 to September 2015. This huge mismatch between HSCIC data and police data suggests that medical reports are not being followed up and the true scale of FGM in England and Wales is not being properly investigated.
Conclusions
The effectiveness of FGM mandatory reporting could provide a useful background to decisions regarding mandatory reporting for all forms of child abuse. At present, it appears that that records are made but are not followed up in significant enough numbers for the purposes of reporting. There should therefore be a cross-party approach to solve these issues, providing an effective system for linking recording and reporting to allow for meaningful follow-up, and for de-identifying data for both public consumption and legal-medical research. To this end, three proposals can be made.
Proposals
In April 2018, the Home Office changed data collection provisions to collect FGM data separately from other assaults. This was a major recommendation from this study, along with the view that FGM data should be collected by police forces in such a way that useful data can be extracted without endangering confidentiality. Since some police authorities in this study were already able to provide these data on FGM reporting, this must be possible. This would also solve the cost burdens identified by South Yorkshire Police and West Midlands Police. The authors further recommend that aggregate national data should be collected by a central authority, led by an FGM Commissioner.
The authors also recommend that NHS data is collected against the same criteria as police data, and that clinicians' recordings are similarly subject to aggregate analysis. While HSCIC/NHS data may not be directly comparable to data on multi-professional mandatory reporting to the police, any disconnect may provide a veil for those practising FGM. The difference between mandatory recording (NHS) and mandatory reporting (police) data comes down to age. Relevant professionals have a duty to report to police only if a girl is under the age of 18 at the time the concern is raised, whereas HSCIC makes it mandatory to record the diagnosis of FGM in girls and women of any age. As this is more broad, HSCIC data picks up many more cases of FGM, although the benefit of this is unclear. A joint approach to data collection is therefore recommended.
Lastly, the authors recommend that new guidance be provided to police forces to respond to requests for information where figures rather than facts are being sought. In appeals, it was argued that requests for FGM data were not plausibly endangering ongoing investigations or the confidentiality of victims, and that the public interest lay in the need to evaluate mandatory reporting of FGM before implementing any mandatory reporting for other forms of abuse.
Point 55 from the Government's Violence against Women and Girls Strategy 2016-2020 (HM Government, 2016) requires the development of a meaningful action plan for FGM data but the issues identified in this study suggest that mandatory reporting and recording of FGM is more symbolic than effective.