Female Genital Mutilation (Protection and Guidance) (Scotland) Bill
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First meeting transcript
Welcome back. Agenda item 3 is oral evidence on the Female Genital Mutilation (Protection and Guidance) (Scotland) Bill. I welcome our first panel. Dr Ima Jackson is senior lecturer in the department of nursing and community health at Glasgow Caledonian University, Andy Sirel is head of the Scottish refugee and migrant centre at JustRight Scotland and Dr Saffron Karlsen is senior lecturer in social research in the school of sociology, politics and international studies at the University of Bristol.
You are all very welcome. Thank you for being with us. I start by asking you about your experience and knowledge of female genital mutilation and asking you to say a few words on whether you support the bill’s aim to strengthen the existing legal protection for women who are at risk of FGM. Who would like to go first? Everyone is looking at you, Dr Jackson.
Dr Ima Jackson (Glasgow Caledonian University)
Thank you for the opportunity to speak this morning.
My experience is working as an academic with communities, looking specifically at the processes of policy engagement and the research that is done on them as opposed to with them. I have come to this evidence session because I undertook a piece of research that ended in February this year with the communities of colour, some of whom are practising communities. The research project was funded by the Scottish Government and the European social innovation fund and it looked at the experience of the communities within the process, of which this is a part, as well as their experiences as community organisations. The Kenyan Women in Scotland Association was the lead organisation in the project and my colleague Julie Wasige and I developed and undertook the research.
The main issue is that the communities have faced challenges with the processes. I am asking the committee to recognise the expectations of communities within our processes, and that there are risks to them because of how they are asked to engage in the processes. There are real risks to the communities, and that came out strongly in the research.
There is a feeling of being co-opted and there are concerns about the bill and the actions, but the communities welcome the Scottish Government not bringing forward legislation on anonymity of victims, the duty to notify police and the failure to protect. They understand, respect and welcome the approach.
Although the women are supportive of the statutory guidance, they are concerned about the reasons why the protection order is needed for FGM over and above existing child protection legislation. I came to that because of how our systems position the experiences of women, particularly those from African diasporic communities, as different from everybody else’s experiences.
That is part of how the research that I do works. It looks at why that perspective is positioned as different. The issue might be different, but why is the perspective seen as different? Why do the solutions that we already have in place, particularly for child protection, require something specific for FGM?
Thank you. That is helpful, and we will come back to those points.
Dr Saffron Karlsen (University of Bristol)
Thank you for inviting me to join the panel. I have spent the past 20 years doing different sorts of academic research trying to better understand ethnic and religious inequalities in a range of different social phenomena such as health and socioeconomic status and other sorts of experience. I have looked at outcomes in people’s lives and their lived experiences, as well as the impact on their sense of groupness—their group identity—and the interrelationships between those.
The research that brings me to the panel is the work that I did as part of a team at the University of Bristol and Cardiff University last summer, looking at the experiences of ethnic Somalis living in Bristol with FGM safeguarding services within the city. The project was led by academics but motivated by a call from local Somali groups to talk about what they felt to be negative experiences of services, which they did not feel were being voiced in the conversations that were going on among the policy makers and practitioners.
It was an independent, ethical, university-led study, but it was very much driven by the calls of the local community, although the research did not engage only with the groups that had called for it—we aim to take a much broader position. I will come on to talk—over the next few minutes and as we come to questions—about what we found in that research.
My feeling about the bill, which seconds a lot of what Ima Jackson said, is that it is appropriate that measures are taken to protect those who are at risk of genital or indeed any other form of mutilation, particularly without or when they are not able to give their consent, but our and other research suggests that there is a range of ways to provide that protection and there is far greater potential than is generally realised for the involvement of FGM-affected groups in the development of those policies. That is for a range of reasons, which, again, I will come on to, but the important point is that policies around the issues can be much more effective if we approach them in a more collaborative way.
Our and other research suggests that some policy responses to FGM that are already in practice in the UK and elsewhere have led to the stigmatisation and criminalisation of many innocent families. That is problematic in and of itself, but our research suggests—this is why I mentioned the work that I have done around ethnic identities—that it has directly undermined not only relationships in those families and communities, but people’s sense of Britishness and inclusion in British society. The things that we are talking about today have far bigger implications than we might realise and—this is important—than are necessarily reflected in the bill.
None of us wants a more divided society. You have a really valuable opportunity not only to develop approaches to the management of FGM risk that can be more effective in achieving our longer-term aims of ending the practice of FGM in the United Kingdom and elsewhere, but to do that while minimising the negative impacts that current approaches are having on people from FGM-affected groups.
Our research suggests that people from FGM-affected groups are very keen to collaborate. They really want to be involved, and they have tried to be involved. A lot of the frustration that was noted in the study was due to people feeling that there was a collaborative approach that had somehow lost its way.
There is real potential in Bristol, and most likely in Scotland as well, as Ima Jackson said, to have more conversations about effective approaches to these issues.
Andy Sirel (JustRight Scotland)
Thank you for the opportunity to be here. I will provide evidence from a legal perspective, drawing on my and my colleagues’ long-standing practical experience and expertise in providing legal information, advice and representation to women and girls who are seeking international protection and who have survived gender-based violence.
We work with women and girls across a range of issues in UK and Scots law, including immigration and asylum, child protection, and human trafficking and exploitation, and we sit on the Scottish Government’s implementation group on FGM. We are also the legal providers for the Government-funded Scottish women’s rights centre, through which we have extensive experience of advising on and obtaining protective orders for women who are affected by gender-based violence, including forced marriage protection orders.
For the avoidance of doubt, I echo what my colleagues have said about the use of the law as a tool in preventing and combating FGM. The law should be handled with care, I think. Our view is that we require a broader focus on creating broader change and the law is only one tool in that process. That said, I am a lawyer and I am here to speak about the law, and we believe that the proposals in the bill will improve effectiveness in the fight to combat FGM and safeguard those who are at risk.
FGM has been a criminal offence for 34 years in the UK. Although that has sent a clear message of intolerance, it is not controversial to say that our criminal response will not, by itself, eliminate FGM. We all know that no successful prosecutions have been brought in Scotland and the first one brought in England was only a few months ago.
We agree that FGM protection orders would be a useful and important tool. I have mentioned that our primary experience is working with women and girls who have survived or are at risk of FGM through their interaction with the asylum process. I am happy to answer questions on that today. Our view is that the existence of FGM protection orders would play a positive role on whether a woman or girl receives international protection.
We also work with women and girls at risk of other forms of so-called honour-based violence, such as forced marriage. To some extent, many of the same cultural and social factors are at play. Through the Scottish women’s rights centre, our solicitors have first-hand knowledge of forced marriage protection orders and the importance of that type of remedy. Because of that experience, we believe that protection orders would add value to the current approach, and we are happy to expand on our reasons.
Our experience highlights that a particular gap or barrier might exist for the protection of girls who are 16 and 17 years old. We acknowledge that younger children are predominately at risk of FGM, but the risk persists for teenage girls.
The definition of child varies in different legal contexts. Our experience tells us that 16 and 17-year-olds are often caught in between the legal protections available for children under 16 and those for vulnerable adults. Sometimes, 16 and 17-year-olds operate in the middle. That makes the existence of specific protection orders, whether that be forced marriage protection orders or FGM protection orders, all the more critical as a tool for local authorities, for example, to keep all girls in their care safe. It is vital that local authorities understand when such orders can or must be used, and we look forward to seeing the statutory guidance that will help local authorities understand what their role could be. I am happy to answer any questions.
Dr Jackson, you said that the existing legislative framework for protecting children and adults is sufficient to protect women and girls. You also spoke about risks to the community because of how they were involved in the engagement process. Will you expand on that a little?
My expertise is on the process. Although I undertook a research project related to FGM—and there are specific reasons for my undertaking that research—my expertise is on the policy-making and research processes in Scotland. I am particularly interested in issues to do with the racialisation and marginalisation of people whose voices we should be hearing.
My understanding is that we would be adding to the existing child protection framework in a specific way. I do not know the details of that, but I understand that the existing child protection legislation is the strongest legal framework within which measures on FGM would sit. If that is the case, I am interested in why a bill on FGM has been introduced.
I want to explain that our research was to support the existing work of the women who took part and to allow them to look at the processes of how they participate in what becomes a consultation and a framework. The consultation call came during the lifetime of the research and gave the women an opportunity to respond collectively because of the project that we were developing at the time.09:15
There were issues about how the women’s voices could be heard in the process, because it was complex for them to articulate their experiences in that timeframe. It came out clearly that all of us—the women, policy makers, researchers, academics and politicians—are learning about how to engage with this issue, particularly in Scotland. That is related to whose knowledge is viewed as expert in the process. I did the research project with the communities because the intimacy of the unique issue and the demographic change in Scotland highlighted many issues about processes in Scotland. We are not used to engaging with those issues, so the research was developed with the communities to help us all to understand how we experience engagement with our processes.
I want to talk about the pressures that the communities felt when they were asked to participate. One woman who took part in the research said:
“In my head I said I cannot do this on my own.”
She wanted to open it up so that she was part of a group. She said:
“You want to be with other sisters”.
She also knew that it was a really important decision-making process.
“They’re going to put it as a law. You don’t have to take that single decision by yourself ... I said to myself ... how can we three of us sit here ... and make a decision?”
What was important was the speed, the timing, the thinking required and the support needed for the women to be able to speak about the issue.
The research was intergenerational; the schoolgirls were from Notre Dame high school in Glasgow and older women worked with them to support one another in the processes that we created. Some were from communities that were practising or potentially practising, and some had come to live in Scotland. The older generation of women understood and had experience of how to manage and fight against FGM in their communities.
How to speak about it with families, friends—your best friend—and schools is complicated. When we ask for something to happen, our processes have to recognise that it is really complicated.
You have asked us to comment on the potential equalities and human rights issues in the bill. Some participants in our research on the policy felt strongly that there was evidence of racial profiling in the provision of safeguarding protection, which follows on from what Dr Jackson has said. There is not much consideration of those concerns in the current bill, although there has been reflection on gender discrimination and the need to protect women.
The committee will have to be mindful of the need to mitigate racial profiling, which includes consideration of and careful reflection on how the bill will add to current protection for different forms of child abuse. People in our study felt that they were being identified because they were Muslim and African, regardless of any established level of risk to their children. Why do we need additional attention and surveillance over and above those horrific things that people are experiencing? That is a serious question.
There may still be a clear purpose for a specialist bill, but if that decision is made, clarity about why would be useful, to show how the bill provides additional coverage that is needed over and above current legislation.
You also asked us about prevalence. Figures from Africa and Asia are generally used, but from our research on FGM prevalence in the UK, particularly among the under-18 resident population, we know that most cases are genital piercing and there are rising rates of cosmetic labiaplasty; those are all considered to be part of the World Health Organization FGM types but they are absent from the bill. That raises the question why the bill focuses only on practices that are considered to originate in Africa and Asia, particularly given that some forms of pricking or scraping could be considered much less mutilating than genital piercing and other things that are absent.
I do not know the legislation particularly well, but there are suggestions that the Prohibition of Female Genital Mutilation (Scotland) Act 2005 does not include some forms of intervention that might be considered to be less severe.
I will bring in questions from committee members now.
I thank the panel—this is incredibly illuminating. I have a couple of questions about your evidence. Dr Jackson referenced—and the convener followed it up—that child protection provisions might be enough to deal with the issues that we are talking about. However, a bill team briefing suggested that FGM is not limited to children and that, sometimes, a woman might be mutilated again, particularly after childbirth. Is that assumption wrong? Is the issue solely to do with children?
I am not able to answer that question. I understand it, but I am not sure of all the legal aspects.
I will expand the question slightly. The bill is about preventing FGM for everyone. We need to be confident that everybody is protected by the laws of this land, and nobody over the age of 18 is protected by child protection legislation. That is what I am trying to ask about.
I am uncertain of that reach. The challenge in using the bill as a tool is its effect on other work that is going on to engage and develop. A decision about that has to be taken.
You have inferred that the bill would single out cultural communities and that the protection order seems quite unique in that. However, there are examples of such orders that Parliament uses quite readily, such as risk of sexual harm orders that prevent young people and vulnerable adults from being groomed sexually online. That is an example of another group being singled out, but the order is a necessary tool of protection that we, as lawmakers, try to extend to vulnerable groups. Do you accept that point?
I accept the point, but my research comes from the perspective of how the system can create an experience of marginalisation and racialisation. It may not intend that to happen, but that comes from its approach to specific issues, however it is intended to function. Because of those issues, we have to be extremely careful about what we do in this area.
For me, one of the issues is the documentation that comes with the bill. I have read many documents, but I have not always seen graphic examples in them. Although they are helpful, is it usual practice to have such diagrams and explanations in the submissions to committees? I am not sure. Maybe it is usual practice to explain the issue in that way.
I am grateful for that contribution, which will inform the tone with which the committee will proceed. We recognise that, in this area, we have to proceed with a heightened level of sensitivity.
I have one final question, which is for Dr Karlsen. You opened up an interesting point about the fact that the vast majority of female genital mutilation in this country, whether it is piercings or labiaplasty, is consensual and is sought out by the individual. Is the issue—the difference here—about consent and the question of whether it is a conscious decision by someone who has attained maturity? Is there a disaggregation of two kinds of FGM, and do we need to reflect that in the bill?
That was going to be my exact response in following up your question to Ima Jackson. We were talking about whether child protection legislation is enough, and that goes back to my point about why cosmetic labiaplasty and genital piercing might not be included. There is a written submission that questions whether we should have laws about the age at which people can have genital piercing.
Those points are all about whom we perceive as being in a position to provide consent. Generally, we assume that we are talking about those aged under 18, although the evidence around the prevalence of FGM is problematic—I will talk about that in a minute. The evidence suggests that the prevalence is concentrated in under-15s and under-18s. Therefore, allowing for what you say about further reconstructions—or whatever you might want to call them—as far as we can tell, a first incident tends to happen during childhood.
There is then the question of when we perceive that people are informed and responsible enough to provide consent. If we do not include clinical or cosmetic labiaplasty and genital piercing in the bill, because we assume that people who have those procedures are providing consent, it is difficult to understand why we do not consider women who make other decisions about what they do with their bodies—when they are older or after having children—in the same way. People from affected communities and people who are conducting the research are asking those questions.
Also, some of the concerns come from misunderstandings about the current prevalence. You asked for information about the prevalence of FGM in Scotland. You also acknowledged that there is not a lot of evidence and that the evidence is problematic. I have not looked at that data in particular, but we have just finished a study that looks at the available data in England and Wales. I am also aware of other research that has been done in the UK and in Europe. All the evidence suggests that the level of FGM risk is much lower than we generally assume. We have figures showing that 98 per cent of Somali women and girls are at risk; but, although we should protect those who are at risk, we should also recognise that all the research suggests that the majority of UK-resident people, including those from FGM-affected groups, do not support FGM and are committed to working to end it.
The policy memorandum says that there is a lack of evidence, but then it relies on prevalence rates from different parts of Africa and Asia and extrapolates directly from that information to establish a risk: it takes the number of women from those countries who are living in Scotland and the number of children those women—who may or may not have had FGM—have had, and it uses those figures to make an assessment of risk. It assumes that the risk in Somalia transfers to Somali mothers in Scotland and the UK, and then on to their children. However, the research suggests that that approach is not appropriate. Using those figures to establish the level of risk in the UK is not efficient. That does not mean that we should not protect those at risk, but it does shift the balance between the number of people who will be protected by the legislation and the really serious impacts that it will have on innocent families that get caught up in the legislation—as our research shows.09:30
Research suggests that people who migrate to and live in the UK and other low-prevalence countries, such as Sweden, Australia and other countries in Europe, have much more negative attitudes towards FGM than people who live in the countries from which they migrated. The cultures are changing. It may be that the people who move have much more negative attitudes towards FGM before they move, or it may be that their attitude changes once they have moved into this environment, where the attitudes towards FGM are very different—in the UK, people are stigmatised for having FGM in a way that they are not stigmatised elsewhere. Reflecting on the issue in that way gives us a very different sense of the scale of the problem. One case is too many, but we are talking about far fewer people than was first thought.
I am conscious that we are coming into the last half hour, and I want all committee members to get a chance to speak.
Angela Constance (Almond Valley) (SNP)
I have three questions, which I hope to direct to the appropriate witnesses. For the committee to carry out our role, we need to focus and distil the issues.
Dr Jackson, you pointed out that, as practitioners, policy makers and politicians, we are learning the best ways to engage with the issue. Do you think that practitioners—health professionals, social workers, teachers and so on—have a residual anxiety about beginning to engage with the issue? Are we still nervous about, and resistant to, talking about it and raising issues because people feel disempowered and do not know the best way to go about it? If so, how would guidance help?
Yes. The eradication of FGM will happen only if it is inspired by the communities who are involved—they know that. The communities that I have been working with have been working really hard to engage, although they have little resource or infrastructure to support themselves to do that.
Your question was about practitioners and policy makers who are relatively new to the issue, but there is anxiety about how to talk about FGM within the communities. That anxiety was really clear in the research that we carried out with the young girls. Their task was to go home and try to speak to their mother, father and a friend about the issue of FGM. It was a huge process for them to learn how to speak about it. The anxiety is not just on the part of the service planners.
Yes. I heard that loud and clear in your earlier evidence on the needs of communities and on how we need to be better tapped in, to really listen to them. However, my question was specifically about whether professionals worry that they might be accused of being racist or culturally clumsy and whether we should help to address that.
We need to address that. The point that I was trying to make is that the knowledge and expertise that exists in the communities will help us. We need mechanisms and levers to ensure that the perspective on how to speak about FGM, what to speak about and who controls the decisions made around it is theirs.
I know that the Scottish Government is trying that approach in other areas—I see it with the children’s hearings and poverty action, for example—and we desperately need it here, in order that policy makers and service planners become confident. With support, the women are confident about what they are deciding. When the national action plan committee was set up, there were three community members among the—I think—16 people who were on it. In the research, the women spoke specifically about how that balance already offset whatever they produced.
If I can paraphrase you, Dr Jackson—correct me if I am wrong—you are saying that we need to really listen to the community and ensure that its lived experience is baked into our policy and legislative responses from the start.
Yes. We have to trust them and trust that they know.
Okay, thank you.
As Mr Sirel is a lawyer, I will pick up with him some of the issues relating to our children’s hearings system. The FGM protection orders are for children and women of all ages. I would like to hear Mr Sirel’s view on the question of whether children’s hearings should be able to grant an FGM protection order. We know that the courts can refer back to the children’s hearings system, and I personally am a bit concerned about folk bouncing around between two systems. I know that there are already a range of civil orders. However, is there an argument for the children’s hearings system having an FGM protection order as a potential disposal?
My position is that, if properly applied, the existing tools in the children’s hearings system—such as compulsory supervision orders—are already sufficient to do the job here. That is an important point, which relates to what Dr Jackson said about our needing to not racialise the issue. For younger children who are before the children’s hearings system, existing procedures may well be sufficient if they are properly applied. The problem is that the children’s hearings system only goes up to 16 years old.
Forgive me—I heard your evidence about 16 and 17-year-olds loud and clear. I and my committee colleagues will certainly come back to that point.
Are you saying that, if a legal route is being pursued for children who are under the age of 16—and ideally for 16 and 17-year-olds—the first place of reference should be the children’s hearings system as opposed to an FGM order?
The children’s hearings system is a specialised and child-friendly legal process. It was designed for the specific purpose of keeping children outside extremely adversarial sheriff courts and whatnot. On the basis that that is a strength of the system, we should keep it within the realms of the mechanisms that are already in existence.
I have one final question, convener. I am very conscious of the time. Dr Karlsen, could you summarise what we should learn from the Serious Crime Act 2015? There are a few years of learning, based on the experience of England and Wales, that we can benefit from. On the basis of the experience south of the border, what should we definitely do and what should we definitely not consider doing in relation to the proposed legislation?
As that is not my area of expertise, I do not feel that I am in a position to respond in relation to the 2015 act. However, in response to the questions that you directed towards Dr Jackson, I will say something about the professionals that relates to some of the more specific things that we can think about.
Some professionals are concerned about being seen to be racist or Islamophobic. Going back to what I said about the prevalence of FGM, we found that the participants in our study felt very strongly that professionals are far more concerned about missing children and not protecting children in their care. Sometimes, that leads to a tendency for professionals to jump to conclusions out of a genuine desire to protect children, but that means that many more innocent families are brought into the system than is necessary.
It is important that the bill is clear about the guidelines for professionals and that its implementation is straightforward. Families should not be referred without there being a reasonable level of concern, which should be established through communication with the family regarding the individual case and the individual risks. For example, the fact that someone comes from a family that has a heritage from, or that goes on prolonged holidays to, FGM-affected countries or communities is not an adequate factor in establishing risk in relation to the policies that are being developed by policy makers, particularly those in Bristol.
Other potential risk factors are much more ambiguous. We should bear in mind the fact that conversations about a girl becoming a woman might involve conversations about menstruation. We all have secrets in our families—it might be about surprise birthday parties or presents—and we all have conversations about becoming a woman. It is important to recognise that some factors are not suspicious and might not be related to criminal activity.
I am conscious that some of my colleagues might want to explore the risk assessment that professionals undertake. You have raised an important issue.
That is as much as I wanted to say on the matter.
I turn to Mr Sirel and Dr Jackson. What are the top three lessons that we have learned from implementation of the 2005 act south of the border about what we should be doing and what we should definitely not be doing?
Is your question about implementation of the 2005 act?
I am sorry—I meant the Serious Crime Act 2015, which contained FGM provisions and applied only to England and Wales. There have been a few years for the provisions to be implemented and put in practice. Are there any lessons to learn from that?
The 2015 act has multiple provisions on which the Scottish Parliament consulted, but which it opted not to go for in the end: those relating to anonymity, the offence of failure to protect and so on. The reason why we came down against a specific anonymity provision for people who are at risk of FGM, against the offence of failure to protect and against the duty to notify is that, with respect to the last two measures, we did not see any evidence from England and Wales that they were effective.
There has been a pretty high number of FGM protection orders in England and Wales. The numbers are quite interesting. Between July and September 2018, 36 applications and 40 FGM protection orders were made in England and Wales. Since FGM protection orders were introduced in July 2015, 296 FGM protection orders have been granted. We can compare that with, for example, the number of forced marriage protection orders in Scotland: between November 2011 and January 2017, 12 such orders were granted. There is clearly a difference in the numbers of those types of applications being made. I appreciate that the issues are separate, but there are some commonalities and there may be lessons to learn from the approach that has been taken in England and Wales—from good practice and bad practice—in order to ensure that the tool is effective. If it is not effective, we should not have it.
Recent research in England is covered in the 2018 report, “Perception and barriers: reporting female genital mutilation”. The report goes through a list of barriers and gaps, as described in interviews with 14 survivors. I refer members to that report.
I cannot really say more beyond that.09:45
Oliver Mundell (Dumfriesshire) (Con)
I have listened carefully to Dr Jackson. The bill has been published. A lot of work has been done on it and you are here to talk about it with the committee. How do we capture points that you have raised?
I was going to ask you about what can be done now. I do not know what capacity there is within the development of the statutory guidance to implement what we have been talking about. What opportunities are there within existing processes to do that? I do not really know what the processes are. I want to know how we can use the processes for creating statutory guidance to enable communities to affect what will become the statutory guidance.
That is really helpful. You are saying that we really need to hear the voices of lived experience in development of the statutory guidance.
Yes—those voices need to take the lead. I do not know how creative and imaginative the process can be, but decisions are being made about what will constitute whatever this thing is that we are all talking about, so it is important to include those voices. Traditionally, the people—the voices—that all this work is trying to bring in are not there when decisions are made. That must not happen in this case.
That is helpful. I have a broader question for all three panel members. Why have there been so few prosecutions under the existing legislation? Connected to that, in the context of England and Wales, why have we seen people coming forward for protection orders, but we have not necessarily seen the prosecutions to go with those? What is the difference?
That question is difficult to answer. To be honest, I do not know why there has never been a successful prosecution in Scotland or why there has only recently been one in England. I suspect that the answer is rooted in interactions between the police, local authorities and communities—barriers to reporting, lack of trust and so on. However, I am not an expert in those issues, so I defer to my colleagues on this and the next panel.
Does anyone else have comments on why we do not see prosecutions?
It is important to say that the one successful prosecution was not about a family that had a heritage in an FGM-affected country, which links back to the problems with the risk factors that I mentioned.
The participants in our study say that the lack of prosecutions is testament to the fact that FGM does not happen very much and that all the investment is to address what is essentially a small problem. It is a significant problem for the people it happens to—I am by no means diminishing the impact of FGM on individual lives and the lives of families and communities—but that is the reason for the lack of prosecutions that is given by our participants.
The other problem with assuming that the lack of prosecutions is due to a lack of police attention or enthusiasm or anything else, which has been the traditional assumption, is that it encourages the feeling that there is a criminal underbelly of people who are committing FGM, or who would be trying to commit FGM if only they were given the opportunity. That really impacts on how the affected communities are responded to by various authorities and by society in general. That has impacted on their sense of inclusion. It reinforces their distrust in all sorts—education, healthcare, police, legal services and social services. Again, delicacy is imperative.
I am trying to ascertain why hundreds of people look for protection orders—although many are sought by police and local authorities—if FGM is not prevalent.
I am not in a position to comment on that in an informed way, but protection orders not leading to prosecutions or not being granted might suggest something about the evidence, to a layperson.
I will add a point in support of what Dr Karlsen has said.
The vast majority of women and girls with whom we have worked, who have survived or been at risk of FGM, are seeking international protection, because if they are sent back to their country, there is a risk that FGM might occur. They are seeking protection from something that happens in their home country; they are not necessarily seeking protection from something that will happen here. When we talk about stigmatising communities, that is an important point to bear in mind. The women and girls with whom we have worked do not want FGM to happen. Their community is being accused of the very thing from which they are seeking protection. That is a common issue across immigration and asylum, more generally.
That is helpful. Thank you.
Fulton MacGregor (Coatbridge and Chryston) (SNP)
The panel members have been very informative. As Dr Jackson said earlier, the evidence is helping to shape my journey towards understanding the issue.
Dr Karlsen mentioned the risk being low. How confident are you in that assertion? During the committee’s pre-engagement process, I spoke to a group of people who were involved in the issue, which was an informative visit. Some of the men whom I spoke to were 30 or 40 years of age and had lived in their community all their lives but had not realised that FGM was going on until they spoke to other people. They then became involved in supporting people in communities in Glasgow, Edinburgh and other parts of Scotland. If it is difficult for people who are living in those communities to get an understanding of the issue, how can we have faith in any risk assessment?
The data that we use to make the risk assessments is a long way from being what we want. We will make recommendations on how we can generate more effective risk assessments based on the research that we have just been doing.
At the moment, I cannot say categorically that there are or were so many cases, what types they were or where they happened, because the data that is collected as part of Government statistics does not enable us to say that.
However, we have research studies that have been done with groups from FGM-affected communities, who have talked about their attitudes to FGCM. Surveys have been done around the world to engage on changing attitudes to FGCM. People talk about it as something that happened in the past—it is something from their history that they do not consider to be relevant to their lives or their children’s lives. Part of the frustration in the on-going engagement on protection is the fact that those people are just British people who are living British lives and who want to go on holiday and visit their families. They are being prevented from doing that by a system that does not reflect how their culture has changed, as all cultures change all the time.
I will move that point on a wee bit. Do you and other panel members think that if we do—
I am sorry—but I will just cut in for a second. Did you use the term “FGCM”?
“Female genital mutilation” is the term that is traditionally used in statutory services, but it is quite a loaded and problematic term. Other people use “female genital circumcision” or “female genital cutting”. We would prefer to use FGC, but FGCM is for completeness.
Based on what has been said by the panellists on discussions that we have had, and following my previous question, if we do not get the bill right with regard to bringing the community on board, is there a risk that understanding of the matter could be pushed even further out of reach?
My work as an academic all focuses on communities’ experiences. If something is so serious that it warrants the committee’s work and legislation, I have to look at what has been put in behind that work. My research project with communities worked really hard to engage them, develop trust and support their work has ended. Where has that expertise gone? The issue is so important that there is a bill about it, but many community groups and many people like me—a black academic in Scotland who is working really hard to bring that voice through—are in project-bid land. We need to grow the knowledge and expertise.
I do not know whether the statutory guidance can develop and recognise our knowledge base in Scotland, but I hope that it can, so that we can become more knowledgeable about how to manage such intimate issues in our lives. We need to increase confidence in our mechanisms, such that policy and processes are able to make everybody feel confident about them.
Consideration of how we fund such work is really important. Our demographics have changed forever, so we really need to think about that deeply within our processes, in order for us to get the knowledge. We are learning how to do that, but there are risks in what we do and how we process that. If we build the resources, five years from now we will not be saying the same things.
That risk was raised by our participants, who were anti-FGM campaigners and also regular members of the community who were interested in, and keen to see the end of, FGM. People who were referred from schools were people who had handed in their holiday forms to say that they were taking extended leave—they were ticking the boxes and filling in the forms, as they had been asked to. The concern is that if we start to criminalise those innocent families, the people who want to do FGM will go underground.
However, the issue is bigger. We have had Somali-led anti-FGM campaigners in Bristol for decades, who have had a massive impact on education on FGM. I do not have the statistics on the impact on prevalence, but it has been significant. Those campaigners feel that FGM safeguarding procedures have caused cleavages in the community and have undermined the work that has been done. Communities feel stigmatised and unfairly criminalised, which has undermined their sense of Britishness, encouraged their sense that they are living in a hostile environment and undermined their trust in services, as I have explained. The issue is not only about FGM, but the impact that the bill could have far beyond the specific legislation, by the ways in which it could reinforce many other things that are happening in society.
Thank you, Dr Karlsen. We have all heard your point loud and clear.10:00
Annie Wells (Glasgow) (Con)
Thank you all for coming along. I have listened with great interest to everything that you have said.
Do you know of any countries that have made successful interventions that have not involved legislation?
That is a good question. No, I am not aware of any, but it is not my area of expertise.
Education initiatives are far more effective than punitive ones. We want to catch criminals and protect children who are at risk, obviously, but long-term solutions are about community-led and community-engaged collaborative education. The bill needs to be part of an armoury, but it is difficult to see now how the bill will fit with your wider services for FGM protection. In general, moving away from punitive measures and towards educational measures is the way to go.
Do you know of any countries where they take a different route with their FGM interventions?
Generally, interventions are pretty heavy handed and are not very positive.
I do not have much to add. In Europe, the most well-known country in the issue is France, which pursues ruthless criminalisation of FGM and has the highest number of convictions for FGM in Europe. The panel might agree that that is not a particularly effective method. That is just an observation from our research.
I thank all the panel members for their evidence. Many of the questions that I would have asked have been covered already, so I will be brief.
I would like to start with Mr Sirel. Should legal advice be free and freely available to anyone with a query on FGM protection orders?
That is very helpful.
Not only should they get that, but—perhaps guidance could help with this—there should be comprehensive access to legal and non-legal support, including local authority support, and referral pathways to access free legal information and advice. It is not just about free access to a lawyer, but broader access to legal information.
So, there should be wraparound support that does everything that is required.
Before I ask the other panel members the same question, I ask you, given your background, how much weight is placed on the risk of FGM in the asylum process?
That is an interesting question. We can learn from England and Wales on that, because the High Court in England and Wales ruled on it in 2017. The High Court said that, in the context of an asylum claim, when the Home Office is assessing risk on return to the home country, it is not bound by the existence of an FGM protection order, but must take that into account. The Home Office has published guidance on that that states that an order can provide strong evidence in the context of a claim for asylum.
Our strongly-held view is that, in that context, if we are trying to demonstrate a past risk, a risk in the UK and, most important, a risk on return to the home country if there is a forced marriage, an FGM protection order being in place would be helpful, because it might have elicited further evidence and will have produced a result on a higher burden of proof.
Do other panel members have a view on legal advice? I would be grateful for answers that are as short as possible, so that I can ask my second question before we run out of time.
It is not my area of expertise, but I completely support there being a broad umbrella of legal support.
I very much support free legal advice, and legal aid more generally, but something else that came from our research is the need to be really clear about the guidelines. For example, there is the issue of how people access the advice. There is also the issue of pathways. We had a number of people who have been involved in FGM protection orders, who said, “I didn’t know what evidence they had”, “I didn’t know what was happening”, or “I didn’t know how long they were going to hold my passport for.” The lack of knowledge was really frustrating and problematic for families.
The second thing that I want to ask about is guidance, which is a word that has come up frequently in the past hour. I have a bit of a bee in my bonnet about guidance, because it can either be incredibly useful or it can be a complete and utter waste of time. Multi-agency guidance about FGM already exists. I am keen to hear the panel’s views on what guidance should come with the bill. Should it be statutory? I get what Dr Jackson said about consultation of the community. Whether or not the guidance that comes with the bill is statutory, it seems to be really important that the community be heavily involved in developing it.
I would also be keen to hear the panel’s views on whether, in addition to the guidance, something should be built in to the bill to say that there should be on-going community engagement and education, and that provision should not just be about acting when there is perceived to be a risk, or doing a bit of work in schools or with community groups and then nothing else.
The question about guidance is helpful. I do not understand all the ramifications and potential of statutory guidance, but I know that the issue is creating ways of engaging in policy that require us to think differently. From working with the women, I understand how deep their knowledge is of how to engage with the issue. Instead of just being consulted, they should have authority and be decision makers. We have to rethink our processes about who makes guidance and whose voice is allowed to influence what it becomes. That is where we can make real change in Scotland. As I said, I have seen attempts to do that in committees on other matters, but I have not often seen it happen around people of colour or around migrants. They are so far from that process. That engagement is allowed to happen in other areas, so I am saying that this is an area where there is a real opportunity to do something.
That is very helpful.
I completely agree. The populations who are affected by the issues that are under discussion need to be involved in the framing and identification of the problem and in identification of the solutions. I do not know whether you would call it evaluation, but there needs to be on-going, long-term co-production. This is partly about undoing some of the problems that have arisen as a result of less communicative approaches. It would be very valuable if authorities could be very proactive in being seen to be communicating.
We are in favour of statutory guidance. Robust and clear guidance would complement the measures that are already in the bill. Such guidance could provide clarity around the risk assessments that should be undertaken in this area, and when legal orders to protect children must be applied for. In the past 18 months, our experience in respect of forced marriage has shown us that there are times when authorities have not acted and the consequences of that have been severe. Guidance would help local authorities to make decisions.
The last thing I will say is that I agree with what my colleagues have said about community engagement on developing the guidance. It is not possible to talk about risk factors on a subject that is so closely connected to cultural, social and familial issues without involving the community.
Thank you all very much for your evidence this morning. It was really helpful.10:09 Meeting suspended.
10:16 On resuming—
I welcome our second panel to the committee: Jan MacLeod, manager, Women’s Support Project; Angela Voulgari, gender-based violence services manager, Sacro; Anne Spiers, deputy chief executive officer, Multi-Cultural Family Base; and Hassan Darasi, project manager, Community InfoSource. Good morning, everyone. Some of you were here for the first panel. We have a lot to get through and I will try to be disciplined with my questions, as will other members, so that we can hear all that we need to hear from you.
Can you give us a brief comment on the work that you do in relation to FGM and your views on the bill? I will start with Angela Voulgari.
Angela Voulgari (Sacro)
Good morning. I am here today because I work for Sacro, the lead partner for the bright choices project, which was a partnership between Multi-Cultural Family Base, Sacro and the Edinburgh and Lothians Regional Equality Council. The project was funded by the National Lottery Community Fund between 2015 and 2019 to provide support to individuals, families and communities affected by any form of honour-based conflict or honour-based violence. Under that umbrella, we realised that there was an overwhelming need for support, both for women who had survived FGM and children in Edinburgh who might be at risk of the practice.
My colleague Anne Spiers from the Multi-Cultural Family Base was one of the partners for the delivery of bright choices. The FGM support and protection worker for bright choices is still placed in the Multi-Cultural Family Base. That is our connection to that work.
Jan MacLeod (Women’s Support Project)
Good morning. The main issue for the Women’s Support Project is violence against women. We became involved in work on FGM after being approached by women survivors of FGM who wanted to be involved in community engagement work because they believed that there was a significant number of people who were not aware of the law in Scotland or the negative impacts of FGM on women’s physical and mental health. Through that we got drawn into work at the local and national levels.
It is important to acknowledge that we are all here today because of the grass-roots work, which has been led by African women in particular. We have tried to use that to guide our work. I caught the end of the previous panel and I agree that the involvement of the communities that are potentially affected and of women who have experienced FGM is vital.
We have been working within the wider context of violence against women and girls and human rights. We have tried to remain aware that, although FGM is a serious form of child abuse and can have a lifelong impact on the health of some women, in the vast majority of cases, parents believe that it is the right thing to do or is what is expected of them and that not carrying it out might have immediate negative consequences for their daughters.
That is a difficult issue for child protection systems here to struggle with. It also leads to an understanding that, in order to work effectively with communities or for community-led change to take place, we need to amend our approach slightly. For example, if someone genuinely believes that their religion requires them to carry out FGM, the law might not change their behaviour, but if we can work with their faith and show that no religion requires or condones FGM—as far as I am aware—we can get change for people overnight. We try to have those principles inform our work.
The work that we have delivered has included developing resources and training materials for practitioner training and public education, and supporting networking between statutory, voluntary and community sectors through newsletters and meetings. Last year, we had a national conference, which had a trauma focus. We have done a small bit of community engagement—we always try to do that in partnership with black and minority ethnic or survivor-led organisations. For example, we have worked with the Kenyan Women in Scotland Association, which has done excellent work in communities; Hassan Darasi and Community InfoSource; Saheliya; and the violence reduction unit. Although we do not have funding for a support service for women, we get a gradual trickle of referrals from lawyers, social workers and health visitors because we are involved in public education, so we are aware of the lack of services for women.
Anne Spiers (Multi-Cultural Family Base)
Thank you for inviting us. I work for the Multi-Cultural Family Base, which is, among other things, a social work training agency, so we work with social work students from all over Scotland. We also provide family support services to black and minority ethnic communities, from age naught to adulthood, across our various projects. We have always had a focus on new and emerging communities and on people who move to Scotland. Twenty years ago, we worked with Sikh and Pakistani communities, which are well resourced and self-supporting these days. We now work with a lot of refugees and asylum seekers, for example from Syria.
As Angela Voulgari said, we were part of a collaboration, partnership and philosophy that was called bright choices. Through that, we have in place our FGM support worker, who works with women, girls and families. MCFB also has an honour-based violence support worker, so we have two workers who work specifically on those issues. A Venn diagram would show that there is quite a big overlap between the two issues.
Hassan Darasi (Community InfoSource)
I am the project manager for challenging violence against women, at Community InfoSource. As a company, Community InfoSource started in 2006 and has a legacy of working with disadvantaged communities, particularly black and minority ethnic groups. I am one of the people who has benefited from Community InfoSource. I came here as an asylum seeker and helped to start the Scottish asylum seekers residents association, which was unique in the United Kingdom, given that asylum seekers were tenants and the landlords were white people. We have been working on a lot of pilot projects, such as the living well in Glasgow project. Our projects have benefited a lot from working in partnership with Jan MacLeod and the Women’s Support Project.
In doing that work, we discovered a need to work with men. We brought the issue to one of our partners, Saheliya, but, given that Saheliya works only with women, it said that it would give the work to community social workers, who deal with all genders, and we tapped into that work.
We work in a very challenging environment in which we deal with men from east and west Africa as well as some men from the middle east—many people from places in the middle east, such as Yemen and Kurdistan in Iraq, also practise FGM.
The work that we do with men is very challenging. The need to work with men came because we stand little chance of doing away with FGM if we work with only one gender. The involvement of men is therefore very important. That is where we come at the issue from.
Thank you—that is very helpful. I will go straight to committee members for questions. Not every witness has to answer every question, but if you wish to contribute, you can. I will start with Oliver Mundell.
We heard from the previous panel about how the protection orders have been working in England and Wales. I note that only 3 per cent of those orders were made at the request of the person who was to be protected. As we bring them forward in Scotland, how do we empower more people to come forward and seek protection themselves?
We do that through education, first of all. The approach that we as a partnership have taken—it has also been taken by many partner organisations around Edinburgh and Glasgow—is about not jumping in and telling people what to do but making sure that people are on our side through an understanding of why FGM is a damaging practice and of the lifelong effects that it will have on the child, the girl and, later, the woman in her adult life. A lot of the time, once people understand those impacts, it becomes a lot easier to get them on our side and to get them to say, “That’s not the future I want for my child and I’m prepared to work towards protecting her.” I believe that my colleagues will agree with that to a large degree. It is about education, raising awareness and making sure that people understand that we are here to support, not punish.
To clarify the original question, was it about how we encourage people to engage with and seek protection orders themselves?
Yes, that was the thrust of my question. In England and Wales, 39 per cent of orders were requested by local authorities and 58 per cent—I think—were requested by the police or other third parties.
Reflecting on the first panel’s evidence and on other evidence to the committee, I think that there is a feeling that the process is something that is being done to communities, rather than people coming forward themselves and having confidence in the process.
My starting point, which was reflected in the discussions that I had with my colleagues in the run-up to today’s evidence session, is that, like the previous panel of witnesses, we have some questions, not necessarily about whether the protection order is required but about what teeth it would have and whether it would be useful in addition to orders that already exist, such as child protection orders. Obviously, we are more familiar with some of those orders at Multi-Cultural Family Base.
If we could go back the way, we would change the title and call it a protection and support order, because if we are asking people to come forward and request something themselves, there needs to be something in it for them. Our experience of intervention is that it is best received when it goes alongside tangible support to people, so the order needs to offer people support as well as protection.
Although I take on board some of the points that the previous witnesses made about the prevalence of FGM, our view as an organisation that works directly with people who are affected by FGM is that if we have a child who is at risk of FGM, we have a circle of people around that child who are at various levels of risk as well. If one of the additional risks to them is of prosecution or criminalisation, they will not come forward or engage. Who would? If it is likely that it will put someone’s other children at risk of having a parent who is prosecuted or criminalised, the hope that they will engage on that level with a protection order is reduced. We have a lot of concerns about that area. If we offer protection and support, there is a better chance that people will engage more readily.10:30
I agree with the replies from Angela Voulgari and Anne Spiers. When we had meetings with women from communities that are affected by FGM and we asked about the protection orders, the number 1 response was, “You can have as many laws as you like but if people don’t know about them or if they don’t believe that you are going to use them, it doesn’t matter what the law says.”
On how we increase the number of people at risk who apply for protection orders, the first thing is that they need to know about them. I can imagine situations in which both young women and adult women are at risk, because there can be a link with forced marriage. In some cultures, FGM is carried out on the eve of the marriage. The Rosa project research suggested some years ago that the age of protection should be raised to at least 25. That is an important gap in people’s thinking.
For children or younger women, the fact that somebody else applies for the order is not necessarily a bad thing. It is a huge step for anybody to take. Given the overlaps that sometimes exist in relation to domestic abuse, honour-based violence or cultural attitudes, it can be a help for family members if they are able to say, “Well, it wasn’t really us; it was that social worker that did it,” or, “The police made us do it.” Otherwise, it can cause a huge fall-out in the family.
Another thing that struck me about the discussions that we have had is that women often say that a woman cannot say no to her husband or her mother-in-law. That came across strongly—it is relevant to a different point, which was the suggestion of an offence of failure to protect, which was a huge concern in communities.
I agree with what my colleagues have said. We have also been discussing the issue with other groups. We had the same view as Anne Spiers that we should call the orders protection and support orders. We did not say it that way but I like that expression.
We said that the measure is a real contribution to prevention. The strategy provides a deterrent and not just punishment. One of my colleagues used a nice expression: “If you are going only to punish, it is like closing the stable door after the horse has bolted.” Deterrent measures are far more important. People should be educated, and we should raise awareness in all communities. That is what is needed. Do not bolt the door by jumping to the punishment. We agree with having a protection order.
To follow on from that point, will people see the protection orders as being sufficiently distinct from criminal prosecution, or will people see them as being connected to the criminal process?
It is hard to judge that. The understanding of the legislation and powers that might be brought to bear could be minimal among communities. In my experience, that is certainly the case in the white Scottish community. It is the same for all of us; unless something is specific to us, we might not have much interest in it. There could be a deal of confusion. Who delivers the information and in what way is probably more important to individuals and communities. I do not know whether my colleagues would agree with that.
It is hard to say. In discussions, people have understood what the orders are trying to do, which is to be a first stage that can protect people without it criminalising their parents or close family. The forced marriage protection orders do not seem to be a huge issue, so the orders should be workable.
The committee sent out a call for evidence on the bill, and we received 13 submissions, which were pretty mixed in their views on the additional protections that should be in the bill. Three provisions come to mind: lifelong anonymity for the victim, the offence of a failure to protect, and a mandatory duty to report. Should those provisions be included in the bill, or does it go far enough?
The bill has gone far enough. We had huge concerns about the failure to protect, and it came out in all our discussions that there might be serious unintended consequences. I am not a legal expert, but that seems to be contrary to everything else that we do in law. How can it be proved that someone failed to do something?
To go back to my original point, I have heard stories in which parents did not wish to carry out FGM but came under huge pressure when they went back home. I am sure that the committee can imagine a situation in which someone would say to them, “You should have just said no.” However, as I have already said, women have told us strongly that there are circumstances in which a woman cannot say no and stay safe or have her children stay safe.
On anonymity, our view was that it is not helpful to pick out FGM when we do not have similar legislation about child sexual abuse, incest, rape and sexual assault. If something is needed, it should cover all victims of gender-based violence—males and females. I am not convinced that that is necessary.
Our view was that, for FGM, lifelong anonymity should be guaranteed for any victim or complainer purely because of the further risks for them and their extended family members and community as a result of having spoken out against a centuries-old practice. There could be further repercussions from the wider community, and there could be all sorts of unintended consequences should the name of the person or the family be made known to the public.
The question on the failure to protect was quite divisive. Overall, we responded “Yes”, but our answer contained seven or eight considerations that need to be taken into account. Although we can see the benefit, it is not black and white. We need to be able to ask whether we have considered the specific circumstances in which the situation came to be what it is, and, if so—as Jan MacLeod suggested—how we prove that one way or another.
You also mentioned the mandatory reporting duty. That was another question for which answering why took a very long time. As Anne Spiers mentioned earlier, it is not just about making the reporting mandatory; it is about making the support for the child, woman or wider family and community mandatory. If we do not provide that support, further generations and potentially other members of the family will suffer, too. We need to step back and consider both sides of the argument.
I am sorry if that is not a very clear answer. However, it is not a very straightforward question, unfortunately.
I agree with what my colleagues are saying. The proposals were discussed at the FGM summit in July, and there were many issues. The phrase “failure to protect” is very elastic and cannot be defined. What is meant by “failure to protect”? It might even put the victim in the same boat as the culprit. There were other issues, such as the question of anonymity.
I think that the bill goes too far. There is no clear guidance for various issues, including the failure to protect. The third sector does not have any clear guidance. On Tuesday, we were in a meeting about the national action plan. Even the statutory bodies are not clear about all those things, so how can we expect communities to be clear about what the law says? We do not know whether there will be some guidance for the third sector.
The language is too technical, as well. It will be hard to deliver to communities at the grassroots level, for example, where English is not people’s first language. All the technical language would be very hard to understand for the people whom the law is aimed at. There could also be some profiling of communities or stigmatising of people. If you are going to use the legislation only for certain categories of people, how will the communities perceive that?
As Jan MacLeod said, there are some similarities with people’s perceptions of the forced marriage legislation, but that affects only certain communities in the Asian community, not the community as a whole. The bill could be different from the forced marriage legislation. It would have an effect on the wider community.
In the previous panel session, Dr Jackson made the interesting point that there is potentially sufficient protection coverage in existing child protection legislation to at least make the protection orders unnecessary. However, as I mentioned to Dr Jackson, we heard in a briefing from the bill team that sometimes adult women are subjected to FGM. Obviously, no adult is protected by child protection legislation. Can you talk about the prevalence of FGM among adult women if you have knowledge or evidence of that? Is there another route that we could go down instead of using a protection order which would not single out cultural groups in that way?
On prevalence, nobody can say for sure how many women in Scotland are affected by FGM, because that information is not collected anywhere.
On whether FGM protection orders are absolutely necessary, I know that, when we first discussed the issue at a multi-agency meeting in Glasgow some years ago, there was a feeling that it was already possible to effectively protect children. However, I think that I am right in saying that, as discussions have developed, there has been a feeling—certainly among the women and some of the workers from other organisations that we have discussed the matter with—that there would be a benefit in having something specific on FGM. It would bring to people’s attention that this is very much an issue for Scotland and for Europe because of migration, and it will continue to be an issue. Various pieces of research have been done that show that migrant communities sometimes hang on to their cultures and traditions much more strongly than they would in their home countries.
We could certainly protect children and young people without those protection orders, but there might be advantages in having FGM-specific protection. One particularly problematic issue—again, I could not give the committee the national numbers—is that the asylum system’s approach to FGM risk is very definitely at odds with what you are all trying to do and what Scotland is trying to do to end FGM.
I will give an example of that. It involves a woman who was married in her home country. Her people did not practise FGM, but her husband’s family did. They were Christian and believed that it was part of their religion and that it was rooted in other traditions. They expected the woman to undergo FGM before her marriage, but her husband did not want that to happen.10:45
Everything was fine—they brought up their family for 12 or 15 years, and then the husband died. The daughter was 11 at that point. The family had just arranged to come to the UK to visit the mother’s sister. They got an unexpected visit from the husband’s family, who had the attitude that the husband had died prematurely because he had broken the family traditions and who believed that they could remove the bad luck and prevent any further bad luck in the family by restoring the traditions. They had arranged for the daughter to be married at the age of 12 and for the woman to be married to her husband’s brother. I almost forgot to mention the key thing, which was that the daughter overheard that conversation. When they came to the UK, the sister said, “You need to go to a lawyer.” The lawyer in London told the daughter, “You don’t need to worry—you’ll be protected in the UK.” Since then, their asylum claim has been refused again and the mother is terrified to tell her daughter that, because she is very concerned about her daughter’s mental health.
When that family came to us, a social work referral had been made, but months had gone by. I am very interested to know whether an FGM protection order would have some weight in such cases. I heard the response that the previous panel gave. In that particular case, FGM was not just a possibility but was planned. Despite that, the claim failed. That makes me wonder what communities make of the fact that, even though legislation has been put in place that is directed at their cultural practices, another section of British society says, “No, you’ll be fine—just move to a different town.”
I am sorry that that was a long answer, but I think that that example highlights the point.
That has opened up several new avenues of inquiry for us, particularly as regards the interrelationship between our deliberations on the bill and the deliberations in relation to the UK immigration system.
I want to ask a question that I asked the previous panel, which is about the fact that FGM is a spectrum. There is the brutal mutilation of young girls, which happens against their will, right up to women from all cultural groups choosing to have changes made to their genitals, such as piercings or labiaplasty. Is there a danger that, by singling out one cultural practice, we might create an artificial racial barrier? There are cultural practices in our culture that are not traditions, but which are more prevalent. Do we need to reflect that in the bill, particularly in the context of consent?
That goes back to the previous question that you asked, with which there is a connection. You asked about the protection of women as well as girls and the extension of protection orders to women. With protection orders under other pieces of legislation, such as the adult support and protection legislation, the issue of consent for adults is a primary consideration. There needs to be a different approach when it comes to consenting women and offering protection to people with capacity so that a choice is involved.
I am sorry—I have slightly lost track of what your second question was, because I was working on the previous one.
I asked whether the bill needs to be more nuanced in relation to the spectrum of FGM and whether it might need to refer specifically to consent. If what is regarded by the WHO as FGM is undertaken with consent—I am talking about a procedure such as labiaplasty—do we need to disaggregate that within the bill?
I was very interested in what our colleagues said previously on the issue. I am not sure that I have any answers, but some of the discussions that we have had have been about the risk of racial and ethnic profiling being too much of a consideration when FGM protection orders are looked at. We are talking about ethnic profiling that can go hand in hand with people who come from particular areas of the world. It can look like ethnic profiling, and we are concerned about that. On a spectrum, we have a mild, unconcerning area at one end. I am not concerned about what causes people to be influenced to undertake cosmetic FGM, for want of a better term, but I certainly have concerns about ethnic and racial profiling, which my colleagues spoke about earlier.
I will clarify my question, which is about my growing thoughts about potential changes to the bill. If it explicitly referred to consent, all of that issue could be covered. We could remove some of the racial stereotyping that we are rightly worried about by saying that this happens in increasing numbers of cultures and most of it may be consensual and the person’s decision, but there might be times when a woman in our culture in Scotland will be forced by an abusive and coercive husband to have changes to her genitals, and she will probably need protection.
That is like changing the world. If you could do that, please do.
The issue comes up quite a lot in our training. We ask practitioners to think about being challenged when they say that they are a social worker and that FGM is against the law. A person might say, “How come? If I wanted to, I could just go and get labiaplasty.”
The bottom line is that there are women, including young girls, who are eagerly waiting until they are old enough to get it done because of social and cultural pressures, and also the impact of pornography. When I grew up, we rarely saw pictures of genitals, but now young people see them all the time. That has an impact on girls who have had FGM and did not realise how much they had been changed, and on girls and young women with regard to body image. There is a perfectly solid and strong argument that cultural pressures are leading to the same impact. However, most practitioners and people in general are clear about the matter. Although there might be concerns about people’s reasons for cosmetic genital surgery, the key thing is that it is not generally intended to limit women’s sexual pleasure or control their sexual behaviour.
References to piercing can be confusing. My understanding—I might be wrong—is that the original World Health Organization wording about “pricking” or “piercing” did not refer to jewellery, but was about tightening the vagina or something like that. That is unhelpful now. Sometimes, when midwives ask the question, it might be easier for people who are a bit uncomfortable to focus on the jewellery side, which is not really what the question is about.
That was very helpful.
That is an interesting issue and your response was helpful. The first thing that popped into my mind was that we need to be careful not to say, “That stuff that’s done in a cosmetic surgeon’s studio is fine—it’s a free choice—but that other thing is bad,” because all those things are related to the same structures in which women are not valued.
Lots of colleagues are waiting to come in—I am trying to remember in what order.
I want to go back to the issue of anonymity. Do Ms Voulgari and other members of the panel have a view about whether, in the context of the bill, anonymity for victims should be automatic? How might that work in practice? At the moment, the courts can grant witness anonymity under the Criminal Procedure (Scotland) Act 1995. Four criteria must be met for that to happen.
You support witness anonymity. How would that work in practice? Are the existing provisions for the court granting anonymity sufficient?
We firmly believe—this goes back to Alex Cole-Hamilton’s question, too—that automatic anonymity should be provided immediately. Many victims are children, but we have worked with women as old as 43 or 44 who were at risk of FGM and—if they refused to undergo the practice—at risk of an honour killing. We need to be aware that we are not just talking about children. The provision must be extended to adult women, including those in their late teens and early 20s.
Another consideration that influenced our response is that it is sometimes not necessary to state someone’s name, especially when they are a member of a community that is quite small and tightly knit. People in such communities know one another very well, and one of the issues that we raised in previous discussions was the way—
I understand the arguments for automatic anonymity—they have come through well in your responses. What I am trying to get at is how it would work in practice if the current act was amended by the bill, and why the current provision is insufficient with regard to the courts providing anonymity when women or girls are the victims, or at risk of being the victims, of FGM. The Government will say that the existing law provides for the courts to grant anonymity. I am asking you why that is insufficient.
If I am perfectly honest, I am not entirely familiar with the four conditions. We based our response with regard to this particular type of abuse on what we thought would be the most appropriate course of action as a stand-alone process.
Thank you. Ms MacLeod, do you want to comment on that issue?
I am a bit like Angela Voulgari in that I am not the best person to inform you about the details of the law.
The point that was just made came up strongly in a recent case in Bristol involving a Somali family. People in Glasgow knew which family that was from the way in which the media reported the case, even though no names were mentioned. People said that they could not imagine how additional legislation could be constructed that would stop the spread of information on social media. They talked about how quickly it spreads from one country to another, which has implications, such as family back home being threatened. I do not know how you could ensure anonymity.
We can perhaps bottom that out with the Government.
Ms Spiers, given that your organisation supports the training of social workers, do you have any views on whether it would be useful for the children’s hearings system to be able to grant FGM protection orders?
If FGM protection orders end up coming into being, I would agree with the children’s reporter having the power to grant them as part of the children’s hearings system. It would be really useful for such orders to co-exist with the other orders that are available to the reporter.
I would say that it would be useful for the children’s hearings system to have the ability to grant FGM protection orders for all the reasons that have been mentioned, and because of what Andy Sirel said about the benefit in the children’s hearings system not taking children and their families further into the judicial system—the courts and so on—than is necessary. That would be a more supportive approach.11:00
I want to follow up on questions that I asked the previous panel. The academics on that panel were not sure how prevalent FGM is in Scotland. From my experience of the issue, it would seem that there is not a body of evidence on FGM. Many of the services that your organisations provide are front-line services. How prevalent is FGM in Scotland?
In the interests of time, I will combine that with another question that I asked the previous panel. If we do not get the engagement right with communities, does the bill have the potential to make it even harder to reach people? Might the practice be pushed even more underground, for want of a better term?
I completely agree. In our direct practice, we are in the business of building relationships with people who are vulnerable; at MCFB, they can be vulnerable for lots of different reasons. However, if we ignore the fears among communities or individuals, we will be in danger of driving practices underground, alienating our services from communities and not being able to offer support to the people who really need it. We already work very hard to engage with people, and if they associate that engagement with some sort of accusation or insinuation of criminal behaviour, we will be on a really sticky wicket.
I agree that we need to get it absolutely right. The last thing that we want is to perpetuate the fear of engagement, not just with statutory services but with any kind of service.
To go back to your question about prevalence, that really is the golden nugget. Unfortunately, I do not think that there is an answer, partly because a lot of the numbers that we have come from maternity services, and not every woman who is a survivor of FGM will access maternity services. We tend to try to estimate the numbers using extrapolation based on census information, and prevalence in countries of origin. When it comes to women who are not going to access maternity services, are other professionals aware of what questions to ask in order to establish whether FGM is present? That includes not just health professionals but teachers, social workers and people working in services across the board that women are likely to access.
Nobody can say for sure what the numbers are, but we have one Glasgow-based project, rights and choices, which, although not FGM specific, works with asylum seekers, refugees and migrant women. About 70 per cent of the women there have undergone FGM, and a significant number of them would have had type 3. We regularly—month in, month out—come across women who have been in touch with services and who have not been asked the questions or given the information that has allowed them to talk about physical or mental problems—health impact, rather—or problems in the family, some possibly relating to child protection. There are definitely significant numbers of women, and families, who have been affected, and who could have more negative impacts that are not being identified. We have made a big difference in raising awareness, certainly in the central belt, but I agree that we need to continue that work.
The answer to getting a better idea of the prevalence of FGM and to improving engagement is to target resources at key points of contact. Not everybody has children, but everybody should have a general practitioner, and women should be part of the national smear testing programme. Key points of contact include registration with a GP, the smear testing programme and maternity services. We should also ask whether there is an opportunity, when children go to nursery or school, to include something in every parent’s pack of information and to engage at that early stage, so that we start to build up a better picture. It is particularly important to do that in parts of the country where the percentage of the population who are at risk is very low, because if FGM does take place, it could have a catastrophic effect on girls.
On the argument about FGM being driven underground, I do not think that the bill will do that. However, if the law was badly applied in the first instance, that could certainly happen. Skills and training will require to be provided. My view is that if the first orders that were placed were seen as the family was just planning to go on holiday, that would have a really negative impact and would have unexpected negative consequences. At one meeting, a woman made the point quite strongly that, if a family really wanted FGM to take place, they would send the girl abroad and not bring her back. Families who are really committed will be able to do that anyway, but the bill could protect other young people.
It is very hard to know how prevalent FGM is. I work with men, so it is very hard to know. Three weeks ago, we had a workshop where there were people from a number of communities. There were three people from the Yemeni community, who argued that there is no FGM in their country. They said that not even one person had been affected, although the rate of practice is 23 per cent in Yemen. We spent half an hour arguing with them, by showing them websites and googling. We showed them newspapers from their own country, but they said that they could not be relied on. We showed them other resources from their own country, but they were still adamant that the rate was not even 1 per cent there. If people do not know that FGM is happening in their own country, it could be happening in this country without their knowing.
The same is true for me. I have two daughters, and it was only when I engaged with these issues that I knew that FGM had occurred with them. In our communities, although there are some cultures in which men are involved, mostly, these things are done through the women. People do not necessarily know that it is happening, so it is very hard to know about the prevalence.
The other question was about whether protection orders will lead people to go underground. The answer is yes and no. A protection order could be empowering for people, if it is used correctly.
As Jan MacLeod said, many people perceive FGM as a religious thing. For our projects, we bring in some imams for Muslims, as well as some priests, to educate people, because there is a wrong interpretation of some religious sayings. For example, some sayings in Islam make it seem as though such things are acceptable. We bring in religious men to talk to people, and we give some examples. For example, Saudi Arabia is a totally Muslim country, but nothing is happening there. If FGM was related to Islam, Saudi Arabia would be one of the countries in which these things are done. North Africa is a predominantly Muslim area, but FGM is not practised there, except in the north-east, in Egypt, where the rate of practice is more than 90 per cent.
Protection orders will be a blessing if they are used properly to empower communities and raise awareness. A lot of work is needed, so we should not rush the introduction of the orders, because that might have a negative impact.
While we are talking about the protection orders specifically, do panel members have a view on what length of time they should cover?
They would need to be very flexible and potentially long term.
Sometimes it is helpful for us to understand a scenario or a circumstance—it can seem a bit abstract just to talk about orders being out there. Can witnesses think of examples of women whom they have worked with and what type of intervention would have given them the protection or space to take action?
I am probably competing with my colleagues to give you examples—yes, we have examples. One involves a woman who was referred to us as a survivor. She was receiving support from us and she declared her fear that FGM would be performed on her two-year-old when the family returned to its home country after a period of study; they were in the country on a study visa. The two-year-old of the family would be at risk, as that had been declared to be the plan of the extended family back home. Her husband was, at best, ambivalent. He saw it as a tradition and—as has been said—did not feel that he had much of a part in it. For him, it was just something that was going to happen.
My colleague, the FGM support worker, worked with the woman closely, to the point at which we felt that the child was at risk and that the woman had very little agency to do anything to protect the child. At that point, following the getting it right for every child guidelines, we involved our statutory colleagues. The family then engaged with specialist social work services—in that case, asylum and immigration. The family went forward, engaging voluntarily, because there was a six-year-old little girl in the family who was an FGM survivor and the woman was an FGM survivor. She also had male children and she was in great fear.
An issue for her was that she came from a relatively affluent and well-educated family. She lived comfortably while she was here with her children, who were settled at school in Scotland. In pursuing the protection of her child, which was her number 1 priority, she faced, in all likelihood, the prospect of losing her husband, who would go back home without her. He may have attempted to take the children with him; however, secure arrangements were made to prevent that from happening. In her view, she would certainly be abandoned in a country that was not her own, speaking a language that—although she could speak English—was not that familiar to her. Her family would be uprooted because she would have to seek asylum. The children would be taken out of school and nursery, and they would be moved to and accommodated in Glasgow, where they knew absolutely nobody. That would be the result for her—she would be on her own in Scotland, where she did not choose to come in the first place, in order to protect her child.
That is where we talk about protection and support. The little bit of breathing space that a protection order might have provided in the first instance would perhaps have given her some time to think about her options, with some protection. However, it would not have changed her options much, because of the concern that we have all expressed about the interface between protection orders and the legislation that we have in Scotland and Home Office legislation. Hypothetically, there was the potential for that woman’s immigration and asylum situation to change and for asylum to be denied to her. She would then have been an abandoned woman going back to her home country with her children, and all that we would have done would have been to increase her vulnerability and the vulnerability of that child.
How would a protection order make such a situation better?
I know that that sounded like a very well-rounded case study, but that is the question that I came here with.
It is the key question, and it is one that we will certainly put to the Government. Does anyone have anything else to say on that question?11:15
That is the scenario that I would have picked. I gave you the other example—the most common referral that we get is when there are quite urgent child protection concerns, especially when the family states that plans are definitely in place and it is not just a theoretical risk.
An FGM protection order might help only with winning an asylum claim. It might not help at all in relation to having an impact on the family, and what is needed is support for the family.
Thank you. That is helpful.
I thank you all for your evidence, which has been very helpful. I will ask you—as I asked the previous panel—about the guidance that will come with the legislation. That guidance will be incredibly important, and the committee can make suggestions about what we would like to see in it. I am keen to hear your thoughts about whether there is something in particular that should be included.
Mr Darasi, I was particularly interested in some of your comments about the work that you do with men in communities. We cannot exclude men from any of the learning, education and support for families. I appreciate that we do not have a huge amount of time, but I am keen to hear whether you know of any good practice in communities that we could recommend including in the guidance. If you cannot go into all the detail today, I would be grateful if you could contact the committee later, to let us know about that.
We have discussed this in a group as well as with some people from here who visited us. What is available is a little porous, and it is not very clear. First, there is no clear indication of what the guidance is and whether the third sector will have its own guidance. We put something in writing about that. For example, it is not clear in the bill which people can apply for an FGM protection order. The list of people who can apply includes “any other person”, but only with the permission of the court. We are not clear about what that means, and we need some answers on that. If we do not have those answers, it will be hard to know what to do.
There should be some examples of what triggers the protection order. For example, as Jan MacLeod said, if a girl is going away for a longer period during the summer, that could give an indication that something might happen, but it could happen in an even shorter time. There are many things to consider.
We also want to know whether there are scenarios from other parts of the UK that could help us in our work on guidance. We work with different cultures—for example, some men come from the middle east and are Arabic speaking. There are some Kurdish people, and we deal with people from different parts of east Africa—Somalis, Eritreans, Ethiopians, and Sudanese people—and from west Africa. We deal with some Egyptians as well. It is very challenging.
It is mostly those people who come from east Africa who depend on their religious teachings, saying that type 1 FGM is a religious requirement, whereas in west Africa it is mostly cultural. The topic needs more time, and maybe I can give more feedback on it later.
That would be very helpful. Thank you. Ms Spiers, do you want to comment?
My view of guidance is influenced by our training role. If guidance is issued, it needs to be accessible for training purposes. As you would expect from the third sector, we would say, “Could that please be resourced?”, because we cannot carry the burden of that training. In my previous role, I was a learning and development adviser, so I understand the importance of training as it comes down through the statutory sector to the workforce. Sometimes, in the third sector, we carry that burden ourselves. Angela Voulgari and I worked in partnership, and a big part of the bright choices initiative was to offer local authorities advice, training and support in relation to a number of the topics that we have covered today. Any guidance that is issued needs to be resourced in such a way that it can be disseminated.
Okay. Do other panel members have a view?
The existing guidance has a lot of helpful information in it, which can be built on. Obviously, we need to keep working on general awareness and, if the legislation comes into force, promoting it. However, there is a lack of practice skills such as how we ask the question, whether people are clear why we are asking it and what should follow from a positive response.
We need something that would get key organisations to have regard to the development, at key points, of appropriate skills such as going to the GP, using maternity services and entering education. Every family will do one of those things. If they have kids, they will have to use maternity services. We need to concentrate the resources, because just saying, “We should do more training” will have no impact.
I am not sure how it could be done, but we should highlight the importance of carrying out community engagement even if, initially, it is just engaging with organisations, so that practitioners are aware of organisations such as the Kenyan Women in Scotland Association—KWISA—the my voice project and the other projects that have submitted evidence. We should not talk to communities just when we have a crisis; communities should be able to inform us.
Work that was done in Glasgow about engagement was really informative. The good practice guide that came out of the Rosa-funded multi-agency initiative has strong and clear guidance for community engagement, and I recommend it. The guide recommends highlighting positive change, because African communities have demonstrated that they can change attitudes to FGM. It is not a simple story, but there has been a significant fall in its prevalence. If this initiative could be linked to positive, community-led change, that would go a long way to avoiding possible negative consequences and a bad start to the legislation.
You asked for specific examples that can be used to inform further guidance. In July 2017, the Edinburgh child protection committee published the “Edinburgh and the Lothians Inter-Agency Procedures for the Protection of Girls and Women at Risk of Female Genital Mutilation (FGM)”, which has been instrumental in our work. It is a supportive, detailed and informative document that, as Hassan Darasi said, has been helpful because it breaks things down into the specific responsibilities for each professional. For example, what would a health professional, a social worker or a third sector worker do? It is clear about what they are expected to do. I highly recommend that, in any consideration, it would be a good document to consult.
That is helpful. Thank you.
I thank the panel members for their evidence. It has been very helpful and we are grateful to have had them here.
At our next meeting, we will continue to take evidence on the Female Genital Mutilation (Protection and Guidance) (Scotland) Bill.11:24 Meeting continued in private until 11:37.
12 September 2019
Second meeting transcript
The Convener (Ruth Maguire)
Good morning, everybody, and welcome to the 21st meeting in 2019 of the Equalities and Human Rights Committee. I ask everyone to switch off their mobile phones and put them away. We have received apologies from Angela Constance and Annie Wells.
Agenda item 1 is stage 1 of the Female Genital Mutilation (Protection and Guidance) (Scotland) Bill. I welcome our first panel. Esther Kamonji is from the Kenyan Women in Scotland Association, Girijamba Polubothu is manager of Shakti Women’s Aid, and Sara McHaffie is the violence against women development officer at Amina—the Muslim Women’s Resource Centre. You are all welcome. Thank you for being with us.
Can you tell us about your knowledge or experience of FGM, and the work that you do in relation to it and, in doing so, say whether you support the aim to strengthen the existing legal protection?
Sara McHaffie (Amina—the Muslim Women’s Resource Centre)
At Amina, we have a helpline that offers support for women who call us for any reason, including because they have a concern about FGM or have experienced it themselves.
My role involves training our staff and volunteers, including on FGM and related issues, and it involves awareness raising in the communities within which we work. I might, for example, lead a session in a women’s group during which we talk about violence against women and girls in general. We would include FGM as part of that, so it is not set off to one side as a stigmatised issue.
We also work with men’s groups: we work with sheikhs and imams and show a film that features them talking about FGM and the position on that within Islam.
We do campaigning, blogging and social media, to correct attitudes more widely than among the folk to whom we have time to reach out. Obviously, we also contribute to policy, locally and nationally.
Girijamba Polubothu (Shakti Women’s Aid)
We provide domestic abuse services and support women who are suffering all forms of domestic abuse, including FGM, forced marriage and dowry-related abuse. We are actively involved in campaigns on those issues.
We have been supporting women from countries where FGM is practised. FGM has already happened to the women whom we support and who have migrated to this country. However, recently, we have also had cases in which mothers are fleeing domestic abuse, and there is an element of fear of FGM happening to their children.
Currently, we have five cases: one mother with three children, a single person and another woman with children. I hope that it is okay to say this: for one woman, FGM took place in Europe and she fled from there to prevent further harm. Those are the types of cases that we support.
We also support other domestic abuse cases; we support the women to get access to accommodation and to financial support, including benefits. If there are issues to do with immigration and asylum seeking, we help the women and children to get them sorted out.
If a woman or child discloses that FGM is happening, we support them to access protection orders, on which we work closely with the police and social work.
Esther, could you say a bit about your organisation, please?
Esther Kamonji (Kenyan Women in Scotland Association)
Thank you. I am sorry for being late.
Our work is mainly focused on African women. I will give the whole context. Most of the people whom we work with and associate with in respect of FGM come from the African continent and its diaspora, and many come from the FGM-affected areas.
I will briefly give the historical context of the Kenyan Women in Scotland Association and how we came into being. We were not the first to fight FGM. In Scotland, the Prohibition of Female Genital Mutilation (Scotland) Bill was introduced in 2005, and a lady called Khadija Coll, who is still very active today, fought hard until it came into being.09:15
In 2002, Akina Mama wa Afrika, a group of Scottish African women, came together. They worked on FGM and talked about it, and thereafter even offered training. Akina Mama wa Afrika has since become an international organisation that has its head office in Kampala.
Over the years, many people have become experts on FGM. At one point, everybody was talking about it. However, within the community, people were getting very disgruntled. In 2013, we decided to come together to address the issues because our voices were not being heard and our faces were not being seen in relation to FGM. Everybody else’s fingers were in the pot, but our fingers were not; we were just being dished the food, as we say.
In 2014, KWISA had a seminar in Linlithgow with the assistance of West Lothian Council. Eighty women came from 14 different countries. You will note that KWISA is Kenyan Women in Scotland Association: we had to register some organisations because if you are not registered, you are not known. All those women were involved in fighting against FGM in one way or another, but we did not have a platform. That is how we came together.
At that seminar, we cried and laughed at the same time, but it was clear that we needed to have our voices at the front, and that we needed to contextualise how FGM was being discussed at that time. The issues were about everybody else being an expert, and the language that was being used. Our involvement in the whole discussion was just a token and we were not part of it: people talked about us, but without us. That is how all the women who came to that seminar felt. It was clear that we needed to raise awareness, to talk among ourselves and to be involved with other people.
After that, in one year, women tried to come together on a voluntary basis, but it could not work because of other commitments and because it was voluntary. African women in Scotland against FGM was formed, and it was recommended that, having worked for one year, we really needed to formalise that properly and move forward. Later on, we were funded through a grant of £20,000 from the Scottish Government, which propelled us on in starting the project.
I will show the committee our model later. The KWISA engagement model is not the traditional engagement model that is used, especially in policy making and the process as a whole. You will see that, when we make policy, we start with the policy agenda, then move on to risk assessment, then formulate the policy, then we do consultation, then implementation.
This is a community issue. So that is where we start. That concept has been used in many countries. Our community issue at this time is FGM within the context of other things, so we analyse and prioritise it, and we do community learning, looking at skills and development. Then we consider delivery of services that we have around us and which influence us, and then we look at changing behaviour. We started with the women. We have worked with other stakeholders, but the community is the main stakeholder.
We are insiders. Some of us have been through FGM so we know the context. We wanted to avoid the single story that was being told that there is only one type of FGM—cutting—because there is a lot more to it than that. FGM is not just about cutting.
Looking at the whole picture of what happens, it is critical that we engage men, women and faith leaders, when it comes to FGM. The service delivery organisations also need to be engaged, especially social workers and the national health service, which we have worked with.
Esther, I will pause you. Many of the things that you are saying about what has happened in the past will be relevant to what we are doing now. I hope that questions will draw out more of your experience.
What are panel members views on the existing legal framework? Are the approaches that we have to hand at the moment being used effectively, and if not, why not?
The existing legislation describes FGM quite well. It would be ill advised to adopt new language without thinking that through. As Esther Kamonji said, it is a matter of consulting extensively with practising communities. Some of the language in the consultation was quite inaccurate. It included, for example, “vaginal elongation”, which is not a thing.
The existing legislation is quite clear. It covers things such as labial stretching in type 4 FGM. I think that the current legislation is sufficient in how it describes FGM. There are issues related to the fact that we have not had prosecutions. We have to consider whether this is about supporting women and girls who have already experienced FGM, as well as criminalising what might happen, that we might not currently be able to capture. Protection orders might fill that gap through prevention, rather than through retrospective criminalisation.
Does anyone else wish to comment on the existing provisions?
I agree with most of what Sara McHaffie has said. Before the meeting, we discussed other things. Esther Kamonji referred to the language that is used in describing FGM. Also, demonisation of communities in which the practice happens seems to be a problem.
There is a way to do things better. The bill is good, but as Esther said, we should work with the community and find the words that describe FGM. For example, some of the women whom we support do not like the word “mutilation”; they prefer “cutting”. Sometimes, we push the communities away through the language that we use; they go on the defensive because they have been used to the practice, which has been passed from generation to generation. I am sure that in the past nobody even thought about it as being against human rights or anything else. Our role is to work with communities, while supporting the survivors of FGM.
I will mention one more thing. There is a problem of cases involving domestic abuse such as we support, in which men have used FGM to prevent women from visiting their families. There was, for example, a case involving the death of a family member in which the woman could not go to her family.
To be clear, are you saying that abusive partners are using FGM as an excuse to prevent women from travelling?
Yes. When women want to visit a family member, the men say no, especially when there are female children. They might say that there is a fear that she is going somewhere for FGM. That creates a problem. That is not the intention of the woman, but it is used.
Alex Cole-Hamilton (Edinburgh Western) (LD)
I have a brief supplementary question, but I will come back later with other questions.
Girijamba’s point is really interesting, and we have not heard it before—at least, I had not—so I would like to explore how to deal with that, perhaps through guidance that would accompany the bill.
Further to the convener’s question, we heard powerful evidence last week about dangers in respect of racial profiling and stereotyping, through the bill, and about the creation of a legislative framework that might unnecessarily prejudice a community. We are very sensitive to those issues. The same person also suggested that existing child protection legislation is sufficient to protect young girls in such situations. Do you agree?
Sometimes, when we get calls asking for our advice in such cases, we simply say, “I’m not a lawyer, so I don’t really want to comment on something I’m not an expert on.” As a woman and as a domestic abuse worker, I sometimes get so frustrated when people come in and say that a child is at risk of either FGM or forced marriage and they concentrate more on the cultural aspect and whether they will offend the community. In such cases, we ask those people what they would do if the child was part of mainstream Scottish culture and they felt that some harm was going to come to that child. Of course, they would use a child protection order. People should think about the subject in that way, rather than finding barriers and saying, “Maybe I’ll offend them” and “This is a cultural thing”. People get entangled in that discussion. We need both the existing child protection legislation and the bill, because we might need to use both.
So, you do not oppose the introduction of the bill.
No—it would be good to have the bill.
You think that it would be good to have the bill, on top of the child protection legislation.
Yes. I want to make it clear that we support the bill.
I agree with Girijamba Polubothu: the child protection legislation and the bill are definitely both needed. Of course, we can get entangled in the cultural aspect, because everybody has a fear of racial profiling, but it is important to name the problem so that we can frame it adequately. Both measures are important.
Fulton MacGregor (Coatbridge and Chryston) (SNP)
I will follow on from Alex Cole-Hamilton’s question about child protection procedures, a big part of which is the children’s hearings system. We have asked previous panels for their thoughts on whether the children’s hearings system should be able to make an FGM order, which is not currently provided for in the bill. What are your thoughts on that?
I am not so sure—I think that it should still stay in the children’s hearings system. Most of the people who undergo FGM are underage. There may be instances when some adult women undergo FGM after marriage or for whatever reason, but most cases involve children below the age of 18, so we should handle them like every other child. That is what we believe.
Perhaps I can rephrase the question, because I probably did not put it very helpfully. At present, the children’s hearings system can implement legal orders for children who are at risk of harm and in need of protection. That was mentioned in the responses to Alex Cole-Hamilton’s question.
However, the bill proposes that only a court would be able to make an FGM order; the children’s hearings system would not have the ability to do that, although the court could refer the issue back to it. I am trying to find out whether you think that it would be helpful if the children’s hearings system also had that power, or if you feel that it would be best placed with the court.
One answer might be to look at how forced marriage orders are currently implemented. Obviously forced marriage can affect adults as well as children, but since those orders came into being it has sometimes been felt that not enough bodies are able to ask for an order. Perhaps the provisions could be widened to include another body with expertise. That approach could even be trialled—it does not necessarily have to be a black-and-white change. Amina tends to support adults rather than children, so it does not have specific expertise on children’s hearings.
As regards how the bill will be put into place, looking at how forced marriage orders have been used and monitored will definitely be helpful.09:30
Although we have children’s services, I do not know much about how children’s hearings work so I would prefer not to comment on that.
As Sara McHaffie has said, it is better to widen the number of people who can seek orders. For example, the right to seek forced marriage orders has been extended to the police, which was a development that we supported.
I come back to the earlier point about why we would ever treat girls who have been affected by FGM differently from any other girls we were concerned about.
Our argument is that we should treat such children the same as we would treat Scottish children who might be at risk of harm from their parents because of the parents’ drug addiction or similar problems. If a child is at risk of FGM, that is a family issue that we must treat in the same way as any other.
I want to move on to what are perhaps wider questions. What does the panel think the overall impact of FGM protection orders will be? Will there be a need for training across the various agencies and bodies that are likely to be involved?
We find that whenever legislation on FGM is passed, disclosures and reporting increase—and, of course, there is now more awareness of the subject among the public. However, there are no services to support survivors once they have reported cases. It is good that legislation is being passed, but the Parliament also needs to look at how survivors who report cases might be supported.
You also asked about training, which is a very complex subject. Services need to partner with people who come from the practising countries. Organisations represented on this panel offer services. We all have service users who we consult and our workers do that too, so we are quite confident in our training. Unless a person comes from the relevant community they will not be able to answer some of the questions that arise in training. I know that because I have been training myself and have come across such questions. At the same time, I repeat that we do not want to see communities being demonised. FGM has been practised for a long time, but we want to work with communities and survivors to eradicate bad practice.
I agree that there will definitely be a need for training and informing everybody—the community, practitioners and service providers—because the bill adds value to what exists. However, when it comes to training, what Girijamba Polubothu has just said will be critical. I add that the reason for KWISA’s coming into being was that everybody was training back then, in 2013 or 2014, and they have continued to do so. We have discussed before, however, in the context of the FGM national action plan, that there is a need for standardisation, attention to language, understanding and community involvement, because this is not a single story. There are many and diverse reasons why people practise FGM.
Also, the context in which training is done might either offend individuals in the community or allow them to take up the issue. I will give you an example. A housemate of mine, who is South African and has gone back there now, knew that I was involved in a lot of FGM and community work. She once went to a training session somewhere in Edinburgh—I do not know where. She is not from a practising community, but she is a mature woman. In that group, men and women were seated together and a young person was doing the training. The trainer was excellent and knew everything, because she was a highly qualified nurse and she understood everything.
When my housemate came out of the training, she came home raging and said to me, “Esther, in your FGM work, do you actually go out there and tell people to look at what African women look like?” I asked her what she meant, and she said, “I am upset because people are being exposed.” Remember that, under normal circumstances, even within the communities that practise FGM people do not know what is happening. She told me, “I felt that they are telling people that when they meet an African woman they should expose her and check.”
That trainer was well versed with the programme, and with training and the issues, and if my housemate came out feeling that way, what about the person who has absolutely no idea of what is going on? That is my tic. We need to be very careful about how we do things and to partner with the communities so that we can standardise, speak their language and support what is already there on the ground. That is why I talked about the history. Women have been working on those programmes in this country since 2005, but we are still talking about the same things today, in 2019.
My speciality is training, so you must tell me to stop when I have talked too much. As white Scottish people, we need to remember that FGM is not something that one community is doing far away from us, and remember our relationship with those communities. As white westerners we have a long history of fetishising sub-Saharan African women. We can look at what happened with Saartjie Baartman and the way that she was treated and exposed; particularly, the way that her genitals were made a feature of her identity in a way that other women do not experience. Also, we exported Victorian colonial attitudes to other countries and seeing those attitudes reflected back reflects on us more than it does on those communities.
When we talk with women—and men—from practising communities, one of the big concerns is that it becomes their whole story. Those people do not necessarily have a platform or access to ways to tell the stories of their achievements and of themselves as human beings. In effect, the first thing that somebody might assume about a person is that they are from a community that practises FGM. It does not necessarily respect geographical boundaries; we cannot assume that because somebody is from a certain country they have experienced FGM, and we certainly cannot assume that they approve of it or otherwise without having a gentle conversation around attitudes.
Even health professionals can sometimes demonstrate that a little knowledge is a dangerous thing by assuming that somebody who looks as though they might be of sub-Saharan African origin has experienced FGM. Other examples might be assuming that someone has sickle cell anaemia when they are not remotely from the side of Africa where that is a thing. There is a lot of, “Oh, you are from this place: therefore, this must affect you and you must feel like this about it,” while on the other hand they do not unpick personal bias from the side of being a white western practitioner.
Training needs to be funded enough to allow people to unpick that bias. If it is e-learning, for example, where somebody rapidly reads it through, perhaps on their lunch break because they are so busy, it does not go in in the same way and people do not necessarily notice their own bias. Even if someone has a long history of reflective practice, there can be blind spots.
Some practitioners might be more able to attend training sessions, which is great, but other people working in the area—interpreters, for example—will not necessarily have the ability to do that on a paid basis. When issues come up locally, there can sometimes be a general sense of panic, even though we have great harmful practices protocols. I might be running around like a blue-arsed whatever doing training here and there, and there are other wonderful organisations doing the same, but people panic. They do not necessarily look at the protocols, and they sometimes push the responsibility on to third sector organisations. They might even ask those organisations to provide interpreters. Obviously, that presents a conflict of interest. The interpreter could be a family member—again, that would be a massive conflict of interest.
There may be a paid interpreter—the family may have had their right to access an interpreter explained to them, or a social worker may have organised an interpreter—but interpreters do not always have the chance to debrief after a session. They are paid sessionally, generally speaking, and they do not have the chance to attend training on a paid basis. It would really help if interpreters could be reimbursed for attending training sessions that were provided by organisations recognised as training to a gold standard, as Esther Kamonji mentioned. It should not just be anyone who provides the service; there should be some way of centralising what the training is meant to be. That goes for all the issues around violence against women and girls—VAWG issues. The training should be in line with the values of equally safe, and no one community should be stigmatised.
It would be really helpful to have something like a training bursary. I know women from practising communities with whom I have co-facilitated training, or who have helped me to create materials for training if they have not felt able to speak openly themselves. I am trying to mentor women who seem promising as trainers, and when I suggest to those women that they should go to this session or that session, we find that there is no training budget. They might be working in the area, but they are not able to access funds. They may be developing expertise, but they might not be able to put it into a wider context, because of the restrictions on working for third sector or voluntary organisations. It might help to have some kind of budget to allow people who are already experts to give training. It would also be good if there was some magical way to pressure people from the courts to access training, if they are going to be passing orders.
I have a further question, although I am aware of the time constraints.
There was a wee bit of discussion earlier about criminalisation, and we heard some views about that for the record, which is good. Are the members of the panel able to give their views about the penalties that have been set for breaching an FGM protection order?
It is okay if the panel members do not have a view on that.
This next point taps into some of the questions that we have been discussing about the application of the proposed law. I am thinking about other laws of a similar kind that the Parliament has passed. The clearest parallel can be drawn with the Protection of Children and Prevention of Sexual Offences (Scotland) Act 2005, which created risk of sexual harm orders, or RSHOs. The order is a preventative measure that can be applied to protect potential victims from online grooming. That act came into force more than 10 years ago, but we have discovered that the number of RSHOs that have been applied by the courts can be counted on one hand. That is not to say that the problem is not happening or that children are not at risk of sexual harm, but there is a lack of guidance to the police, the judiciary and other stakeholders. What additional measures do we need to take to make the bill that we are discussing real, so that it protects people and is used, and so that it is not allowed to wither on the vine?09:45
It is important to have protection and support. If we just go criminal, it will not work. It would be good if we had protection and support for the person who is reporting. Remember that these things happen within the family and the community. It does not matter if the community is in Scotland, London or Africa. Today, with WhatsApp and the media, people will find out. It is important for the community or individuals to understand that they are being supported through the process.
At the moment, there are a lot of issues around protection. A child may come and say, “I am being taken away. I am going for FGM. What happens to my mother?” Remember that it is done in love but it is a crime at the same time. Does the child want their mother, their uncle or their auntie to go to prison? We must have protection and support systems in place.
I have another example. FGM has been fought, especially in Kenya, for more than 100 years. You should read “Facing Mount Kenya” by the first president, Mr Jomo Kenyatta. We need to understand why communities practise FGM. Why is the practice there? Why has fighting it legally not worked? It has worked in places where the communities have taken the lead, so that the people are supported. There are plenty of examples of that across the world. For me, the bill needs to come with protections and support.
That was a helpful answer. Do we need to ask the Scottish Government to provide money to properly train social work, the police and the judiciary in understanding the issues around FGM, so that they can use that arrow in their quiver, rather than just applying normal child protection laws?
Training is good and it is important to the practitioners, but where is the community in all that?
That is a helpful question.
The community must be there, giving its views on the way things happen. The KWISA model works from the ground up. We are just women who came together. This year, the Scottish Government gave us £25,000, which is helpful, but our way of working is about the fact that I know people back home and people here. Women from 15 countries have something back in Africa and something here. Within the bubble of their communities, there is a snowballing effect. That information is gathered together.
If we want change to happen, we should train the community members and get them involved. We should get the leadership, especially the faith leaders, involved. Faith leaders are critical in all this, because people go to churches and mosques. We should also get opinion leaders involved; not just one person, because then we get a single story, such as, “It is only cutting”, although we have four other stories.
Yes, we should train the practitioners, but we should also get the communities involved, so that we get the whole picture, people talk to each other and we know the intrigues and intricacies of the whole concept.
Thank you. That was helpful.
The training should be made mandatory for social work, police and anybody who is involved in supporting or who may come across FGM cases.
Esther Kamonji mentioned the communities. For me, it is important that we work with the survivors, irrespective of whether it is historical FGM that was done elsewhere or here. It is important to take their opinions and ideas into the training. I agree that there should be money available to train the survivors to become trainers. If a survivor has just some input into a whole day of training, that would be a good idea.
It might also be good to have some awareness raising available to MSPs or Scottish Government policy people who speak out about it, because there has been some unhelpful language from politicians. For example, the word “barbaric” is racially loaded. I am picking up the word “traumatic” a lot. We are all obsessed with language but, if you have only a couple of column inches to put the message across, it paints a vivid picture of disgust at somebody who is a Scottish citizen. That is never appropriate. To call it inherently traumatic does not pick up on the fact that some survivors will use that word and some will not. It does not echo what we hear from women who have experienced it. When the change is implemented, the way that we put the message across is just as important as the way that support bodies and statutory organisations use it. When it comes to awareness raising, we get one shot at press releases and that kind of thing. That will put it in the news. If it is done in the right way, it will increase the need for support; if it is not, it will entrench secrecy and stigma.
That is helpful, if mildly terrifying. To that end, if that feeling exists, I would appreciate a submission on the language that we use here, such as a glossary of terms that are racially charged or unhelpful. We do our best, but we have many different plates spinning and we might easily get that wrong. Please make a submission to guide us through the process.
I have a final question. It is only if we can reach the girls who are most at risk of FGM and impart to them the reality that FGM is not right, that they have a choice and that they can be protected, that the bill will be a success and that we will fully eradicate the practice or risk of FGM in this country. As we have discussed, a range of barriers, such as language, culture and, sometimes, family, mean that those girls are potentially further removed from society and other girls. How best can we communicate directly with those girls? How can we get them to talk to one another about what is right and about their right to protection?
With any form of abuse, whether it is forced marriage, domestic abuse or FGM, we have to start talking about it in schools. It has to be part and parcel of education. It is not just about talking to the children from African communities. We want the mainstream children to know about those things, too, because they are our future citizens and they are the ones who will lead the country. We want to raise awareness with every child in the country. It is not just about the children who come from practising communities. As I said, with every form of abuse, that is what should happen.
I agree. Looking at the way that we have worked, KWISA started working with women, then with men and women. Our most recent project, which we did with Glasgow Caledonian University, was a research project with Glasgow City Council. Unfortunately, the project ended after a year. We were working with schoolchildren. The beauty of the project was the energy that we saw in those children. Some of you came to the conference on 6 February and saw the impact of the information on those girls after we had worked with them for six weeks. Although they are African children, some of them had never heard about FGM. Nobody talks about it in school.
However, it is not just about FGM. We cannot put FGM in isolation without talking about human rights and the other issues that go with it. Traditionally, FGM is supposed to be a rite of passage. We need to have those programmes in schools but in a way that will not stigmatise the children. I agree with Girijamba that everybody needs to talk about it. The girls need to start knowing, because some of them opened up when they were asked to go and talk to their families. It is about giving them the knowledge, the confidence and the aptitude, because it is not an issue that is openly talked about. That project was for one year and it is finished now, so we have to find a way to work with it and, we hope, with you.
Thank you. That was helpful.
We probably need more than a glossary to properly address our inherent bias. I appreciate that issue. Feel free to challenge us if we use language that is not helpful.
Mary Fee (West Scotland) (Lab)
I apologise for my voice. I have a couple of questions around guidance, which I will ask together. I also have a specific question around training.
The bill gives ministers the power to introduce statutory guidance. Do you agree that the guidance should be statutory and not advisory? What should be in the general guidance and in the specific guidance on the protection orders?
I made a submission to the original consultation. It took me a while to think through, look at what was out there already and give a fully informed answer. I cannot do justice to the question in the five minutes that we have left, but moving towards having statutory guidance might lend credence to the fact that, as we were saying, people need to take it on board and take it seriously.
The guidance should be statutory, but without going into the details. People need to see the seriousness, whereas if they are just advised they can decide to take it or leave it.
What was the question about training?
I will come on to training in a moment. Does Girijamba Polubothu have a view on the guidance?
We worked intensely on the forced marriage statutory guidance and had a lot of input into it. From our experience of that, it is necessary for the guidelines to be statutory. We can strengthen the current guidelines. Whether or not there are guidelines, it is the responsibility of every citizen in Scotland to prevent FGM and protect survivors of FGM or any other forms of domestic violence.
My second question was around training. I will start with Sara McHaffie. Multi-agency guidance on FGM already exists. Do you use that as part of your training? Should whatever guidance is issued with the bill be suitable to use as part of a training process?
Yes—to both questions. I highlight the laws and guidance that exist and other resources and organisations, such as the FGM aware website, KWISA, Shakti Women’s Aid and Saheliya, which offer support. I use what exists and I would like to be able to say that it is statutory guidance. Even if, as we were saying before, there might be few times when somebody is the subject of an order, that would help me, just as having a law helps me when I am training. Although I can think of only one time in the north-east of Scotland when it would have been helpful, it would have been really helpful for that family. If we can say, “This law exists” or “This guidance exists”, that might strengthen what we say as Scottish people about FGM being unacceptable and about how best to work with communities in which children might be at risk.
The guidance should incorporate the experience of folk who work in that area. We more often come across someone who has experienced FGM than we come across a situation of risk for a young person. We might see someone who is the subject of a lot of panic, although they have no intention of subjecting their child to FGM and would be shocked that somebody thought that they might do that, because they see FGM as trauma.
In any guidance, it would be helpful to recognise the fact that figures can be unreliable. A Scottish Government report said that around 24,000 folk
“in Scotland were born in a country where FGM is practised”.
However, a lot of people who were born in France, Italy or Scotland are from a practising community. Looking at someone’s country of origin is not necessarily the most useful thing. Sometimes, it can be reassuring to have definite, black-and-white facts and figures. At other times, it is better to be open to nuance and learn more about the reality of how things play out on the ground.10:00
I agree. There is definitely a need to use the guidelines and all the information that we have. Above all, we need to incorporate the experiences of people on the ground. If the training is standardised in understanding the culture, the feelings and the whole concept of FGM, it will not be rejected. When people walk out of a training room, you have talked and finished and nobody else has said a word. I have come across a number of people like that. They went into training but when they left they were a little bit disappointed. We do not want that, because it means that nothing has been taught and that people go back into their own cocoons and say, “Those people were speaking to themselves.”
We mostly deliver training on forced marriage, but we are developing training on FGM. Like I said, we want to do a good job of it. We want to consult our survivors and get the real stories. With the forced marriage training, we talk about the legislation and the consequences of breaching it because it is important for whoever we are training to know that.
We do not do specific training on FGM although it is part of harmful practices. As Sara McHaffie said, that is how we will be training on it. We want to involve our survivors, and one of them is an active campaigner. I wanted to ask her to come today, but she is in Gambia so she could not come. She was part of the launch of the bill; she was on telly, which is good. We like to see role models.
KWISA cannot do major training with the £20,000 that we have been given. Although we have trained outreach workers and community champions—women who are within the communities—they are constrained because they are doing that on a voluntary basis. When we think about training, we should think about resourcing the whole package, including connection to universities and colleges—the whole works.
Thank you; that is helpful.
Oliver Mundell (Dumfriesshire) (Con)
The bill is a slight departure from the approach that has been taken by the rest of the UK and in the Serious Crime Act 2015. Do you have any views on anonymity for victims, the offence of failure to protect and the duty to notify? Should they have been included in the bill, or are you happy with the bill as it is?
The submission that I made in December or January talks about that in a bit more detail, and I am conscious that people have to leave. Anonymity or some way of preventing the names of victims from getting into the press one way or the other is helpful.
I am sorry to interrupt, but could you clarify whether you mean your submission to the Scottish Government consultation?
Yes. I do not think that I can say anything that is not already in there.
We were also part of the Scottish Women’s Aid submission.
When a women is suffering domestic abuse, she can be identified as the perpetrator of FGM by the abuser. We have come across that. Police, social work and such services have to look outside the box. Sometimes the woman is under so much pressure and that is part of the domestic abuse that she had gone through. She really does not want to do that to her child, but she ends up implicated in the act because of tradition.
When we come across cases of domestic abuse in which the woman is accused of being the perpetrator of FGM, we perhaps need to consider who the perpetrator is. That issue is raised by our survivors, who say that they were not the perpetrators, but that there was family pressure and everything else, and that that was the reason that they left the home.
We have heard that from others, and the committee would acknowledge the coercion around the issue and how it can be a continuum. We would also acknowledge that risk and protection factors in such things can sometimes be muddled up a little bit. Thank you for that—it was really helpful.
One thing that can be helpful to social workers, if they are in an area where there is a safe and together model, is just to use the training that they already have in that context. If it is part of domestic abuse, they should look at the strengths that the mother is displaying and not jump to thinking, “Oh, we can get a prosecution for failure to protect”, or something like that.
My other question—witnesses touched on this when we talked about education—is whether there are other things that the Scottish Government should be considering to sit alongside that, or whether there are alternatives to help eradicate FGM.
I think that education in schools is the best thing. I said that education should be for everybody, and one of the reasons that I said that is that an African child may disclose to a friend, who is a mainstream child, that FGM is happening. If that friend knows about FGM, they will be able to support that child. Education also means that, as we go along, we will not need to be talking about training, because people will already be trained and know about the issue from school.
As we mentioned, another thing is working with communities. At Shakti, we have a women’s group, and we bring in subjects such as FGM and sexual abuse—all kinds of issues. We also bring in people to talk to the women, and not just to the African women. We want them to talk to all our women, who are of different ethnicities, because we want everybody to know about it. It is about raising awareness not just in schools but in communities and in women’s groups everywhere—they can be Scottish, Irish, African or Indian women’s groups. Awareness should be for everyone; it should not target just those communities in which the practice is in existence.
We need to look again at the way in which we resource and fund various organisations, including KWISA. There are a lot of small funds, so all the community groups end up competing for resources and for the same people, and not being as organised as we should be. That also means that programmes are started but never really finish—they start, and then they are left on high. We train community outreach workers, but then we leave them to do their own thing. We work with faith leaders—we even had a big declaration that they signed to say that FGM is not part of their religious order, whether Islam or Christianity—but then we leave it on high. We work with schoolchildren, but then we leave it on high.
As such, the communities are always going through the phases of, “We are running and we are doing something” and then, “Oh no, we are deflated.” It is therefore important that we look again at the way in which organisations are funded. Of course, it is important to work with various groups and definitely with children. Whichever way we look at it, for me, resourcing and considering expertise are also important.
Thank you—that was helpful and very interesting.
The points that witnesses have made have also been picked up in our budget inquiry. It is useful to hear them in evidence today as well.
There is an on-going issue with funding for voluntary and third sector organisations. It would be good to think that all bodies that ask for training would have a budget to pay for that training, so that we were not necessarily having to ask for all the money from a very small equalities budget. Equally, if that budget could be increased, that would be fantastic.
It is good to think about ways of training people who want to look at the whole manifestation of violence against women and girls. There is a real risk that people ask because they are fascinated about one particular aspect, such as FGM. I will not be able to expose someone who has experienced FGM to that environment. Thinking about what training can do—it is not a form of entertainment—is also quite important.
Okay. Fulton MacGregor has a very brief question, and I am sure that there will be really succinct answers.
I just want to return to Oliver Mundell’s earlier questioning on anonymity, which I think is a very interesting part of the discussion on the bill. Do you think that the courts already have powers that they could better use to provide anonymity? Are there powers already in place?
That is not my area of expertise, so I cannot comment.
Okay. Thank you.
Thank you very much for being with us this morning. Your evidence has been really helpful.10:11 Meeting suspended.
10:16 On resuming—
Welcome back, everybody. I will introduce our second panel. We have Vickie Davitt, gender-based violence midwife and FGM lead at NHS Lothian; Dr Rachael Wood, consultant in public health medicine in the Information Services Division of NHS National Services Scotland; Obi Amadi, lead professional officer at Unite the union; and Katie Cosgrove, organisation lead for gender-based violence at NHS Health Scotland. I thank the witnesses for being here this morning.
Do you support the Female Genital Mutilation (Protection and Guidance) (Scotland) Bill’s aim to strengthen the existing legal protection? If not, why not? What is your general view of the existing legal framework in Scotland? In your answers, you might want to say a bit about your own work.
Katie Cosgrove (NHS Health Scotland)
We support the bill’s provisions. The work that we have been doing on FGM, as part of the gender-based violence programme, is specifically about the national action plan and its implementation. I chaired the writing group that produced the multi-agency guidance. Part of our work is about ensuring that that guidance is disseminated and implemented.
The bill’s provisions undoubtedly strengthen the options that are available in the existing legal framework. The orders will create more visibility within communities, which will be fairly positive in raising awareness. We also support putting the guidance on a statutory footing.
Obi Amadi (Unite the Union)
We support what is proposed, but the bill should go a bit further on providing clarity and sending a very clear message on FGM. We would like the committee to consider whether the bill could better reflect the legislation in England and Wales, so that the legislation across the UK would be more similar. That would be beneficial in providing clarity for professionals.
We will probably get into that issue a bit more later.
Dr Rachael Wood (NHS National Services Scotland)
I support the bill’s aims, but I do not think that I am well placed or qualified to comment on whether the specific proposals in the bill are the best way of achieving those aims. My role is in the NHS Information Services Division, and I am the clinical and public health lead for our national data on maternal and child health. That is my area of expertise.
Vickie Davitt (NHS Lothian)
I can speak only from an NHS Lothian perspective. The existing legislation needs to be strengthened. The bill is helpful in that it sends a clear message that Scotland will not tolerate FGM. However, I stress that I am speaking from an NHS Lothian perspective, because that is my job.
How is FGM currently recorded by health services? Are there ways by which we can more accurately record it, so that we can better establish a baseline for how much FGM is happening in Scotland? A previous panel told us about how we are calculating numbers, and it would be interesting to hear this panel’s perspective on that.
I have my figures, but those are only the NHS Lothian maternity services figures. We need to find some way of recording FGM. The Royal College of Midwives has launched an e-platform that is accessible to people working on FGM at various levels, as well as people from affected communities. One of the bits on the website concerns figures. There is a list of services that are available across the UK but, when you look at the section on figures, you see that everyone falls into the sea at Berwick-upon-Tweed, because there is nothing for Scotland. You could interpret that as meaning that FGM is not an issue in Scotland, but we know that it is. Therefore, as I said, we need to find some way of recording FGM.
Part of the problem concerns people using different systems that do not talk to each other. In Lothian, we use the TrakCare system for our electronic patient records, and we can extrapolate figures from that, but in Glasgow, they use BadgerNet.
Another issue is that as an FGM midwife, I would not be supportive of something that would create extra work for people who are working in this sphere—we are busy enough as it is without having to remember to record things on a different system. However, we need to find some way of getting figures that are as accurate as possible. I know my figures, because they represent the number of women who have been referred to me by staff from NHS Lothian maternity services. I have got figures from a colleague in Glasgow and a colleague in Aberdeen, but they are very much anecdotal. We need to be more accurate because that has implications for resourcing. I can prove that my job is needed, because of the figures that we have got, but the issue is wider than that.
So, there are complexities around the various systems and the need to not add to people’s workload.
There are two issues to consider. One is the recording at local level, in patients’ full clinical notes. In 2014 and 2016, the chief medical officer issued guidance to say that, if a woman was known to have experienced FGM, that should be recorded accurately in patients’ notes. Vickie Davitt is right to say that different boards use different systems to maintain those local notes.
There is then a separate question of national returns—that is, the returns that come to ISD from across the health service. It might help your understanding if I give a little bit of context. Different types of records will be generated depending on the element of care that the NHS provides to a patient. For example, when someone attends a consultant-led out-patient clinic, there is a certain return that comes to ISD; when someone is discharged from general in-patient care, there is another record; there is a specific record when a woman is discharged from an episode of maternity care; and there are also child health records, which operate a little differently—I could speak about them separately. If a patient undergoes an operative procedure during their care, whether in-patient or out-patient, a specific code from a particular coding classification—the OPCS-4—is added to that record. There is also a separate coding system for in-patient records that can be used to record the diagnosis that a patient has—that is, the reason why they came into hospital as well as any other significant medical problems that they have. The CMO’s guidance is clear that, if a woman is known to have had FGM, the code indicating that should be included on those records.
It is important to understand what that means. Those are coded records. FGM or procedures to correct FGM can only be recorded once there is a code for that. The procedure codes for deinfibulation were introduced in 2014, so we have been able to count those events since then, and the diagnosis codes that indicate that a woman has had FGM were introduced in 2016, so we now have three years’ worth of data in our national data sets. Before coming today, I looked at the figures. ISD holds the figures in the general data sets that we hold, and we publish general information on the number of people coming into hospital. Currently, we do not specifically publish the number of women with FGM, but we can provide those figures on request.
The number of women being recorded as undergoing a deinfibulation procedure remains very small. Looking across out-patient and in-patient records, we see that fewer than 10 women a year have been recorded as having that procedure. The number of women being recorded on national records who are being cared for by the NHS, either because of their FGM or for something else, and who are known to have a history of FGM, is now at around 100 women a year. That has increased from 2016-17, which was the first year that we could look at it. It was about 50 in that year; in the most recent year, 2018-19, about 100 women are recorded.
That shows that FGM is now being recognised in the health service and is being recorded more accurately than it could be previously.
Do any other panel members wish to come in on that point?
I am unable to comment on the detail of the data capture that is used by the different organisations in Scotland. However, on the national data collection, I would very clearly support the need to be sure that everybody understands the categories and what it is that they are recording and reporting. We had an issue in England with confusion among professionals about recording and reporting. Being clear on that is essential. The training for professionals that needs to go along with that recording and reporting is also key, to make sure that they are addressing the issue and addressing it properly.
Thank you. That is helpful. Katie Cosgrove, do you have anything to add?
The main issue is about identification of FGM in presentations—whether it is directly related to that experience or not. Quite a lot of our information is captured in recorded notes, which do not necessarily make their way on to the system. The practice for the health service in Scotland has been fairly fragmented over the past few years, but it is relatively new, so I would anticipate that there will be growing recording that the ISD will be able to capture in future. The challenge for us is to ensure that staff are aware of the requirement, that they know which codes to access and that they record accurately.
That leads me quite nicely to my next question. Will you give the committee your reflections on whether health professionals feel supported to have discussions about FGM with women and girls whom they are caring for?
A lot of health professionals are covered under that umbrella. Certain aspects of the health service, particularly maternity services, probably feel more supported than others, because there is more focus on them. There has been a huge concentration of effort on ensuring that we can have sensitive conversations with women when they present to maternity services around some of the implications that FGM might have for their subsequent pregnancy. There has perhaps been less attention in other areas of the health service.
One of the issues that has dominated discussion over the past few years is child protection—the need to prevent FGM and to protect children. That has been a little bit to the neglect of the other needs of women who have experienced FGM. They are not just mothers. They have been through an experience that may have been traumatic—I bear in mind what Sara McHaffie said earlier—and the repercussions for their long-term mental and physical wellbeing need to be taken into account. I am not sure that we have given as much attention to that across the rest of the health service as we have to the need to put in place provisions to ensure that the child protection concerns are noted and acted upon.
We have a challenge in relation to ensuring that our mental health service professionals understand how to have conversations with women on the impact of those procedures if the women’s mental health has been affected. Professionals in other areas of the health service must also know how to have those conversations, because there are multiple points of entry into the health service and we know the litany of subsequent emotional and physical impacts of FGM on women’s health.10:30
I have a supplementary question about something that both Vickie Davitt and Katie Cosgrove have addressed. We heard in our initial briefing from the bill team that the bill needs to cover women as well as children because, after childbirth, a woman might be taken somewhere to have further FGM conducted on her. Are you aware of that being a practice? After childbirth, might there be further mutilation?
Certainly, from a Lothian perspective, that is not very common, but we are aware of the possibility. We had a case where we were not concerned about the potential of FGM being carried out on the daughter who was born, but we were concerned about the mother because, when I questioned her, she could not tell me why she would want to be restitched.
It is important to us that women know that, if they have type 3 infibulation and it is opened to allow for the delivery of a baby, they will not be stitched closed. We are not allowed to do that and we would not do that. However, we knew that after that woman’s first child was born, she went back to her country of origin and was restitched there. We were clear that that could not happen here, but she could not answer me when I tried to talk to her about it. That goes along with what the earlier panel said. We were fairly convinced that there was a lot of controlling behaviour from the husband, so we were more bothered about it being a problem for the woman than we were about the potential of FGM being carried out on the little girl who was born.
What action did you take to protect that woman when you realised what had happened?
It was really difficult, because she is over 18 and therefore, in theory, she has a choice. However, you could debate choice up, down and sideways and you might never get the answer. She would say that she is freely choosing to have that done, but it is not a free choice if she is choosing to have it done because she is worried that if she does not, her husband will take another wife. In another case that we heard of, a woman who had infibulation did not want deinfibulation because she was convinced that her husband would take another wife if she did. I am trying to think of a delicate way to say this—she was convinced that if he did not get the enjoyment that he wanted from her, he would go looking for it elsewhere. That was a real concern for her.
Should we put something in the bill to protect those women, even though they might suggest that it is their choice?
It would be a useful adjunct to raise awareness of that possibility. As a midwife, I have a foot in both camps—I am aware of the child protection issues surrounding FGM but I am also aware of the issues for women who have had FGM as children. It would be a useful way to bring into the light the fact that FGM is not all about children; we are dealing with some women who have been severely traumatised by events that have gone on in their lives, and that needs to be recognised. To include that point in legislation would give credence to the idea that it is a problem and that we are aware that it is a problem. Certainly, from a Lothian perspective, it is not a massive problem, but we need to be aware of it.
I will bring the discussion back to how professionals interact and talk with women about FGM. Does anyone have any reflections on that?
Certainly, in Lothian—you are going to get bored with me saying that—I fought very hard to get my role included in maternity services. I am lucky that my boss in NHS Lothian is very supportive of me in the role. Part of it is working with women and part of it is training midwives. One of my colleagues on the team was speaking to medical students at the beginning of August. We get invited to speak to all sorts of different health professionals. It is important that health professionals are aware of the language that they use when speaking with women.
A month or so ago, I was at Glasgow airport working with the UK Border Force and Police Scotland on operation limelight and I needed to tell them about the importance of the use of language. If you ask a woman, “Do you know about FGM?”, there is a good chance that she will not know what you are talking about, and some women might be very offended by the use of the term FGM. It is about finding out what words women use—what do they understand? If I say “female cutting”, what do you understand by that? A woman to whom I was speaking yesterday calls it circumcision, so with her I called it circumcision. However, that is not a word that I would usually use, because of the links to male circumcision, which is a whole other issue—let us not get into that.
It is important to use language that women recognise. At our training, we give out a little postcard—I think that it came from the Scottish Government—with different words in different languages. I know that there are four different words in Arabic, for example, and it is a question of picking out which word is useful. When I was working in Glasgow, I managed to peel from somewhere at the back of my head the Somali word for FGM when people were speaking to a Somali woman. It is about using language that women understand. Health professionals can be good at that, but they can also be bad at it.
I wonder whether in the sort of environment where you are caring for someone, you are not necessarily asking questions directly and using that language. Are there other routes of inquiry in terms of symptoms that people experience? With something so sensitive, even in maternity settings, just coming out with that question may be tricky.
In Lothian, we have a policy of universal inquiry—this goes back to the possibility of racial profiling. All women are asked whether they have had any form of cutting or piercing that might cause problems in childbirth. That might include something such as a genital piercing that has gone wrong and got badly infected, which could cause a problem. If the woman gives a positive response to that inquiry, she will be referred to me and I then ask questions, because women often do not know what has been done to them. I work as a midwife and am very familiar with women’s anatomy, but a lot of women are not familiar with what a woman should look like. For example, a woman expressed surprise when I described the fact that there are three holes, because she thought that there was only one. If a woman does not know what her anatomy should look like, she does not know whether hers is normal.
A lot of my work is teasing out what problems a woman might have. She might say, “I’ve not had a lot done; it was just a little bit.” However, when I talk to her, I might realise that she has bigger symptoms than she is telling me. I have a colleague in Birmingham who would describe the same thing—women are told one thing and sometimes the opposite is true. It is about finding out how each individual is affected by her personal experience of cutting. I can tell you what type 1 or type 3 is, or whatever you want, but within those categories are women who may have been cut by a doctor or by an old woman who does not see very well and is just doing whatever she thinks. The categories are useful but only up to a point, because it is about the individual woman and what her symptoms are.
Does Obi Amadi have any reflections from a health visiting perspective?
Unite has found that health professionals often feel uncomfortable about broaching the subject of FGM, which is why we favour a universal approach, such that everybody is included, involved and asked. Some health professionals have concerns that, when they begin to have such conversations, there will be time pressures to get everything done. We recognise that co-operation is needed for that important work to be successful.
The input in schools is very important. In their conversations, health professionals ask that work be done with boys as well as with girls. Much of the time, the focus is so much on women and girls, and people forget about men and their roles within families and communities. It is definitely of value for health professionals to speak to everybody about FGM.
Apart from work pressures, people feel uncomfortable about being viewed as racist if they raise the subject. We know that the majority of occurrences are on the African continent, but there is concern about questions being asked about people’s views and whether they are racist. Clearly, those conversations should take place and are of value. Until we have a system that works, in which professionals feel trained, competent and confident to raise the issue, there will always be people with doubts. In the past, people felt the same about domestic violence—they did not want to ask questions or broach the subject. Now, professionals are much more comfortable with doing that and it is routine. We need to get to that position with FGM.
Given what the witnesses have said about guidance, I take it that you all agree that there should be statutory guidance with the bill. What specific information should be included in statutory guidance to assist health professionals in dealing with women and girls who have had, or who are at risk of, FGM?
I am not sure that I can think of any gaps. Moving the guidance on to a statutory basis would give it more weight among professionals and ensure that it has wider reach than it has at the moment. The idea of speaking to women about abuse could be highlighted in the guidance. When we pulled our guidance together, we consulted women from various communities on the language that should be used in the guidance, and on how we should reflect how those women want to be spoken to about FGM. That was not just about whether we call it “cutting” or “circumcision”; it was more about the atmosphere and circumstances in which we ask about the subject.
From a health point of view, it is important that health information be highlighted. We should not just ask whether a woman has experienced FGM on the basis that she is African; it should be much more about asking whether FGM has had an impact on the person’s health and, if so, what that impact has been. We should ask, “Has it affected your presentation here, today?”, “Will it affect your pregnancy?”, “Will it affect your mental health?” and we should ask what we can do to mitigate and ameliorate those circumstances.
Strengthening the guidance by giving it a statutory basis might allow more focus on areas of the health service outwith maternity care. There is a preponderance of focus on that area because most of our statistics on FGM come through maternity services. We know that affected women use all our health services, but that is not reflected in the stats, which suggests either that there is a very good clinical and health service response, so further work is not required, or that we are not having those conversations across the different domains in the health service.
I will ask Vickie Davitt a specific question on that. I was struck by what you said about being at an airport with the Border Force and the different language that is used by different communities to describe and talk about FGM. Are the differences of language and the words that are used already in the multi-agency guidance? If not, should that be included in statutory guidance to help all the different agencies when they come to talk about FGM?10:45
We have multi-agency guidance in Lothian and there is the national guidance, which I do not know as well as I know the Lothian guidance because I was on the working group that put the Lothian guidance together. There is, at the back, a glossary of all the terms that are used in lots of different languages. It is at least one page of A4, if not more.
If I talk about female genital mutilation, female genital cutting, cutting and circumcision, I have already said four different things. However, within that, there is also, for example, labial elongation, or it could come down to something as simple as what we mean by piercing. Piercing can mean having your ear pierced, where there is a hole and you put something into it, or it can mean that a hole is made, which is, potentially, type 4 FGM.
There is a glossary in Lothian’s guidance; I assume that there is one in the national guidance. It would do no harm to put one in Government guidance so that everybody would know what they are talking about.
Would you use guidance in training?
Yes. As has already been said this morning, Government guidance gives everything more weight, so that when we are training, we can say, “Look—this is the law; this is what you need to do.”
When I speak to women, I always make very clear the legal position in Scotland, which is backed up with the Scottish Government leaflet. All the women are given that. Whether they know the law or express protective views, they are all told the same thing. It is the same when I am doing training; everybody is told the same thing. We have the law, and they cannot argue with it. That is how it is.
That is helpful. Do other panel members have anything to add?
I confirm that there is an appendix in the national guidance that covers terms that are used. However, health staff are unlikely to learn multiple terms. The point of flagging them up in the guidance is to ensure that staff are aware that there is not just one term that can be used.
The other thing that has come across in the work that we have done with women is that routine inquiry of any form of abuse has to be couched in such a way that it makes sense to the person who is being asked about it. We want questions of that nature to be couched in terms of whether anything has happened to them that has caused them hurt, that might be causing them health problems or concerns, or, in the case of pregnancy, that might make it difficult for them to have a smooth and uninterrupted labour.
The way in which the topic is broached is much more important than understanding 30 or 40 different terms that are used across different communities for a particular procedure.
As I understand it, the multi-agency guidelines focus primarily on advising and guiding front-line staff on identification of risk of, or actual, FGM, and on responding to that appropriately. I am responsible for what comes after FGM has been acknowledged and recorded in someone’s notes, which should be coded accurately in national records. ISD is responsible for producing national guidance for health records departments on how to code things. We produced guidance on that in response to CMO letters of 2014 and 2016. Our national terminology team produced guidance on how to code for all the health records departments in Scotland. If FGM is identified by front-line staff and appropriately recorded in the woman’s notes, there is guidance on how it should then be recorded in the national returns.
That is probably separate from the multi-agency guidance that you are talking about.
Thank you. Obi, do you want to add anything?
No. I agree with my colleagues.
I want to ask a question that I put to the previous panel. Should children’s hearings be able to grant FGM prevention orders?
I do not feel qualified to comment on that.
I am not sure. If hearings had such a power, that might expedite matters a bit. However, I am not sure that it would necessarily change the situation greatly. Children’s hearings currently have powers on compulsory supervision orders, and cases are often referred from the children’s panel to the sheriff court. I do not see any huge detriment to cases of people seeking FGM prevention orders coming through the courts, but that is just my personal opinion.
I do not have enough experience of children’s hearings to comment in detail, but I agree with what Katie Cosgrove has just said.
Anything that would expedite or clarify matters should be pursued. If children’s hearings having that power would be more helpful to professionals in the system, then it should be considered.
The committee has explored the matter previously to try to get a sense of what people think of that prospect.
I will move on. What are panel members’ views on criminalisation of breaches of FGM protection orders and on the penalties that have been set for them?
I can tell you what the women say. As I have just explained, I set out the legal position to all the women whom I see. More often than not, when I mention the length of custodial sentence that is possible, many of them say that it is not long enough.
I am not qualified to comment on that.
I cannot comment, either.
I will go back to Vickie Davitt’s answer. Do the women whom you speak to feel that the penalties should be increased?
That is very much the opinion of women who are survivors of FGM. They want the practice to stop and they think that one way that that could happen is much tougher sentencing.
There is a difficulty in that there has been only one conviction in the UK. Until we have more evidence on how courts treat cases, it will be hard to say that penalties should be increased, because we do not have evidence to support that view. In that one case, the woman who was convicted went to jail for 12 years, so it was taken very seriously. However, we do not know whether that would happen in all cases until more cases are decided. That would send the right message—that Scotland takes FGM very seriously—and it would show what will happen to people who are caught practising it. Yesterday, I was speaking to a lady who said, “Well, I know that if I did it I would go to jail”, so the message is already out there that it is taken very seriously in this country, which is important.
It is interesting to hear about your direct experience of working with women. The panels that we heard from last week expressed the fear that the tougher the sentencing, the more the criminalisation process could force the practice underground. It sounds as though a balancing act between those two aspects is needed. Do panel members acknowledge that?
I definitely agree with that. On the one hand, women are saying that sentences are not long enough, but we also know that they are already quite vocal about FGM being wrong and about the need for it to be stopped. However, there is, among families and communities that still practise FGM, the potential for it to go underground. Just because I say to women that it is illegal in Scotland, that does not mean that it is not happening. We know that murder is illegal, but it still happens.
A delicate balancing act is required. There is difficulty getting the right intelligence from within the communities, because women are told that they should not talk about FGM. If it is not talked about, how can we find out whether it is being done? It is a difficult issue.
The anecdotal information that we have is that women want there to be custodial sentences, but I cannot support or advise the use of a particular sentence term. The existence of custodial sentences sends a clear message to perpetrators that FGM is a crime.
In respect of the fear that that would drive the practice underground, I say that it is already underground. If there were a shop that people could go to for FGM, we would know that it was not underground, but that is not the case.
We need to work with communities and professionals. It is an issue on which we cannot work in isolation. A much wider approach in terms of educating and supporting people is needed. If we do that, there will be fewer opportunities for an underground system or practice to thrive.
We need to think about the matter in terms of all of the stuff that is going on behind the scenes and we need to think about how we can work with communities. The leaders in the communities are the key to reducing the occurrence of FGM. As my colleague said, other things that are criminal offences continue. In order to make a big impact, we need to ensure that other people are involved in the right way.
Earlier, you talked about the fact that there are slightly different systems in England and Scotland. I will ask Obi Amadi to answer the question first, then others can come in. What lessons can be learned from the approach that is taken south of the border? Are there things that are working well there that are not proposed in the bill, or are there things that we have missed?
One of the most difficult issues is mandatory reporting, which has been controversial and, perhaps, unpopular in England. However, some of us view it as having been quite successful, because it has enabled the professions to be clear about FGM. We had a situation in which some health professionals felt that when someone said that they had had FGM, they needed to examine them, but that is completely inappropriate. Examination must be left to professionals who have specialist knowledge. Mandatory reporting has led to an increase in people who have specialist roles around FGM. There were always some midwives who specialised in the area, but the number has increased, and other professional groups are starting to have people who have such knowledge. Identification and confirmation of FGM are specialised.
One of the opinions that was given to us—either by a witness in a committee meeting or someone on one of our visits—was that mandatory reporting could be harmful to the relationship between a GP and their patient. It was accepted that there would not be collusion in the practice, but the possibility was raised of harm being caused in relation to communication. How would you address that?
I do not agree with that. In England, a lot of general practitioners were concerned about what might happen to their relationships with patients when mandatory reporting was introduced. The things that happen in a GP practice are quite important; the practice nurse or the GP will see people who come repeatedly with backache or urinary tract infections, but might not always think that those are symptoms of something that they need to have another conversation about. That is why universal provisions are much better.
Much of the success around issues such as FGM is the result of good relationships. Deterioration of the relationship is much less likely in an open and honest relationship in which people trust each other. As is the case in child protection and safeguarding situations, if people are honest and clear about why they are doing and saying something, there is less chance of deterioration.11:00
Do other members of the panel have a view on mandatory reporting?
We need to be clear about what type of mandatory reporting we are talking about, because health professionals in England are under two separate duties in that regard. First, they have a duty to report any cases of FGM involving children to the police. Secondly, they have a duty to report identifiable information to NHS Digital, which is ISD’s rough equivalent.
I think that, today, you are talking about mandatory reporting in the health service. I must respectfully disagree with Obi Amadi and say that ISD is clear that we would not support that in Scotland. There are established mechanisms in England to mandate returns to NHS Digital, because the secretary of state works under different legal powers. In Scotland, we do not have those mechanisms. Obviously, some health events are subject to statutory reporting, but they are subject to specific laws in and of themselves. For example, terminations of pregnancy are reported to the chief medical officer and notifiable infectious diseases are reported under public health legislation. However, currently, there is no mechanism for ISD to mandate an identifiable return on FGM. There are practical issues why we would not support such reporting.
My personal preference, and the preference of my organisation, would be to support the accurate recording of FGM as it is identified in the routine records that we already receive. As I have already said, I think that that process is strengthening, and we are already starting to see that coming through as a result of the guidance that is available.
There are wider professional issues to do with mandating reporting. I have concerns about how it influences the relationship between health professionals and their patients. It potentially puts doctors in conflict with their professional duties from the General Medical Council, as the duty of an individual patient’s care must always be our primary concern. If a doctor is under separate mandatory duties that take away their clinical judgment about what that person’s best interests are, that can put them in an uncomfortable professional position.
I echo what Rachael Wood has said. When we were developing the guidance, we considered some of the issues to do with mandatory reporting that they have in England. We were very much concerned with the need to have a proportionate response. We were also concerned about the need to ensure that we can support health staff to identify and respond sympathetically to women presenting with FGM, and ensure that that confidentiality was maintained.
When we consulted, women were concerned about the fact that they would not have any control over the information. They were not sure what would be done with it and they did not necessarily make the distinction between what was being done with it internally in the health service and externally with the police. Part of the concern was about the impact that that would have on their relationship with their practitioner.
There is clear guidance on how we share information across the health service. At times, sharing information is obviously very important. However, the concerns that were raised by women—and by practitioners, because there has been concern about the nature of that reporting among some practitioners in England—certainly shaped our thinking when we decided not to support mandatory reporting in the bill.
There are a number of articles that I could point you to in which health professionals express serious disquiet about the mandatory reporting requirements. Ironically, mandatory reporting does not necessarily lead to good information. You can mandate it, but, actually, NHS Digital continues to publish its statistics as experimental, and there are concerns about the quality of the information that is being generated.
It is always helpful for the committee to hear differing perspectives.
What would we be trying to achieve with mandatory reporting? The current system would not cope with its introduction. You risk criminalising women who have had something done to them. Who are we trying to get to here? Are we trying to give a woman who was subjected to FGM as a five-year-old child a criminal record? When I talk to midwives about mandatory reporting and I say that it includes the reporting of tattoos, there is general hilarity, because we have all seen 17-year-olds with tattoos; legally, they should not have them, but they do. Are we going to give those girls a criminal record because they have chosen to get a tattoo? That is completely different from a 17-year-old who was subjected to FGM when she was five. The two things are not the same. I respectfully disagree with my colleague. Mandatory reporting is not the way to go.
I think that Vickie Davitt’s question about what we are trying to achieve through mandatory reporting is really important. I assume that we are trying to achieve better visibility of the prevalence of FGM in the Scottish population, so that we can plan to meet the needs of those women appropriately. As I said, I think that there are better ways that we can do that through routine NHS records, but it would also be interesting for the Scottish Government to consider commissioning research on the prevalence of FGM, because there is none for the Scottish population. That is a positive thing that could be done.
Vickie Davitt’s point about the mandatory reporting of tattoos is well made. My interpretation is that mandatory reporting is more about issuing protection orders than it is about giving someone a criminal record. For example, Vickie Davitt talked about the woman she assisted who had given birth, who had talked about getting restitched or whatever it was. If there was legislation that could be leaned on, so that a protection order could be imposed on her—for example, that woman could have her passport removed until she felt that she was no longer at risk—she would not be able to fly back to a country where that restitching could take place. That would not be about giving her a criminal record; it would be about protecting her. How do you feel about that scenario and having the obligation to report such a concern?
The two examples are not necessarily the same. It is very difficult. If you take away a passport from somebody, when do you decide that the risk is no longer there? My colleagues and I in the al-nisa service in Lothian work on a continuum of risk. The risk never goes away. It is always there, but it just changes over time. At what point would you give that woman her passport back? Are you really going to prevent her from going back home to visit her family when she may or may not be at risk?
If the woman is over 18, this is, again, about choice. For a lot of the women whom I see, their body works how their body works and that is how they like it. I have seen one woman who has had two pregnancies so she has been through my system twice, but I have also had discussions with her twice outwith pregnancy. Therefore, I have had four interactions with her to talk about deinfibulation. She does not want to have deinfibulation because her body works how her body has always worked. It is her husband who is trying to persuade her to have it done, which is a bit different. She is just not interested. She would say, “My body is fine, thank you very much. I don’t want to change how it works.”
For women over 18, when do we decide that somebody is being coerced into having something done or whether they just want their bodies back to how it was? That is what all women want after they have had a baby, but it just depends on what the meaning of that is.
That is the challenge before us.
I did say that the issue is controversial.
On what my colleagues said about doctors finding it difficult, doctors are the same as all other health professionals and it is no different for them than it is for other people. If they have the information and are clear about it, there is no issue with deteriorating relationships. We do not believe that and have not seen it.
Another thing to remember is that many survivors, when we have conversations with them, want to speak, tell, be asked and share, because they do not want it to happen to other women or, in particular, to girls.
On criminalisation, we are talking about mandatory reporting when it comes to children, but the reporting is more along the lines of recording when it comes to adults.
Thank you all for coming along this morning. Your evidence has been very helpful.
At our next meeting, we will take evidence from third sector member organisations, regulators, inspectors and third sector equality organisations as part of our scrutiny of the Scottish Government’s budget for 2020-21.11:11 Meeting continued in private until 11:26.
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