05 November 2015
The End of Female Genital Mutilation – A Step Closer
The NHS has issued new guidance regarding reporting requirements for staff when treating patients who have undergone FGM.
Details of the guidance can be found here. Female genital mutilation (FGM) - sometimes referred to as female circumcision - is defined as a procedure that includes the partial or total removal of the external female genitalia for cultural or other non-medical reasons.
It is illegal to perform FGM in the UK or to assist any person outside the UK in performing the practice.
The new guidance confirms the change in reporting requirements from 31 October 2015. It is now mandatory for all registered professionals to report to the police when a child has disclosed that FGM has been performed or there are signs that FGM has been undertaken. The concerns must be recorded in the patient’s records together with details of the report.
This duty only applies to minors and enhances the existing safeguarding duty. The responsibility to report the concerns applies even if the patient does not wish for details of their FGM to be disclosed. This obviously gives rise to difficult issues with regard to discussing concerns with family members where there are siblings or other persons that may be at risk.
In certain circumstances, the mandatory reporting duty does not apply, such as when someone else has disclosed FGM or there are no actual physical signs of the procedure having been carried out. However, if a professional fails to report their concerns in circumstances where there are clearly signs of FGM or a disclosure by a minor then they may be subject to disciplinary procedures under their professional standards.
This duty embodies the changes to the Serious Crimes Act 2015 and reflects the serious approach the NHS is taking to eradicating FGM as a practice in the UK. The enhanced reporting standard will inevitably raise issues of patient autonomy however I believe the need to protect children from this form of abuse must override any such concerns.
It is also hoped that these reporting requirements will help to avoid the situation that arose in 2014, when Dr Dhanuson Dharmasena was charged with performing FGM after carrying out the procedure on a mother during an emergency delivery. The patient had previously been subject to FGM in Somalia and it was revealed at Dr Dharmasena’s trial that this should have been identified and reported earlier before the baby’s birth.
It was only discovered by Dr Dharmasena when he performed the emergency delivery. The patient’s labia had been partially sewn together and following the delivery, Dr Dharmasena, who had not been trained to recognise or treat FGM, sutured the woman’s labia back together given that by not doing so would have left the patient in a very difficult position.
Dr Dharmasena was reported to the police and subsequently charged with performing FGM. He was acquitted at trial and it was noted that had the patient’s history been reported previously, a plan of management could and should have been put in place.
Christian Beadell is a senior solicitor specialising in clinical negligence claims at Slater and Gordon Lawyers in Liverpool.
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