I've been asked to speak about the relevance of child protection procedures in relation to female genital mutilation in Britain, I have been asked to answer two key questions
Is female genital mutilation child abuse? If it is, how should children be protected?
I'll be describing the key elements of the British Child Protection System and its limitations. International comparison is outside my brief and experience, though you may make your own comparisons as I go along. A sensitive and compassionate approach to FGM is required which will present a challenge to all of the welfare agencies and professionals working in the field of child care and child protection in Britain. The approach that is needed flies in the face of the way that children are protected in this country.
First, about the NSPCC. The National Society for the Prevention of Cruelty to Children was set up in England at the end of the 19th century, and was at its inception a campaigning organisation. There already existed the Royal Society for the Prevention of Cruelty to Animals (RSPCA), and the NSPCC came into public consciousness after an early campaigner dressed as a child in a horse blanket at a meeting of the RSPCA and asked whether children should be treated as animals for the purpose of protection, because at that time many children were still being abused in Britain.
Over the forthcoming decades the NSPCC took on a role providing back-up to the police in respect of cruelty to children. It was after World War 2, in the context of an emerging Welfare State, that the NSPCC was under increased pressure to change. In most recent decades the organisation has led the development of a child protection framework in Britain, Wales and Northern Ireland at least, and has resumed a campaigning role. Alongside this role, the organisation retains unique powers for a charity in being able to take legal action to protect children, and bring adults to court. The NSPCC remains a largely white, middle-class organisation commanding financial support from a largely conservative constituency. Happily things are changing.
In recent years the society has set up a number of specialist projects trying to improve the delivery of our services to black and minority communities. We have just completed an 18 months research project with the National Institute of Social Work and Race Equality unit called "Taking the Initiative", trying to give ourselves help, insight and confidence into "really" providing services that reach black minority communities and bridging the gap between good intentions and good practice. The report of this project has just been completed and will be published later this year. The Society made contact with LBWHAP in 199z and since then we have supported them in carrying out research on FGM and participating in seminars, and in the planning of this conference.
I am particularly grateful to Yvonne Joseph for the work she has done over the past two years, alongside the LBWHAP and for her help in preparing these remarks today.
So, is female genital mutilation child abuse?
The label "child abuse" covers a wide variety of symptoms, behaviours and contexts. Its root lies in the term "battered baby" which was described as a very specific kind of behaviour towards a child of a particular age. The term "child abuse" can mean many things to many people. Indeed, the American Henry Kemp, who first coined the term "battered baby syndrome" …………….as a term covering virtually anything dissonant in the relationship between parents and children from problems of early bonding onwards, The term has become too easy, it slips off the tongue too easily, and we need to be clear about what kind of behaviour we mean to be covered by it.
Even then there will be no consensus about how abusive a particular piece of behaviour should be viewed. Whilst there may be consensus that the murder of children is wrong, and abusive, and that the rape of a child is wrong, and abusive, there will be much less consensus at the margins of acceptable and unacceptable behaviour, particularly if the behaviour is in some way understandable, for example, smacking as a chastisement.
Professional responses to child abuse in general, depend on the culture of the professional person and his or her experience. In a recent research study about the operation of the Child Protection Registers in England, looking at how referrals were dealt with and which children were registered, it was found that there was little difference between the representation of black and Asian families to white families in the sight of areas studied - Local Health Authorities.
Black and Asian families were over represented among referrals for physical injuries compared to whites and under represented among referrals for sexual abuse. Black Africans and Asian families were more often referred for using instruments, such as canes, to inflict physical injuries associated with discipline.
The point made in the research was that there are cultural differences in child rearing and difficulties in deciding what forms of physical abuse are more "acceptable" than others, in Britain. The consequences of the injuries inflicted on Black and Asian children were no more likely to be longer lasting than on white children being smacked by hand. It was the form of the punishment taken that was unacceptable to those who referred the children.
Female genital mutilation is more emotive than corporal punishment and is rooted in traditional practice. The form that FGM takes arouses strong negative feelings in many people inside and outside traditional cultures.
How are we to judge what to do?
The United Nation's Convention on the Rights of the Child is the place to start. There are three key articles that relate to FGM. In the language of the UN Convention, FGM is a breach of children's rights to physical and personal integrity. Firstly, in Article 19, the Convention requires the State to ensure protection of all forms of physical and mental violence" while children are in the care of parents, or others. Secondly, article z43 explicitly insists that States should take "all effective appropriate measures with a view to abolishing traditional practices prejudicial to the health of children". This provision is not directly referring to FGM of girls and young women, but was included because of concern over the particular issues.
Thirdly, Article 2 emphasises that there must be no discrimination of rights. Thus, traditional practices which involve physical or mental violence, or are prejudicial to the health of children cannot be justified by reference to culture, race or religion. FGM poses short and long term risks and because FGM is most usually performed on children at an age when they are unable to consent or to resist, we can conclude that FGM is a violation of the child's rights to personal integrity, whatever the motivation, and is therefore physical abuse. In its report to the United Nations on its implementation of the UN Convention, the British Government referred, under the heading of "traditional practices" to the prohibition of Female Circumcision Act 1985. This Act makes it an offence to carry out any procedures which are known as female circumcision, but which are more accurately described as female genital mutilation. It points out that this Act also makes it illegal to aid, abet, council or procure the carrying out of these procedures.
However, it seems at though the Prohibition Act has not been effective in ending the practice in the UK. By November 199z, there had been no prosecutions under it. In 1991, the FORWARD survey showed that of 65 social work departments canvassed, 10 reported case work intervention because of suspected FGM. A further 18 departments were concerned about communities "possibly" practising it in their area.
So, what is the legal protection provided in Britain and how relevant might it be to stopping FGM?
The key piece of legislation I wanted to refer to is the 1989 Children Act, which brought together 13 existing statutes in private and public law, and through a wide consultation process, looked to draw on lessons we learnt from child care and child protection since 1969, the date of the previous legislation. It is the key piece of law for protecting children and promoting their rights. It puts the interest of the child paramount and looks to ensure that legal interventions are undertaken as a last resort, when other forms of support have failed. Partnership with parents - though not a phrase used in the Act - is a key throughout. The Act is strong, or intends to be strong, on children's rights, and for the first time on issues of race, culture and religion.
The guidance says: The child's age, sex, health, race, culture, personality and life experiences are all relevant considerations of needs and vulnerability and have to be taken into account when planning or providing help. Under the Children Act, the Local Authorities have the general duty to safeguard and promote the welfare of the children who are in need within their area, and promote their upbringing by their families by providing a range and level of service appropriate to those children's needs.
The test of the need for protection rests in the term "significant harm". Emergency action and care and supervision orders can be made if the Court is satisfied that the child concerned is suffering, or is likely to be suffering, significant harm and that the harm or likelihood is attributed to the care being given to the child by parents or if the child is beyond parental control. Harm means "ill treatment" or the impairment of health or development. This means physical, mental health; physical, intellectual, emotional, social or behavioural development and ill treatment includes sexual abuse and forms of ill treatment which are not physical.
The question of significance turns on the child's health or development compared with that which could be reasonably expected of a child of similar age. The Act as a whole, intends to provide services to children who are in need. Prevention first, child first, court orders last resort. Since the Act was enacted, indeed, the number of Emergency Protection Orders has dropped compared to the number being taken under previous legislation. That need not be an indicator that the Act is working well, despite government exhortations.
It seems that there has been misunderstanding about the point at which Orders should be sought. Should it be when the child needs it, or when partnership with parents has irretrievably broken down?
It seems also that the lower number of Orders could be because of concerns about what to do for the best, also attitudes of workers have not changed, they are uncertain, this is due to a lack of resources rather than the presence of effective preventive services.
But now, I will turn to the description of child investigations in Britain, probably approaching 200 000 a year. Child protection procedures have become institutionalised and like the worst institutions seem to have a life of their own. They need fundamental review.
It is important to recognise that the government has brought FGM within the ambit of child protection systems in the most recent guidance issued in 1991. The guidance refers to the Female Circumcision Act. It points out that if a local authority has reason to believe that a child is likely to suffer significant harm as a result of female circumcision, it should consider to what extent it should exercise its investigative power under the Section 47 of the Children Act 1989. It points out that in areas where there are significant numbers of children of a particular ethnic minority or cultural background, workers will need to be alert to the possibility of female circumcision.
It refers to the organisation FORWARD as an organisation where advice can be obtained. This paragraph should be viewed as the absolute minimum which could have been said. Having brought female circumcision within the ambit of the Child Protection Procedures, it would not be possible for a government to then offer less guidance than it does about what to do. It is true that the Local Authorities did not have to investigate every allegation of significant harm, although they have a duty to consider whether or not to investigate.
But how do they judge what to do, and which agency should do what?
The government guidance "Working Together" doesn't help, nor does it offer guidance on particular demands of the child protection work in a multicultural community, which might have established first principles for practitioners to work out what to do in relation to FGM.
In a section on community responsibilities the government exhorts communities to take responsibility for the well being of children and report as necessary. In a chapter on working with individual cases there is a reference at the beginning to the basis of effective child protection service being professionals and agencies working together with shared mutual understanding of aims, of objectives and of what is good practice. This should take into account the sensitive issues associated with gender, race, culture and disability. As far as these issues are concerned in a document of 1~6 pages, that's it.
The key elements of the Child Protection System are sixfold:
o Firstly, a baseline to help recognition and referral.
o Secondly, immediate protection in situations where there is a risk to life or the likelihood of serious injury is recognised.
o Thirdly, in most cases, a strategic discussion between agencies about the conduct of an investigation and initial assessment.
o Fourthly, there is an investigation and an initial assessment.
o Fifthly, a child protection case conference and decisions to register the child.
o Sixthly, the registration of the child and planning post-registration services.
Although emphasis is given to Multi-agency working, the primary responsibility for legal action is with the Local Authorities. The criteria for registration covers physical injury, sexual abuse, neglect and emotional abuse. The threshold for registration is lower than the significant harm in the legislation. This process sounds quite plausible, so what are its limitations?
Child protection work has been driven since the 1970s by a string of child deaths, and practice in relation to child protection is often defensive. There has been a mushrooming of official guidance procedures and statutory requirements and at the same time massively increased referral rates with increased workloads. In this context, the focus and prime concern is upon investigation and assessment where both are framed in terms of narrowly defined requirements for evidence. There has been a shift since the 1970s from a socio-medical model of intervention based on talking, information sharing, diagnosis and treatment to a social-legal model based on gathering evidence, establishing the criminality of the event, and deciding what to do next, often balancing tensions between criminalising the parents and caring for the child.
The role of the Police and the legal professions has become central. Moreover, other developments in the criminal justice legislation have been an unintended consequence of more police involvement a little bit earlier in the investigative process in more cases. Moreover, these developments have been taking place in a stringent economic context. Three times more children are living in poverty now in Britain than in 1979.
In real terms, resources available to caring agencies and professionals have been cut. So, despite, good intentions, child protection investigations and assessments are happening in a context where there are not the resources to provide community support and help.
Decisions are about whether to go to court or not?
Prosecution or not?
Protection or not?
Very serious physical abuse, especially sexual abuse tends to be dealt with adequately in this system. Other forms of abuse do not. The needs of children are being investigated as being allegedly abused. Evidence is not available. Concerns are not being substantiated. They are not being registered and receiving some level of help and their families, parents and children can become alienated from local welfare agencies. Abuse is being pushed underground. Children in need are not being helped.
If that analysis is correct, and I think it is, it is not a helpful child protection environment within which to deal with an issue of such cultural sensitivity, and so potentially damaging to children, as FGM. The system is stacked towards obtaining evidence, Workers with more sensitivity than the procedures envisage, would not want that route for children and families. In this context, workers, especially white workers investigating FGM, would find themselves in terrible dilemmas about what to do for the best. There is evidence from the wider Child Protection world, that when workers are confronted with these kind of extreme dilemmas they switch off and find ways of justifying not doing anything.
So, what are the alternatives?
I think there are alternatives which, to be effective, challenge the way we protect children and prevent child abuse in this country. In contributing to the NlSW/Race Equality Unit research, the Black Workers Group at the NSPCC has provided a unique Black Perspective on Child Protection today in the UK. They reflected on the institutionalised nature of the child protection procedures and systems, and indeed, the institutionalised definitions of abuse itself. The group sees the antidote to a white institutionalised response to predominantly white child abuse, being an opening out of services and a reaching out in an active sense to groups that traditionally, organisations have not worked with.
They mean, I quote: "real working class people, black children and young people, black mothers, black families, using family in its widest sense". They emphasised the need for agencies to work with black communities and voluntary organisations, businesses, churches and mosques, valuing the role of black elders and kinship in supporting children. From the black perspective, our black workers are in touch with the need to unpack child protection systems, to move away from defensive practice to a reaching out to groups in a culturally more diverse society. Put another way, to genuinely try to implement the preventive commitments based on child need at the heart of the Children Act, all children's needs, rather than evidence gathering. As part of this, there is a general need for parental community education about the dangers of abusive behaviour to children and parents and how to prevent it.
Education, information, is primary prevention and in this country it has generally been given much less priority than hard end protection of children at risk. That is extreme short-term action. It seems to me that a genuine reaching out of services and well-funded effective information for both practising communities, and for professionals, is what we should be looking for to prevent the mutilation of girls and young women, and help those who have been subjected to it. I would like to end my presentation by picturing a few action points that you may wish to consider over the next couple of days.
o Firstly, I think that in order to ensure compliance with article z43 of the UN Convention, the government should encourage and enable a comprehensive review in all communities of any traditional practices which threaten the physical integrity of children and/or are prejudicial to health.
o Secondly, the government should encourage and enable educational campaigns, required within communities to emphasise the child's rights to physical integrity in relation to any traditional practice which involves physical or mental violence or may be prejudicial to health.
o Thirdly, the government should take a lead in funding and delivering practice guidance on FGM to professionals within the ambit of child protection and child care work, which encourages real services to be available to those who need it.
o Fourthly, Local Authorities should have a multicultural and anti-racist policy to protect girls in that area from FGM and the government should actively monitor this through the ACPC reports. The ACPC is the Area Child Protection Committee, a Multi-disciplinary group responsible for establishing and maintaining child protection policies and procedures in that area.
o Fifthly, that this committee, the Area Child Protection Committee, must ensure that guidance is in place for the investigation of allegations of FGM to ensure the most sensitivity to the child's needs, wishes and feelings and the long term continued relationship between the child, the family and the community group.
o Sixthly, guidance for professionals needs to cover the availability of face to face information, and advise to parents and children and highlight the desirability of working with community groups, who are often the best placed to deliver counselling and other support services, rather than by the Local Authority discharging an investigative power. Guidance also needs to cover what happens if after advice the family intends to proceed. Encouraging effective protective action from individuals in the local communities, trusted by the child and family. It seems preferable to action by the Local Authority through public law.
However, guidance must cover the conduct of investigations, if they are needed by Social Services Departments, the NSPCC and the Police. The Police's role must be identified clearly as the last resort. That should be the removal of children from the family home. Guidance should also cover the help to be given to the child who is found to be already mutilated and the availability of relevant health services and counselling which should be available to all women and children if they request it. The key players within the authority are workers in health, social services and education, women's groups and most importantly, the community groups themselves. But the government cannot be let off the hook. It can fund education campaigns and it should be called upon to do so.
Delivering this model of intervention, this model of health, is a challenge for all of us. Not only because of the practice itself, but because this kind of approach flies in the face of the impetus of British Child Protection work. If you like, British Child Protection Culture. It is an impetus, and a culture, that much needs changing. The task is a challenge to all of us, if it is to be done effectively and I hope that with confidence we will be able to change things. The NSPCC is committed to helping community initiatives and an initiative has been undertaken by groups dedicated to eradicate FGM. We see the need for the initiative to come from the black community; if we can act in a supportive role, we will.
Now, for you all, best wishes for a productive conference and support for finding the best way forward.
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