asked Her Majesty’s Government:

Whether they will consider the introduction of routine disclosure by health professionals when evidence of female genital mutilation is discovered in patients.

My Lords, health professionals have a duty to ensure that they work within safeguarding law as well as professional codes. For women who have undergone female genital mutilation, it is normally expected that information is shared with others, with the woman’s consent. When FGM comes to the attention of any professional, consideration needs to be given to any child protection implications, for example younger siblings and members of the extended family, and a referral made to social services or the police if appropriate. Indeed, under the Children Act 1989, everyone with information that a child is potentially or actually at risk of significant harm must inform social services or the police.

My Lords, I thank my noble friend for that Answer. Is she aware that estimates of the number of women involved and their geographic location made by agencies all over the country are necessarily based on estimates, so the figure of just under 270,000 may be very wide of the mark? Can she ask if the Government would fund a confidential inquiry, possibly done by a university, to establish the number of cases of FGM and other significant data such as the geography of its occurrence? Does she agree that this would be of great benefit to health professionals, so that difficulties in gynaecological examination, notably the use of the speculum, could be anticipated and a woman’s fears allayed? The data might also be of benefit to the police in bringing forward prosecutions; there have been no prosecutions under the 2003 Act, which is now five years old.

My Lords, I commend my noble friend’s record on this issue and record the debt of gratitude that we owe to her persistence in pursuing it with other Members of the House who have been active in this regard over many years. The Department of Health has commissioned research on the prevalence of FGM and has instigated awareness-raising initiatives, including training for health professionals which includes the appropriate response to FGM, information-sharing and a comprehensive training video. Indeed, this week a cross-government regional information exhibition is beginning to raise awareness of FGM, forced marriage and so-called honour-based violence for front-line professionals to increase their understanding and knowledge. I take on board the very good point made by my noble friend. I undertake to take this away and to explore what further might be done.

My Lords, does the Minister accept that there were for some years unsubstantiated rumours to the effect that certain doctors serving immigrant communities were prepared to carry out so-called female circumcision? I am sure she is aware that the Police and Criminal Evidence Act 1984 makes it quite clear that it is appropriate for a doctor to breach medical confidentiality to aid the police in the investigation of a grave or serious crime. Does not she therefore agree that this illegal act of genital mutilation is a serious crime and that any doctor thereby disclosing this information to the police, without consent, would not be in breach of the law?

My Lords, the noble Lord is right: doctors are bound to release such information to the police—of course they are. As well as pursuing a legal framework around domestic violence and child protection it is very important that we work with the communities where FGM may occur. That is why initiatives such as the Metropolitan Police’s Project Azure and financial support for the FORWARD organisation, which is campaigning on this issue, are also very important.

My Lords, I was a member of the all-party group in the other place that investigated female genital mutilation way back in 1998. Despite its very comprehensive report and the renewal of the original 1985 Act of Parliament in 2003, there have still not been any prosecutions for female genital mutilation practised either in this country or on our citizens who go abroad for this horrendous operation. I appreciate that it is a desperately sensitive and difficult issue, but does not the Minister agree that until we have a well publicised prosecution of someone who has committed this act we shall not get any real progress?

My Lords, the noble Baroness makes a very good point. Child protection agencies always face a difficult dilemma with cases of FGM. There is little warning that a child is about to undergo the procedure; research suggests, as the noble Baroness will know, that the key barrier to prosecution is pressure from the family or the wider community that leads to cases being unreported; and, of course, at the time, mutilation victims may be too young, too vulnerable or too afraid to report offences or to give evidence in court. However, despite the lack of prosecutions to date, the Female Genital Mutilation Act 2003 provides a clear message that FGM is an unacceptable practice. We believe the Act has been a catalyst for the outreach work which has helped to raise awareness of FGM.

My Lords, what guidance is given to midwives and health visitors dealing with families in which FGM has taken place?

My Lords, all nurses and midwives have a duty of care to girls and women who are at risk of having FGM performed and to those who have already been cut in the past. The Nursing and Midwifery Council’s professional code of conduct states that nurses and midwives in the UK must act to minimise the risk to their clients. This includes reporting information that a child is potentially or actually at risk to the social services and to the police.