§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Mike Hall.]
§ 10.3 pm
§ Mr. Alan Simpson (Nottingham, South)
The Minister will know that, on 28 October 1999, I tabled a written question to the Home Secretary asking him if he would list by police authority area the number of women medical examiners available for examinations involving child victims of sex attacks, and whether, in all areas, child victims or their families are able to choose whether the child is examined by a female doctor.
The background to tabling the question was not simply a passing interest, but one of the most disturbing experiences that I have had as a Member of Parliament. A young mother came to see me at one of my advice surgeries and described the horrific circumstances in which it became apparent that her daughter had been the victim of rape and sexual attack since the age of six. The abuse had continued for more than five years before it became known and part of a police investigation and subsequent prosecution.
The details of the case are not really relevant to this Adjournment debate, but what troubled me was that, in the course of explaining what had happened, the mother took me through the exchanges with police; the very constructive and supportive help provided in the early stages of working through the traumas; and the explanation that, in a prosecution, it would be easier if her daughter could undergo a forensic medical examination, so that the evidence of the sexual attack could stand as the principal basis of the trial.
The mother talked the matter through with her daughter, who agreed to go through the process to minimise the inevitable trauma of having to give evidence in the trial. The real shock came when they discovered that the forensic medical examiner was a man, despite the fact that they had both asked for—and expected—a woman. Their shock was compounded by the fact that, when they asked whether they could have a female forensic medical examiner, they were told, "No." They were given that answer because there were no female examiners in Nottinghamshire.
I confess that I was shocked by the case. I do not consider myself to be particularly naive or sheltered, but I was unprepared for those statements, which showed how limited are the rights of the child in our judicial system as we approach the end of the 20th century. I was also unprepared as a father, brother, and partner—as close as a man can get to understanding how traumatic it is for a girl to be sexually attacked and abused—for the realisation that we still require girls to be medically examined by someone of the same gender as the person responsible for the attack.
I was slightly surprised at the response to my parliamentary question. The Minister will recall that, in his reply of 3 November, he said:Comprehensive information about numbers of female medical examiners is not held centrally. It is accepted as good practice that child victims of sexual assaults, or their families on their behalf, should be given the choice of being examined by a female doctor. Unfortunately, this cannot always be guaranteed as there are some police forces which do not have female medical examiners."—[Official Report, 3 November 1999; Vol. 337, c. 194W.]372 I was as surprised by the answer as by the statements that the Nottinghamshire police gave the family.
I could not understand why the Home Secretary was not in a position to provide me with that information on a national basis. I could not understand why Parliament cannot say how many areas of the country leave parents and child victims of sex assaults in a similar position, with no right to exercise a choice about the gender of the person who conducts the forensic medical examination. I also could not understand why it was not a priority for the Home Secretary to say not only that he did not know, but that it was unacceptable for him not to know and that he would find out.
In the absence of such an answer, the only way to proceed was to follow up the matter myself. I wrote to chief constables to ask about the provision in each police authority area. I asked them to detail the number of forensic medical examiners available to female or child victims of sex attacks and how many national health service general practitioners or paediatricians were in training with the police to provide the targeted examination service for women and children where they request it.
The replies that I received to my letter have also given me cause for concern. Some of the chief constables and their police forces have been extremely helpful, and I praise those who came back to me with full replies. Replies have been received from police forces in west Yorkshire, Cheshire, Kent, Cleveland, Surrey, Derbyshire, Merseyside, Avon and Somerset, Staffordshire, south Yorkshire and Lincolnshire. All gave full replies to my questions, but I suspect that one reason they were willing to do so was that, in each of those areas, positive and specific provision was available to women and children who were the victims of sex attacks. In those areas, anyone who requested to be examined by a female forensic medical examiner would have the right to be so examined.
A number of the other police forces that replied simply said that that was a matter into which the Association of Chief Police Officers was looking. Their response would not come to me direct but would go through ACPO. I pay tribute to ACPO's responsiveness and to those involved in the compilation of the inquiry. However, the information that has come back to me is somewhat patchy.
The national picture is as follows: some 18 per cent. of forensic medical examiners—sometimes referred to as police surgeons—are women. That is, by any standards, a fairly poor measure of the important role that must be fulfilled for child and women victims of sex attacks. However, the replies that came directly to me showed the better part of the picture. In many of the police authorities that replied, more than 18 per cent. of medical examiners were women.
Forces that did not have specific female provision did not bother to reply to me. Sadly, my own police authority in Nottinghamshire is included among that number—to date, it has provided me with no explanation about the absence of female forensic examiners in my county.
I am also uncertain whether, as a result of the ACPO survey, the Minister can come up with the more detailed information that I still do not have. I am appalled that the House and the Government do not regard the need to do something about the situation—and, at the very least, to know what is happening—as being of paramount importance.
373 I had helpful, if saddening, discussions with members of the women's centre in Nottingham, who provided phenomenal support for the family. The saddening aspect of those conversations was that they considered this problem almost a matter of course, and had had to live with and struggle against the problem for many years, with little or no public attention given to the plight of victims of sex attacks. They said that they regard this as the second of three rapes: the first rape is committed by the assailant; the second happens during the medical examination within the police investigation system; and the third is committed by the court.
I pay tribute to the Government for taking considerable steps to improve and protect victims of sex attacks in the way in which court proceedings are conducted. I understand that that has to be balanced against the conflicting rights of the accused, but I cannot for the life of me see what we have to balance in the medical investigation process within the police investigation against the demand that we recognise and respect the rights of the child. There are no contradictory pulls. It is simply a matter that baffles me as much as it offends me.
When I asked for explanations of why this should be so, the first and almost absurd reason given was that women did not like that sort of work. I am sure that there is not a single hon. Member who is not aware that a large number of women work in the health service as GPs or paediatricians in hospitals. There cannot be a shortage of qualified women doctors capable of doing forensic examinations.
On further inquiry, the position became a little clearer. The reply that I received from ACPO about the shortage of female doctors available was:This is a constant problem, since many women Doctors who are willing to undertake this task are reluctant to become involved in other forensic medical work and it is essential that their level of expertise is sufficient to ensure the effectiveness both of the investigation and any subsequent prosecution.I understand the importance of the fact that competence extends through to the prosecution process, but the real obstacle seems to be that women GPs who offer their services specifically for women and child victims of sex attacks are asked whether they are willing to undertake all other aspects of forensic examinations, such as those on bodies pulled out of ditches, found in canals or dragged out of car accidents, or in cases relating to the full range of responsibilities of the police.
It does not surprise me that those who specialise in paediatric care say that that is not what they are offering. They are offering their expertise in relation to children, their vulnerability and their right to be examined by someone who understands their plight, not necessarily someone who has competence across the board. The reason why we are in the current national predicament is partly of our own making. There is a dispute between the Home Office and the police forces about how forensic medical examiners are to be paid retainer fees. There is also a conflict in police culture about whether it is appropriate to allow women to offer a specific service rather than sign up to the full range of services that the police require.
At the end of the 20th century, a civilised society that has signed up to the European convention on the rights of the child and stands at the edge of a decade in which it is 374 supposed to be a signatory to the international decade for the culture of peace for children, ought to have a different benchmark for the adequacy of our policies and procedures.
I have three specific requests to make to the Minister. First, will he complete and publish the national database of police returns on the number of female medical examiners in each police authority who are made available to respond to requests from women and children victims of sex attacks? Secondly, will he go back and look at the current ministerial guidelines, not to add a further recommendation about best practice but to define a non-negotiable statutory obligation for every police force in the land? It must be every child's right to request and to expect examination by a female doctor, should that be the child's choice.
Finally, during the Minister's negotiations with police forces, will he consider the introduction of measures to guarantee flexibility and training? We need to ensure that there is no distinction between those GPs who are retained and those who are not, and to acknowledge the importance of defining the obligation to provide special services to meet the needs of women and children victims of sex attacks.
We can never turn the clock back on the sex attacks that have taken place, but we ask the House and the Government to take this small step: to guarantee that we will listen to children's pleas not to repeat or compound the nightmare that they have lived through by requiring them to undergo medical examination by a doctor who is not of the gender of their choosing.
§ The Minister of State, Home Office (Mr. Charles Clarke)
I begin by congratulating my hon. Friend the Member for Nottingham, South (Mr. Simpson) on securing the debate. I appreciate the way in which he made his points. As he acknowledged, and would expect me to point out, it is not appropriate or right for me to comment on a specific case which is before the courts. However, he raised an important and interesting question—as he did in the written question that I answered on 3 November—upon which he has elaborated in the debate.
The investigation of sexual attacks on children is an extremely important part of police activity, and it must be handled with the greatest care and sensitivity. The Government are determined to ensure that the criminal justice system is effective in protecting children from those who might harm them—that includes improving the way in which child witnesses are treated.
A key principle in dealing with children as victims or witnesses is to ensure effective partnership between the police and social services. Area child protection committees provide a framework in which that participation and partnership can take place. Parents and victims should themselves also be fully involved in the process wherever possible; their views and choices must be respected.
The partnership approach, which we established and formalised in the Crime and Disorder Act 1998, is fully endorsed by the Government and is reflected in the work of police forces throughout England and Wales. It is on that basis that I deal with the issues raised by my hon. Friend.
375 My hon. Friend is correct to say—I confirm it—that it is certainly good practice for child victims, or their parents on their behalf, to be offered a realistic choice of examination by a female police surgeon. In the second of his concluding points, he asked that ministerial guidelines be issued, which would require a statutory obligation to request and expect that children have that choice.
I understand, and appreciate, the legitimacy of my hon. Friend's demand, but he will realise that we can implement such a principle only when we are sure that it can be fulfilled. I shall refer later to the statistics and surveys that he mentioned. I am prepared to confirm that it is good practice for that choice to be offered, but I am not able to commit the Government to the introduction of ministerial guidelines that would require that to be the case. The demand is important, and I shall set out some of the ways in which we might deal with it effectively.
That good practice should be possible in the majority of cases, but some forces have no—or few—female police surgeons, as my hon. Friend pointed out. I shall refer to the data in a moment. In many cases, victims and their parents will feel happier about examination by a male police surgeon once they have had the opportunity to talk the issues through. In a sense, the most important factor is to ensure that the input from the police surgeon is high quality and sympathetic. Many examinations can be carried out by, or in partnership with, a paediatrician, who will often be female. However, none of those important qualifications invalidate the thrust of the point made by my hon. Friend. We shall consider that matter.
What is the national picture? The truth is that there have been difficulties in recruiting and retaining female police surgeons and there are a wide variety of reasons for that. Some relate to the unsocial hours, some to the working environment and some to the issue of breadth of experience that my hon. Friend mentioned. His third point on the guarantee of flexibility in training for different disciplines is important. As he said, many forces believe that all police surgeons should cover the whole range of issues that may arise. Establishing more flexibility may be worth considering in that regard, but it would require a significant change in practice in the police service across the country. The fact that my hon. Friend has raised the issue has put it sharply on the agenda.
I come to the figures to which my hon. Friend referred. The survey of the Association of Chief Police Officers, which was reinforced by his own research, revealed that many police forces have a high proportion of female police surgeons. For example, more than a third of the police surgeons in Bedfordshire, Surrey and Leicestershire are women. Some police forces have no female surgeons. The survey suggested that three forces had none; and 41 out of the 43 forces responded to it. However, as my hon. Friend pointed out, it showed that, across England and Wales, more than 17 per cent. of police surgeons are female. Therefore, it reveals a wide variety between police forces; some have a significant proportion of female police surgeons while others have very few or none. That was a fair point for him to make.
The first of my hon. Friend's final three questions was about the completion and publication of a national database. I shall consider his request in discussion with ACPO and others to see to what extent we can have a 376 wider and more informed debate on the issue, which has been given greater profile by this debate. I understand why he wants more data, but he will understand that I am not able to answer yes or no to his question from the Dispatch Box. However, I assure him that I shall discuss with ACPO and the inspectorate whether it will be possible to publicise the data more fully and provide a comprehensive assessment.
As my hon. Friend said, each police force is operationally independent. Therefore, we as central Government do not have data that is universal across the whole country on a variety of issues about which there is general concern. For very good reason, we have been loth to publish partial data. That is why I have been qualified in response to my hon. Friend's question tonight and why I was qualified in my written answer on 3 November. However, I shall certainly consider with ACPO and the inspectorate whether we can provide more data in the way that he requests.
The central facts, however they are published, are as my hon. Friend set out. The general proportion of female surgeons in police forces across the country is 17 to 18 per cent. and that figure ranges from more than a third in some forces to zero in others. That is the picture and all that greater data will reveal is a clearer mapping of the proportion in each force.
My hon. Friend also referred to some broader issues. It is a fact that retaining female doctors has been very difficult for forces at a time when some of them have been struggling to maintain an effective overall police surgeon service. In some parts of the country, the right way to deal with that problem has been a major issue. There have been problems in achieving full geographical coverage and 24-hour availability, both of which are real demands; in providing the breadth of expertise that my hon. Friend mentioned; and with the total cost of the service. A small number of forces have gone as far as to contract out the service to the private sector.
§ Mr. Alan Simpson
Does my hon. Friend feel that it might be helpful if the questions that he goes away with after the debate include looking at those police authorities that have been able to ensure that over 30 per cent. of their police surgeons are women, how they have gone about doing that, how they have managed both to recruit and to retain those people, and whether there are models of good practice that other areas with no women police surgeons should be directed to follow?
§ Mr. Clarke
With the exception of one word in my hon. Friend's intervention, I completely agree. It is right to say that there is good practice to be learned, and to understand how recruitment procedures should operate. The one word is "directed" because, at the moment, the Home Secretary does not have the power to direct police forces on this and many other matters. We can offer guidelines, to which my hon. Friend has referred, but direction is not one of the powers.
I am probably alone in the House in watching "Dangerfield" from time to time, but we are talking about many of the issues that are raised on television evenings and weekends: flexibility, the difficulty of 24-hour availability and geographical cover. Those are the things that we see on our screens—the theatrical elements, each of which have important implications.
377 The need to review at national level key issues of the type that have been raised by my hon. Friend was recognised by the establishment of the Home Office working group on police surgeons. That has proceeded relatively slowly over recent years, but I believe that it should report in the early part of next year. I give him the assurance that the substance of what he said not only in the question that I answered on 3 November, but in the debate, will be taken fully into account by the working group in its report, which we will then be able to discuss. Among the issues to be addressed are training, organisation and the arrangements for providing a service at force level. The issue that my hon. Friend has raised is, of course, important and substantial and needs to be addressed.
My hon. Friend mentioned pay. The establishment of new national arrangements to negotiate police surgeons' remuneration is a positive development.
378 There is a wide range of other issues, including how child witnesses should be treated, how examination should be conducted, how videos should be used, how the steering group can move matters forward and how victims of child abuse can be dealt with, but the central issue that my hon. Friend has raised—the availability of female police surgeons in forces throughout the country—is important.
§ The motion having been made after Ten o'clock, and the debate having continued for half an hour, MR. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at twenty-eight minutes to Eleven o'clock.