HC Deb 11 July 2003 vol 408 cc1556-8
Mr. Wilshire

I beg to move amendment No. 8, in page 1, line 5, leave out "or mental".

Mr. Deputy Speaker (Sir Alan Haselhurst)

With this, we may take amendment No. 9, in page 1, line 21, leave out subsection (5).

Mr. Wilshire

Amendment No. 9 would remove a subsection, thereby ruling out a specific defence. I want to make it clear that that is consequential on amendment No. 8. I do not want amendment No. 9 to be considered as a free-standing amendment. It flows from amendment No. 8 and I hope that no one would read anything more into it.

I am not a doctor or an expert in such matters. I am not involved with psychology or psychiatry. However, over the years, one gets a sense of some of the relevant arguments and issues. Again, to draw out some of the reasoning, amendment No. 8 would remove the justification of carrying out female genital mutilation on the ground of mental health needs.

I have no difficulty with the argument about physical health needs. The reasons that the Bill sets out are straightforward and sensible. Sadly, there are occasions when the procedure has to be carried out. A doctor is sitting near me and perhaps the hon. Member for Richmond Park (Dr. Tonge) will correct me. However, I accept that there will be occasions, when, with all the good will in the world and the different methods of tackling problems, there is no other alternative for the health and life of the relevant person. That must be a difficult decision for medical practitioners, the relevant person and perhaps the families, but I have no quarrel with that.

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There have, however, been occasions on which practices with which we do not agree have been justified on the ground that they were carried out in the interest of the mental health of the person concerned. I sense a loophole there. As I suggested in relation to new clause 1, a girl or woman, or her family, might have considerable pressure brought to bear on them in this regard, on the grounds of ritual, custom, tradition or religion; it does not matter which. They could be told that if they did not do this, they would be letting the family down, letting themselves down or letting their guru down. Whatever the argument might be, I, as a lay person, suspect that there would be a real risk of mental ill health resulting from the repeated pressure and the repeated argument that a person would be a failure because they had not done certain things that we are seeking to make illegal.

Can the hon. Member for Cynon Valley (Ann Clwyd) reassure me and anyone else who shares my concern that it is possible to have a reason that I can understand as to why mental health could be relevant. I find it difficult to see how, for mental health reasons, a woman could be helped by having part of her genitalia removed. It puzzles me, as a layman, that that should be a justification. If there is a reason why that sort of thing has to be done for mental health purposes, I would bow to that superior judgment and would be happy to withdraw my amendments. For the moment, however, I put this issue in front of the House in order to ask what the mental health justifications are. How can I be certain that this is not a loophole? Would it harm the Bill if this provision were taken out?

Ann Clwyd

I should like to reassure the hon. Gentleman. The effect of amendment No. 8 would be that any surgeon carrying out an operation of this kind for which there was a genuine psychological need would be committing a criminal offence. As the hon. Gentleman said, amendment No. 9 is consequential on amendment No. 8.

Operations that are genuinely necessary for mental health reasons might well be rare, but it would be wrong to criminalise them. That was certainly not Parliament's intention when the Prohibition of Female Circumcision Act 1985 was passed, and there is no reason to suggest that the intention of this Bill is any different. In particular, we need to allow for the fact that gender reassignment surgery is less rare than it once was. That is a good example of an operation that may be necessary for mental health. The British Medical Association supported that view in guidance issued in 2001. I hope that, in the circumstances, the hon. Gentleman will withdraw amendments Nos. 8 and 9.

Paul Goggins

I rise briefly to confirm what my hon. Friend the Member for Cynon Valley (Ann Clwyd) said. Surgical operations of this kind carried out for mental health reasons are extremely rare, but there may occasionally be strong grounds for allowing them to be carried out. For that reason, the Government believe that these grounds should be included.

Dr. Tonge

If the hon. Member for Spelthorne (Mr. Wilshire) would like to see me afterwards, I could give him a whole catalogue of reasons why there might be mental health grounds for carrying out operations on the female genitalia. I understand his reservations, however. We have all heard stories about people having breast operations, for example, with mental health being given as the reason, when it probably should not have been. There are, however, genuine mental health reasons for carrying out operations. I assure him that there is a huge range of female genitalia out there, and sometimes they cause enormous problems, both mentally and physically, but primarily mentally. I want to reassure him that this provision is necessary.

Mr. Wilshire

Earlier, I had some free advice from a lawyer, which is a rarity. I have enjoyed my free consultation, but I will pass on the offer of free medical advice. There are things in this world that I do not wish to know, and those may be some of them.

A number of points arise from what has been said. I say to the Minister that I am sure that there are strong grounds. I think that he used that phrase, but I would have found it helpful had he said what they are. To assert that they exist is helpful, but to know what they are would be doubly helpful.

I am not sure that the hon. Member for Cynon Valley (Ann Clwyd) necessarily reassured me as much as I know she was trying to. Again, I am happy to stand corrected, but I am not sure that I buy the argument that it is wrong to criminalise a surgical procedure. I think that that is what she suggested. I would be surprised if there are not surgical procedures that are already made illegal. I think of the abortion legislation. Under certain circumstances, late abortions, as I recall from the debates in the House, are indeed prohibited. That might not be the best example, but I am not sure that I buy the argument that we must not do this because we cannot make surgical procedures criminal offences. I think that we can, and there are occasions when we should. Whether this is one is a different matter.

The hon. Lady then offered me the fact that gender realignment might be a justification. I tend to understand the term as sex change. I am not sure that I have got into the newspeak on some of those issues, but we shall let that pass. If this procedure is necessary for that procedure, it would be perfectly possible to make the procedure of gender realignment one of the justifications for it not being a criminal offence, rather than using the blanket argument of mental health reasons.

I do not think that either argument that the hon. Lady offered in itself persuades me that the amendment is not worth pursuing. Fortunately, the hon. Member for Richmond Park (Dr. Tonge), who sits on the Liberal Democrat Benches, managed to save the day by saying that a range of other issues gives rise to mental health problems should surgery be necessary. Coming from a medical practitioner, I unhesitatingly accept that. She is an expert, but I ask her to spare me the gruesome details. In those circumstances, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

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