Domestic Abuse-related Deaths: NHS Prevention

I beg to move,

That this House has considered the role of the NHS in preventing domestic homicides and domestic abuse-related deaths.

It is a pleasure to serve under you, Sir John. I am grateful to the Backbench Business Committee for giving me the opportunity to open a debate on the role of the NHS in preventing domestic abuse and dealing with it when it presents to the NHS. I thank my hon. Friend the Member for Lowestoft (Jess Asato), who, since we secured this debate, has been appointed as the violence against women and girls adviser to the Department of Health and Social Care. I think we shall hear from her later. I also place on the record my thanks to Standing Together Against Domestic Abuse, IRISi, Respect and, from my own constituency, Stroud Women’s Refuge, which have really helped me with this speech. I declare an interest: I am a working GP and sometimes need to deal with these issues.

On average, five people a week die as a result of domestic abuse in this country. Now, there are actually more suicides related to domestic abuse than homicides. Behind each of those statistics is a life lost and a family devastated. In far too many cases, there has been repeated contact with health services and there have been moments when the health service could have intervened. The NHS is the most consistent point of contact for people living with abuse. Each year, about half a million people seek support from the NHS in relation to domestic abuse and 85% of them ask at least five times before they receive effective support. That is not because clinicians do not care. It is really about recognition of domestic abuse and getting referral services that are easy to understand and well known in practice. If we are serious about preventing domestic abuse, we must be serious about the role of the NHS—not just in primary care, but across all mental health services, across maternity services, through emergency departments and through community care. It has to go right across the NHS and not just primary care. This is really a debate about making sure that we do not miss chances and that we provide meaningful intervention when people present with signs of domestic abuse.

The Government have committed to delivering on our promise to halve violence against women and girls by 2029, and I welcome the comprehensive strategy to tackle that. For too long, support services have been unable to support victims and survivors effectively. They have been without sufficient resources and, in too many cases, women and girls have not been able to access the support they need. Therefore I welcome the Government’s supporting victims through the largest ever investment of £550 million in victim support over the next three years and an additional £5 million each year from the Department of Health and Social Care.

I would like to say a few things about how GPs specifically are often the first port of call, and how presentation to GPs is incredibly important for recognition of this issue. I shall quote from Killed Women, an organisation for bereaved families of women who have been killed by men in the UK. It says about one woman:

“She had gone to the GP a few days before her death as she couldn’t take any more. She was only offered antidepressants. On the day of her murder when I spoke to her, she said they are not helping and she had had enough. She said the GP knew her situation but yet again she was failed there.”

That shows that simply giving out antidepressants is not the right strategy. We need to build support around women subjected to domestic abuse. Often, they present with mental health issues and will not give any details of their abuse. One thing that I teach GPs in training is that there is something called a hidden agenda. Women particularly will present to the GP but they will not say that they are being abused; they will have other symptoms. We must recognise that presentation straightaway, and there are ways we can recognise it. Sometimes the woman in question will present with a partner and not feel comfortable talking about the situation. I often ask the partner to leave the consultation and I speak to the woman individually, which can be an effective way to find out exactly what is happening. We need to be aware that women in this situation are often nervous and walking on eggshells. We also have to recognise that often there are physical injuries, often of different ages. We sometimes see women presenting in sunglasses to cover up a black eye, for example. The health profession must recognise all those symptoms.

As I have said before, there are very high rates of mental health problems. Women who are being abused often present with symptoms of depression caused by domestic abuse, so we need to ask those women whether anything is going on at home. Female survivors of domestic abuse are three times more likely to develop mental illness. There are also other high risk periods, such as when women are pregnant and they often have poor outcomes in those situations. We must also be aware, across the health service, that women might disclose domestic abuse. Health visitors are in an ideal situation to hear about that type of thing and must be aware of that potentiality.

In A&E, women often present with overdose, and underneath that there is domestic abuse. Midwives are often presented with this, as are mental health workers, and even gynaecology services as well as social services. Often women present to the health service with different symptoms, but that is a cry for help, which we must recognise.

What do we need to do to support those women? One thing I am delighted about is the concept of steps to safety. The Department of Health and Social Care will roll out a domestic abuse and sexual violence referral service across integrated care boards, giving GPs the tools and ability to identify and refer victim-survivors to support. What is important is that it is a simple service with one number. If it is not simple, it will not be used by health services, and that is incredibly important. It is also important that we make use of existing resources. I visited the sexual abuse centre at Gloucestershire Royal hospital recently. It is a fantastic resource with really well-trained staff who are available 24/7.

It is really important, particularly in practices, to have a safeguarding or domestic abuse lead who is totally up to date with what is available, because quite often services change and GPs themselves are not on top of that. So that is important as well. Can I also stress the importance of women’s refuges? In Stroud we have a fantastic refuge. It does not advertise itself, for obvious reasons, and the people working there are simply amazing, supporting women who have difficulties, and often their children as well. It is inspiring to see the work they do, and it is important that those services are available immediately if women feel in danger.

Can I also make a plea for support for the perpetrators of abuse? It is usually men that perpetrate abuse and they often abuse at least five times, so it is important to catch them the first time and institute really good treatment and management for them. There are often drugs, alcohol or mental health issues behind their problems, so we must deal with that before they continue to abuse. Although that is controversial, I think that is incredibly important as well.

What do we need for the whole of our health strategy? We need things to be co-ordinated. There is a suggestion that we have domestic abuse co-ordinators for a group of GP practices. As I said, I think we need to have leads in general practice, with one person leading who can keep up to date and keep reminding the other members of staff that that is really important. When we are training in primary care, it is important to train everyone. For example, the receptionists in primary care are often aware of the people coming in. They need training to detect domestic abuse so that they can inform the doctors. It is a whole team approach, with pharmacists, nurses and physiotherapists also needing to be trained and aware of the signs and symptoms of domestic abuse.

That training should be essential for everyone, but I want to step back from mandatory training. Many people in the health service find that irksome and a tick-box exercise. I do not want domestic abuse training to simply be a tick box where someone goes on an hour-long course every year and that is it. We need a more integrated approach and it needs to be part of an appraisal process so that every doctor, nurse and healthcare worker is aware and trained in domestic abuse—but without it being made mandatory so that it does not simply become a course that people must go on, but is instead properly integrated into the service.

Last of all—and this seems incredible in this day and age—we need to share data between all of the health services, for example, A&E, GPs and mental health. We often do not get any information from mental health. It is important that we get that data sharing up to speed because domestic abuse can present in many different situations in the NHS and it is important that everyone is aware of the risks. In terms of funding, the £5 million a year from the Department of Health and Social Care is a good first step, but we need quite a lot more than that to bring this service to the fore.

In conclusion, if we are serious about preventing domestic abuse and the deaths that so often follow it, then the NHS must be properly equipped to play its full role. There are three points that I would like to make. The first is on funding, and around training and investing in services that will really help in domestic abuse. Those steps to safety are key because it must be simple for women to access those services. It is also important that wherever a woman presents to the NHS, that the person they present to is trained to detect domestic abuse and aware of what is available for that woman. Finally, we must have a comprehensive whole-health plan for the NHS and tackling domestic abuse and violence against women and girls. That must cover primary care, mental health, maternity and accident and emergency services—and I would like it to be published by 2027 at the latest.

It is a pleasure to serve under your chairmanship, Sir John. I thank my hon. Friend for securing this debate. At the beginning of this debate my hon. Friend mentioned suicide. As we are talking about NHS services, and when we have women trying to take their own lives, I wanted to highlight the devastating impact of the deaths of two people from Portsmouth who took their own lives because of coercive control. Does my hon. Friend agree that all of the agencies across the NHS, our wider health service and our police need to be joined up to stop the loss of lives and that that is a public health issue?

I know that my hon. Friend is invested in trying to help women subject to domestic abuse. Coercive control is very important as it often stops women presenting to healthcare workers. As I have said before, one key thing as a clinician is that we have to be brave and ask the man to step out so that it is possible to have a proper conversation. They can often resist that and can get violent as well. It is important that we take a brave view on this to protect women in general.

To conclude, if we get those three things right—funding, recognition, and a comprehensive and integrated care service—we can move forward to a service that repeatedly sees and recognises abuse and immediately steps in to stop it. That is the shift I am calling for in this debate, and it is one that could save many lives.

I remind Members that they need to bob to catch my eye— although I can see they already know that.

It is a pleasure to serve under your chairmanship, Sir John. I congratulate the hon. Member for Stroud (Dr Opher) on securing this important debate. He is a real champion for the NHS, and it is a benefit to all of us that he brings his former experience as a GP to bear in this debate.

The NHS has more contact with people experiencing domestic abuse than any other service and, therefore, it is vitally important that staff feel adequately equipped to comfort and reassure victims who take that brave step of reaching out for support, often for the first time. In turn, it is essential that victims can feel confident that when they confide in the NHS, the staff that they speak to have the knowledge to properly support them.

While NHS staff do receive the statutory general safeguarding training, it can be easy, as the hon. Member for Stroud has detailed, to miss the signs of abuse and the cries for help, especially when staff are tired from working extensive and difficult hours. As a country, we have so much to thank our NHS for—whether it be for the sacrifices that staff made during the pandemic, or for working additional hours to take care of our loved ones—so my speech is intended to ensure that staff have the tools they need at their disposal to help the most vulnerable, rather than critique their best intentions.

Victims are often hesitant to ask for support; they feel trapped by their abuser and fear the repercussions. The extent to which domestic abuse and sexual assault is known to the authorities is somewhat unknown. It is estimated that only 16% of people report their experiences to the police. One reason is mistrust of the authorities, which emphasises the importance of ensuring that those who treat victims’ injuries are prepared to provide them with the help and support they need. Of the 16% of people who do report an assault, only 2.6% of alleged offenders are charged or receive a summons. Even in cases where the offence takes place in public, the percentage of reported sexual assault offences that receive a charge is disproportionately low; fewer than 5% of reports on public transport resulted in a charge in 2025.

It is a pleasure to serve under your chairmanship, Sir John. I thank my hon. Friend the Member for Stroud (Dr Opher) for securing this debate on such an important issue.

In 2022, 44% of victims surveyed by the Domestic Abuse Commissioner said that their first disclosure was to a healthcare professional. Unlike the criminal justice system, health spaces focus on wellbeing and recovery and are therefore a crucial front door for identification and referrals into specialist services, not just for the many women affected by domestic abuse, but the 105,000 children who, right now, live in homes where there is high-risk domestic abuse. We know that victims who reach out to police are just the tip of the iceberg, given that fewer than one in five ever contact the police about their abuse. Getting our response to violence against women and girls right in healthcare is key to unlocking our ability to properly tackle domestic abuse. For that reason, I was delighted to be asked by the Health Secretary to become his violence against women and girls adviser.

I worked for six years at the domestic abuse charity SafeLives and saw first hand the huge role that health could play. In the report “A Cry for Health”, we found that nearly a quarter of victims at high risk of serious harm or murder had been to A&E as a result of domestic abuse injuries in the year before they were able to get help. We also found that staff were worried about asking, even though it is required under National Institute for Health and Care Excellence guidelines, because they felt they would open a can of worms and, in some cases, make the situation worse. In some cases we found victims visited A&E 15 times before getting the help they needed. Health professionals were patching victims up and sending them back into the violent and controlling arms of their abusers.

Research from Standing Together Against Domestic Abuse, as we have heard, has shown that in 2024, 89% of domestic homicide reviews had at least one recommendation for professionals in the health system—professionals who could have helped save the life of the woman who had been murdered. I have met families whose relatives were killed after repeated contact with health services. In SafeLives’ report on health in London, a survivor who was interviewed and who did disclose at A&E said:

It is always a pleasure to serve under your chairship, Sir John. I thank the hon. Member for Stroud (Dr Opher) for securing this debate, setting the scene incredibly well and giving us all an opportunity to participate.

As always, I want to give a Northern Ireland perspective of what is happening. Unfortunately, the things happening in Northern Ireland are replicated, as shown in what other Members have said and what others will say after me. In some ways, things in Northern Ireland are even worse—the numbers of women being killed are at such a high level in proportion to the rest of the United Kingdom, and outpace what is happening elsewhere.

The Minister, who I am always pleased to see in her place, has a special interest in Northern Ireland, and because of that she will be aware of the stats, which are incredibly worrying. In Northern Ireland, the Police Service recorded almost 30,000 domestic abuse incidents in the 2024 to 2025 period, translating to roughly 85 incidents daily. Almost 18,500 of those became crimes, although many incidents do go unreported. Call volumes, particularly around Christmas, highlight a consistent challenge for victims seeking help. There are about 15 incidents and 10 crimes per 1,000 people, which puts the stats into perspective. Although that is a decrease on the previous year, those numbers are still incredibly jarring.

One of the worst times of the year, as we all know as elected representatives, is Christmas and the new year. There is a strain on relationships, whether it is a combination of financial and emotional pressures, or everything just building up at that time of year. The Police Service of Northern Ireland received 1,407 calls in the period from 20 December 2025 to 2 January 2026, seeing a peak of 116 reports on new year’s day. There is pressure on the PSNI back home, and on the police here, to respond to quite difficult issues. I know the Minister always tries to be responsive to our requests, so has she had the opportunity to speak to the relevant police in Northern Ireland, to get an idea of what they are doing and how we can help each other?

It is a pleasure to serve under your chairship, Sir John. I congratulate my hon. Friend the Member for Stroud (Dr Opher) on securing this important debate.

Too often, domestic abuse is framed solely as a criminal justice issue when, in reality, it is one of the most urgent public health crises that we face. The NHS encounters victims and perpetrators far more frequently than any other service, yet the system consistently misses opportunities to save lives. As the British Medical Journal highlighted, fewer than 24% of domestic abuse crimes are reported to the police, meaning that the health service—not law enforcement—is the front line.

A recent review of domestic abuse-related deaths revealed that 89% of domestic homicide reviews contained at least one recommendation for the NHS—recommendations that occur again and again across cases, showing a pattern of missed signs, inconsistent responses and staff who suspect something is wrong but lack the training, systems or confidence to act on that.

NHS staff are uniquely placed to intervene in suspected domestic abuse. In my own career as an operating department practitioner working in theatres, I can recall many instances when we treated patients with what looked like run-of-the-mill injuries, but all was not as it seemed. A young woman came in for manipulation under anaesthesia of her nose after breaking it in a fall, but she became inconsolable when we told her that she could go home after the operation. “Can I not stay overnight?” she cried. As I talked to her more, we discovered that she was being abused at home by her partner.

I also want to highlight honour-based abuse; sadly, I encountered that many times in my career—from extreme female genital mutilation, to the woman undergoing an endoscopy for severe oesophageal pain, which turned out to be from her family poisoning her with battery acid, stripping the lining of her oesophagus and stomach.

It is a pleasure to serve under your chairship, Sir John. I thank my hon. Friend the Member for Stroud (Dr Opher) for securing this important debate, which has crucially focused on the important fact that prevention has to work across the NHS.

When domestic abuse escalates towards serious harm or death, what can the NHS do to stop it? For too long, we have talked about domestic abuse as if it happens outside public services—as if it starts and ends behind closed doors—but the truth is that the NHS is already in the story; it just has to connect the dots. The moment someone sits in a GP waiting room trying to keep their voice steady, the moment that someone turns up at A&E with an injury that they cannot easily explain, the moment that someone finds out they are pregnant at a maternity appointment and are terrified of going home, or wants to ask for help but cannot because their perpetrator is sat there with them—those are moments of contact with the NHS and crucial opportunities to save a life.

The NHS absolutely has a duty of care to its patients: it must not just treat injuries but respond when someone is at risk. In domestic abuse, risk is not theoretical. The most recent national figures show that there are 108 domestic homicides a year. For the first time, suspected suicides linked to domestic abuse have overtaken intimate partner homicides. That is a flashing warning light for the health service. If suicide is preventable, domestic abuse-related suicide must be treated as preventable too.

A duty of care is real only if staff are trained and equipped to carry it out. If someone reaches out in the NHS and gets silence or disbelief back, or if a note is taken but there is no action, that can be the moment that they stop asking for help. In domestic abuse, missed moments can be fatal.

For the majority of victims and survivors, health professionals are the first—sometimes the only—person they disclose to. People often assume that a victim’s first call is to the police, but the first brave step for many survivors who disclose is often telling a GP, a midwife, a nurse, a health visitor or even their pharmacist. Our healthcare system is the frontline of support for victims of domestic abuse. Tragically, too many survivors are forced to seek help again and again before the system even responds. In fact, 85% seek professional support about five times before they finally receive help.

I start by thanking my hon. Friend the Member for Stroud (Dr Opher), not only for securing this debate but for all the work that he does in the NHS as a GP on the issue of domestic violence and abuse.

The NHS has opportunities to safeguard against domestic violence and, in the most serious cases, domestic homicide. Domestic homicide can be a consequence of honour-based abuse, which is particularly grounded in lived experience in my constituency in Leeds. Honour-based abuse is widely misunderstood, meaning that hundreds of victims are not being helped and perpetrators are escaping justice; I thank my hon. Friend the Member for Stourbridge (Cat Eccles) for highlighting it in her speech and in the work she did when she was in the NHS.

Honour-based abuse, a form of domestic abuse, is motivated by the abuser’s perception that other persons have brought, or may bring, dishonour or shame on themselves, their family or the community. It can take many forms and be complex to identify, but perpetrators of honour-based abuse often use methods of coercive control to force their victims to behave in certain ways, or to subscribe to certain beliefs. For some people, the concept of honour is prized above the safety and wellbeing of individuals, and to compromise a family’s honour is to bring dishonour and shame. That can be used to justify many types of abuse and even disownment or physical harm.

Honour-based abuse is frequently missed or misidentified within health settings. It is often framed as family conflict, particularly when it involves multiple perpetrators, rather than being recognised as domestic abuse and a form of violence against women and girls. This is particularly concerning because victims of honour-based abuse often have repeated contact with the NHS, including GPs, A&E departments and other hospital services, sometimes over many years. Those touchpoints present critical opportunities for early identification and intervention.

For the benefit of the large number of visitors in the Public Gallery, I say that we now move to the wind-up speeches. I call the Liberal Democrat spokesperson.