Domestic Abuse Bill

Debate between Baroness Armstrong of Hill Top and Baroness Crawley

Committee stage & Committee: 2nd sitting (Hansard) & Committee: 2nd sitting (Hansard): House of Lords
Wednesday 27th January 2021 Lords Chamber

[Baroness Armstrong of Hill Top (Lab) [V]]

My Lords, Amendment 53 seeks to amend the Bill to put a statutory duty on public services to ensure front-line staff in those services are making inquiries about domestic abuse. It looks to further support this duty with appropriate training and funding so that staff are equipped to ask the question, and to ensure services are available and ready to support survivors when they do disclose. The amendment also seeks to accompany the duty with robust data collection and good training standards. The campaign to include this in the Bill has been led by Agenda and supported by over 20 other charities, trade unions, practitioners and leading experts. I thank them for their work and their commitment.

The impact of abuse on survivors means that they are likely to come into contact with a whole range of public services. While four out of five victims never call the police, many visit their GP because of the abuse they are suffering. Some turn up at the housing department, some at DWP. For some it is the police; for others it will be the health service. Wherever it is, it is important that the abuse and its consequences are recognised and that appropriate support is offered.

Unfortunately, research by Agenda and the National Commission on Domestic Abuse and Multiple Disadvantage in the report Breaking Down the Barriers found that too often public services fail to pick up domestic abuse and therefore fail to respond appropriately. Routine inquiry, whereby practitioners routinely ask patients about experiences of abuse, is already recommended by NICE guidelines in services including mental health, drug and alcohol treatment, and maternity services—but it often does not happen.

I say to your Lordships, ask friends who are pregnant about their experience. I did, and got a variety of answers. Some had not been asked at all; one was asked in front of her partner; and others were asked in what they described as a tick-box exercise, where it was clear that the person asking was embarrassed and did not want a difficult answer. A third of mental health trusts that responded to a freedom of information request from Agenda did not even have a policy on routine inquiry, despite the NICE guidelines. When they had a policy, it was often applied inconsistently, with one trust saying that it asked only 3% of patients about experience of domestic abuse.

The Joint Committee on the Bill urged the Government to consider how to ensure greater consistency of approach and training for front-line staff. The Government’s response was that routine inquiry was already taking place in maternity and mental health services. However, as we now know, tragically, it is not. Some 38% of women with mental health problems have experienced domestic abuse. Many of them have not had that taken into account in the response that they get in treatment. We need to go further than health services. All our public services, from jobcentres to GPs, should be asking about abuse, so that they can then offer appropriate support.

There are examples of good practice, which show that the approach suggested in the amendment would work. The IRIS programme in primary care, a training and support programme to improve service-level response to disclosure of abuse, found in its research that the number of referrals to domestic violence agencies made by clinicians in practices where IRIS was in place was six times higher than in those not involved in the programme. It has also been evaluated that there are social costings of £37 per woman registered in a GP practice. So we know that there is training that works and makes a real difference. We know that too from the SafeLives training programme that is delivered to police forces, because it produces much better practice and outcomes in those forces that take up the training.

I have not put in the amendment the precise nature of the training, which is probably a matter for guidance. However, most people agree that it should be some form of trauma-informed practice. I have talked to organisations such as Changing Lives and Fulfilling Lives, which ensure that all their staff have trauma-informed training. There are two main consequences of this. They know how to deal with people who come before them, mainly women, who have experienced the trauma of domestic abuse. They know how to give them the feeling of a safe space, how to help them disclose, and so on.

They also deliver training to other organisations, so Fulfilling Lives, with some of their experts by experience who have been through the training, then offer it to the DWP in Newcastle. DWP managers have told me just how valuable this is. We know that this sort of training works, and the Government have recognised it in making sure that it is offered to veterans who suffer from PTSD. It needs to be recognised in those who have experienced domestic abuse. Appropriate training also helps front-line workers deal with the trauma of colleagues who have their own experience of domestic abuse or deal with those experiencing trauma. We have learned a lot about that during the pandemic.

This amendment would give public services a real opportunity to rethink training and development for their workforce, and offer meaningful support to the victims of domestic abuse. I think it is really necessary, and I sure that the Government know this, but are worried about it being overburdensome. I do not believe it would be. It would be enormously helpful to public services and front-line workers, because they would be much more confident about how they are dealing with people. I hope that the Government see how to adopt this, and I beg to move.

[Baroness Crawley (Lab) [V]]

My Lords, it is a pleasure to follow the wisdom and experience of my noble friend Lady Armstrong and to be in the company of my noble friend Lord Hunt in adding my name and support to this amendment. What brings us together is the need for this most welcome Domestic Abuse Bill to place a statutory duty on public authorities to ensure that front-line staff make trained inquiries into domestic abuse, backed, as my noble friend said, by sufficient funding to make it a reality.

The Government said that routine inquiry is already in place in maternity and mental health services, and that all staff working in the NHS must undertake at least level 1 safeguarding training, which includes domestic abuse. While I acknowledge that much guidance is out there and that many levels of training and training commissioning exist, the problem is that there is no trained, routine and consistent inquiry into domestic abuse for front-line workers across public authorities.

Since best-value performance indicators were dropped several years ago, local authorities—often the local trainers and commissioners—have no way of measuring their performance in training and commissioning compared with other local authorities. Often, the first contact in a trauma is the most important. Their interaction with an abused person decides the trust and confidence that that person has in that service, be it the police, housing, mental health, the NHS or social care. I know that local authority trainers, in particular, would welcome greater consistency, accountability and scrutiny.

The alliance organisation Agenda has worked tirelessly on this aspect of help for victims of abuse. It has found that, despite NICE guidance, trained practitioners are not routinely asking patients about domestic abuse. One mental health trust asked only 3% of patients, when it was meant to be asking everyone. The Government are aware of these continuing inconsistencies, as is seen in the shift in their wording in the draft statutory guidance published in July 2020—from routine inquiry on domestic abuse “already takes place” to “should be taking place”.