Domestic Abuse Bill

Debate between Baroness Finlay of Llandaff and Baroness Burt of Solihull

Monday 15th March 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, this amendment is important and it has been carefully worded to cover all the suggested improvements, as my noble friend Lord Ramsbotham said. It must be incorporated into guidance to prisons. The victim of a domestic abuse brain injury, normally a woman, may suffer memory loss, get confused and her speech become slurred because of brain injury. There is no physical wound or bruise; the damage is internal and invisible. Some in the criminal justice system doubt her because she appears confused and disorganised through loss of some executive functions. The brain injury remains unrecognised, and most victims will never have consulted a doctor, often through fear of talking about the abuse.

The Disabilities Trust’s work in Drake Hall prison which my noble friend Lord Ramsbotham referred to found that 64% of women prisoners coming on to the secure estate for the first time had a brain injury, and almost two-thirds were from a domestic violence incident. Some 40% of the women had a traumatic injury labelled as a mental health diagnosis, and for many this was the first time anyone realised the cause of their behavioural symptoms. Similar work with male prisoners has verified exactly the same situation.

Women who have experienced domestic abuse need treatment. They may need surgery to remove a chronic clot on the brain, and they certainly need neurorehabilitation services to understand the condition and cope with it. As I said, the data from male prisoners is similar, and it is similar in young offenders too: around 40% have an acute brain injury affecting their behaviour.

We cannot ignore the size of the problem, with almost two-thirds of women having a brain injury that came about from domestic abuse. This must be incorporated into guidance. I feel that if the Government will not agree to do that, my noble friend will be forced, unfortunately, to divide the House.

[Baroness Burt of Solihull (LD)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Finlay, who is so immensely knowledgeable in these matters. I recall clearly the debate we had in Committee and what we learned about the shocking prevalence of acquired brain injury among prisoners and domestic violence victims alike.

As regards this amendment, women victims should be screened if they have been subject to domestic abuse, including women in prison. The amendment sets out quite strong qualifying criteria for screening and treatment for whether the woman qualifies as a domestic abuse victim.

In Committee, the noble Baroness, Lady Finlay of Llandaff, expressed concern about the practicality of being able to perform scans within two weeks, given the large waiting lists, which have been made appreciably worse by the pandemic. She also cast a depressing light on the fact that much acquired brain injury is irreversible. Therefore, I believe it is a balance between what is practical and what is desirable.

However, we know that productive discussions have been had by the Safeguarding Minister, with the noble Lord, Lord Ramsbotham, and Chris Bryant MP in the Commons. The noble Lord has done a great service to the House in raising this issue, and I greatly commend the work he has done over many years to raise awareness of the importance of acquired brain injury.

The noble Lord also secured a commitment from NHS England and NHS Improvement to add further questions to their existing screening tool to identify how an acquired brain injury occurred and whether violence was involved. He told the House about the extensive health examination given to new prisoners. That has certainly improved since my prison days. Much seems to be being done—or planned—by the NHS through non-legislative means. I agree with the noble Lord, Lord Ponsonby, who spoke in Committee, that it is not totally necessary to include this amendment in the Bill.

Domestic Abuse Bill

Debate between Baroness Finlay of Llandaff and Baroness Burt of Solihull

Report stage
Wednesday 10th March 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, Amendment 45 is crucial and unreservedly welcome. It is awful to see someone subject to coercive control; to see how the woman—I have seen only women subject to it—is made mentally and physically ill by such passive-aggressive behaviour. Sometimes it is more active than passive. By adding her name to this amendment, the Minister has shown her understanding of this.

Amendments 46 and 47 are similarly essential. Coercive control can be very difficult to pick up under safeguarding. As the noble Baroness, Lady Jolly, stated, disability applies to those with profound learning difficulties as well as serious physical difficulties, but their communication difficulties can make it very hard to detect what is going on. As the noble Baroness, Lady Uddin, described, the terrible fear induced in the victim is something that feeds the controlling coercive behaviour from the abuser.

None of us wants to delay the Bill. I hope the Minister will take to heart and address the difficulties that my noble friends Lady Campbell of Surbiton and Lady Grey-Thompson have been put in, and will seek to ensure that the statutory guidance relating to the Bill recognises that there is true domestic violence occurring from personally connected intimate care providers.

[Baroness Burt of Solihull (LD)]

I am grateful to have the opportunity to speak. I was delighted to see the Minister’s name on Amendment 45 and the consequential Amendments 88, 89 and 96. That is three times that I have been delighted today so I do not quite know what is going on. I welcome the extension of “personally connected” in the context of coercive control to family members or people who have been in an intimate relationship, whether living together or not.

The noble Baroness, Lady Lister, talked about how important training for police and professionals is in the implementation phase. As several noble Lords have said, a lot of individuals who are being coercively controlled do not know or appreciate that fact. It is a bit like the story of the frog in the beaker where the water gets heated more and more, very gently, and the frog does not realise that it is trapped until it is too late. It really makes a difference if other people can recognise what is going on, perhaps even before the victim themselves.

Post-separation abuse is a terrible thing. Having thought that you had escaped the abuse but then realising that you are being dragged back and dragged down financially and emotionally takes a toll. We have heard a number of examples of just how awful that is, so I cannot say just how happy I am.

We have been pushing the boundaries somewhat regarding the definition of “personally connected” in several contexts. I will talk about disabled people in a second but, with regard to family members or people who have been in an intimate relationship, whether or not they are living together, I am glad that the Minister has listened. I am sure that is right, and the Bill will be stronger for it.

Amendments 46 and 47 extend the definition to the relationship between a disabled person and their carer. We had this discussion on Monday, so I will not repeat the arguments that were used then, but I was disappointed by the Minister’s response. The House showed its concerns and feelings, and I hope that the Minister takes them into account in her remarks, but also takes the opportunity to have another think before Third Reading and the Bill goes back to the House of Commons.

We strongly need disabled people to be heard. We heard strong arguments for this on Monday and tonight, not least from the noble Baroness, Lady Grey-Thompson. I hope that the Minister listens to them. I very much welcome Amendment 45.

Domestic Abuse Bill

Debate between Baroness Finlay of Llandaff and Baroness Burt of Solihull

Committee stage & Committee: 5th sitting (Hansard) & Committee: 5th sitting (Hansard): House of Lords
Monday 8th February 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, the noble Lord, Lord Ramsbotham, has raised an important issue and outlined the size of the problem. Brain injury can arise from many different causes such as violent trauma, lack of oxygen to the brain or self-medication with alcohol and drugs. Sadly, brain injury is in large part irreversible, although sometimes the brain has the ability to relearn under intense rehabilitation, which is why rehabilitation services are so important.

One can see the motivation behind the amendment, but I fear that it may be difficult to have it in the Bill. In acute head injury, haemorrhage, usually a subdural haematoma, needs to be detected rapidly and the clot removed neurosurgically. If missed, the injury may become a chronic subdural as the clot acts like a wick, drawing fluid into it so that it slowly expands in the fixed box that the skull provides.

The other main category is that of repeated impact injury, sometimes associated with episodes of concussion as classically seen in boxers, which can lead to dementia. The part of the brain that is damaged determines the clinical signs exhibited. If the frontal lobes or some of the main nuclei of the brain are damaged, there can be profound personality and behavioural changes, while in others, speech and movement are affected. It can be very variable. Sadly, although supportive care can help a person to cope with deteriorating brain function and slow its effect, it is not reversible.

A possible difficulty with the amendment is that it requires a two-week timeframe for assessment, given that there are already waiting lists for MRI machine time for those with symptoms indicating brain pathology, such as cancers that need urgent treatment. Awareness of head injury is gained first and foremost from the patient history, followed by appropriate physical examination, after which further investigations may or may not be indicated. It is the history of the injury and the clinical signs that may indicate brain injury; the screening itself can establish only that the findings and type of injury described are, on the balance of probabilities, likely to be causally linked. This well-motivated amendment should raise awareness of head injury so that women are asked about the type of injury, including how it happened and when. A high index of suspicion of head injury is needed, but I fear that the amendment as worded would not be workable in practice.

[Baroness Burt of Solihull (LD)]

I support the amendments in the name of the noble Lord, Lord Ramsbotham, which he spoke to so convincingly. Amendment 155 deals with screening for traumatic brain injury for female domestic abuse victims who choose to have it within two weeks of a domestic abuse protection notice or order, or when the abuser has been charged. This should provide valuable evidence of abuse for the court and possibly a diagnosis that could help health authorities to treat the injuries that have arisen both physically and mentally. We heard from the noble Baroness, Lady Finlay, about the harm to victims that acquired brain injury can cause; they are complex and worrying.

Amendment 156 relates to female prisoners. As the noble Lord, Lord Ramsbotham, confirmed, many prisoners of the male variety have been knocked around and may well have brain injuries, although I would suggest that that does not happen very often as a result of domestic abuse.

As we have been told, the amendment is based on research by the Disabilities Trust which shows that nearly two-thirds of offenders at Drake Hall had had a brain injury, of whom 62% claimed that the injury was a result of domestic abuse. Of those diagnosed as having a brain injury, nearly all of them had suffered traumatic brain injury, potentially leading to very serious health consequences, as we have heard.

The amendment provides for all female prisoners to be screened within two weeks of starting their sentence. While they are inside, remedial treatment can be started, I hope, although I accept the very informed and concerning comments of the noble Baroness, Lady Finlay.

Domestic Abuse Bill

Debate between Baroness Finlay of Llandaff and Baroness Burt of Solihull

Committee stage & Committee: 3rd sitting (Hansard) & Committee: 3rd sitting (Hansard): House of Lords
Monday 1st February 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, I am delighted to follow my noble friends Lord Ramsbotham and Lady Andrews. In a response to a Written Question in June last year from Geraint Davies, the Member of Parliament for Swansea West, the Minister drew attention to the government website provisions and referenced different languages and British Sign Language. These are all welcome and laudable initiatives, but they require a person to be able to read, have reasonable IT literacy and be able to communicate to others. As chair of the National Mental Capacity Forum, my specific concern here is for those with learning difficulties.

I have become very aware of the startlingly high incidence of abuse of people with any type of disability, as we debated last week. For many, even easy-read format is not enough. I draw attention to Books Beyond Words, which explore topics in pictorial format. One example is Telling About Abuse: a Leaflet for Deaf Adults. These books can be used irrespective of any language. The Ask for ANI initiative is excellent and the easy-read information on the government website is easy to follow. It lays out the number 55 to use on dialling 999 in a way that is indeed easy to follow.

This amendment does not imply any criticism of all the Government have done so far. However, I suggest that they can build on it by including the spirit of this amendment in statutory guidance. The important 2015 report from Public Health England, Disability and Domestic Abuse: Risk, Impacts and Response, states:

“Effective domestic abuse services for disabled people should be accessible and barrier-free.”


Those with severe sensory, cognitive or communication impairments or mental health issues may be particularly at risk and unable to access support through any standard routes. Even having a severe stammer can make using the phone difficult, let alone if a person is aphasic or dysarthric. Some people may need augmentative and alternative communication devices or urgent speech and language and other specialist support.

People with an intellectual disability are at least 1.6 times more likely to experience violence. They may be less able to defend themselves or even to recognise, report and escape abuse. Impairment, such as traumatic brain injury or intellectual, learning or cognitive impairments, may limit a disabled person’s ability to understand and recognise the potential signs of danger and abuse. All this is compounded if people with sensory impairments miss visual or auditory warning signs of abuse.

NICE guidance on domestic abuse recommends that support is tailored to meet disabled people’s needs. In responding to this amendment, I hope the Government will be able to provide assurance that the guidance will require all domestic abuse services to stay up to date with advances in communication and information resources, including new technology.

[Baroness Burt of Solihull (LD) [V]]

My Lords, this is a small amendment but nevertheless it is definitely a point worth making. I was not privy to the debate last week, but my reading of the amendment was that it piggybacked on Clause 55(1)(b), on the requirement to prepare and publish a strategy for providing support. I read it as requiring the local authority to communicate the support available, as opposed to the strategy itself—so I was right there.

“Accessible and inclusive” is important too for people with communication difficulties. It is obvious that to have support available, you have to have potential recipients actually know about it. That means putting notices in accessible, everyday places where potential victims will see them. I have seen them on the back of toilet doors, and I would like to see them on workplace notice boards, buses, Tubes and billboards, and in shops and myriad other places. They must be accessible for everyone: in Urdu, Romanian, Greek, African—you name it. In order to be able to read or see a notice, people need it to be there in front of them.

As the noble Baroness, Lady Andrews, said, as well as ease of reading, it is important that we consider all kinds of disability and use more innovative, technical methods of communication. The message must be clear. The noble Baroness, Lady Finlay, also mentioned books without words, which is a very useful idea. That message, “you are not alone”, “help is at hand”, “dial this number”, “go to your pharmacist and ask for ANI”, and so on, could literally be a life saver.

Domestic Abuse Bill

Debate between Baroness Finlay of Llandaff and Baroness Burt of Solihull

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

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, like several others, I wanted to sign this important amendment, led by the noble Baroness, Lady Armstrong of Hill Top, which I strongly support.

I alluded in the last grouping to my past clinical experience of decades of listening to people—patients of all ages, relatives, staff and others—in the detective work that is part of diagnostic medicine, where you listen not only with your ears but also with your eyes and all other senses, with undivided attention and from the heart. When I reflect on my early career, I am painfully aware how often signals of abuse were missed or picked up all too slowly, or, very occasionally, wrongly inferred from a clinical sign.

That is why awareness is so important. Listening skills can be used to trigger sensitive open questions that allow those abused to get help. GPs know only too well the importance of an aside uttered by the victim who is about to leave the room, with their hand on the door, or when bringing their child in. When reopening a consultation, gently exploring and reflecting back on what is being said results in the stark reality of someone’s life being revealed.

There is a commendable scheme by the Government on the GOV.UK website, Domestic Abuse: Get Help During the Coronavirus (Covid-19) Outbreak. It relies on someone having summoned up enough courage to step forward for help, but many are too scared, ashamed or damaged to do so. That is why awareness-raising is essential. In the area of dementia, a dementia-aware campaign across society has been important. We need to do similar, but even more widely, on domestic abuse. Across health and social care, schools and the police, so many need to have the skills to ask the right questions, to give permission to people to speak up.

There is a list in the Bill. I wonder if the Minister can confirm that the authorities in that list in Clause 15(3)—

“(j) an English local authority … (n) Her Majesty’s Chief Inspector of Education, Children’s Services and Skills … (o) a body approved as an independent inspectorate under section 106 of the Education and Skills Act 2008”—

will cover schools of all types, and explain how colleges of further education and universities will be included in this obligation to co-operate with the commissioner. Will this ensure that the people who are the shop window of all health and social care services—the receptionists, telephonists, domestic staff, porters and so on—are also trained to pick up on all the important cues? Will this be monitored to reveal whether those cues are appropriately acted on?

This is an important amendment and I am sure we will return to it on Report.

[Baroness Burt of Solihull (LD)]

My Lords, I am delighted to support this hugely important amendment. Public authorities of all kinds should be involved in identifying, signposting and providing services for victims. But unless they are properly trained in all these areas and work together, victims will continue to fall through the net and fail to be offered the services they need, or receive them to a good enough standard.

The amendment ensures that workers on the front line such as teachers, police, health workers and housing officers—“from job centres to GPs”, in the words of the noble Baroness, Lady Armstrong—know the signs of abuse when they see them, inquire sensitively and ensure that victims are put in touch with all the services that can help them. This is a huge operation, which is why the commissioner needs to play that pivotal role in ensuring that these bodies are up to the job and on the job. She can require reports on what has been done, how many have been trained and to what standards. She can ask how many potential victims have been approached and what outcomes have been achieved. The amendment specifies that there is nothing to stop authorities conducting their own training, but this should be as well as, not instead of, what the commissioner specifies. We want her to report on her work, findings and recommendations, every year.

We could go further. We should place a duty on these authorities to work together and the commissioner should oversee this co-ordinated effort, as well as the work of the separate authorities. The Minister may be tempted to say that this happens already. I am sure it does—to a degree. But unless the Minister can disabuse me, I do not think that any one person has responsibility for overseeing this co-operation and for requiring reports on work done, results and progress. I would be grateful if the Minister shared her thoughts with the House. I am hopeful, as she spoke from the heart in an earlier group about the effectiveness of multiagency interventions. This is urgent. We know that the pandemic has made the plight of victims even worse. It has shone a bright light on a dark place. Shame on us if we do not do our best to help as effectively and speedily as we humanly can.

Domestic Abuse Bill

Debate between Baroness Finlay of Llandaff and Baroness Burt of Solihull

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Monday 25th January 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, I wish to speak in support of the spirit of these amendments and the arguments so clearly explained by the noble Baronesses, Lady Hamwee and Lady Newlove, and the noble Lord, Lord Hunt of Kings Heath. They have explained why these amendments are needed, certainly in spirit, even if the wording of some of them is not quite right for the face of the Bill.

If the commissioner position was made full-time and the commissioner was able to appoint staff, they could better determine the scope of work and allocation of resources to respond according to need. It is an important fact that the commissioner needs to have some control.

To take one example—I have already declared that I chaired the Commission on Alcohol Harm—we know that, in general, lower socioeconomic groups experience higher levels of alcohol-related harm, particularly violence. The poorest groups are most affected by alcohol-related domestic abuse. You see this with the number of instances of alcohol-related domestic abuse every year, which are fourteenfold in that group compared with the least deprived. The prevalence rate of alcohol-related domestic violence is five times higher among the most disadvantaged groups compared to the least disadvantaged.

This is a huge job. The commissioner must be free to make decisions on how the budget is used, have their own independent office space and not feel in any way stifled by any influence from government in the work that has to be undertaken.

[Baroness Burt of Solihull (LD) [V]]

My Lords, as my noble friend Lady Hamwee has outlined, the aim of this group of amendments is to ensure that the commissioner is independent and able to perform her role unhampered by time and resource constraints.

The term “independent” would be in the title, reinforcing, as with the role of the anti-slavery commissioner, that this person can be free to represent victims as they see fit, reporting to the whole of Parliament, not just the Secretary of State, and paid full-time. This has been questioned by several noble Lords, including the noble Lords, Lord Rooker and Lord Hunt, and the noble Baroness, Lady Newlove. The thinking behind this, frankly, is that it is demeaning to the post to imagine that its holder could ever be regarded as a part-timer, given the scale of the challenge she faces. However, we did not intend that there should be no flexibility in the role at all.

The commissioner should of course appoint their own staff, carrying out the challenges of the role as they see fit within the constraints set out in this Bill; the ex-Victims’ Commissioner, the noble Baroness, Lady Newlove, emphasised this, showing how important that element is. It is a hugely important role: let us give her the tools to do the job.