Domestic Abuse-related Deaths: NHS Prevention

Karin Smyth Excerpts

Tuesday 20th January 2026 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship this morning, Sir John. I thank my hon. Friend the Member for Stroud (Dr Opher) for securing the debate and, as others have said, for sharing his direct experience as a practitioner—he is still a jobbing GP, among his other roles. His expertise was apparent throughout his speech.

As a Member of Parliament I have long talked about this issue, which is massive for me personally and as a constituency MP. All colleagues will be aware, through our casework, of how widespread domestic abuse is. It is one of the biggest issues for me in Bristol South. The number of women who fear injury or worse at the hands of their partners should keep us all up at night.

The Office for National Statistics estimates that well over 2 million women have experienced domestic abuse in England and Wales in the last year alone. Year on year, domestic homicides are present in all our constituencies. There were 108 domestic homicides in the year ending March 2024. Getting the right support early could help to prevent these needless and tragic deaths.

My hon. Friend the Member for Stroud asked the Government to publish a comprehensive plan for health. We now have a clear agenda for officials, as set out in the commitments in the violence against women and girls strategy. I will personally ensure that we make progress on that throughout 2026.

My hon. Friend asked for the Department’s contribution to the VAWG strategy to be increased in future budgets. I am happy to confirm that we are doing that over this spending review period. As well as the £5 million annual investment for victim and survivor support services, we are committing up to £50 million over the next three years to the roll-out of the child house model. In addition, the Department will provide dedicated funding for the Steps to Safety referral service for those affected by domestic abuse. I will address both those points later in my speech. My hon. Friend was also right to emphasise the importance of specialised NHS training on domestic abuse, which I will also pick up later.

Tackling domestic abuse has to become everyone’s business, as we have heard today, so the whole of Government are behind the agenda to prevent abuse and save lives. We saw before Christmas—if people had not recognised it before—the Prime Minister’s personal commitment to this agenda.

I spoke plainly from the Opposition Benches about how the cost of living crisis was impacting women, and I will not now sugarcoat that fact from my Government position. Many women face the impossible choice of staying in an abusive situation or destitution. My right hon. Friend the Work and Pensions Secretary is doing everything he can to support people back to work more generally, and particularly to help women to gain financial independence and keep them free of coercion.

While this work is all necessary, it is not sufficient. NHS staff will play a vital role in helping victims and survivors to access health, housing and justice. As we have heard, healthcare workers are often the first point of contact, offering support, treatment and rehabilitation. They have their eyes on those at risk. My hon. Friend the Member for Stroud made an excellent point about fragmented services, and I take the point made by the Opposition spokesperson, the hon. Member for Farnham and Bordon (Gregory Stafford), that with recognition comes responsibility for delivery. We absolutely recognise that.

The support we offer must be consistent, responsive and easier to reach. As the Liberal Democrat spokesperson, the hon. Member for Epsom and Ewell (Helen Maguire), said, the incidents we have heard about from colleagues this morning are not isolated; this is a systemic issue. As my hon. Friend the Member for Bolton North East (Kirith Entwistle) said in her excellent speech, we need to join the dots.

Like all our public servants—teachers, social workers and the police—NHS workers already play an essential role in safeguarding. As my hon. Friend the Member for Leeds Central and Headingley (Alex Sobel) said, that includes dealing with so-called honour-based killings. For instance, partners are often asked to leave the room before a midwife asks a mother whether she feels confident that no one will try to hurt her or her baby. We take our duty of care towards survivors of abuse extremely seriously, because violence against women and girls is, as we have heard, a public health emergency.

GP surgery staff are at the frontline of our commitment to safeguard lives. Since we came into office, we have supported primary carers and GPs as the front door to the NHS, and we have recruited over 2,500 more GPs. We have since seen patient satisfaction improving, with the recognition that access is improving, and online consultations are ending the morning scramble for appointments, thereby supporting that frontline.

This year, we will work with all ICBs to help staff in GP surgeries to identify and support victims and survivors of domestic abuse and refer them into wider support services. As we have heard, the Steps to Safety strategy will, first, introduce training for all staff in GP surgeries, to help them to spot the telltale signs of abuse and give them the skills and confidence to offer support to affected people. Secondly, a specialist worker will advise GP practices on supporting victims and survivors to take their first steps to safety by linking them with local support services. Thirdly, we will learn from the excellent practice that is already happening locally—for example, in places like Devon, Cornwall, Birmingham and Solihull.

Support services could help women to escape their abusers and get back on their feet, whether by helping them to find housing, to get back into work or to put the perpetrators behind bars. We are rolling out this initiative from April, starting with 10 ICBs in the first year, and by 2029 any victim or survivor in England will be able to get the help they need by talking to staff at their general practice.

We are determined to ensure that services do not become a postcode lottery. It is a shameful truth that some of the most alarming health inequalities are those faced by victims and survivors of domestic abuse and sexual violence. That is why my right hon. Friend the Secretary of State has asked my hon. Friend the Member for Lowestoft (Jess Asato), who made an excellent contribution to the debate, to advise the Government. She will look at how we reduce the impact of alcohol on violence against women and girls, how we commission services to ensure that the right support is in the right place, and how we embed support into neighbourhood health services so that women and girls can be connected to the specialist support they need.

A lot of colleagues talked about training, including the hon. Member for Richmond Park (Sarah Olney) and my hon. Friend the Member for Stourbridge (Cat Eccles). We need to remember that health professionals are trained to identify and respond to all types of violence and abuse, using blended learning methods including e-learning, in-person training and supervision. National mandatory safeguarding training is being strengthened for launch in late 2026. We recognise that that needs to be done.

The training will reinforce to staff their safeguarding responsibilities and support them in identifying and responding to victims of abuse. It will include training on the importance of recognising the impact of trauma and the cultural barriers to discussing abuse. It is the responsibility of employers to ensure that staff complete the mandatory safeguarding training. The Care Quality Commission assesses compliance with that requirement. The NHS England safeguarding team oversees this work, and has audited integrated care boards on completion rates. We will strengthen that work.

It takes immense bravery for survivors, not least the survivors of child sexual abuse, to come forward and tell their story, and we are doing everything possible to end the trauma of children and young people having to relive their ordeal over and over, by bringing a range of specialist support services under one roof in every NHS region in England. This is called the child house model. We have started to recruit the extra mental health workers we want by the end of this Parliament, to help survivors who still carry the scars of their abuse, and we are more than halfway towards our target. Whenever and wherever a victim or survivor contacts the NHS, it must be there for them with compassion, care and dignity.

The changes we are making to NHS England are to resolve many of the problems outlined by the Opposition spokesperson. We have huge problems with pathways as a result of layer upon layer of provision and bureaucracy have been introduced to the system over the last decade. There are confusing pathways, confusing levels of accountability, and massively increased costs with no improvement to the services received at the frontline. We need to support local delivery, where people present, and that is our intent with the changes. I was not aware that the Opposition were against the abolition of NHS England, but we will obviously make sure that we focus on service delivery as we go through the changes.

Our starting point is that women and girls who are victims of abuse are never responsible for the abuse. The perpetrators are responsible for it, but tackling it is everyone’s problem. That is why my right hon. Friend the Home Secretary has started to deploy domestic abuse experts in 999 control rooms, building on best practice across the country, including in my own Avon and Somerset police area. It is why my right hon. Friend the Justice Secretary has introduced new measures to protect victims of stalking, and why my right hon. Friend the Education Secretary is taking steps to challenge misogyny in the classroom.

The hon. Member for Strangford (Jim Shannon) highlighted the really shocking levels of killings, as well as abuse, in Northern Ireland. It is good to have that voice in this place. As he knows, I take a great interest in Northern Ireland, but we do not often hear about that particular situation there. I assure him that the Home Office, as the lead Department, has been working with all devolved partners to produce the strategy, and the Department of Health and Social Care is sharing learning, but we absolutely need to keep an eye on that to ensure that we support colleagues in Northern Ireland on this agenda.

We are working across Government, which is why I am determined that the NHS will do its part in halving violence against women and girls by the end of the decade. However, our strategy is not just a Government plan; it is a national endeavour. Everyone in this room or watching on screen has their part to play.

I want to end by speaking directly to survivors and anyone who may be trapped in an abusive relationship. This Government are on your side—and we have heard this morning a willingness across all parties to make this work. We have not forgotten you. You can get in touch with the Refuge national domestic abuse helpline, Women’s Aid or Respect—an organisation that works with male victims and perpetrators of abuse. Please get in touch with those or other specialist charities, or contact your local sexual assault referral centre. The Government are determined to make the strategy work and I am really grateful to have had the opportunity to respond to the debate.