Domestic Violence and Brain Injury

Lord Markham Excerpts

Monday 23rd October 2023 Lords Chamber

[Lord Hunt of Kings Heath]

To ask His Majesty’s Government what analysis they have undertaken into the links between domestic violence and brain injury.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

In June this year, the Government, through the Medical Research Council, announced the £9.5 million traumatic brain injury platform, which will facilitate research and analysis of victims of brain injury following domestic violence. The platform is being led by the University of Cambridge, with the aim of revolutionising data collection and curation for TBI research. This will include data linkages between the underlying causes of head trauma, such as domestic violence, and health outcomes.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very grateful to the Minister for his Answer. The death of Sir Bobby Charlton, that great footballer, has brought attention to the impact on sportspeople of head impacts in relation to an increased incidence of dementia. Professor William Stewart from Glasgow University, who has undertaken much of the work in the sports arena, is doing parallel work in relation to domestic violence. The scale of intimate partner violence, with between 20% to 30% of women affected, is huge, and 90% of those women may suffer brain injury impact. In addition to the welcome news about research, could I ask that the Minister’s department looks very closely at stepping up the research but also at increasing knowledge and awareness throughout the health system, in terms of prevention and treatment as well as research?

[Lord Markham (Con)]

I add my condolences following the passing of Sir Bobby Charlton—a true great. I thank the noble Lord, Lord Hunt, for the work he has done in this space; it is another example of where being asked a Question forces us to look at the situation. The noble Lord made the point very well. Sport is in the news, and we have all seen the head injury assessment protocols, especially in rugby, but you are 11 times more likely to suffer a traumatic brain injury from domestic violence than you are from sport. When we get the findings from the research, early in the new year, I invite the noble Lord, Lord Hunt, to join me in ensuring that we have an action-oriented approach to make sure that the awareness and research supports a good action plan.

[Baroness Verma (Con)]

My Lords, can my noble friend assure me and the House that, when he is collecting data, he will also be looking at people from minority communities, particularly those who cannot report domestic violence issues for language reasons? Would my noble friend also talk to his colleagues in education, to ensure that everyone living in this country has access to learning English?

[Lord Markham (Con)]

Yes, on both counts. Unfortunately, domestic violence is something that affects all sorts of people from all sorts of backgrounds and minorities. About 5.7% of women and 3% of men, and a lot of children, are thought to suffer domestic violence. I am absolutely happy to give that undertaking.

[Baroness Walmsley (LD)]

My Lords, the Minister has clearly noticed the care taken by both players and officials during the Rugby World Cup to avoid head injury. However, there is no referee on behalf of women suffering brain injury during domestic violence. Will the Government support training programmes, such as those run by Headway, for professionals dealing with survivors and victims, and ensure that that training is extended to the police? Will they ensure that, at the end of those programmes, the trainees have resources to which to signpost victims?

[Lord Markham (Con)]

The noble Baroness is correct. We need to make sure that all our front-line services are trained to identify potential brain injuries—that is A&E, GP surgeries, the police and schools. There is already a programme in schools for children affected by domestic violence. We have also made sure that every ICB has to appoint a domestic violence and sexual abuse lead, so that they can identify these sorts of issues.

[Lord Patel (CB)]

My Lords, data collection and research is very good news. However, under normal circumstances, any person who suffers a head injury, for whatever reason, would be subjected to immediate testing for a brain injury. Why would that not be the case for someone who suffers a head injury from domestic violence?

[Lord Markham (Con)]

It is a very good point. As all noble Lords are aware, often the challenge is getting people to come forward when they have suffered domestic violence. Some of this research shows that there are tools, such as a spit test, to understand whether someone has suffered from a traumatic brain injury. Bringing some of those things into play, so that people are identified and encouraged to come forward, is vital.

[Lord Winston (Lab)]

My Lords, the Minister is to be congratulated on his call for more research. Would he care to comment on the use of organoids—clumps of generative stem cells—which act as an artificial brain in culture and show clear evidence of certain injuries, such as whether the brain may be easily propagated? That kind of research is important but is often condemned in the press. Can the Minister make sure that the Government will allow that kind of research to continue? It is completely harmless ethically.

[Lord Markham (Con)]

Yes. The main thing is that £9.5 million is being invested into research on traumatic brain injury, but this is a platform to allow spin-off research from there. When speaking to people on this, I am clear that this is not a cap: if we get good research proposals put forward in areas such as the one the noble Lord mentioned, the money is there to pursue that.

[Baroness Manzoor (Con)]

My Lords, it is good news that research is going to happen in this area. We all know that women suffer through domestic violence much more greatly. However, there is also research that shows that young girls in sports suffer more from concussion. Can we look at the preventative elements to ensure that girls are safe in sport, and by working closely with DCMS?

[Lord Markham (Con)]

The hope from this research is understanding all the different causes and some of the protocols. I know it is controversial sometimes, because, speaking as a centre half myself, heading the ball is a key part of the game. However, making sure that children under a certain age are not heading the ball a lot is one of the things that we should be looking at as prevention.

[Baroness Merron (Lab)]

My Lords, as not all brain injury from domestic violence is immediately apparent, will the Minister raise with his colleagues in the relevant departments the consideration of a reappraisal in policing and the criminal justice system? Will the Government also work with those supporting victims of intimate partner violence to actually give a name to the brain trauma that victims may be suffering? If victims know that traumatic brain injury is part of their trauma, it can give a source of strength and guidance to those who are suffering, enabling them to seek the right medical support.

[Lord Markham (Con)]

The noble Baroness makes a very good point; it is often the hidden side of domestic violence. The problem is that there is not much information on this, but a US study shows that as many as between 30% and 74% of women who suffered domestic violence had suffered from traumatic brain injury. It is about making people aware that this is not an edge case; this is something that unfortunately is all too familiar. As the noble Baroness mentions, every strand of society needs to be aware of this and to act on it.

[Baroness Bennett of Manor Castle (GP)]

My Lords, the Minister reflected that many victims of intimate partner abuse sometimes do not report until weeks, months or years later. Will the Minister ensure that there are services available that recognise this medical issue when they may not present primarily as a medical case, making sure that all the support that is available to victims of domestic violence is aware of this issue? In responding to the noble Lord, Lord Hunt, the Minister said that we will wait for the research. I think there is already clearly enough evidence in what we have heard today, and the fact that 3% of dementia in the community is attributed to traumatic brain injury. We need to act now, not wait for research.

[Lord Markham (Con)]

It is a good point, and there are already some very good examples, such as in Cambridge, where the ICB has a single front door to make sure that all facilities, whether it is neurologists, psychologists, physios or speech therapists, are there and available. The noble Baroness is correct: there are lessons we can learn and roll out straight away, and we are looking to do that.

[Baroness Bull (CB)]

My Lords, research projects in Glasgow and at Drake Hall prison in Staffordshire have shown a very high percentage of female prisoners to have traumatic brain injuries that have been sustained as a result of domestic violence. Is it now routine to screen female prisoners for brain injuries as they enter the Prison Service?

[Lord Markham (Con)]

My understanding is that it is not routine at the moment. I know there is some conflicting research as to how much screening should be used as a regular tool. I must admit that I do not fully understand the reasons behind some of that, so I was not quite persuaded as to why that was. It is something on which I want to do more research to understand. I will happily write to the noble Baroness to give her more information.