Domestic Abuse-related Deaths: NHS Prevention

Simon Opher Excerpts

Tuesday 20th January 2026 Westminster Hall

[Dr Simon Opher (Stroud) (Lab)]

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.

[Amanda Martin (Portsmouth North) (Lab)]

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?

[Dr Opher]

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.

[Several hon. Members rose—]

--- Later in debate ---

[Dr Opher]

I thank the Minister and all those who spoke and brought their fantastic experience of this really difficult problem. Let me say two very simple things. We need to imprint on healthcare workers the idea “Think domestic abuse”, so that we do not miss it. If someone presents, we must have in the back of our minds the question, “Is this domestic abuse?” That will help to identify victims much earlier. After that, we need to enable them to be referred in a simple and effective process that brings them support immediately.

I thank everyone here, and you, Sir John, for chairing the debate.

[Sir John Hayes (in the Chair)]

Thank you for winding up. This has been a really important debate and I am so pleased that everyone was able to contribute. I hope that, had I spoken in the debate and not chaired it, I would have spoken with the same passion and insight that everyone has shown.

Question put and agreed to.

Resolved,

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