Domestic Abuse-related Deaths: NHS Prevention

Jess Asato Excerpts

Tuesday 20th January 2026 Westminster Hall

[Jess Asato (Lowestoft) (Lab)]

It is a pleasure to serve under your chairmanship, Sir John. I thank my hon. Friend the Member for Stroud (Dr Opher) for securing this debate on such an important issue.

In 2022, 44% of victims surveyed by the Domestic Abuse Commissioner said that their first disclosure was to a healthcare professional. Unlike the criminal justice system, health spaces focus on wellbeing and recovery and are therefore a crucial front door for identification and referrals into specialist services, not just for the many women affected by domestic abuse, but the 105,000 children who, right now, live in homes where there is high-risk domestic abuse. We know that victims who reach out to police are just the tip of the iceberg, given that fewer than one in five ever contact the police about their abuse. Getting our response to violence against women and girls right in healthcare is key to unlocking our ability to properly tackle domestic abuse. For that reason, I was delighted to be asked by the Health Secretary to become his violence against women and girls adviser.

I worked for six years at the domestic abuse charity SafeLives and saw first hand the huge role that health could play. In the report “A Cry for Health”, we found that nearly a quarter of victims at high risk of serious harm or murder had been to A&E as a result of domestic abuse injuries in the year before they were able to get help. We also found that staff were worried about asking, even though it is required under National Institute for Health and Care Excellence guidelines, because they felt they would open a can of worms and, in some cases, make the situation worse. In some cases we found victims visited A&E 15 times before getting the help they needed. Health professionals were patching victims up and sending them back into the violent and controlling arms of their abusers.

Research from Standing Together Against Domestic Abuse, as we have heard, has shown that in 2024, 89% of domestic homicide reviews had at least one recommendation for professionals in the health system—professionals who could have helped save the life of the woman who had been murdered. I have met families whose relatives were killed after repeated contact with health services. In SafeLives’ report on health in London, a survivor who was interviewed and who did disclose at A&E said:

“When I went to A&E the doctor told me we only do bones here, not that ‘relationship mental health stuff’. But didn’t offer to refer me to somewhere that did.”

This has to change.

In 2018, Elena was killed by her partner, Razvan. The month before her murder, she was treated in hospital for abdominal pain after using crack cocaine, but she left hospital with Razvan before she could be discharged. As a result, a child and family assessment was conducted, and they were visited at home together the day before she was killed. She was not seen alone. She was never seen alone. She was pregnant. Razvan was with her and never, ever left her side, and no one thought to question her on her own or spotted that she was subject to an extensive range of domestic abuse as well as sexual exploitation.

There are, of course, thousands of hard-working health professionals who do safeguard their patients, but it is clear that there is much more to do. I will always remember a senior GP who told me, honestly, after I asked why health did not share information when a patient was at clear risk of serious harm, “Well, I care more about the thud of an envelope with a GMC logo on it, than hearing that one of my patients has been murdered.” That is why the co-location of specialist domestic abuse professionals in all health settings is so important.

The “A Cry for Health” report found that when independent domestic violence advisers are located in hospital settings, they make a net positive saving of £2,050 per victim in health costs. They also lead to 84% of victims feeling safer, with 73% seeing an improvement in their quality of life. It is about their health and their wellbeing, which makes them both safer and more likely to recover. Hospital-based IDVAs also identify victims earlier, on average. It is a preventive measure, with their victims on average experiencing six fewer months of abuse than those engaging with local services. We can prevent abuse through the co-location of specialists in health settings.

We also know that co-location works in primary care settings, as the IRISi— identification and referral to improve safety—programme has demonstrated for decades. That is why Steps to Safety, announced in the VAWG strategy just before Christmas, as we have heard, is so welcome. The programme aims to ensure that by 2029 any victim or survivor in England can get the help they need through their GP. It will also ensure that each GP practice is linked to specialist support workers who can support victims to access their local specialist support services. It is crucial that the support is independent from statutory services and sits within those local specialist services, not generic services, if it is to be trusted by victims.

As well as supporting the Department to roll out Steps to Safety and to look at other areas and neighbourhoods to locate VAWG expertise, I will also be focused on improving VAWG commissioning in the NHS and on exploring links between alcohol and violence against women and girls. I am clear, as is everyone, that alcohol does not cause VAWG, but it can be a factor in escalation and serious harm.

There is much that I have not shared: mental health, maternity, links into family hubs and other community health settings, where we need to be exploring the role of health. We need to treat this as a public health epidemic if we are to reach our goal of halving VAWG. If anything, health has a bigger role to play than the police and courts in identifying perpetrators and in identifying and providing lifesaving support for adult and child victims. I am clear that the DHSC is serious about doing just this, and I am personally committed to doing everything I can in my role to help.