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The Friday Surgery

This week The Friday Surgery has been brought to us by Allison Livingstone, membership secretary for the National Health Action Party.


As the Archers storyline with Helen on trial for the attempted murder of her partner Rob, climaxed with a “not guilty” on all counts, many of us let out a collective sigh of relief. The storyline which had gripped like no other, was brave on many levels and the actors (and writers) deserve special credit for the research, sensitivity and power of the narrative. But why was it brave rather than just a gripping plot? And while the vast majority of people understand that domestic violence is wrong, why should we really care about a fictional character? It was a great story, it’s over, let’s move on...

For many, domestic violence constitutes physical assault. Slapping, punching, pushing, kicking, being attacked with objects, being denied food, being cut off from friends and family who might notice something is wrong, and sexual abuse and rape. This sits ‘comfortably’ within our understanding of domestic violence; we understand these things are wrong. What we understand less well is the violence that doesn’t involve a fist, or at least, not all of the time. The psychological and emotional violence that creates cognitive dissonance. And this is why the writers in particular deserve to be recognised for their efforts, because they decided to tackle gaslighting.

The National Domestic Helpline describes gaslighting: “It is an extremely effective form of emotional abuse that causes a victim to question their own feelings, instincts, and sanity, which gives the abusive partner a lot of power (and we know that abuse is about power and control). Once an abusive partner has broken down the victim’s ability to trust their own perceptions, the victim is more likely to stay in the abusive relationship.”

The very nature of this kind of abuse is that it’s hard to spot from the outside, and it’s hard to prove from the inside. It’s not the sledgehammer of a fist - it’s subtle, insidious and flies mostly under the radar. Chillingly, as the victim gets ‘weaker’, they become even more reliant on the abuser who seems to offer comfort and understanding, and the victim works harder to please their abuser, this is referred to as “trauma bonding”. If that makes you uncomfortable, it really should. Gaslighters are dangerous narcissists, and this type of abuse takes place over a long period of time. The effects, as I saw with my own mother who was a victim of this, and physical domestic violence, can last a lifetime.

But I say again, this was a story, why not move on now? Because it has highlighted a need for two critical things: public awareness and appropriate service provision. Public awareness has undoubtably increased. There was reportedly a sign on the M60 declaring ‘Helen is Innocent’. #FreeHelen was used by tens of thousands on Twitter, and social media thrummed with outrage and questions. Many said simply, ‘for all the real Helens out there, we believe you’. (You may never realise how powerful those words truly are, unless you too have been a victim of abuse).

Paul Trueman, an avid listener of the Archers, went a step further and raised over £150,000 for the charity, Refuge. On the 11th September he wrote “One radio show. One amazing charity. 7 months. 7440+ donors. Countless inspirational people getting involved. We all did this together.”

Domestic violence was the headline, and up and down the country the complexities and horror of this type of abuse, so often ignored, were being discussed. People were beginning to understand what could, and was, happening. But sadly, as public awareness soared, service provision plummeted. In fact it has been since 2009.

Only this morning, those of us in Cornwall, saw headlines that provision for rape and domestic violence victims is under threat as part of the Sustainability and Transformation Plans. Something which the NHA has been campaigning about for some time. Don’t be fooled, what seems a fairly positive title (who doesn’t like transformation?), masks the reality of what the plan actually is: hospital closures, services being downgraded or disappearing altogether and ultimately, peoples lives being put at risk.

Domestic violence costs the UK economy £15.7 billion per year (1) . Two women die every week, and yet domestic violence services are disappearing rapidly. 32 specialist refuges closed in England between 2010 and 2014 (2) , Legal Aid cuts have, well, cut deep. Victims without recourse to legal professionals, are increasingly being forced into facing their abusers in court (3) . So has all this been admirable, but, let’s be honest, largely a waste of time? Is the conclusion basically that we can be outraged by a radio programme, and even exercise that outrage on social media in our hundreds of thousands, but we can’t protest in person against the cuts to the most vulnerable in society? When does this matter to us?
When it’s not ‘Helen’ but our mothers, sisters, uncles and brothers? When the hospital closing isn’t upcountry, but the hospital you gave birth to your children in, the hospital that fixed your broken arm, gave you the all clear after a cancer scare, or which performed complex surgery on you? When we have to travel twice the distance to get the help we need (figuratively and literally) does it matter then?

The character of Helen has a long road still to travel. The trauma of abuse leaves ugly scars and while everyone else in Ambridge might be ‘getting back to normal’, Helen won’t know normal for a long time to come. Without service provision for victims of domestic violence, this journey becomes so much harder. Even when help is available, for some it’s too little, for others it’s too late. Moreover, the lack of services is a huge failing; it is not the sign of a progressive society, it is immoral and discriminatory. It is part of an austerity agenda which is not an economic necessity, it is a political choice. So with all that in mind, surely we can and must do something?

Join the NHA as we campaign against cuts which discriminate against not just victims of violence, but those in need across society. Help us to draw attention to the insidious plans to further destabilise the NHS. Don’t accept that time has run out for the NHS, it hasn’t. We can save it, and we can also protest and reverse the cuts to voluntary community service provision like the helpline Helen called. Despite feeling often feeling overwhelmed and unsure where to start, we could very easily and very quickly begin to make a difference. Not just for all the Helens out there, but for ourselves, our families and our communties.

If you or anyone you know is suffering from domestic violence, help is available. Call 0808 2000 247 which is free helpline run in partnership by Women’s Aid and Refuge, and which is totally confidential. Male victims may prefer to call The Men’s Advice Line 0808 801 0327, which is also free and also confidential.


(1)In November 2009, Sylvia Walby of the University of Leeds estimated the total costs of domestic violence to be £15.7 billion a year. This is broken down as follows: The costs to services (Criminal Justice System, health, social services, housing, civil legal) amount to £3.8 billion per year. The loss to the economy – where women take time off work due to injuries – is £1.9 billion per year domestic violence also leads to pain and suffering that is not counted in the cost of services. The
human and emotional costs of domestic violence amount to almost £10 billion per year

(2) https://1q7dqy2unor827bqjls0c4rn-wpengine.netdna-ssl.com/wp-content/uploads/2015/11/SOS_Data_Report.pdf

(3) http://www.independent.co.uk/news/uk/crime/government-s-cuts-force-victims-of-domestic-violence-to-face-abusers-in-court-a6841851.html

The Friday Surgery is a sometimes satirical, sometimes serious blog on the subjects close to NHA's heart - democracy, the NHS, health and equity. If you would like to send in a contribution to be shared on the The Friday Surgery blog please write to us at info@nhaparty.org with your piece and a couple of lines about yourself.

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