This report presents the findings of a research study exploring the health service response to domestic violence within Wakefield. Recent international, national and local research has identified domestic violence as a serious health care issue resulting in a wide range of long and short term health implications for women1 (Butler, 1995: Stark and Flitcraft, 1995, 1996: Campbell, 2002). The research highlights the changing face of domestic violence considering the implications of the recent reframing of domestic violence from a social care issue into an integrated health and social care issue (Glendinning, 2003). Explored is the impact of such changes for health policy makers, health professionals and women who having experienced domestic violence then access health care services in the District. / Eastern Wakefield Primary Care Trust

In this article we take a critical stance toward the rational progressive narrative surrounding the integration of domestic violence within health care. Whilst changes in recent UK policy and practice have resulted in several tangible benefits, it is argued that there may be hidden dilemmas and challenges. We suggest that the medical model of care and its discursive practices position women as individually accountable for domestic violence-related symptoms and injuries. This may not only be ineffective in terms of service provision but could also have the potential to reduce the political significance of domestic violence as an issue of concern for all women. Furthermore, it is argued that the use of specific metaphors enables practitioners to distance themselves from interactions that may prove to be less comfortable and provide less than certain outcomes. Our analysis explores the possibilities for change that might currently be available. This would appear to involve a consideration of alternative discourses and the reformulation of power relations and subject positions in health care.