Obesity and Fatty Liver Disease

Tuesday 28th October 2025 Westminster Hall

09:30

[Dr Beccy Cooper (Worthing West) (Lab)]

I beg to move,

That this House has considered obesity and fatty liver disease.

It is a pleasure to serve under your chairship, Mr Efford, alongside my parliamentary colleagues who have kindly come along this morning to debate and highlight the public health emergency that is obesity and fatty liver disease.

The vast majority of us do not often think about the health of our livers. If we do, our biggest concern is how many units of alcohol we drink every week and whether our livers can keep up. But we do talk about our weight a fair amount, either in terms of how we look and how our clothes fit, or, if we are linking it to disease, whether we are blocking up our arteries and risking a heart attack. Today I want to make the case for linking our concerns about being overweight and sedentary with the very real risk of developing fatty liver disease. Before I give the alarming statistics about the huge increase in liver disease in the UK, I want us all to hold on to the fact that a weight loss of 10% can halt and even reverse fatty liver disease progression, and the way to help us all to do that is not to point fingers and tell individuals to try harder. There are much more effective public health solutions than that.

Now for the alarming statistics that should give us all pause for thought: after heart disease, liver disease is the biggest cause of premature mortality and lost working years of life in the UK. In stark contrast with other killer diseases where the mortality rate has gone down, deaths from liver disease have increased by 400%—yes, 400%—over the past two decades. Every year we are seeing 18,000 deaths from liver disease. It is now the biggest killer of 35 to 49-year-olds in the UK. In two to three years it is set to surpass heart disease as the leading cause of premature death in the UK.

Today’s debate matters because fatty liver disease is becoming one of the defining public health challenges of our generation—a disease that already affects as many as one in five adults in the UK, equating to about 1 million people, but one that hardly anyone knows about. When I asked my parliamentary colleagues to speak in today’s debate, they said, “Fatty liver disease? What’s that?” So hopefully this debate will highlight this alarming disease.

Closely linked to our ongoing struggles with obesity, fatty liver disease—for the record, its clinical name is metabolic dysfunction-associated steatotic liver disease; that is the last time I am going to say that today—is deeply rooted in our broken food systems and the stark health inequalities that our communities face.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Lady on securing the debate. She is outlining very clearly the importance of the issue. It is vital that people are aware of it. Does she agree that if we do not deal with the issue, the NHS waiting lists over the coming years will be compounded even further than they have been already?

[Dr Cooper]

I thank the hon. Member for making that excellent point. He is absolutely right. The issues of the NHS waiting lists are pertinent and stark. Reducing them will mean that we have to get the left shift right as well as invest in acute services.

Our policies have failed the population for decades. This debate is an opportunity to make the urgent case for a national liver strategy, joined-up public health work and profound reform of the conditions that stop us all living well. Because we have failed to build an environment where healthy food is affordable and accessible, two thirds of UK adults are now overweight or obese, and one in three children in England are above a healthy weight when they leave primary school.

Fatty liver disease is a silent killer, often asymptomatic until at a very advanced stage, meaning many patients are diagnosed too late for effective intervention. Left untreated, as too many are, fatty liver disease can progress to liver inflammation, fibrosis, cirrhosis, liver failure or liver cancer. Fatty liver disease also increases significantly the risk of heart attacks, stroke and heart failure. It is projected to overtake alcohol as the leading cause of liver transplants within a decade.

How do we treat fatty liver disease? Despite high and rising mortality rates, there are limited treatment options for patients with this disease. As I have said, weight loss and lifestyle change are essential.

[Clive Jones (Wokingham) (LD)]

I thank the hon. Member for bringing this very important subject to Westminster Hall. She is absolutely right. Fatty liver disease is the fastest rising cause of liver cancer death in the UK and highlights the risk of developing a less survivable cancer for people living with obesity. Does the hon. Member agree that improvements to diagnosis of and treatment for fatty liver disease should be covered in the national cancer plan, which I called for a year ago and the Government are to announce early next year?

[Dr Cooper]

I thank the hon. Member for his excellent intervention. I absolutely agree that the national cancer strategy is essential. We must make sure that liver cancer is integrated into it, and that diagnosis and treatment are a key part of it and are funded across the country, to make sure that the inequalities that I am going to talk about are addressed sufficiently.

Before we get to the issue of diagnosis and treatment, weight loss and lifestyle change are essential. We know that a Mediterranean diet plus exercise improves liver function and that reducing ultra-processed foods reduces intrahepatic fat. However, for those whose disease has progressed to scarring of the liver, or liver fibrosis, there is an urgent need for therapies that directly target the liver.

Currently, no drugs are licensed to treat fatty liver disease in the UK. We have fallen behind the United States and Europe, as our market is too small for prioritisation. If I might get a bit more political, that is driven in part by our decision to leave the European single market. But this is a rapidly advancing field and we are approaching a potential breakthrough in treatment. With adequate planning, co-ordinated action, investment and leadership, we can ensure that our national health system is patient-ready to deliver the next generation of medications, and that all patients, regardless of postcode, can benefit.

Early diagnosis offers significantly better outcomes and a wider range of treatment options, but despite fatty liver disease being medically recognised in the 1980s, clinical and public awareness of it remains far too low. We urgently need to increase public understanding and encourage early liver checks, particularly for those at higher risk because of obesity or type 2 diabetes. What is more, we have seen primary care systemic failures to improve early detection, such that three quarters of people are diagnosed with cirrhosis at hospital in an emergency, when it is too late for effective treatment or intervention.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I, too, congratulate my hon. Friend on an excellent and really important debate. May I take her back to what she was saying about the food industry, wider population prevention measures and what this means for school meals and for our poorer communities, who are reliant on food supporters, such as the Trussell Trust and others, in terms of the type of food made available to them?

[Dr Cooper]

I thank my hon. Friend for that excellent intervention. She is absolutely right. With her public health expertise, she highlights the very real problems that lead to fatty liver disease: our broken food system, the issue with access to good, nutritious food for children in school, and the need to ensure that our stark health inequalities are addressed. I will come to that later in my speech.

To go back to the issue of diagnosis and treatment, we should note that a staggering 80% of England currently has no effective detection and treatment pathway—yes, a staggering 80%. The British Liver Trust, whose representatives are here today, is rightly calling for an end to this postcode lottery, so a key ask raised in this debate is that every integrated care board, every regional and national health area that we have, should have a full pathway for early detection of liver disease.

There is some excellent, innovative work out there that can help us to get to a much better place in tackling this disease. I recently met the team at Predictive Health Intelligence—whose representatives I think are also here today—who have developed hepatoSIGHT, which is a great name; well done. That is an inspiring example of how technology can transform early detection. The system uses existing NHS data to identify people at risk of liver disease before symptoms develop, allowing GPs proactively to invite patients for screening and support. I am delighted to say it is now being implemented across NHS South West. It is proof that, with genuine support from senior NHS management, clinical and digital teams at all levels can come together for the good of patients. That system is exactly the kind of innovation we need in order to make early diagnosis and prevention the norm and not the exception.

I now come to prevention. Screening and early diagnosis are vital but, as for all population health issues, as my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) rightly highlighted, we must have a laser focus on preventing the root causes of fatty liver disease.

[Steve Yemm (Mansfield) (Lab)]

I thank my hon. Friend for raising this debate. We are calling obesity the enemy, but the liver does not count in pounds or kilograms. The real culprit is not body weight; it is metabolic dysfunction, as she points out—insulin resistance, poor diet, genetic risk and so forth. Lean people also get fatty liver disease, not always people who are overweight. Does my hon. Friend agree that we should talk less about obesity and more about screening early, taxing junk food and treating metabolic disorders and disease rather than strictly BMI? If we chase the scales, we might miss the science.

[Dr Cooper]

I thank my hon. Friend for that excellent point and agree absolutely. In our society, we focus on how people look for many reasons, cultural and commercial, but this is purely about health. This is about keeping people healthy on the inside and allowing them to live good quality lives. My hon. Friend is absolutely right in that sense.

Poor diet is now the leading risk factor for death and disability. It is responsible for millions of preventable deaths each year. In the UK, almost two thirds of adults are overweight or are living with obesity, increasing the risk of fatty liver disease, cardiovascular disease and a multitude of cancers. In my job as a public health consultant, I see a lot of data and read many papers, but this statistic shocked me: four in 10 children with obesity may already have fatty liver disease. That demonstrates the urgent need to act now to prevent an even greater epidemic of disease in future.

That has not happened by accident; it is the result of a broken food system, which has made the UK Europe’s third most obese country and one of the world’s biggest consumers of ultra-processed food. We have a system that makes the unhealthy choice the cheapest, easiest and most available choice. Healthier food now costs more than twice as much per calorie as unhealthy food. That is £10.24 per 1,000 kilocalories compared with £4.50. For fruit and vegetables, the cost is even more at £11.90 per 1,000 kilocalories.

For the lowest income households, following a recommended healthy diet would swallow half or more of their disposable income. It is no surprise that obesity and fatty liver disease hit hardest in poorer communities. As I said at the beginning, this is not about personal failure. As hon. Members have said, sometimes people feel that that they are failing to lose weight and failing to keep themselves healthy. This is not about personal failure; it is a political failure. It is our collective failure to create a food environment that protects rather than undermines public health. If we are serious about prevention, we must be serious about reform—the right type—with stronger fiscal and regulatory measures to reduce the availability and marketing of foods that are high in fat, salt and sugar, and to rebuild a food system that serves public health and not profit.

Why have we not addressed this yet? Weighted against the commercial gain of the food and drink industry, our obesogenic environment is killing our population and costing the taxpayer billions. Economic analysis last year suggests that excess weight costs the economy £126 billion a year. A Budget is coming up next month; I am fairly sure that our Chancellor would like £126 billion a year. That figure takes in wider factors, such as lost productivity, care costs and lost years of healthy life. The direct NHS cost of obesity is projected to rise from £6.5 billion to £9.7 billion by 2050. We cannot separate our health and our wealth, and we cannot hope to achieve economic growth without tackling issues such as obesity and fatty liver disease.

Since 1990, there have been nearly 700 policies proposed by Government to reduce obesity. Imagine having 700 policies about your life! Past strategies fell short because they targeted behaviour change—individual choice—rather than the structural and commercial drivers of diet. Many lacked delivery plans, timelines or evaluation frameworks, leading to fragmented progress and limited long-term impact.

What can we do now to ensure that this public health emergency is addressed? My key asks for our Health Minister, who is kindly listening here today, are as follows. First, there is a clear need for a national liver strategy, ensuring increased public awareness, early liver checks and primary care pathways. As stated earlier, every integrated care board should have a pathway for the early detection of liver disease.

Secondly, we need strong planning and co-ordination to be ready to deliver the next generation of medication for liver disease. Thirdly, if we truly mean to deliver the left shift to prevention, promised in the 10-year health plan for England, then we have to change the environment that is driving poor health. There is strong consensus about the necessity of upstream interventions to regulate the unhealthy food and drink environment. We can build on that strong consensus to extend the levy model to high-sugar and high-salt foods; to enforce the 9 pm watershed for high fat, salt and sugar advertising, closing brand mark loopholes; to provide stable funding for local food partnerships, so that councils can act on local needs; to reinstate the full childhood obesity plan; and to address food affordability via fiscal reform.

None of this is easy or it would have been done already, but right now our environment is draining our health service of billions each year and weighing heavily on the nation’s health—no pun intended. Let us not keep repeating our mistakes, but rather embed food policy as a national health priority. Through our work on preventing obesity and fatty liver disease, let us support and finally see the long-discussed and essential shift towards prevention and a healthier, wealthier country.

[Clive Efford (in the Chair)]

I remind Members to bob in their places if they intend to speak.

[Several hon. Members rose—]

[Clive Efford (in the Chair)]

Right, that gives me a better idea. We will bring in the Front Benchers at 10.28 am, so that gives an idea of how much time there is for the six or seven Members who wish to speak.

09:49

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper), who is co-chair of the all-party parliamentary group on liver disease and liver cancer, for setting the scene incredibly well. I thank her for the detail and for her requests to the Minister. It is, as always, a pleasure to see the Minister in her place. I wish her well and I look forward to her answers. I also thank the British Liver Trust and the Foundation for Liver Research, which supplied me with a briefing that made clear the excellent work at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research into metabolic liver disease to shape how it is diagnosed and treated.

Liver disease is a growing cause of premature mortality and lost years of working life in all four nations of the United Kingdom. It has been estimated that some 4,878 potential years of life were lost due to chronic liver disease in Northern Ireland. It is clear that the UK is in the midst of a liver disease crisis, to which the hon. Lady referred. It is as serious as that, and we should all take note. While premature mortality rates from other major diseases have fallen over the past two generations, deaths from liver disease have risen 400% since the 1970s. There are more than 18,000 deaths from liver disease and liver cancer each year in the United Kingdom.

[Clive Efford (in the Chair)]

Order. Members are asking that you speak into the microphone, Mr Shannon, so that they can hear you.

[Jim Shannon]

That has never been a problem in the past, Mr Efford. Do I need to lift it up to my mouth? I thought it was good enough to carry my voice; apologies if it is not. This would be the first time it has not worked.

Two thirds of adults are overweight or living with obesity, and one in three children are classified as overweight or obese when they leave primary school. Sadly, four in 10 children with obesity may already have liver disease. One in five people are affected by liver disease and liver cancer in the UK, and as many as 12% of those—more than 1 million people—go on to develop the more severe form of fatty liver disease.

The stats for Northern Ireland are unreal. That is not the Minister’s responsibility, but it gives a flavour for the debate. Some 64% of adults in Northern Ireland were overweight or obese, a marked increase from 23% in 2010-11. My goodness me—if ever we needed a reality check, that is one for us. Shockingly, Northern Ireland has the highest rate of overweight or obese primary 1 children in the UK, with 25.3% of children fitting that category. In my constituency of Strangford, 27% of year 8 children were overweight or obese. It is estimated that 70% of adults and 40% of children who are overweight or obese have fatty liver disease, so urgent work must be done to prevent this health crisis in the making.

Shockingly, 37 million extra sick days are estimated to be taken by people living with obesity, harming economic output on a massive scale—a figure of 1% to 2% of UK GDP as estimated by the Institute for Government. The NHS alone is expected to shoulder an estimated £10 billion per year obesity bill by 2050, with obese patients costing twice as much as those of a healthy weight. Reducing obesity prevalence by 10% could save £6 billion per year in the UK economy.

Let me tell a personal story. I am a type 2 diabetic. Some 16 or 17 years ago, I realised that I needed to drastically change my eating habits. I was 17 stone. To be honest, to put it very starkly, I was a big fat pudding. I realised that if I did not lose weight for my diabetes, I was going to be in trouble, so I reduced my weight quite substantially, by 4 stone. I have managed, by and large, to keep at that reduced level. First, it was down to stress but, secondly, it was down to Chinese takeaways five nights a week with two bottles of Coca Cola. That just does not work; when it is added up, you just get fatter and fatter. I took that away and tried to reduce my chocolate intake.

My hon. Friend the Member for East Londonderry (Mr Campbell) has said that he is reducing his sugar intake—well done to him; he does not need to, but it is definitely a good purpose to have. The point I am making is that not everyone can. For those who cannot, it is important to look towards the weight-reduction injections, to which I will refer in a moment. I have been able to control my diabetes for the last 10 years by tablets. I take nine tablets in the morning and five at night to keep everything under control.

Newly released weight-management drugs such as Ozempic and Mounjaro have been shown to reduce the weight of patients by an average of 5%, reducing the risk of a variety of health effects, including fatty liver disease. However, although those drugs are available for those who obesity and type 2 diabetes, they are not for those with fatty liver disease. Making that happen would be my one request of the Minister. If someone has a body mass index of over 40, and does not yet have those comorbidities, unfortunately they will not qualify.

There is a new generation of drugs targeting advanced fatty liver disease. Resmetirom has recently been approved by the US Food and Drug Administration and is expected to be approved in the UK within 12 to 18 months. Could the Minister give us an indication of where those drugs are in the system? Those new drugs—some of which improve liver function and some of which enable weight loss—can reverse fatty liver disease and must be made available in a timely fashion to save lives. The NHS needs to ensure that services are ready to support that, as previously no treatment has been available for those patients.

The UK faces a very challenging commercial environment for drug pricing. Lilly recently announced that it will increase the price of Mounjaro by as much as 170% in response to pressure from the US Government and historic pricing inconsistencies. My second question to the Minister is about what has been done to ensure that the price of drugs is reduced or kept controlled in a way that can make a difference.

Thirdly, I say to the Minister that ICBs must have an effective pathway for the early detection of liver disease. A new nationally endorsed pathology pathway to improve early diagnosis of liver disease is essential. Every community diagnostic centre should also have a fibroscan to assess fibrosis.

Finally, I say to the Minister that patients with advanced liver disease and cancer need access to weight management services in line with access for people with type 2 diabetes. This is a ticking timebomb, but there are scientific breakthroughs there to address it. I believe in my heart that the Government need to cut that wire and stop that timebomb now.

09:56

[Dr Simon Opher (Stroud) (Lab)]

I thank my hon. Friend the Member for Worthing West (Dr Cooper) for securing this very important debate. I also thank the British Liver Trust and the Foundation for Liver Research for providing me with a lot of data and information. As a GP, I have learned quite a lot from preparing this speech—we will come to that a little later.

As my hon. Friend said, what we really need is the right type of reform. My Government are proposing three shifts in care. Probably the most important is from cure to prevention, and this issue fits in very well with that. It also fits into the other shifts that we want. We want to get out of hospitals and into the community, and a lot of work around fatty liver disease can be done in the community. We also need to use data properly to target people and to look at the digital ways in which we can identify high-risk people.

Fatty liver disease affects 20% of the population. I do not want to repeat all the statistics that we have heard, but 12% of those people go on to develop very severe disease, and that is 90% preventable. That is a perfect example of our being able to prevent disease rather than just allowing it to happen.

As GPs, we often do a liver function test—often if someone is on a statin or something similar—as a screening test, and we find that the alkaline phosphatase is slightly raised. We then do an ultrasound scan and, lo and behold, people who are overweight often have fatty liver disease. That is often as far as it goes in GP land, so we need to change that pathway. There is an obesity epidemic and two thirds of adults are overweight. As my hon. Friend the Member for Worthing West said, children also carry a great burden of obesity and overweightness—by year 6, 32% of children are obese.

As my hon. Friend also said, there has been a massive increase. Most diseases are going down in frequency, but there has been a 400% increase in fatty liver disease. That leads first to fibrosis, then cirrhosis and even liver cancer. As she pointed out, detection is often at the acute stage when people are admitted to hospital with cirrhosis and sometimes hepatic failure. That is a sign of a poor medical system. We are failing those people.

Where I come from in Stroud, we have the fourth-highest hospital admission rate for liver disease in the whole south-west, and Gloucestershire has the highest. We need to get on and start dealing with fatty liver disease. How do we do that? As we have heard, prevention is probably the single most important thing, so I urge the Government to grab that ethos of preventing disease and really go for it. We have a national food strategy—there is plenty in there, which I will not talk about now—and ultra-processed foods are obviously causing a lot of harm. There are also some exciting options in the 10-year plan in relation to supermarkets, such as how they need to keep their data and about starting to sell healthier foods, rather than foods that are high in fat, sugar and salt. The plan also refers to the reformulation of some products.

I will point out two other things: first, free school meals reduce obesity in children; and secondly, as a Government, we are bringing in rules about advertising unhealthy food before the 9 o’clock watershed, which I welcome. We also need to halt brand advertising before that time, because when people see a sign saying “McDonald’s”, they do not think about salads, do they? That is also important.

Screening needs to be data driven. In general practice, we know that a lot of people with a BMI of over 27, for example, should get near-patient testing for liver function, and those who have raised liver function should then have a fibroscan in their neighbourhood practice. That would be a fantastic community response to the problem: neighbourhood practices could take hold of the issue and start screening properly, reducing the burden of disease on our population.

Training is also important. I am a standard sort of GP, and I did not know as much before preparing this speech as I do now. We need to educate GPs on the importance of detection.

Lastly, although GLP-1 agonists are not authorised for treating fatty liver disease, we are certain that they are effective at reducing weight and would certainly reduce fatty liver disease. We must invest in weight-management services to wrap around that treatment. We have a great opportunity to prevent disease.

10:02

[Peter Dowd (Bootle) (Lab)]

It is a pleasure to see you in the Chair, Mr Efford. I find it difficult to believe that the hon. Member for Strangford (Jim Shannon) was a big fat pudding, but I suspect that even if he was, no one would have really noticed, given his charm and personality—I say that in all sincerity, as he knows.

I thank my hon. Friend the Member for Worthing West (Dr Cooper) for being the driving force behind today’s debate. She has indicated that

“people do better in more equal societies.”

To some extent, as she made clear, that goes to the heart of what we are discussing. I will not repeat what she and other Members have said, but I will briefly discuss inequality in relation to my constituency. I also thank the British Liver Trust for its comprehensive and incredibly enlightening briefing on the issues that we face, which put into context the impact of those issues on our constituents. We are talking about individuals—mothers, fathers, sons, daughters and children—whose lives can be destroyed by this dreadful condition. My hon. Friend set the scene in relation to that. Time and again, the trust reinforced that fatty liver disease is a silent killer that is on the increase and clearly has been for a considerable time.

To put that into context—some figures have been mentioned—there are about 19,000 deaths each year across the country. If my maths is right, that is about 52 deaths every day. In my constituency, that would equate to about 29 deaths a year, but I suspect the figure would be much higher if health inequalities were factored in, given that the rate of the disease is five times as high in the most deprived areas, of which mine is one. The figure in my constituency might be five times that amount —100 or 150 deaths a year.

We should take into account that the average age of death is 61 for men and 62 for women, which, in this day and age, is really no age at all. In men, the chance of death is twice as high as in women. In that context, it is also important to emphasise that nine out of 10 cases of liver disease could be prevented.

I hope that this debate will enable the calls to action by the British Liver Trust and by hon. Members to be heard in relation to prevention, early diagnosis, treatment and tackling inequalities. Perhaps the most sobering issue, which my hon. Friend the Member for Worthing West touched on, is the level of fatty liver disease in our children. She indicated that as many as 40% of children are affected in the more deprived areas, whereas in less deprived areas it is more like 14%—and even 14% is far too high.

I am pleased that my hon. Friend has enabled us to look at this issue in more depth. I look forward to the responses from the Opposition spokespeople, the hon. Members for Sleaford and North Hykeham (Dr Johnson) and for Winchester (Dr Chambers), and of course my hon. Friend the Minister.

10:06

[Lorraine Beavers (Blackpool North and Fleetwood) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank my hon. Friend the Member for Worthing West (Dr Cooper) for securing this vital and timely debate.

Liver disease is quietly stealing lives in every corner of our country. It is now the second-biggest cause of early death in England and Wales. Deaths have risen by more than 40% since 2001, which is in stark contrast to deaths from heart disease and cancer, which have declined. What makes it so heartbreaking is that 90% of liver disease cases are preventable.

In my constituency of Blackpool North and Fleetwood, this crisis is felt deeply. Blackpool has the second-highest rate of liver disease deaths in the entire country, with over 41 deaths per 100,000 people—almost double the national average. Childhood obesity rates are among the worst in England, meaning that many of our young people are already on the path to serious illness before they have even left school.

This is not about blaming people for their weight or lifestyle; it is about the world we live in—one where the cheapest food is often the least healthy, and where families in struggling communities have fewer choices and less support. Across England, people in the most deprived areas are more than six times as likely to die early from fatty liver disease. In parts of the north-west, people are dying 10 years younger than those in the wealthier areas. That is not right and it is not fair. Behind every statistic is a family torn apart.

Jamia and Stuart, in my constituency, were together for 35 years and cared for two disabled children. Stuart was fit and kind. When his stomach began to swell, he did not realise it was a warning sign. By the time he was diagnosed with fatty liver disease, it was too late. He passed away just eight weeks later. Their children still wake up at night looking for their dad. No family should go through that, but, tragically, they are not alone. The British Liver Trust has shared similar stories. Stephen, for example, was diagnosed far too late after years of missed opportunities for testing.

These stories are painful reminders that three quarters of people with cirrhosis are diagnosed only when they turn up at A&E, when it is often too late for treatment. We can change that. Early testing can save lives. Simple, painless scans, such as fibroscans, enhanced liver fibrosis testing, or the new intelligent liver function testing pathway, can spot liver damage long before the symptoms appear. Pilots of those tests have shown a 43% increase in early diagnosis and major savings for the NHS. Every community diagnostic centre, including the one on Whitegate Drive in Blackpool, should be able to offer those tests. Early diagnosis makes liver disease largely reversible and gives people the chance to act before it is too late.

We also need to tackle obesity at its roots, not by lecturing people but by making it easier to be healthy. That means fair prices for good food, limits on junk food advertising aimed at children, and continued action such as the soft drinks industry levy, which cut sugar content by nearly 30% across the market without hurting sales, and even reduced childhood obesity among girls in year 6. We need stronger measures to make the healthy choice the easy choice: reformulation of ultra-processed foods, a comprehensive 9 pm watershed on junk food advertising and a level playing field for businesses that want to do the right thing. Such structural changes, not finger pointing, can reshape the food system for good.

Finally, we must make sure that the NHS is ready for the new medicines that are coming. Medicines that target liver scarring directly and other treatments that improve weight loss and metabolic health could be transformative, but those new therapies, which could stop liver disease in its tracks, must be available on the NHS to everyone, not just to those who can pay privately. That means planning for workforce capacity, diagnostics and equitable access because if we fail to prepare, we risk widening the health inequalities that have already cost too many lives in towns such as mine.

Liver disease may be a silent killer but we do not have to stay silent about it. If we work together across parties, communities and the NHS we can stop this pandemic before it claims another life like Stuart’s. We can give families hope, and give our children the healthy future that they deserve.

10:12

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

It is a pleasure to serve under your chairmanship again, Mr Efford. I thank my hon. Friend the Member for Worthing West (Dr Cooper) for securing this important debate. It is a pleasure to follow all the hon. Members who have spoken; we are all concerned about what is happening in our constituencies. This issue was brought to my attention by a constituent whose father had died—I will go into her human story later. After speaking to her in Portcullis House, I wrote to every practice in my constituency highlighting the facts of St Helens, in case they did not know them—and that is no disrespect to our medical professionals.

Before I go into some facts, I thank the British Liver Trust and the Foundation for Liver Research, which have worked closely to prepare a joint debate briefing for MPs. I also recognise the excellent work by the Foundation for Liver Research at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research in metabolic liver disease to help to shape how it is diagnosed and treated.

Sadly, St Helens has the highest rate of deaths from liver disease in England, at 43.5 per 100,000, and the second-highest rate of deaths from fatty liver disease. The north of England consistently has the highest rates of liver disease and obesity, and premature mortality from liver disease is as much as six times higher than in the least deprived areas of the country. My constituency suffers at the knife-edge of this crisis: premature death rates from liver disease in St Helens were the worst in the country in 2023, at 43.5 per 100,000—double the England average of 21.9 per 100,000. Premature death rates from fatty liver disease in St Helens were twice the national rate, and the rate of overweight or obese year 6 children is 41.2%, which is markedly higher than the national average of 35.6%.

The NHS Cheshire and Merseyside integrated care board that covers my constituency has in place only a partial pathway for the early detection of liver disease, despite the north of England having the highest rates of death and hospitalisation from liver disease. As of 2023, it did not have a named person responsible for liver disease, and only Liverpool carries out proactive case-finding for patients at high risk of liver disease. The inconsistencies in care that face my constituents and many more people are played out across England, placing thousands of patients at high risk of developing serious liver outcomes.

I will turn now to the human impact of obesity and fatty liver disease, speaking on behalf of one of my constituents, Sara, the young lady I met with her widowed stepmum. They have asked me to speak out and share their story. Sara’s dad, Stephen, was diagnosed with type 2 diabetes in 2000 and told he had a fatty liver in 2014, but not to worry about it. He received a liver scan two years later, after which no further action was taken. It was only when Stephen was admitted to hospital in 2024, for an unrelated condition, that he was diagnosed with advanced fatty liver disease, and he sadly died from the disease a few weeks later, aged 62.

Sara said:

“I know everyone thinks their dad is amazing, but mine really, really was. He was a gentleman in every sense of the word and was so kind, loving and generous. To say we’re shocked, devastated and heartbroken at his death due to MASLD (metabolic dysfunction-associated steatotic liver disease) and HE (hepatic encephalopathy) is an understatement. He was just 62 and had so much to look forward to.

My dad Stephen wasn’t a drinker, but liked a sweet treat every now and then when he was diagnosed with type 2 diabetes in 2000. His diabetes was well managed and he didn’t need much in way of medication due to his healthy lifestyle. Dad especially loved cycling and walking in the Lake District. He did everything right, but it wasn’t enough.

In 2014 blood tests revealed deranged LFTs and in his annual diabetic reviews my dad was told he had an abnormal liver but not to worry about it. He was never referred to anyone and the only scan I can see in his medical notes was in 2016, then nothing.

In April 2023 he was feeling really lethargic which his doctors thought was an iron deficiency and prescribed tablets. He told my sister his blood results had come back fine, adding: ‘Nothing to worry about, love, I have a fatty liver, but I’ve always had a fatty liver’. By September Dad was quite withdrawn, forgetful, slurring his words, and kept going back to bed. The doctors were doing lots of tests and thought it might be something neurological like Parkinson’s Disease, but still weren’t looking at his liver. By December my dad was like a zombie and I thought could it be depression. If only we had known then that they were mild HE episodes.”

As Stephen’s family come to terms with their loss, his daughter Sara and widow Dorothy have been campaigning with the British Liver Trust to raise awareness of fatty liver disease and its causes, and the urgent need for early diagnosis and effective national liver care pathways. It is those two ladies who brought this issue to my attention. One of their key asks is as follows:

“We need assurance from government that the NHSE Liver Transformation Programme will be extended (as NHSE transition into Department of Health) and that the programme will be properly funded and resourced to ensure consistent care and early detection across England.”

I will add to that a request for ICBs to look at the illnesses in their area and focus their attention on their community and our constituents.

10:20

[Dr Danny Chambers (Winchester) (LD)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper) for securing this really important debate.

We have a lot of medical professionals in the room. It might surprise colleagues that, although I am a rudimentary vet, we treat fatty liver disease quite commonly in animals as well. It is most commonly seen in very large, fat cats that are really cuddly and people like to have on their lap. It is really common for them to get fatty liver disease if they stop eating, and it is genuinely very serious and takes intense treatment. The other time we see it commonly in animals is in cows that are in good body-weight condition, immediately after they give birth; often, they end up with hepatic lipidosis, which can be quite difficult to manage.

My first charity visit as an MP—it was the week after I was elected—was to the British Liver Trust in Winchester. I met Pam Healy, its chief executive officer, who is here today. It is a brilliant organisation. I thank everyone for all the briefings we were given; the hon. Member for Stroud (Dr Opher) mentioned how much he learned from them, despite being a trained GP. On that note, I know he is doing some social prescribing—when is the comedy show?

[Dr Opher]

It is on 20 November, with Jonathan Pie, and it is on investigating men’s health.

[Dr Chambers]

Fantastic. Hopefully it will improve people’s mental health—and if they leave halfway through, it will probably improve their physical health, too. That is a fantastic initiative.

Other Members have talked about the soaring rate of liver deaths, which has shot up in the last 20 years. The hon. Member for Worthing West talked about it costing the NHS £6.9 billion directly, and some studies show that it has cost the economy over £100 billion in other ways, such as from people being off work.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I suggest to the hon. Member that one of the principal reasons that non-alcoholic fatty liver disease has shot up so radically in recent years is the increasing prevalence of food that is simply bad for people and is causing them damage—in particular, food that is high in fat, sugar and salt. For that reason, the Health and Social Care Committee, of which I am a member, is currently doing an inquiry on food. Does the hon. Member agree that the Government need to focus on making healthy food more affordable and accessible, and to tackle the advertising and marketing of so much of the unhealthy food that is out there?

[Dr Chambers]

I completely agree—that is hugely important. The sugar levy has been a huge success: between 2015 and 2019, the amount of sugar in soft drinks reduced by about a third, which reduced sugar intake in our collective diet by 48,000 tonnes. If we expect the Government to pay for people’s treatment when they are sick, as we rightly do, there is also an onus on them to help people to maintain their health. That is both a moral and an economic imperative.

It is often not noted that as well as the direct implications of obesity, diabetes and liver issues related to genetics and diet, there are also indirect costs that affect the NHS, such as the number of hip replacements and knee replacements, and other types of expensive and intense interventions that could probably be significantly avoided if we had healthier diets.

As we know, the issue with many liver problems is late diagnosis. The liver can take a huge amount of abuse in many forms until it stops functioning to the level at which it appears compromised. When symptoms are finally seen, there has often been sustained damage for quite a long period of time. The scanning that is done by the British Liver Trust and others—I encourage everyone to get their liver scanned when they come into Parliament—can pick up diseases such as fatty liver disease before the clinical symptoms are seen, which is absolutely key.

The UK ought to be one of the healthiest countries in the world, but we know we are not. Winchester is a relatively wealthy constituency, yet 54% of adults are overweight or obese, along with 27% of children. We are a country with a long history of world-leading medical research, grassroots sport and high-quality food production, yet over the last 14 years people have been becoming sicker for longer. That is multi-factorial, but it is in part due to the gradual erosion of public health funding by the previous Conservative Government.

The issue of improving health is multifaceted, and obesity is certainly an example of that. Factors such as poor mental health and the broken food system contribute towards the growing numbers of people who are overweight or obese. The hon. Member for Stroud talked about the importance of free school meals in helping to reduce childhood obesity, the hon. Member for Blackpool North and Fleetwood (Lorraine Beavers) talked about inequality and poverty levels, and the hon. Member for Bootle (Peter Dowd) highlighted the issues of different demographics and incomes. I spent seven very happy years in Liverpool and have very happy memories; ironically, my liver probably does not, as I was a student there for many years.

There has been a political failure. As has been said, over the past 30 years successive Governments have proposed more than 700 policies to tackle obesity, yet none has ever been successful. We have never had a coherent strategy. We cannot underestimate the scope that must be taken into account when discussing how we tackle obesity. We need to look at every intervention possible, including having a robust, well-supported food production system, ensuring that everyone can afford good-quality, locally produced food, and ensuring that we expand free school meals even further to help to keep children healthy.

The Tobacco and Vapes Bill is a really good example. When Chris Whitty gave evidence to the Bill Committee, he said not only that it was the biggest piece of public health legislation in 30 years, but that it is probably going to be the most significant piece of legislation to help to address inequalities, because smoking rates are one of the most significant reasons why there is such a difference in life expectancy between some of the more deprived postcodes and the wealthier ones. That type of intervention is not only good for health but really good for addressing inequality.

As other Members have said, we cannot tackle this problem without also ensuring that food is produced to high enough standards, that we have limits on junk food advertising, and that we force big food manufacturers to reduce salt and sugar in their products and have a much better labelling system, so that people can make more informed and affordable choices.

I am so impressed with the hon. Member for Strangford (Jim Shannon) for being able to lose 4 stone. I have put on the best part of a stone in the last 18 months, since I was elected, partly because of my increased food intake since I have been here and also because the strange hours mean that I lack time for exercise. I used to have a fairly active job, which I do not really have any more.

Yesterday I went to the Winchester Boxing Club, where a guy called Glyn Parkin gave me a really good workout—I can still feel it today. I did the Compton 10K and the Alresford 10K this year—both big fundraising 10-kilometre events. Despite trying to keep up my exercise, however, it is really hard if I am not focused on food, because about 80% of weight loss is due to diet. At best, perhaps 20% is down to exercise. I am aware that if I do not get on top of my weight, it will affect everything from knees to hips, and in some ways, exercise will become more difficult. If I end up with knee or hip pain, I will end up exercising less—and when I exercise less, I make worse dietary choices as well. We need to encourage people to stay healthy and keep exercising, but if we do not get the diet right, those two things are almost impossible to achieve.

I again thank the hon. Member for Worthing West for securing this hugely important debate, and I thank the British Liver Trust for all that it does. I encourage everyone to go and get scanned by the British Liver Trust when it next comes to Parliament.

10:31

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship this morning, Mr Efford. I congratulate the hon. Member for Worthing West (Dr Cooper) on securing this important debate, and I thank the British Liver Trust and others who provided information and reading material in advance of today’s debate.

Fatty liver disease, as has been said, is often asymptomatic in its early stages. Even when symptoms do occur, they can initially be non-specific symptoms such as tiredness and feeling generally unwell. Initially, the fat deposits in the liver; in the next stage the fat causes inflammation, which causes metabolic dysfunction-associated steatohepatitis. It can then progress to fibrosis and then cirrhosis. As mentioned earlier, liver deaths have increased substantially in the last 50 years, but early detection can help to prevent them. What is the Minister doing to ensure that liver function tests and fibroscans are more available? Does she regret having to delay her workforce plan? Will that have an impact on the treatment of liver disease?

As many have said, fatty liver disease is caused by obesity. Two thirds of adults are now overweight or obese, but obesity starts in childhood. As an NHS consultant paediatrician, I have in my time seen a 12-year-old weighing 120 kg and a nine-year-old weighing over 90 kg—around three times the weight of an average nine-year-old. That has a serious cost in terms of life expectancy, taking three to 10 years off a person’s life. It also has an economic cost to the state of about £11.4 billion on the NHS, estimated at £75 billion per year when taking into account the wider economic factors.

We all know someone who has struggled with their weight and who has had huge success recently, including Members of this House who have talked about it in other debates, using Ozempic, Wegovy or Mounjaro. That is great, but do we want a future where a substantial proportion of the population are dependent on medication to maintain their weight?

[Ben Coleman]

If I may bring the hon. Member back to childhood obesity, does she agree that there is a serious problem with sugar being pumped into so much baby food? Does she therefore welcome what the Government have finally done after many years of the issue’s sitting unaddressed? They are giving the industry 18 months to take the sugar out of baby food and to stop marketing basically unhealthy products, which no one should buy, as healthy or healthier. Does she welcome what the Government are doing here?

[Dr Johnson]

I certainly think it is wise to ensure that people get off to a good start in infancy and that unhealthy products are not advertised as healthy if they are not, although the definition of healthy is somewhat elusive and difficult to pin down. It is also important that we do not routinely feed little babies under one high-sugar foods, although I do not want to see them fed artificial sweeteners, either. It is about making things less sweet, so the reformulation will need to be done carefully. That is my personal view.

Going back to the medications, we know they can be very helpful for some and can improve their health. They may be able to help with fatty liver disease as well, although they are not licensed yet. Can the Minister update us on when the Government expect applications to be approved and whether the NHS is ready to deliver for all eligible patients? We have heard about the prevalence and burden of the condition across the country and the number of people affected. What is she doing to ensure that the NHS is ready so that, when these drugs are licensed, it has the capacity, workforce and money to provide them?

We have seen that drug prices can change quite dramatically. In August, Eli Lilly announced a huge price increase for Mounjaro. What plans does the Minister have to guard against that? Will she update the House on negotiations on the voluntary scheme for branded medicines pricing and access?

We understand she is reviewing the National Institute for Health and Care Excellence quality threshold; when does she plan to reach a conclusion? We have seen investment in this country’s life sciences sector by companies such as Merck and AstraZeneca being withdrawn from the United Kingdom or paused due to the environment created by the Government. We need urgent action to support that sector. Will the Minister update the House on discussions she has had with industry and the Treasury on that?

Medications are part of the issue, but there are also surgical implications. Many people who have lost large quantities of weight require surgery for excess skin, which can cause further medical problems. What is the Minister doing to ensure there is an assessment of demand for post-weight loss surgery? Are surgeons and capacity available to deliver it where medically indicated?

As many have said, prevention is better than cure. We know that fewer than one in three people eat five portions of fruit and veg a day, and that that is falling. We also know that starting early is important and have talked about children and infants. What is the Minister doing to ensure that school food is healthy and good for children? What work is she doing with the Department for Education on food choices and preparation, particularly advice on food that can be made in advance or quickly? We know that many young people will become adults in households where there are two working parents, where one of the largest challenges is not just the money needed to buy food, but the time required after returning from work to prepare and deliver it to children before they do their homework and go to bed.

We have talked about reformulation. The soft drinks industry levy has reduced sugar per 100 ml by 47.4%, but I am concerned that is leading to an increase in artificial sweeteners rather than a reduction in the sweetness of the product, ultimately meaning that people are still hooked on the sweetness. What does the Minister think of that? Some hon. Members talked about the advertising ban on less healthy food. Will the Minister tell us why that has been delayed until next year?

Why have the Government added the brand exemption? Do they think the addition of the brand exemption will make it harder for new market entrants, compared with well established brands? If I whistled the short tune for one food brand—I will not—it would be immediately recognised, without further introduction. That would be more difficult for advertising new entrants to the market.

The 10-year plan talks about mandatory healthy food sales reporting. Will the Minister update us on what she defines as healthy? There are also mandatory targets on healthiness of sales. What does that mean and when will it be implemented? We understand there is a planned update to the nutrient profile. Some are concerned that the free sugars that that includes mean that items such as date paste will fall under unhealthy sugars. Will the Minister provide information on that? Has she made an assessment of the Conservative Government’s step of informing people by adding calories to menus? What effect has that had on consumption and food portion sizes in the restaurant sector?

Exercise is also important. We know that physical exercise strengthens joints, increases weight loss and helps in the reduction of diabetes, depression and dementia. The previous Government gave £1 billion to support the sports and leisure industry during the pandemic so that it could continue, and had a school sports action plan, guaranteeing at least two hours of PE and supporting after-school clubs.

The current Government have pledged £400 million for new sports facilities, but delivery of that money seems to be at a standstill. Will the Minister update us on that? Many grassroots sports facilities need that money. Will she also update the House on what the Government are doing to improve girls’ attendance in sports? We know that teenage girls in particular are not taking the advised amount of exercise.

In summary, we need an NHS pathway to detect liver disease in the early stages so that it can be treated; an NHS that is ready to deliver the new treatments that are becoming available; and action to tackle obesity to prevent liver disease in the first place. There has been an emphasis throughout the debate on what the Government can do to prevent obesity and on state culpability in that regard. It is important that people recognise that they have agency and do not need to wait for the Government to do something about this. People do not need to wait for the soft drinks industry levy or for changes to regulations. They have the agency to help themselves; they can do that.

[Ben Coleman]

Will the hon. Member accept that there is now a general body of opinion that it is time to stop blaming people for not having the willpower not to eat bad food when they are constantly bombarded with advertising and marketing? Some £6.4 billion a year will be spent by the food industry on advertising and marketing to people, and in many areas it is very difficult to get food that is both affordable and healthy. Is it not time to stop blaming people for being fat and to support them to tackle obesity in the ways that I and many of my hon. Friends here have described? Is it not time to stop sticking up for the food industry and to start sticking up for ordinary people?

[Dr Johnson]

I do not think it is sticking up for the food industry to suggest that people have agency over what they eat. I will give an example. I saw a very small patient—about five years old—who was very obese. I asked the mum what sort of things the child was being fed, and the answer was, “Well, Doctor, he eats lots of crisps all the time.” But there is a simple point there: where was he getting those crisps from? He was getting the crisps from the cupboard without asking, but the crisps did not get in the cupboard because the five-year-old put them there. It is a question of making sure that what is available is healthy and what is being fed to children is healthy.

I have seen even in the last few weeks patients who have low vitamin D levels, critically low vitamin B12 levels and critically low iron levels as a result of the diet that they are getting. It is not just a case of, “It’s all the Government’s fault. The state must make sure that everyone eats healthily.” People have a responsibility of their own as well. This is about working together.

There are wider policy impacts as well. The hon. Member for Chelsea and Fulham (Ben Coleman) talked about food pricing and food security. This Government want to cover Lincolnshire—the breadbasket of the UK, where a third of the country’s fruit and vegetables are produced—in glass solar panels. That is what his Government want to do, so there is a wider policy framework about food affordability. Food inflation is going up hugely under this Government, so they need to look in the mirror and see what they are doing to reduce food prices for people. We need to work together: it is a combination of what the Government can do and what the individual can do.

10:42

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate my hon. Friend the Member for Worthing West (Dr Cooper) on securing the debate. We have veered quite a long way into the public health arena in the last while, but that demonstrates how important it is. I pay tribute to the expertise that my hon. Friend brings to this House and everything that she is doing to promote public health, including sharing the news about the winter flu vaccine—I will get that in while I am here, Mr Efford, because it is so important.

As has been said by many, including the resident GP on these Benches, my hon. Friend the Member for Stroud (Dr Opher), we have all learned from this debate. Well done to the British Liver Trust for its fantastic campaigning and briefing, which has clearly paid dividends. My hon. Friend the Member for Worthing West has given me the chance to update the House on the Government’s efforts to tackle the obesity crisis. I am here on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who is responsible for public health, but this issue concerns us all. Many of us have been involved in this area for some time, and it is one of the defining public health challenges of our time.

We heard today some of the facts. Obesity is a major risk factor for both fatty liver disease and cardiovascular disease; there are common risk factors such as high blood pressure, high cholesterol and type 2 diabetes. Non-alcoholic fatty liver disease now affects about one in three adults in the UK. Prevalence has increased with the rise in obesity rates. Currently, almost two thirds of the adult population in England are overweight or obese, and almost 29%—almost 13 million people—are living with obesity. When children in England start school, just over one in five of them are overweight or obese, and that rises to more than one in three by the time they leave primary education. Children living with obesity are five times more likely than other children to live with obesity as adults.

We have heard that there are major inequalities in how obesity is distributed across the United Kingdom. That was highlighted brilliantly by my hon. Friend the Member for Bootle (Peter Dowd), and by my hon. Friend the Member for Blackpool North and Fleetwood (Lorraine Beavers), who talked about the loss of her constituent Stuart. My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) spoke eloquently for Sara and her stepmother Dorothy on their loss of Stephen, which brought home to all of us the real impact of this disease on people’s lives.

Kids in deprived areas are twice as likely to struggle with obesity as those in the least deprived, so this is an extremely serious matter. We are effectively hobbling the life chances of a little boy or girl before they have had a fair start. The Government cannot and will not look the other way as a generation of kids miss out on the best start in life. The points made by my hon. Friend the Member for Worthing West make sense, given that we both stood on a manifesto that committed to halve the gap in healthy life expectancy between the richest and poorest regions in England, and reverse the legacy left to us by the last Government. We share that goal. The question is: how do we get there?

On my hon. Friend’s calls for a liver strategy and a childhood obesity plan, our 10-year health plan sets out decisive action—we have heard about some of it in this debate—on prevention to tackle the obesity crisis head on and create a fairer, healthier food environment. We are looking at people as a whole: where they live, what services they need and how to prevent illnesses in their communities. That will help us to be better prepared for the changing nature of the disease and allow our services to focus more on the management of chronic long-term conditions. I will talk more about prevention later.

On my hon. Friend’s call to extend the levy model, we are taking steps to ensure that the soft drinks industry levy, which the Lib Dem spokesman, the hon. Member for Winchester (Dr Chambers), discussed eloquently and which colleagues know as a sugar tax, remains fit for purpose. On the request that my hon. Friend the Member for Worthing West made for an ICB pathway, we are working with partners including the British Liver Trust to raise awareness and address the stigma related to hazardous and harmful levels of alcohol use and viral hepatitis, which are key drivers of liver disease. We will continue to work with communities and help those most affected by liver disease through the community liver health checks programme.

[Peter Dowd]

This must be one of the safest places in the Palace, with at least three medics and a vet in the Chamber. My constituency has been designated a pride in place area. One of the aims of that programme is to create safer, healthier environments. Does my hon. Friend agree that there is a great opportunity in those areas, which include an area of her constituency, for funding to be used in a lateral way for local community initiatives such as those that have been highlighted during the debate? There is real opportunity for those initiatives to be tested out, with local people making local decisions.

[Karin Smyth]

My hon. Friend is absolutely right. The pride in place programme does just as it says on the tin, and it is important. The Government’s drive is to make sure that those communities, which know best what they need, are the drivers of how that is done. We will think laterally and bring together all that they know about why there is that level of deprivation in those communities. I know that, with his experience as chair of a primary care trust and as a local councillor, my hon. Friend is well placed to see what needs to happen for us to bring things together and think laterally. In my community, the legacy of the tobacco industry is the source of so much of the long-standing inequality.

The ICBs need to be tied into that community work and support it, and make sure that community health checks proactively identify people suitable for liver cancer surveillance. More widely, as my hon. Friend the Member for Stroud said, our shifts, and particularly the transfer to community and neighbourhood health, absolutely support that agenda. I know that hon. Members will make sure that that agenda is well delivered. This disease lends itself very much to that drive, which we are determined to make happen.

My hon. Friend the Member for Worthing West asked for us to be patient-ready for the next generation of liver disease medications. If my hon. Friend the Minister for Innovation, Lord Vallance, were here now, he would happily chew her ear off about everything that the Government are doing to ensure that the next generation of life sciences discovery is available to NHS patients. I will touch briefly on medicines later.

My hon. Friend also asked about local food partnership funding and action on food affordability. I cannot go into those points in detail here, but we absolutely recognise them, and we are working closely with my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs to develop DEFRA’s cross-Government food strategy to provide healthier and more easily accessible food, particularly in deprived areas. I encourage my hon. Friend to ensure that she is completely aligned with that agenda, as I am sure she is. We want to make that work. On her call to enforce the 9 pm watershed, I will update the House on where we are in delivering our manifesto commitments.

Prevention is clearly an important part of this work, and our manifesto specifically promised to restrict advertising of junk food to children, along with banning the sale of high-caffeine energy drinks to under-16s. We are consulting until 26 November on that ban, and the restrictions on junk-food advertising will take legal effect on 5 January. I thank the advertisers and broadcasters who are doing the sensible thing in getting ahead of the regulations by applying the restrictions already.

We have also restricted volume price promotions such as “buy one, get one free” on less healthy food and drinks, and given local councils stronger powers to block new fast-food outlets near schools. We will go further. Current promotion and advertising restrictions on less healthy food and drinks use an outdated nutrient profile model. That was formulated under the previous Labour Government, almost 20 years ago, because we also took this agenda seriously when we were last in government. We will update the standards that apply to the restrictions, and we will consult on their implementation in the coming year.

In a world first, as per our 10-year plan, by the end of this Parliament all large food businesses will be required to report against standardised metrics on sales of healthier food. That means that the large food companies will have to tell us regularly how healthy the food they are selling is, and whether that is improving. That will set full transparency and accountability around the food that businesses are selling, and it will encourage healthier products. We will also set new targets to increase the healthiness of food sales in all communities. Finally, with regard to liver disease, we are exploring innovative approaches to early detection, such as intelligent liver-function testing, to reach more people at a stage when liver damage can better be reversed.

Our focus is prevention—we have the shining example of the hon. Member for Strangford (Jim Shannon)—but we do need to treat the millions of people who already live with obesity in the UK, so let me say what we are doing for them. First, we are building relationships with the biggest pharmaceutical companies to expand access to weight-loss services and treatments across the NHS.

Secondly, obesity drugs can be game changers in supporting weight loss, and we are entering what could be a golden age for obesity drugs, with many more in the pipeline. Over the summer, the NHS started its roll-out of the weight-loss injection Mounjaro through GPs. About 220,000 people, prioritised by clinical need, are expected to receive Mounjaro on the NHS over the next three years.

Thirdly, our obesity pathway innovation programme, supported by industry, is testing new ways of delivering that care, including through pharmacy-led services in the community and through digital services—again, part of our shifts. We recognise that these drugs are not a replacement for good diet and exercise, as exemplified by the hon. Member for Winchester, and they are not the first thing for patients or the NHS to try. That is why we have committed to doubling the number of people who can access the NHS digital weight-management programme.

On hospital to home, we are providing treatment options for children by shifting care from hospital to community. That comes back to the point made by my hon. Friend the Member for Worthing West about the left shift. Earlier this year, the Government announced that we would support thousands of severely obese children to lose weight and live healthier lifestyles, thanks to the roll-out of specialist NHS clinics and new digital smart technology to deliver expert care at home. That game-changing tool is helping our specialists support and keep track of children’s weight-loss programmes, without those children needing to leave home, while offering regular advice to them and their parents to help build healthier habits.

I have set out how the Government are tackling the obesity crisis head on, especially when it comes to safeguarding our children’s future, but while we are shifting the focus of our NHS to prevention, we are also doing more to help people who are already affected by obesity and fatty liver disease, especially through medicines and new technologies and by shifting care from hospital to home. We remember that we stood on a manifesto that committed to tackle the root causes of ill health and to close the gap between the richest and the most deprived areas. That is exactly what we are focusing on through our 10-year health plan. This Government will not sit by and let ill children become ill adults—not on our watch. I thank my hon. Friend the Member for Worthing West for securing this debate.

10:54

[Dr Cooper]

Thank you, Mr Efford, for chairing the debate this morning. I thank the Minister for her excellent remarks, and all the parliamentary colleagues who have taken the time to be here. I thank the British Liver Trust and everybody who came to hear the debate. I hope they found it edifying and useful.

I have no particular further remarks; I think most points have been covered. There is a lot of work to do. As has been said, 90% of liver disease is preventable. That is a serious amount of disease that we do not need to face in this country, which is incredibly important to remember.

Our obesogenic environment—my hon. Friend the Member for Chelsea and Fulham (Ben Coleman) told me to say that slowly; it basically means it is hard for us to do healthy things and keep well—encourages us, consciously and subconsciously, to do things that are not great for our bodies. The Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), said that we have agency. Of course we do, but we are humans in an environment that is telling us all sorts of things all the time. Our job as parliamentarians, as representatives of our residents, as members of the party that is governing the country, is to make sure that the messages and signals that we send, and the legislation that we pass, encourage a healthy environment for our residents to live in. Within that healthy environment, people can make their own choices.

To those who accuse me and other public health consultants of being part of a nanny state, I say, frankly, the nanny we have in this state right now is not a great nanny. It is one that allows us to eat things that make us ill, that encourages us to not exercise, that makes our children sick and that means we die earlier than we need to. I do not want to live in a nanny state, but I do want to live in a healthy environment that allows our children to live well and allows all of us to live the lives that we want to lead—one that makes the healthy choice the easy choice, the affordable choice and the normal choice, and one where, if we want to do things that make us ill, we really have to try hard. I thank everybody for their time today.

Question put and agreed to.

Resolved,

That this House has considered obesity and fatty liver disease.

10:57

Sitting suspended.