Liver Disease and Liver Cancer: Diagnosis

Debate between Clive Betts and Rachael Maskell

Tuesday 11th October 2022 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Betts. I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on securing this important debate, as well as on the important work that she and my hon. Friend the Member for Caerphilly (Wayne David) do with the APPG.

While there are multiple causes of liver disease, such as from viral hepatitis, obesity and alcohol, I particularly want to focus on alcohol. Successive Health Ministers will know that, over a period of time, I have consistently raised concerns about the absence of a comprehensive alcohol strategy. This afternoon we have heard only too clearly why that is so important. For too long, alcohol has been promoted as a social norm, and not to imbibe as an anomaly, yet the scale of alcohol harm, psychologically and physically, is off the radar. It is something that is causing me significant concern, whether it is used for pleasure or to address pain. It must become a priority of this Government.

In a city where I see more and more licensing of premises, I am aware of the impact and harm that that is having on livers. We see it in the statistics. My discussions with the British Liver Trust over the summer highlighted the fact that more and more people with liver harm were younger and sicker. Our excellent public health team in York says that it is their No. 1 concern. When we match that against the fact that 90% of liver harm is preventable, we realise that there must be a more comprehensive strategy. As the profile of those with liver disease changes, so must investment in prevention, diagnostics and disease management.

Astoundingly, since 2010 hospital admissions for liver disease have risen by a staggering 45%. NHS Humber and North Yorkshire ICS currently has no clinical pathway for the early detection of liver disease. I have written to express my concern, and the ICS tells me it will respond on 4 November.

There are many causes of liver disease and cancer, but prevention and early detection can make a significant difference to outcomes. In Yorkshire and the Humber, our pressurised NHS is seeing a 13% increase on the national average for admission rates due to liver disease, and rates are 38% higher for alcohol-related liver disease. In York, alcohol is a major factor in A&E attendance. For women in York, admissions due to liver disease are 30% higher than the national average. As we focus on York being a drinking capital, we have to look at those correlations.

Over the covid period, many people turned to alcohol as a means of addressing other needs. When so many people are dying from alcohol-related disease, the Government must turn their attention to that matter—not least because we know the impact it has on the most deprived communities, as we have heard. In York, the mortality differential is 10 years between the most deprived communities and the wealthiest. One in four with alcohol-related liver disease will die in hospital within 60 days of detection.

I know from working on a ward specialising in hepatology how important this subject is, but also how tragic it is for families. That is why I urge the Government to focus attention on this public health matter in a way akin to Dame Carol Black’s work on drug-abuse harms. There were 4,859 drug deaths in 2021. I am not belittling that statistic at all, but the fact that there are 10,000 liver deaths—over double—really demands the Government’s attention and a strategy. However, there is none in place.

That is why the Minister has a unique opportunity—one that she must take hold of. Ministers can turn their attention to so many things, but getting on top of this issue, driving a strategy that makes that difference and ensuring that every community has a diagnostic centre, as York longs to, could make a serious difference to our communities and our nation. I trust that she will embark on an alcohol strategy and ensure that there are community diagnostic centres, that alcohol harm is properly addressed and focused on, and that we also understand and focus on non-alcohol related fatty liver disease. We have an opportunity to double down on tackling liver disease, and I trust that this Government will not let this moment pass.

[Mr Clive Betts (in the Chair)]

To co-operate with the timing, we head to the Front Benches, with five minutes for the Opposition, 10 minutes for the Minister and a couple of minutes at the end for the mover to wind up.

Climate Goals: Wellbeing Economy

Debate between Clive Betts and Rachael Maskell

Tuesday 30th November 2021 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member for Brighton, Pavilion (Caroline Lucas) for this hour to reflect on a different economic model—an hour that should pivot the wanton greed of state to one of restoring the scars of its heritage.

Leaving Glasgow with our planet heating at a dangerous rate and the failure to slam the brakes on climate destruction, the Government were given a year to reset. COP27 will be their reckoning. Right now, the global south is paying for the exploits of the global north, and this generation is paying for centuries of colonialisation, industrialisation and exploitation, as people and planet were exploited, minerals, crops and humanity were exploited, and carbon and hope were burnt. In this generation, it is our duty to restore. We have no choice.

Kate Raworth’s work on doughnut economics shows us a path out. York Central development, at the heart of my constituency, could be the first doughnut development, where we see the planned luxury apartments becoming sustainable housing that meets need. We could see that site being car free, wellbeing communities being built and a carbon negative future with our green new deal.

As I set out in my Adjournment debate last week, York is seeking to lead. Our green new deal, BioYorkshire, will create 4,000 green-collar jobs and upskill 25,000 people as it takes 2.8 million tonnes of carbon out of our atmosphere and repurposes 1.2 million tonnes of landfill. With research and development of new precision-farming agricultural practices, it is the point where international development will meet international trade. While partners from the University of York, Askham Bryan College and Fera Science have reached out into the region, it is my hope that this green new deal will reach out across the globe, such is the power of its science.

It is this project that will put pride back into my community—one that to this very day celebrates the Rowntree legacy of integrating good business with good employment and social practices. In parallel, York has developed the good business charter. I hope that the Minister is aware of the charter, supported by the CBI and TUC, as it sets out 10 principles, including a real living wage, employee wellbeing, environmental responsibility and ethical sourcing, resetting the terms for business, the economy and workers. Different parts of the economy should not be able to choose whether or not they opt into those initiatives. We need a comprehensive refocus. Labour in Wales was the first in the world to introduce a wellbeing Act—the Well-being of Future Generations (Wales) Act 2015—and the rest of the UK must now follow. Instead, this Government’s mantra seems to be, “Always need to take, not restore”, and that must be reversed.

Just imagine if those principles had been embedded in our approach to the covid-19 vaccine. We would not be debating omicron today. Given that the west has hoarded and destroyed global vaccine supplies—and taken at least three vaccines for each of us—the vaccine rate in developing countries is just 3%. For the sake of profit for big pharma, this Government are prepared to sacrifice the global south. However, in this interconnected world, we too will fall prey to a virus that does not play by the rules. That is why we need to change the rules that govern us. It may not be omicron that calls us short—it may be the pyro or sigma variants.

This is about moving from a mindset of economic nationalism to one of responsible internationalism. The Government were sent to Glasgow to keep the idea of 1.5° alive, but it is now in critical care. Everything must be injected into rehabilitating our economy. The cost of not doing so will be fatal.

[Mr Clive Betts (in the Chair)]

I thank hon. Members for keeping to time in this debate. We can now move on to the Front Benchers. First, I call Patrick Grady for the Scottish National party, who has five minutes.

School Funding

Debate between Clive Betts and Rachael Maskell

Wednesday 24th October 2018 Westminster Hall

[Rachael Maskell]

My hon. Friend raises an important point. I meet with colleges in my constituency, which are absolutely on their knees with regard to funding. We know that this is an issue right across the education system. It has a real impact on outcomes, which is what I want to focus on.

While our schools have excellent outcomes, in the areas in my constituency where the cuts have been the greatest in real terms, the attainment is the worst. We can easily see the correlation between money and outcomes. If we make those cuts, we must expect those children to be short-changed, perhaps for the rest of their lives.

We are also seeing a change in class sizes. York has the second biggest increase in the teacher-classroom ratio in its primary schools and the fourth biggest fall in staffing numbers in primary schools, with 20 teachers leaving between 2014 and 2017—that has an impact. We have seen the biggest increase in class sizes in secondary schools across the country—the relevant figure is 2.9, with the next biggest being 1.8. In secondary schools, York has the joint biggest teacher-classroom ratio. Pupil numbers are increasing. I know at least one school in my constituency that is really struggling and does not know how it will accommodate its children next year.

We have also experienced a real turnover of teaching staff, as hon. Members have mentioned. Experienced teachers are leaving and being replaced. In one school around 60 teachers have moved and newly qualified teachers have been brought in. That has an impact on the experience of staff and therefore on the teaching of students. We are also seeing the impact on vital support staff. When the pay increase was announced, schools had to find the resource to pay their support staff, which resulted in many having to leave. We must focus on them as well.

The excellent head teacher of Millthorpe School in my constituency, Trevor Burton, had to write to parents to inform them of the reality and what they can expect. The school is unfunded by £169,000, for four years of 1% pay increases, £56,000 for increased employer pension contributions, £78,000 for national insurance, and £21,000 for the apprenticeship levy. The school’s expenditure has increased by £324,000. The school had an 8% real-terms cut, but it received increased funding of only 3.6%, so it has had a 4.4% cut. Of course, that has had a real impact on children through increasing class sizes, cutting events, doing without teacher posts, stopping all year 10 and 11 vocational courses—as we just heard, that has a real impact on children—and not replacing staff when they leave. On top of that, the school, like many others, has had maintenance issues. It has had to spend £900,000 on double glazing in classrooms, to keep them warm and dry, and to replace school roofs in the dining hall, sports hall, gym, language lab and one of the classrooms.

Tang Hall Primary School also faces the pressure of maintaining its building—a matter I have raised since being elected. The school, which has had one of the largest cuts in the constituency, was top of the Building Schools for the Future list to have a new school built. However, that programme was cut, and the school is still struggling and desperately needs a new building. The school is so cold, because it is such an old building, that they have had to change the school uniform so that the children can wear hoodies to school. It is a disgrace that in 2018, after eight years, they are still waiting for their new school. Children cannot study when they are cold. This has an impact on children throughout their time at the school. The head teacher has pleaded for a new school.

Westfield Primary Community School, in perhaps the most deprived area of my constituency, has had the largest cut in my constituency. How can that be the case when children and families desperately need the support? The school does extraordinary work in the face of such cuts. That needs to be looked at, because we are failing some of the most needy children in our communities.

My final point is about budgets and where we need to go.

[Mr Clive Betts (in the Chair)]

Can you wind up?

[Rachael Maskell]

Yes. I have talked about buildings and attainment, and I concur with all hon. Members about mental health support, which we desperately need. Ultimately, however, schools just need to have funds.

[Mr Clive Betts (in the Chair)]

There are 10 minutes remaining for each of the Front-Bench speakers. If they could give up 20 or 25 seconds of that to allow Anne Main to respond, that would be appreciated.