Liver Disease and Liver Cancer: Diagnosis

Feryal Clark Excerpts

Tuesday 11th October 2022 Westminster Hall

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Betts. I thank the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) for securing the debate and for her continued advocacy on this issue. I welcome the Minister to her place, and I look forward to many constructive discussions with her in the months ahead. I praise the contributions from the hon. Members for Darlington (Peter Gibson), for Totnes (Anthony Mangnall), for Strangford (Jim Shannon) and for Warrington South (Andy Carter), and from my hon. Friends the Members for Caerphilly (Wayne David) and for York Central (Rachael Maskell). I particularly thank the hon. Member for Darlington for sharing his personal experience. As the hon. Member for Strangford often reminds us at these debates, it is those personal experiences that remind us of the impact of what we are discussing.

Liver disease is increasing rapidly across the country, with deaths doubling over the past 20 years, as we have heard. Too often people with liver disease have little to no recognition of the condition, which is often asymptomatic in its early stages. As a result, as every hon. Member has set out tonight, diagnoses often come too late, with mortality rates from liver disease far outpacing those for other major conditions, such as diabetes or respiratory conditions, which have stabilised or improved over the past 40 years.

This is a condition that is only getting worse, with the 2020 covid-19 lockdowns seeing a 21% increase in alcohol-related liver disease deaths. We have heard tonight that the stats on liver cancer in particular are deeply concerning, with incidences rising by almost half in the past decade. With the poorest and most vulnerable in our society facing dire consequences from the cost of living crisis this winter, we are at real risk of seeing such a spike happen again. Given the serious inequalities we have already observed for liver disease patients, we know the devastating effects that that would have.

Statistics from the British Liver Trust show that prevalence of liver disease is four times higher in our most deprived communities than our most affluent. The most deprived patients are also expected to die a decade younger, as set out by my hon. Friend the Member for Caerphilly. This snapshot highlights the most glaring of inequalities. How can it be that, before we even look at the provision of services, people are facing such a glaring postcode lottery?

It is bitterly disappointing for liver disease patients, who are so badly affected, that the new Secretary of State for Health and Social Care has decided to scrap the health inequalities White Paper. Given the evidence we have heard from colleagues today, I look forward to hearing from the Minister how the Government plan to address this issue following that decision.

The picture for liver disease patients is deeply concerning, but when we look at the state of care and treatment services on offer, the situation gets even worse. Although, as we heard, access to specialist care improves survival rates by around 20%, provision of specialist liver disease services across the country is incredibly varied. Each year, thousands of patients are dying unnecessarily because they cannot access specialist services or because the services they can access are stretched to breaking point.

The rise in the prevalence of liver disease, combined with the shortage of specialist care, is compounding the crisis facing all parts of our NHS. More people are being admitted to hospital with no specialist care services available to them and no primary or social care capacity in their communities. We must break this all too common vicious cycle if our NHS is to have any chance to recover. The NHS desperately needs a workforce plan—something that has been called for consistently by not only Labour, but the cross-party Health and Social Care Committee. Can the Minister tell us what plans her Department has to address this issue facing all parts of our NHS?

As well as ensuring that we get the fundamentals such as workforce right, when it comes to liver disease, we should be learning from places where things are going right. Fortunately, my local integrated care system—North Central London—was categorised as green by the British Liver Trust survey, indicating that it has a fully effective pathway in place for the early detection and management of liver disease in primary care. Whether it is proactive case finding to identify those at high risk, GPs having the means to assess fibrosis, or effective management of patients, including referrals to secondary care where necessary, we know what effective care looks like, and we know what works.

I will conclude shortly. We need centres such as the North Central London integrated care system to exist not just in north London, but across the country. I urge the Minister to look at the positive examples of ICSs, such as North Central London, and see how the great work they are doing can be replicated more widely across the country. We know what works. We know we can do it. It is time for the Government to deliver.