Obesity and Fatty Liver Disease

Karin Smyth Excerpts

Thursday 8th June 2023 Westminster Hall

[Karin Smyth (Bristol South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone, and to respond on behalf of the Opposition health and social care team. As the hon. Member for Linlithgow and East Falkirk (Martyn Day) said, it has been a very well-informed debate. I thank my hon. Friend the Member for Caerphilly (Wayne David) for the exceptional work that he and the other members of the APPG on liver disease and liver cancer are doing to raise awareness of this vital issue.

As has been demonstrated, rising obesity poses a profound threat to public health. We have heard today—from Strangford to Erewash, and from Southall to Linlithgow—that this is an issue across the United Kingdom. Before we hear from the Minister, I want to say how impressed I am with how everyone has tackled their own health and wellbeing through exercise, and I will certainly try to do better the next time I come to one of these debates.

As we have heard, obesity can impact on cardiovascular disease, as well as a variety of other conditions, not least non-alcoholic fatty liver disease. The British Liver Trust estimates that deaths as a result of liver disease have doubled in the last 20 years—that is a sobering statistic—with mortality rates are four times higher in the most deprived areas, as we have heard. Childhood obesity is also rising at the fastest rate on record, with 39% of obese children estimated to be suffering from non-alcoholic fatty liver disease. Not only is obesity rising and costing lives, but it is also causing people to live less prosperous and enjoyable lives and harming our economic productivity, as my hon. Friend the Member for Caerphilly said.

The case for action could not be clearer. If we want to lead happier, healthier lives, while also reducing pressure on our NHS and turbocharging our economy, we must get serious about addressing the obesity crisis. That can be done only by placing prevention at the heart of our work.

Despite our best efforts, individuals cannot tackle obesity alone. Too often, we have a narrative of personal responsibility, but it fails because it promotes harmful, outdated ideas about our bodies, and that is particularly true for women. We need a step change in how we tackle obesity as a society.

I am proud that Labour’s recently launched health mission set out a blueprint for shifting the focus of Government Departments, the NHS, and wider public services to prevention. Most relevantly to today’s debate, we want to give every child a healthy start in life, with a children’s health plan.

I pay tribute to the hon. Member for Erewash (Maggie Throup) for her work as a public health Minister—she knows of what she speaks. We would want to implement that long-overdue 9 pm watershed for junk food advertising on television and to ban paid advertising of less healthy foods on online media. That would come alongside establishing fully funded breakfast clubs in every school and a balanced and broad national curriculum with a wide range of compulsory physical activities.

That is the start of our vision for Government. For far too long, public health problems such as obesity have been viewed as falling exclusively under the purview of the Department of Health and Social Care but, as we have heard, the causes of obesity are multifaceted. It is about what we eat, but also about our access to green spaces, our genetics, the money in our pocket, our access to community care, and so much more. If we want to tackle obesity and, by extension, this disease, every cog in the Government machine must recognise its responsibilities.

For that reason, Labour has committed to embedding health in all policies through the creation of a cross-departmental mission delivery board. That would bring together all Departments with an influence over the social determinants of health and act as an accountable body akin to the Climate Change Committee. That is the kind of bold, ambitious thinking that will define the next Labour Government.

I am aware that those suffering, or at risk, from NAFLD want action from the Government now. With that in mind, I would like the Minister to address some questions. First, in relation to obesity and prevention more generally, the Government recently launched their consultation for the major conditions strategy, singling out six major groups of health conditions but, unfortunately, there is no mention of obesity in the consultation documents, although cases of several of the diseases mentioned are rising in part because of obesity. It would therefore be helpful if the Minister set out what role preventive obesity policy will play in those major disease conditions. Similarly, concerns have been raised that there was no mention of liver disease in the strategy. Will he therefore set out how he plans to address increases in liver disease, and specifically NAFLD?

I also want to press the Minister on health inequalities. The British Liver Trust describes liver disease as, effectively, a barometer for underlying health inequalities. It points out that the main risk factors—obesity, alcohol misuse and viral hepatitis—are most prevalent in marginalised communities, and we heard some shocking statistics from my hon. Friend the Member for Ealing, Southall (Mr Sharma). That goes back to the point made earlier about the wider determinants of health. Unless the Government implement a coherent strategy for health inequalities, we will never be in a position to drive down liver disease.

The Minister will remember that in 2019 the Government pledged to extend healthy life expectancy by five years by 2035 and reduce the gap in healthy life expectancy by 2030. The clock is ticking. Not only is the target on track to be missed, but things are actually getting worse—inequalities in life expectancy are widening. Given that the Government binned their health disparities White Paper, will the Minister provide an update on how he plans to reverse the health inequalities that have widened on this Government’s watch?

We know that liver disease is largely asymptomatic in its early stages and that diagnosis is essential in providing effective treatment. As we have heard, one in four people diagnosed with alcohol-related liver disease in hospital die within 60 days, and there is evidence of huge geographical variation in the pathways for early diagnosis. Given that grim picture, what assessment has the Minister made of current diagnostic provision for liver disease, and how will he improve that picture so that, no matter where someone lives, they can receive a timely diagnosis?

In conclusion, our current trajectory must not be allowed to continue. Unless we address obesity and rising fatty liver disease, more lives will sadly be lost, and our health service will come under existential pressure. Labour stands ready and waiting to address this crisis, but we cannot afford to wait. The Government must get to work now. We look forward to hearing from the Minister.