Liver Disease and Liver Cancer

Kirsten Oswald Excerpts

Thursday 25th April 2024 Westminster Hall

[Kirsten Oswald (East Renfrewshire) (SNP)]

It is a pleasure to serve under your chairship, Sir Christopher. I am grateful to the hon. Member for Stockport (Navendu Mishra) and my hon. Friend the Member for Glasgow Central (Alison Thewliss) for securing this important debate on health inequalities in liver disease and liver cancer. It is a particularly timely debate, given the recent publication of statistics showing that alcohol deaths in the UK surged during the covid-19 pandemic. While alcohol misuse is not the only cause of liver disease, it is, as we have heard, responsible for a large proportion of cases, and that does need to be addressed.

As the hon. Member for Stockport set out, we need to acknowledge that liver disease has an inescapable link to deprivation. The incidence of liver disease and the risk of hospitalisation and death are all significantly higher in regions and nations of the UK that have higher levels of deprivation relative to London and the south-east of England. It is important to discuss this, and it is welcome that we are having a debate on the topic today. We should do so from the starting point that deprivation leads to poorer health outcomes. In the case of liver disease and liver cancer, that means that someone from the most deprived area is four times more likely to die than someone from a more affluent area. That is not acceptable.

It is now conventional wisdom that preventing a disease is far more desirable than having to treat or cure it. In Scotland, we have rates of liver disease that are far too high. However, I am grateful that the Scottish Government have introduced policies that are making a real difference by reducing deprivation, decreasing the incidence of liver disease and improving early detection.

The Scottish Government, looking at the issue in the broadest sense, have introduced policies such as the Scottish child payment, which anti-poverty charities have described as a “game changer”. Combined with other interventions, it has the potential to lift an estimated 100,000 children out of poverty. That investment is just one example of the Scottish Government intervening at the early stages of life to reduce inequality, and it will undoubtedly help in our fight against conditions such as liver disease, and indeed all other diseases associated with inequality and deprivation.

The introduction of minimum unit pricing in Scotland has also delivered results. In England, where there is no minimum unit pricing, liver disease mortality and morbidity continue to rise, whereas in Scotland, health inequalities are gradually decreasing. This has resulted in chronic liver disease deaths in Scotland decreasing from 17.9 per 100,000 in 2021 to 17.4 per 100,000 in 2022. Let me be clear: those figures are still stark, and more action needed. However, minimum unit pricing has reduced alcohol-related harms and alcohol-specific deaths by 13.4%. That is surely an intervention that we should now see across the whole UK to help to tackle liver disease, among other issues.

Scotland’s innovative life sciences sector has produced groundbreaking tests to help to diagnose liver disease at earlier stages, when damage can be reversed and the progression to cirrhosis or cancer halted. Unfortunately, as we have heard, the reality is that three in four liver disease patients present at crisis point, usually in A&E, with cirrhosis and all the horrible symptoms that come with that condition. Researchers from the University of Dundee have developed the new intelligent liver function test, which uses an algorithm to perform additional investigations on abnormal blood test results. The test can help to refer patients to specialists earlier than would otherwise be the case, minimising the workload of GPs in primary care and increasing the diagnostic rate of liver disease threefold. It has the potential to revolutionise the diagnostic pathway.

Focusing on tackling alcohol misuse, obesity and viral hepatitis are all important in lowering the rate of liver disease and liver cancer, but we cannot escape the fact that the UK Government’s decision to inflict more than a decade of austerity has exacerbated the inequalities and deprivation associated with liver disease. If the UK Government want to get serious about tackling liver disease, they need to get serious about tackling inequality. Threatening to cut the benefits of disabled people who are unable to work does nothing to tackle inequality. Forcing real-terms cuts on departmental budgets that are already strained because of inflation does not deliver the services needed to tackle inequality.

The UK has one of the highest levels of regional inequality in Europe, and until there is a real and concerted effort to change that basic fact, poorer outcomes for liver disease and liver cancer, particularly among the most deprived communities, will remain stubbornly hard to improve. I hope that we will hear today about the action that the UK Government are willing to take to ensure that that statistic quickly becomes a thing of the past.