Liver Disease and Liver Cancer

Preet Kaur Gill Excerpts

Thursday 25th April 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Sir Christopher. I thank the hon. Member for Glasgow Central (Alison Thewliss) and my hon. Friend the Member for Stockport (Navendu Mishra) for securing this debate. I thank my friend, the hon. Member for Glasgow Central, for sharing her personal experiences. I know that both Members are great champions for improving health outcomes for all, and I am grateful to them for bringing forward this debate to discuss a neglected but major killer. I also thank my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) for sharing the shocking figures on liver disease in her constituency.

As my hon. Friend the Member for Stockport highlighted, new data released this month shows that we are facing the worst mortality and hospital admission rates for liver disease in a generation. Over 70,000 people die of liver disease and liver cancer each year, over half of whom are people of working age—15 to 64—at a huge cost to the NHS and the economy. We have heard from Members that 90% of liver disease is preventable, and if diagnosed at an early stage damage can often be reversed and the liver can fully recover. It is an avoidable epidemic, which is being driven by obesity, alcohol and viral hepatitis. All those issues increase in prevalence in the most deprived communities, and drive the health inequalities that we are debating today.

The debate is timely because it comes in the week when we received the sobering news that annual figures for alcohol-specific deaths had passed 10,000 for the first time ever. Seventy-six per cent of those deaths were from liver disease, including liver cancer, and it is the third year in a row that deaths have risen across the United Kingdom, breaking previous records each time. The rise was not inevitable and it cannot be explained away as the product of the pandemic. It is a policy failure, and Ministers today must answer for it.

Outcomes for many types of cancer have seen huge improvements over recent decades, but as we have heard, deaths from liver cancer in the United Kingdom have increased by 40% in the last decade alone. It is the fastest-rising cause of cancer death in the United Kingdom. It has a shockingly poor five-year survival rate of just 13%. Public awareness remains very low, with liver cancer patients overwhelmingly diagnosed at a late stage.

To her credit, the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), recognised the problem when she committed in a letter to the chief executive of the British Liver Trust that the Government would make fibroscans available for use at 100 community diagnostic centres by March 2025. I have used one of those fibroscans, and they are a fantastic piece of kit that can tell if someone has liver damage or early signs of liver disease.

Why then, in the answer to my parliamentary question, which I received in February, did the Minister say that the Government had plans for fibroscans not in 100, but rather 12 diagnostic centres at the end of March? What about the other 88? It is all very well the NHS announcing funding for a new diagnostic pathway, but without the kit in local communities, how will that actually work? How and where will patients access scans and tests? Will they be available in the most deprived communities, where outcomes are far worse? What about in GP practices and pharmacies?

Perhaps the Minister could take up Labour’s fully costed plan for a “fit for the future fund” to double the number of MRI and CT scanners, so that we can catch illness earlier and treat it faster, before it is too late. To tackle health inequalities, we must get serious about public health and a prevention-first approach. Under this Government, for the first time in a century, life expectancy has dropped in England, and a growing number of people live more of their life in ill health.

While the decline affects us all, as we have heard from many Members it is not spread equally across the country. Over a third of all premature deaths were reported in the north of England in 2022, and in my city of Birmingham, life expectancy has dropped by nearly two years in just three years. A person in Blackpool is three times more likely to die from chronic liver disease than people living elsewhere in England. In parts of that town, life expectancy for men is just two years above the retirement age—but what do we expect when the Prime Minister boasted about changing funding formulas to take money away from deprived urban areas?

As I mentioned, alcohol consumption alone caused more than 7,500 untimely deaths from liver disease in 2022, and those mortality figures have risen three years in a row. Yet faced with that, the Government have decided to dismantle the central public health function and, as far as I can tell from the non-answer that I have received to written questions on this, they have abolished the Department of Health and Social Care’s alcohol policy team. Can the Minister confirm whether it is the case that there are no dedicated alcohol specialists in the Office for Health Improvement and Disparities, and that that team have now been redeployed? Should we take that as an indication of how much Ministers care about this issue, and does that help us to understand why there was no real-terms increase to the public health grant in the spending review in March, even as alcohol treatment services have been hollowed out over the last 14 years?

It does not bode well for the prevention strategy that the Health Secretary has promised before the summer recess. I hope that that does not go the same way as the major conditions strategy and the health disparities White Paper before that. I am encouraged to hear that measures to tackle the obesity epidemic should feature in it, if not alcohol. Fatty liver disease and excess weight significantly increase the risk of premature death due to not just liver cancer but colon, breast, prostate, lung and pancreatic cancers, not to mention heart disease. When one in six children are obese by the time they finish primary school and one in four children with obesity are estimated to have fatty liver disease, this Government have been sitting on a ticking time bomb for the last 14 years, without taking action. Labour is committed to ensuring that all children get a healthy start to life, with free primary school breakfast clubs serving healthy food, an active and balanced curriculum and a pre-watershed ban on advertising junk food. Can the Minister confirm that concrete prevention policies to tackle the obesity epidemic will be included in the prevention strategy, and will she finally publish the consultation on the junk food ban and get on with legislating for it?

Mortality rates from liver disease are now four times higher in our most deprived communities than in our most affluent. That makes a mockery of the Government’s rhetoric on tackling health inequalities and levelling up. To build an NHS fit for the future, Labour is committed to hitting all NHS cancer waiting time and early diagnostic targets within five years. We will drive a prevention revolution, with measures to tackle alcohol harms and the obesity epidemic: banning junk food ads to children, boosting capacity in local public health teams and recruiting thousands of mental health staff to give more people access to treatment before they reach a crisis. As part of our 10-year health mission, we will improve healthy life expectancy for all and halve the gap in healthy life expectancy between different regions of England.