Liver Disease and Liver Cancer: Diagnosis

Rachael Maskell Excerpts

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.