Commons Sense

House of Commons · Westminster Hall

Liver Disease and Liver Cancer: Diagnosis

11 October 2022 · 8 other contributors · 8,744 words

Opened by Margaret Ferrier SNP Rutherglen and Hamilton West

Responding minister: Caroline Johnson

NHS

Summarised by AI from the official record, so it can contain mistakes.

Read the full transcript on Parliament.uk

At a glance

Margaret Ferrier raised concerns about liver disease and liver cancer: diagnosis in Westminster Hall. A government minister responded.

Key points

  • Margaret Ferrier highlighted that liver disease and cancer in Scotland have the highest mortality rates in the UK, with around 6,200 new cases of liver cancer occurring annually in the UK.
  • Ferrier pointed out that only 13% of liver cancer patients survive more than five years after diagnosis, and liver disease mortality has more than doubled since the 1970s.
  • Ferrier urged the government to review adult liver services, include non-alcoholic fatty liver disease assessment in NHS health checks, and establish a new pathology pathway.

Key requests to Government

Ferrier urged for a full review of adult liver services by NHS England, routine inclusion of non-alcoholic fatty liver disease assessment in the NHS health check programme, and establishment of a new nationally endorsed pathology pathway. She called on the government to commit to addressing disparities in access to care through policymaking.

How the debate unfolded

MPs spoke in turn to share their views and ask questions. Here's what each person said.

Opened the debate

Margaret Ferrier SNP Rutherglen and Hamilton West

Margaret Ferrier highlighted the high mortality rates for liver disease and cancer in Scotland, which is the highest in the UK. She cited that around 6,200 new cases of liver cancer occur annually in the UK with approximately 17 diagnoses per day and 5,800 deaths. Noting that only 13% of patients survive more than five years after diagnosis, she pointed out that liver disease mortality has more than doubled since the 1970s while other diseases' outcomes have improved or stabilised. Ferrier also mentioned that Scotland's chronic liver disease death rate rose by 11% in 2020 compared to the previous year.

Other contributors (8)
  • Andy Carter Con Warrington South

    Mr Carter highlighted the high rates of liver disease mortality in the north-west of England, citing British Liver Trust statistics that showed 1,838 deaths in the region in 2020. He noted that this area lacks liver transplant facilities and patients have to travel long distances for assessments. Warrington alone saw 51 lives lost due to liver disease last year.

  • Anthony Mangnall Con Fylde

    Mr Mangnall discussed the geographical disadvantages faced by liver disease patients in his constituency, highlighting the long travel times and rejection rates for potential transplants. He mentioned meeting Professor Cramp of University Hospitals Plymouth NHS Trust to discuss improvements and urged for a review of adult liver disease services this year.

  • Clive Betts Lab Sheffield South East

    The wind-ups must start at quarter past, allowing six Back Benchers in about an hour. Speakers should work out their own time limits accordingly.

  • Feryal Clark Lab Enfield North

    Liver disease is increasing rapidly with deaths doubling over the past 20 years. The condition is often asymptomatic in early stages, leading to late diagnoses and high mortality rates. Alcohol-related liver disease deaths increased by 21% during the 2020 lockdowns, raising concerns about further spikes this winter due to the cost of living crisis. Prevalence of liver disease is four times higher in deprived communities compared to affluent ones, with patients expected to die a decade younger. The Minister was asked how the Government plans to address health inequalities following the scrapping of the health inequalities White Paper.

  • Jim Shannon DUP Strangford

    Jim Shannon highlighted the impact of liver disease and cancer on over 2 million people in the UK, noting a 400% increase in deaths since the 1970s. He mentioned that one in five individuals with liver disease in Northern Ireland are unaware of their condition, reflecting a need for greater awareness and prevention efforts.

  • Peter Gibson Con Darlington

    Mr Gibson highlighted the severe impact of liver and pancreatic cancer, noting that his father died at age 47 from these diseases despite being diagnosed only six weeks prior. He cited figures showing a significant increase in liver disease deaths from around 200,000 in 1990 to nearly 400,000 in 2018. Mr Gibson pointed out that the north has the highest levels of liver disease admissions and deaths, with Darlington having the worst mortality rate at 46 per 100,000.

  • Rachael Maskell Lab Co-op York Central

    Ms Maskell highlighted the importance of a comprehensive alcohol strategy to address liver disease, noting that hospital admissions for liver disease have risen by 45% since 2010. She mentioned that in York, alcohol is a major factor in A&E attendance and the mortality differential between the most deprived communities and the wealthiest is 10 years. She urged the Government to focus on this public health matter akin to Dame Carol Black's work on drug-abuse harms.

  • Wayne David Lab Caerphilly

    The chair of the APPG on liver disease and liver cancer highlighted the urgent need for addressing liver disease, noting that three-quarters of cirrhosis diagnoses are too late for effective treatment. He pointed out significant disparities in liver disease mortality between deprived and affluent areas. A survey by the British Liver Trust revealed only 26% of local health bodies have an effective patient pathway for early detection. The speaker also shared a patient's story illustrating gaps in care, emphasizing the need for better quality of care across the UK.

Government Response

Caroline Johnson

I thank the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) for securing a debate on this important issue. She has been a great advocate on this topic, and I share her commitment to tackling this serious disease. The NHS plan recognises the importance of preventing avoidable liver disease through targeted policies to address alcohol consumption and obesity. Unfortunately, most people are diagnosed with liver disease at a late stage when it is less treatable, often during an emergency hospital admission. NHS England has several trials in place for early detection, including intelligent liver function tests and fibroscans through community diagnostic centres. The NHS health check identifies people at risk of alcoholic liver disease. Last year's spending review allocated £2.3 billion for diagnostics to increase the number of community diagnostic centres to 100 by March 2025. Education on alcohol is now a statutory component of relationships, sex and health education in England. The NHS has invested £27 million to establish specialist alcohol care teams in hospitals with the highest rates of admissions related to alcohol dependence. Since April 2022, NHS England has introduced measures incentivising providers to improve earlier detection of liver disease for alcohol-dependent patients. The Government is committed to tackling obesity and has seen important successes since 2016, including a decrease in sugar content of drinks subject to the soft drinks industry levy. There have also been regulations about store placement of products high in fat, salt and sugar, investment in weight management services for people living with obesity. Through the NHS hepatitis C virus elimination programme, we have reduced the number of people living with chronic hepatitis C virus infection by 37% since 2015. New treatment has improved success rates significantly. There is a new opt-out pilot programme of testing for HIV, hepatitis B and hepatitis C in emergency departments, which identified many new cases. The NHS cancer programme has launched the early diagnosis liver programme to detect more liver cancers at an earlier stage, so that more patients can benefit from treatment. The programme aims to support early detection and diagnosis of liver cancer by identifying and referring people with cirrhosis or advanced fibrosis into a liver surveillance pathway, providing them with a peer supporter who can help guide future appointments. Over the last five years, there has been a 20% expansion in the number of consultant hepatologists.

▸ Assessment & feedback
Summary accuracy