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Health: Liver Disease

Volume 767: debated on Wednesday 9 December 2015


Asked by

To ask Her Majesty’s Government what progress has been made to implement the recommendations of the Lancet Commission on liver disease, to address the incidence of liver disease in the United Kingdom.

Since the publication of the report of the Lancet commission, the Government have continued to address the incidence of liver disease through a number of measures which focus on both the prevention of liver disease, and improved care for those with liver disease. Public Health England has a programme of public health action to tackle liver disease and is working with key stakeholders, including the Lancet commission, to produce a framework for liver disease next year.

As we enter the festive binge drinking season, do the Government recognise that 28% of deaths in 16 to 24 year-old males are alcohol-related and that 85% to 90% of the cost of in-patient liver disease is due to alcohol? By raising the floor cost of alcohol by 10%, we may be able to reproduce the Canadian evidence of a 30% fall in deaths attributable to alcohol. Do the Government also recognise that we have a responsibility to the next generation because in pregnant women hepatitis, obesity and alcohol are each risk factors, each compounding the other? If we implement a six-in-one vaccine programme for hepatitis B in neonates, we may prevent the next generation suffering from hepatitis B as well as decrease the incidence of foetal alcohol syndrome by tackling alcohol abuse in pregnancy.

My Lords, there was quite a lot in that question. Some 6,000 babies suffer from foetal alcohol syndrome and it is a shocking and appalling by-product of alcohol. Canada has increased the floor price of alcohol and I understand it has seen some reduction in alcohol-driven disease as a result of that. We are watching what happens in Canada carefully. Of course, Scotland is considering a similar move although it is awaiting the outcome of a court case in the European Union. I gather that Wales will possibly follow suit if that court case goes accordingly. We will watch what happens in those other countries, study it and then make up our minds accordingly.

My Lords, my former medical colleagues in Newcastle upon Tyne, including several distinguished hepatologists are gravely concerned by the increasing incidence of alcohol- induced liver disease in young people. The problem is that in Newcastle—in the centre of the city and on the quayside—many organisations sell what are called, “cheap shots” with a very high alcohol content. Surely the time has come, yet again for the Government to give urgent consideration to the introduction of a statutory minimum price per unit of alcohol.

My Lords, there are strong arguments for minimum unit pricing. However, other consequences might flow from minimum unit pricing to do with illicit alcohol sales and the fact that the cost of that would fall very heavily on those least able to afford it. As I said earlier, it will continue to be kept under consideration by this Government and we will study with great interest what happens in other countries which are introducing minimum unit pricing.

My Lords, given the statistics just given to the House by the noble Baroness and the scale of profits of the drinks industry, are the Government content with the amount of financial help given by the drinks industry to the victims, as suggested by the noble Baroness?

My Lords, as part of the responsibility deal, a financial contribution was made by some of the alcohol companies. I accept that it was a small contribution. I shall have to take this under advisement as I am not sure how much the industry does contribute to the victims of alcohol disease. I agree with the noble Lord’s premise that the damage done to many people through excessive alcohol consumption is a cause of great concern.

My Lords, does my noble friend agree with recommendation 3 in the report, which requires the establishment of liver units in district general hospitals, acting in a hub-and-spoke network with specialist hospitals? This is important to provide access to people, particularly in the north-west, where, sadly, there is very little access to specialist hepatology units.

My Lords, the recommendations in the report about a hub-and-spoke approach, to which my noble friend refers, with district general hospitals having some hepatology services but being linked into a specialist centre are absolutely right. It is the right model; I have no doubt about that. We have established 22 operational networks for hepatitis C treatment, which are all linked into specialist treatment centres. We believe that that may be a model for the future.

My Lords, on the issue of specialist centres, has the Minister actually read the Lancet report, which points out that the north-west has the highest incidence of liver disease, yet does not have a transplant centre? In view of the very good outcomes from the transplant centres, are the Government making sure that the north-west gets such a centre?

I have read the Lancet report and I noted this rather unusual omission in the north-west. I do not understand why the north-west does not have a specialist liver facility. It is something that I will follow up and find out. I will write to the noble Lord if I can.

My Lords, the Lancet said that the majority of people with obesity have non-alcohol related fatty liver disease. Does the Minister agree that we need restaurants and takeaways to publish the calorie, fat, sugar and salt content of their dishes? Some of the best do it, but not many do. Will he also consider further restrictions on the advertising of high-calorie junk food to children?

My Lords, I understand that that is precisely one of the issues that the responsibility deal has studied and addressed.

My Lords, thank you. Is the Minister aware that the UK is the worst country in Europe for liver disease? Is he not rather worried about cutting funds for public health?

My Lords, we clearly have a major problem with liver disease—I think that we can all agree on that. The report by the Lancet commission has some very useful recommendations that we must take seriously. It is true that other countries in Europe have had more success in tackling this. I cite France as a case in point. We will take on board the number of recommendations made by the Lancet commission, as well as other initiatives we are taking.