Members of the Scottish Parliament are set to convene a crucial cross-party debate on 14th June 2023 to address the liver disease crisis in Scotland. The debate coincides with the launch of a new British Liver Trust report titled ‘Liver Disease: A Public Health Emergency in Scotland’ which calls for urgent action to address the growing numbers of people affected by the disease. The report reveals a staggering 19% surge in deaths between 2019 and 2021 due to liver disease[i], exacerbated by the pandemic.
Scotland finds itself grappling with a severe public health emergency, marked by the highest mortality rate for liver disease in the UK and one of the highest rates across Europe. Liver disease is also a leading cause of premature deaths in Scotland, surpassing breast cancer and suicide.[i]
90% of liver disease cases are preventable, with alcohol consumption, obesity, and viral hepatitis being the primary causes, yet three-quarters of people are currently diagnosed with advanced liver disease when it is too late for any effective treatment or intervention. Urgent and comprehensive action is now imperative to tackle this pressing issue, improve early diagnosis, and bridge the disparities in outcomes and care throughout Scotland.
Vanessa Hebditch, Director of Policy and Communications at the British Liver Trust, says: "The upcoming debate in the Scottish Parliament is of paramount importance in tackling the liver disease crisis that has been plaguing Scotland. The alarming surge in deaths over the past two years highlights the urgent need for action.
“We need the full attention of Scottish Government and Health Boards to prioritise liver health and implement comprehensive measures that address the root causes and disparities associated with liver disease. Through collaborative efforts, we can make a significant impact in improving outcomes and saving lives."
Alcohol plays a significant role in the crisis, contributing to over 70% of liver disease deaths[ii]. The impact of alcohol-related liver disease is particularly alarming in the most deprived areas, where death rates are 5.6 times higher compared to less deprived regions[iii].
Obesity is another pressing concern, with Scotland's obesity rates surpassing those of neighbouring countries. Approximately two-thirds of adults in Scotland are overweight, and nearly one in three are obese, putting millions at a heightened risk of premature death, chronic diseases, and various types of cancer. Non-alcohol-related fatty liver disease, a consequence of obesity, has emerged as the fastest-rising cause of liver cancer in the UK.
Furthermore, viral hepatitis, especially Hepatitis C and Hepatitis B, poses a significant issue for marginalised and disadvantaged groups. Astonishingly, half of the individuals living with Hepatitis C reside in Scotland's most deprived areas.
To effectively address the liver disease crisis, the British Liver Trust, alongside its partners, calls for the following key measures:
- Better early detection pathways across Scotland so that people can be diagnosed at a point when lifestyle intervention can reverse or halt disease progression
- The Scottish Government should publish a comprehensive Cancer Strategy and an action plan to improve outcomes for less survivable cancers, including liver cancer.
- Ensuring a resilient and equitably distributed liver care workforce across Scotland, guaranteeing that every patient with liver disease has access to high-quality care. This includes adequate access to hepatologists and specialist liver nurses. The Scottish Government is urged to publish staffing levels and establish recruitment targets based on workforce needs.
- Implementation of population-level policies to regulate environmental risk factors for liver disease, including raising the minimum unit price (MUP) for alcohol, restricting alcohol advertising at major sports events, implementing an Alcohol Harm Prevention Levy, and enforcing advertising restrictions and promotions on unhealthy food products. A comprehensive obesity strategy should also be introduced to tackle rising obesity rates.
The Scottish Government and Health Boards are urged to act decisively and swiftly to combat the liver disease crisis, safeguard the health of the Scottish population, and ensure a brighter and healthier future for all.