Liver deaths ‘likely to increase’ after relaxation of alcohol tax policies

The Guardian

By Sarah Boseley, Health editor

November 19, 2015

Deaths from liver disease in UK quadrupled between 1980 and 2013 as alcohol became cheaper due to policy encouraged by lobbying from drinks industry, report says

Deaths from liver disease are likely to increase as a result of the government’s relaxation of alcohol taxation policies, say liver experts, who voice concern about a shortage of specialists to treat patients across the UK.

Only a third of district general hospitals have a liver specialist on the staff, according to a new report. It warns that obesity and alcohol are fuelling a rise in liver disease, which can cause cirrhosis, cancer and death if not caught early enough to be treatable.

Deaths from liver disease in the UK quadrupled between 1980 and 2013 as alcohol became more and more affordable, “as a result of government policy encouraged by effective lobbying from the drinks industry”, says the report from a Lancet medical journal commission on liver disease in the UK. Increasing numbers of off-licences and longer pub opening hours have also contributed, it says.

There has more recently been a drop in deaths, following the introduction of the 2% above inflation duty escalator in 2008. The liver experts say: “We predict that the recent decreases in liver mortality in England will not persist after removal of the duty escalator and the reduction in alcohol duty in the most recent budget. This, in the commission’s view, is unacceptable.”

According to the British Liver Trust more than 16,000 people in the UK died from liver disease in 2008. Of these, 4,580 died from alcohol-related liver disease.

The experts are concerned that their recommendations from the original Lancet commission published a year ago have not been met and point out that other investigations published this year have shown that some liver patients get very poor care.

“Many can recover if they are properly treated,” said Prof Sir Roger Williams, the commission’s lead author and director of the Foundation for Liver Research in London. “The UK’s specialist liver centres provide an excellent standard of care for their patients, but they aren’t evenly distributed throughout the country,” he said. “This results in a postcode lottery for patients with liver disease, who may not be able to access specialist care when they need it.

“We’ve seen very little progress on this problem since we first reported it last year, and the rising numbers of patients with liver problems in the UK means that we can’t afford to ignore these shortcomings any longer.”

Prof Nick Sheron, head of clinical hepatology at Southampton University, said that liver disease had soared since the 1960s when France had 50 patients per 100,000 population and the UK had two. He said: “There has been this colossal increase in liver disease as we have adopted the continental drinking habits. Liver services haven’t adapted to look after those patients.”

Politicians and the public tend to believe people with liver disease have only themselves to blame, even though many other diseases are due to lifestyle. Heart disease, for instance, is often caused by smoking. Sheron said: “It is something to do with our relationship with alcohol in our general psyche. We all love a drink and we celebrate drunkenness.”

Liver disease is very treatable and those who are caught early recover well. But nearly two-thirds (60%) of liver cancer cases in the UK are not diagnosed until the cancer has reached an advanced stage, when it is incurable.

Obesity and alcohol present some of the biggest challenges to the NHS today, say the report authors, who believe fiscal measures offer the best hope of bringing down consumption. They say: “There is convincing evidence to suggest that measures such as minimum unit pricing for alcohol and curbing advertisement and promotional offers for high sugar products work to reduce consumption, but the current government appears to be ideologically opposed to measures like this, which will make tackling these problems difficult.”