The final item of business is a members’ business debate on motion S6M-13569, in the name of Clare Haughey, on raising awareness of liver disease. The debate will be concluded without any question being put.
Motion debated,
That the Parliament understands that, in the UK, there are more than 10,000 deaths due to liver disease each year, and that there has been a four-fold increase in death rates over the last 50 years; further understands that liver disease is closely linked to health inequalities, with key risk factors such as obesity, alcohol misuse and viral hepatitis most prevalent in the most marginalised and disadvantaged communities, including those in the Rutherglen constituency; understands that, while 90% of liver disease is preventable, mortality rates for chronic liver disease are now 5.5 times higher in the most deprived areas compared to the most affluent; notes the belief that greater focus on prevention and earlier detection of liver disease is essential to save lives, including through public health policies to reduce the health harms of alcohol and unhealthy food and drinks that are high in fat, salt and sugar, and pays tribute to the British Liver Trust for all of its work in raising awareness of liver disease, including through its Love Your Liver roadshow.
17:12
I put on record my entry in the register of members’ interests, as I hold a bank nurse contract with NHS Greater Glasgow and Clyde. I thank all the members who supported the motion to allow the subject to be debated.
The debate is particularly timely, as this month is liver cancer awareness month. We know that 90 per cent of liver disease is preventable and that, if it is diagnosed at an early stage, damage can often be reversed and the liver can fully recover. Tragically, however, in the United Kingdom as a whole, there are more than 10,000 deaths each year as a result of liver disease, and there has been a fourfold increase in death rates over the past 50 years. Mortality rates for chronic liver disease in Scotland have increased by 80 per cent in the past three decades, and they have increased by 16 per cent since the pandemic.
Back in May, I sponsored the British Liver Trust’s love your liver roadshow at the Scottish Parliament. It was fantastic to see more than 20 MSPs, including the Cabinet Secretary for Health and Social Care, attending the event.
Liver disease is closely linked to health inequalities. The main risk factors for chronic liver disease are alcohol use, obesity and viral hepatitis, all of which are most prevalent in our most disadvantaged and marginalised communities. Liver disease mortality rates are now five and a half times higher in the most deprived areas, and individuals from those areas are more likely to develop, be hospitalised by and die from liver disease than those in the most affluent areas.
However, Scotland is rapidly making progress on early detection to tackle those inequalities, as nine of the 14 health boards are now implementing fully effective pathways for earlier diagnosis of liver disease. People from the Camglen area of my Rutherglen constituency often access services from NHS Greater Glasgow and Clyde. Between 2003 and 2022, the board saw the largest fall in liver disease deaths—48.6 per cent—across all health boards. Challenges persist, however, as 251 people in the board’s area sadly died from chronic liver disease in 2022.
Nonetheless, Scotland is leading the charge in developing and rolling out new diagnostic technology to accelerate the earlier detection of liver disease. For example, the intelligent liver function testing pathway, which was developed by the University of Dundee, uses an automated algorithm-based system to further investigate abnormal liver function test results in initial blood samples from primary care. There has also been some local innovation, with FibroScan technology being piloted in Glasgow city to target those who are at highest risk in addiction services, which enables rapid referrals to specialist care to take place.
One reason why those innovations in tackling liver disease are so important is that liver disease is the biggest risk factor for liver cancer—it is present in between 80 per cent and 90 per cent of liver cancer patients. Alarmingly, liver cancer is now the fastest-rising cause of cancer death in the UK, with a survival rate of just 13 per cent. Sadly, as a result of barriers to earlier detection, liver cancer has seen the largest increase in mortality rates of all cancer types in Scotland over the past decade.
To tackle that crisis, Scotland has broken ground through the publication of a dedicated 10-year cancer strategy with a specific focus on improving outcomes for liver cancer as one of the six less survivable cancers. Tackling it demands that we look upstream at earlier detection of underlying liver disease—through the initiatives that I described—and at prevention. We all know, of course, that prevention is better than cure. As such, I welcome the Scottish Government’s consultation on advertising restrictions on food and drinks that are high in fat, salt and sugar, which are disproportionately marketed towards children and vulnerable groups. That is hugely significant, given that up to 40 per cent of children with obesity are now estimated to have fatty liver disease.
In addition, given that alcohol is responsible for the majority of liver disease deaths in Scotland, I am delighted to report that the increase in minimum unit pricing for alcohol took effect last week. Evidence from Public Health Scotland has shown that minimum unit pricing is highly effective in tackling alcohol-related liver disease, reducing health inequalities and, ultimately, saving lives. In fact, it is estimated that the policy has, on average, saved 268 lives and averted 899 hospital admissions each year.
In closing, I pay tribute to the British Liver Trust for all its work to raise awareness of liver disease, including through its love your liver roadshow. A continued focus on prevention, and on the early detection of liver disease, is essential to save lives, and the British Liver Trust’s efforts to end liver disease should be commended.
17:17
I am pleased to contribute to the debate, and I thank Clare Haughey for bringing it to the chamber.
Liver disease affects both lives and livelihoods across the country. It is the one major disease for which rates appear to be increasing. The debate is timely, as Scotland, on the Scottish National Party’s watch, is in the grip of the highest alcohol-related death rates in 15 years. National Records of Scotland has confirmed that, in 2023, more than 1,200 Scots lost their lives as a result of alcohol, which is the highest number of deaths since 2008. The same research confirmed that more than 19,000 Scots have died from alcohol since 2007. In NHS Forth Valley’s area, 66 people died from alcohol in 2023, and 952 have died since 2007—that is nearly 1,000 people in that part of my region alone.
To go back to the wider issue in question, it is salient to note that liver disease does not affect all parts of society equally. Analysis by Public Health Scotland shows that death rates from chronic liver disease are nearly four times higher in the most deprived areas of Scotland.
The motion mentions the British Liver Trust’s excellent work, which I welcome and commend. Some months ago, I and fellow members had the opportunity to meet and welcome representatives of the trust when they were in Parliament with their love your liver roadshow, as part of its tour of Scotland. The event provided members of all parties with the opportunity to take a screening test and have a non-invasive liver scan. It was an ideal opportunity to learn more about the campaign that the British Liver Trust was organising to make early diagnosis of liver disease routine. It also provided an opportunity for us to find out more about the trust’s work to improve outcomes for liver disease and liver cancer patients across Scotland and the United Kingdom.
With the aid of diseased liver models, the event graphically highlighted for us how an unhealthy lifestyle that is laden with alcohol and processed food can have a massive effect on the efficiency of our organs. It also highlighted the pressures that are put on our health service as a result.
As the British Liver Trust highlights, a major reason for the increase in death rates has been late diagnosis. In around three quarters of cases, diagnosis of late-stage liver disease happens when it is too late for any effective treatment to take place. On that issue, I know that many health boards are working hard to ensure that the condition is detected as early as possible.
In my region, NHS Fife has been taking forward work on early diagnosis, which is to be welcomed. Last year, the board launched an early detection pathway for liver disease, which is also much welcomed. However, just nine of Scotland’s 14 health boards have an early detection pathway in place, so much more requires to be done.
I hope that the Minister for Public Health and Women’s Health will, in summing up, talk about what we are doing to ensure that health boards are all actively taking part in that pathway. I urge her to confirm that the Scottish Government will work enthusiastically and effectively with the remaining health boards to ensure that it becomes the norm across the country. We must do all that we can to save as many lives as possible from this terrible condition, which is a blight on many of our communities.
17:21
I thank Clare Haughey for bringing the debate to the chamber during liver cancer awareness month. I also thank the British Liver Trust for all its work to tackle liver disease. I was grateful to sponsor the trust’s first-ever love your liver roadshow at the Scottish Parliament, in May 2022, and it is encouraging to see the growing cross-party support on the issue.
The debate is important because Scotland has some of the worst rates of liver disease in the world, which places us at the epicentre of an avoidable public health emergency that is fuelled by stigma and health inequalities. We know that 90 per cent of liver disease is preventable and that many of the causes of liver disease, if they are tackled early with the right interventions, can be dealt with.
However, the statistics show that mortality rates for chronic liver disease are 5.5 times higher in the most deprived areas than in the most affluent areas, which is shocking. Hospital stays as a result of liver disease are 4.4 times higher in the most deprived areas, and people in low-income groups are more than four times more likely to die from alcohol, and six times more likely to be hospitalised, than people in higher-income groups. To be frank, the difference is stark. In addition, we know that thousands have died unnecessarily without access to specialist care because liver services are consistently overlooked and underresourced.
Liver cancer is one of the six less survivable cancers that make up nearly half of all cancer deaths in Scotland. The reality of long waits for cancer treatment in Scotland needs to be highlighted, as we have to have a serious conversation about outcomes. The 62-day urgent referral target for suspected cancers has not been met since 2012. Last year was the worst year on record for Scotland’s cancer waiting times, and they continue to worsen.
Every single health board in Scotland missed the 62-day standard this quarter, which I am sure is deeply worrying to us all. Early diagnosis and treatment is absolutely crucial in saving lives, so I welcome the innovations in diagnostics that Clare Haughey outlined, but we need to do more to meet the 31-day and 62-day cancer treatment standards.
In my local area, NHS Greater Glasgow and Clyde is, unfortunately, categorised as red, because there is no pathway in place for the early detection and management of liver disease. We need to do so much better in every area of Scotland, and we need to support the fantastic national health service staff, who are working tirelessly to deliver the standard of treatment that patients deserve.
Long waits are putting lives on the line. The situation is especially stark when it comes to liver cancer, which has seen the largest increase in mortality rates of all cancer types over the past decade in Scotland.
It is clear that we urgently need improved preventative measures and earlier diagnosis of liver disease, as well as a proper plan to tackle inequalities and geographic variation in treatment outcomes and care. For a disease that is so treatable, there should be no excuse for outcomes to continue to decline year after year.
Health inequality remains deeply entrenched in Scotland and, after 17 years of the SNP Government, it is not getting better. All members have a responsibility to try to close that gap. We must strengthen our NHS so that it works for all, invest in drug and alcohol treatment and bolster front-line services so that we can turn the tide on liver disease.
17:25
I am grateful to my colleague Clare Haughey for securing this incredibly important debate and for raising awareness of liver disease.
First, I hope that the chamber will allow me a moment of remembrance. Sadly, in June 2019, I lost my friend Linda McColl to non-alcoholic liver disease. Linda was a former councillor and the first female depute provost of West Dunbartonshire Council. I will never forget her kindness and guidance when I was elected, so in her memory I will do everything that I can to raise awareness. For Linda, and the great many people who have lost their lives to liver disease, we must do more to promote awareness as part of our prevention strategy. We must also improve support and services for those who are impacted by it.
Liver disease does not discriminate, but unfortunately some folk are more at risk than others. It is imperative that we highlight the disease, not only for people who are currently suffering from it but for those who are at risk, because, unfortunately, it is a silent killer. As has been mentioned, people with a history of excessive alcohol use, or of obesity, and those with viral infections such as hepatitis B or C, are much more at risk of getting liver disease.
Worryingly, many people do not experience symptoms until the disease has reached an advanced stage, so it is important to look out for the symptoms early. Some common symptoms are: loss of appetite, yellow skin, a yellow tinge in the eyes, itchy skin, and feeling or being sick. When it is damaged, the liver can repair itself, but only up to a point. That is why it is so important for us to know the risk factors early, so as to protect our livers.
Although it is welcome that, in Scotland, chronic liver disease rates have generally decreased from a peak in 2003, they are still too high. More definitely needs to be done. According to the British Liver Trust, nine out of 10 cases of liver disease could be prevented. Risk factors such as obesity and alcohol misuse increase our chances of contracting it. As Clare Haughey’s motion states, we cannot comprehensively tackle liver disease unless we also tackle its root causes. Health inequalities play a major part in that respect.
It is quite fitting that this debate follows the debate on challenge poverty week, as both poverty and deprivation are linked with liver disease. Public Health Scotland estimates that chronic liver disease death rates are 3.8 times higher in the most deprived areas compared with the least deprived. Therefore, policies that tackle health inequalities and reduce the harms of alcohol and unhealthy foods are very important.
A great example of that is minimum unit pricing of alcohol. Although it is subject to regular, and often misleading, criticism at times—including, unfortunately, from some sectors of the mainstream media—our academics are clear about its success. A report undertaken by Public Health Scotland found strong evidence that minimum unit pricing in Scotland has reduced deaths directly caused by alcohol consumption as well as hospital admissions due to chronic causes. Deaths caused by alcohol dropped by an estimated 13.4 per cent and hospital admissions by 4.1 per cent, with the largest reduction seen among men and those living in the most deprived areas. That is significant and, I believe, extremely important from the perspective of saving lives.
Finally, I thank the British Liver Trust for all its work in raising awareness of liver disease, and for bringing the love your liver roadshow to Parliament earlier this year. Although Alcoholics Anonymous is not a liver disease charity, I put on record my sincere thanks to it. I have known many people who have turned their lives around through its groups and who have subsequently improved their health as a result. For that, I am grateful.
We must do more to raise awareness. We must also improve early detection of the disease and ensure that treatment and support are easily accessible. The impact that liver disease is having in Scotland needs our full attention. Our constituents expect no less.
17:30
I, too, thank Clare Haughey for bringing the debate to the chamber. As other members have done, I thank the British Liver Trust for its work.
Raising awareness of liver disease is especially important, because, as we have heard from other members, it is a silent killer. In its early stages, it tends to be asymptomatic—which is not an easy word to say at this time on a Tuesday. Statistics provided by the British Liver Trust demonstrate that three quarters of people who are currently diagnosed with cirrhosis receive their diagnoses in an emergency hospital, when it is too late for effective treatment.
The situation is critical, as Scotland has the highest mortality rate for liver disease in the UK, and one of the highest in Europe. The trends are equally alarming, with death rates for chronic liver disease in Scotland increasing by 80 per cent in the past three decades and by 16 per cent between 2019 and 2022—that is, since the pandemic. That is in stark contrast to the rates for other major diseases, such as heart disease and cancer, which have either remained stable or decreased.
I also thank Clare Haughey for sponsoring the love your liver roadshow. I went along, gently dragging some staff members with me for moral support. It absolutely made me think, and worry, about what my liver scan would say. We cannot hide from such results. It was one of those times when the worry made me think twice about going. By no means do I drink excessively, but caffeine is certainly my downfall, and many people do not realise how bad energy drinks are for the liver. It is important for us to be seen to go for tests, and to encourage others to go, too, because we cannot advocate for what we would not do ourselves.
Other conditions that are not alcohol related can affect liver health, and those are very much known about. As we expand opportunities for people to have liver scans, we should ensure that those with certain health conditions receive them, too. For example, polycystic ovary syndrome—PCOS—can be a risk factor in liver disease, due to the insulin resistance associated with it. As is the case with type 2 diabetes, insulin resistance can impact liver health. Despite the length of time that women have to wait for a PCOS diagnosis, we know who they are and can identify them. I wonder whether the minister could say whether such health conditions could be included in scanning programmes and, in the case of PCOS, whether that could be considered in the next, wider phases of the women’s health plan.
Raising awareness of those diverse factors is essential if we are to improve liver health outcomes across the population. In that respect, a lot of work has been done by various organisations in the alcohol space, including Scottish Health Action on Alcohol Problems and Alcohol Focus Scotland, to impress on the Government the need to introduce several important mechanisms on alcohol use. I do not think that any member in the chamber would disagree with the need to tackle the current rates of alcohol-related liver disease, and those organisations have been advocating for an automatic operating mechanism for minimum unit pricing, in tandem with alcohol harm prevention levies on retailers that sell alcohol and profit from minimum unit pricing. We could use those funds for local prevention, early detection, and treatment and care services. More than 70 per cent of liver disease deaths are attributable to alcohol; tragically, three quarters of those cases are diagnosed too late. The British Liver Trust, Scottish Health Action on Alcohol Problems and Alcohol Focus Scotland all recommend the actions that I mentioned earlier.
Understanding liver disease in its entirety is crucial if we are to address the growing health challenges in Scotland. Although alcohol remains a significant factor, it cannot be viewed in isolation, especially for those who come to liver disease in other ways. The complex relationship between liver disease and wider health inequalities, particularly the strong impacts of deprivation, calls for a more comprehensive approach to care. Geographic variation in liver disease outcomes, and the quality of care provided across health boards, further exacerbate such disparities.
More should be done to ensure clear patient care pathways for early detection and management of liver disease. Tackling such issues demands a collective effort to create equitable access to liver care, improve early intervention and ensure that support is available where it is needed most.
17:34
I pay tribute to Clare Haughey for bringing this important debate to the chamber. I endorse and support much of what she and other colleagues have said.
However, I want to speak about a particular issue that is related to liver disease and which a constituent asked me to talk about on their behalf. In recent years, my constituent, who is in their 50s, developed bile duct cancer. According to AMMF The Cholangiocarcinoma Charity, which is the relevant charity, it is a brutal diagnosis, because the five-year survival rate is between 2 and 9 per cent, depending on various factors. Unfortunately, less than 30 per cent of patients survive 12 months, mainly because the symptoms tend to present when it is already too late and because practitioners do not always consider cholangiocarcinoma—excuse me if I am not pronouncing that correctly; I am not a clinician—despite the fact that it is now almost as common as hepatocellular carcinoma, which is the most common form of liver cancer.
My constituent told me that surgery is the only potentially curative treatment but that less than 20 per cent of patients proceed to it. My constituent has had surgery at Edinburgh royal infirmary in recent years, and they continue to be monitored by the oncology team at the Western general hospital. Like many of my constituents, they are very grateful to NHS Lothian for its superb care and treatment.
My constituent wanted me to talk about this today, because they inform me that other life-extending treatments are emerging and that some have already been approved by the Scottish Medicines Consortium. These therapies, which target particular gene mutations, are proving to be highly effective. My constituent states that, for example, ivosidenib, which was approved by the SMC last month, has been shown to be more than effective by doubling life expectancy. However, there are some challenges. My constituent has stated that, unlike other places, NHS Scotland does not fund the genomic testing that is necessary to identify all the new treatment options, and that is why I am speaking today.
I appreciate that there is a lot of detail to this and that the minister might not be able to respond today, but I just wanted to highlight the issue of bile duct cancer, as well as the other issues around liver disease that have been aired by colleagues. On the basis of the experience of my constituent and, indeed, experiences of others that have helped in the past—there will, of course, be others across Scotland—it is clear that dealing with this particular type of cancer is an important part of the debate.
Perhaps the minister could write to me so that I can relay to my constituents what can be done to create cohesion between the Scottish Medicines Consortium approvals process and the necessary testing to ensure that NHS Scotland patients can benefit from advances in medical science in this area.
17:38
I thank Clare Haughey and members from across the parties for bringing the subject to the chamber. I join others in thanking the British Liver Trust for all its work on raising awareness of liver disease, including through its love your liver roadshow. I am one of many MSPs who have benefited from a liver health screening and non-invasive liver scan right outside the chamber as part of a previous year’s awareness campaign.
Everyone will agree that everything possible should be done to raise awareness of liver disease in Scotland. As we have heard, October is liver cancer awareness month, so this debate is timely, especially as liver disease is the biggest risk factor for developing liver cancer. As we have heard, Scotland has the highest incidence of liver cancer in the whole UK, and liver cancer has had the highest increase in mortality rates across all cancer types in Scotland over the past decade, with a worrying 38 per cent increase.
I will not rehearse the stats that we have already heard. In coming last in a debate, it is often necessary to repeat stats, but I will not do that. I will focus on Dumfries and Galloway. Worryingly, the rate of chronic liver disease mortality in my patch—the NHS Dumfries and Galloway area—more than doubled in the decade between 2012 and 2022, increasing by 138.7 per cent from 7.13 per 100,000 to 17.02 per 100,000, and it surged by almost 40 per cent between the pre-Covid period and 2022, increasing from 12 per 100,000 to just over 17 per 100,000. The most up-to-date statistics reveal that there were 732 hospital stays for alcohol conditions in Dumfries and Galloway between 2021 and 2022.
I commend and welcome the fact that my health board has a pathway for early detection of liver disease in development. It has been reported that that pathway will include use of the liver fibrosis score and the introduction of intelligent liver function tests. I am sure that other health boards will watch with interest how that impacts on future improvements.
Of course, 90 per cent of liver disease is preventable, yet, tragically, three quarters of sufferers are diagnosed with cirrhosis when it is too late for effective treatment. Early detection of liver disease is vital in improving people’s opportunity to make lifestyle changes to improve their outcomes. It is a silent killer that is often asymptomatic in the early stages, and it is frequently diagnosed in accident and emergency departments at crisis point, when liver damage is irreversible, thereby putting even more pressure on our NHS.
That is why I agree whole-heartedly with the British Liver Trust that we must act now. The Scottish Government needs to introduce new national guidance on liver disease to improve early diagnosis, including through national roll-out of intelligent liver function tests and FibroScans in primary and community care. We must ensure that liver disease prevention is prioritised through the introduction of population-wide measures to tackle obesity and alcohol misuse as the drivers of liver disease.
Although money is tight, Scottish Government ministers must make the right choice and have the right priorities. Preventing the disease is absolutely critical, as is early diagnosis. The minister and I were at a meeting of the cross-party group on brain tumours earlier this afternoon, at which we heard how critical early diagnosis is. To achieve early diagnosis, the Scottish Government must provide sustainable funding for the nationwide roll-out of the Scottish care and co-ordination service for hepato-pancreato-biliary cancers, in line with action 45 in “Cancer Action Plan for Scotland 2023-26”. At the same time, we must establish recruitment targets for the liver care workforce to address the chronic workforce shortages and the geographical variation in consultant liver nurse specialists and alcohol care teams.
Much needs to be done if we are to stand any chance of beating this silent killer.
17:43
I, too, thank my colleague Clare Haughey for bringing her motion to the chamber in liver cancer awareness month, and I thank all the members who have contributed to the debate.
It is clear from everyone’s remarks that there is agreement across the chamber on how vital preventing liver disease is to supporting good health in Scotland. The Scottish Government is committed to ensuring that everyone with liver disease is able to access the best possible care and support and benefit from healthcare services that are safe, effective and person centred. I, too, attended the love your liver roadshow and, like Gillian Mackay, I was slightly nervous about getting my liver checked. I absolutely agree that we need to advocate people getting their liver checked.
It is clear how important it is to tackle liver disease, which now affects at least 2 million people in the UK. It is clear, too, that health-harming products, such as alcohol and high fat, salt and sugar foods, play a role in the development of liver disease for some people. There are many causes of liver disease, and we know that liver diseases are often associated with lifestyles that cause stigmatisation and prejudice, as Jackie Baillie mentioned.
I can assure members that I am absolutely committed to our public health agenda and the range of priority actions that we have set out in relation to various health-harming products, including alcohol and less healthy foods. Tackling health inequalities and improving healthy life expectancy continue to be key priorities for this Government, and we will continue our efforts to ensure that everyone in Scotland lives a full and healthy life.
I noted Gillian Mackay’s points about PCOS in the women’s health plan, and I will share that with my team that is looking at moving that forward. I thank Ben Macpherson for sharing his constituent’s story and comments. I am very happy to enter into correspondence with him on cohesion between SMC approvals and testing.
Early detection of liver disease is crucial, which is why are supporting NHS Tayside and the University of Dundee to develop their innovative intelligent liver function testing pathway, which is an automated investigation pathway that can maximise early diagnosis of liver-related diseases. That work is being led by liver specialists in response to local need.
Following the successful assessment of the pathway, the tests have been made standard practice across Tayside, and opportunities to support the wider roll-out of the technology across other health board areas is being considered. I recognise Alexander Stewart’s comments about understanding and recognising the consistency of pathways across NHS boards. Both he and Finlay Carson raised the matter in an earlier meeting, and I absolutely recognise the importance of that consistency.
Liver cancer has a tragic impact on too many people in Scotland. Like Marie McNair, I have suffered a personal loss: my father died of secondary liver cancer.
Cancer continues to be a national priority for the Scottish Government and across NHS Scotland. That is why we published our ambitious 10-year cancer strategy and initial action plan last year. Over the 10-year period, our strategic aim is to improve cancer survival rates and to provide excellent equitably accessible care. The strategy and plan take a comprehensive approach to improving patient pathways, from prevention and diagnosis to treatment and post-treatment care. We continue to focus on the less-survivable cancers such as liver cancer.
As many have said, the earlier that cancer is diagnosed, the easier it is to treat. That is why the Scottish Government is committed to raising awareness of all forms of cancer, including liver cancer, through our detect cancer earlier programme. A new earlier cancer diagnosis vision was developed as part of the cancer strategy. The vision is to reduce later-stage disease, so that cancer, when it has been detected, is more likely to be curable.
We have introduced five successful rapid cancer diagnostic services, which are significantly reducing the time that is taken from referral to diagnosis for those with non-specific symptoms of cancer. We will open another service this year. Evaluation has shown that hepato-pancreato-biliary cancers are among the most-found cancers that are diagnosed through the new services, which are helping us to find those cancers faster.
As everyone who contributed to the debate has done, I want to pay particular attention to the importance of preventing liver disease. As the motion recognises, the risk of liver disease is increased by the impacts of harmful alcohol use and obesity. We are determined to do all that we can to reduce alcohol-related harm, which is one of the most pressing public health challenges that we face in Scotland. We take a whole-population approach to tackling such harm, in line with the World Health Organization’s focus on the affordability, availability and attractiveness of alcohol. That approach recognises that it is not just people who are consuming alcohol at the highest levels who are at risk of health conditions due to alcohol. We continue to take steps to prevent the health harms that are caused by alcohol. As others have mentioned, that includes the recent work to increase the minimum unit price of alcohol to 65p, as of 30 September. The Public Health Scotland evaluation of the minimum unit pricing policy found that it is estimated to have saved hundreds of lives and to have had a positive effect on health inequalities.
The World Health Organization also recommends reducing the attractiveness of alcohol as a key step to preventing alcohol harm. In a statement on 12 September, the Cabinet Secretary for Health and Social Care set out the next steps for alcohol marketing. Public Health Scotland is being commissioned to review the evidence on that. We look forward to receiving its review and considering the next steps.
We also want everyone in Scotland to eat well and to have a healthy weight in order that we can reduce the impact of a range of diet-related ill-health conditions, including liver disease. We continue to implement the wide-ranging actions to address that challenge that are set out in our 2018 document, “A Healthier Future—Scotland’s Diet & Healthy Weight Delivery Plan”. That includes our commitment to restrict less-healthy food promotions and to improve the availability of healthier options when eating out, as outlined in our 2021 out-of-home action plan.
In closing, I would like to thank those—
I am sorry; I have just noticed that Ben Macpherson wants to intervene.
I thank the minister for giving way and I am sorry to interrupt just as she was concluding.
What the minister was saying reminded me of something that we have discussed previously in Parliament—namely, the availability of high-sugar energy drinks, which Gillian Mackay mentioned. The Government has considered restrictions on those in the past, and I note that the UK Government is now considering that, too. Perhaps the Scottish Government could review that as part of its considerations.
I thank Ben Macpherson for his intervention. A public health framework is one of the big areas of work that I am looking at alongside Public Health Scotland and Food Standards Scotland. Nothing is being excluded from that work, so it includes high-sugar energy drinks, and we are approaching this from the perspective of the population as a whole. I was pleased to chair a meeting that included not only Public Health Scotland and Food Standards Scotland, but Cancer Research UK, the British Heart Foundation and representatives of the retail trade, so we are taking a fully collaborative and integrated look at what we need to do from a public health perspective.
I thank those who support our NHS and patients who have a liver disease diagnosis, including the British Liver Trust, which has a very important role in raising public awareness.
To members and people who are watching the debate, I reiterate the Scottish Government’s enduring commitment to reducing the burden of liver disease in Scotland through a wide range of actions, from prevention and early intervention to strengthening treatment options and providing broader supportive care.
Thank you, minister. That concludes the debate, and I close this meeting of Parliament.
Meeting closed at 17:52.Air ais
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