Obesity and Fatty Liver Disease

Debate between Clive Efford and Jim Shannon

Tuesday 28th October 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper), who is co-chair of the all-party parliamentary group on liver disease and liver cancer, for setting the scene incredibly well. I thank her for the detail and for her requests to the Minister. It is, as always, a pleasure to see the Minister in her place. I wish her well and I look forward to her answers. I also thank the British Liver Trust and the Foundation for Liver Research, which supplied me with a briefing that made clear the excellent work at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research into metabolic liver disease to shape how it is diagnosed and treated.

Liver disease is a growing cause of premature mortality and lost years of working life in all four nations of the United Kingdom. It has been estimated that some 4,878 potential years of life were lost due to chronic liver disease in Northern Ireland. It is clear that the UK is in the midst of a liver disease crisis, to which the hon. Lady referred. It is as serious as that, and we should all take note. While premature mortality rates from other major diseases have fallen over the past two generations, deaths from liver disease have risen 400% since the 1970s. There are more than 18,000 deaths from liver disease and liver cancer each year in the United Kingdom.

[Clive Efford (in the Chair)]

Order. Members are asking that you speak into the microphone, Mr Shannon, so that they can hear you.

[Jim Shannon]

That has never been a problem in the past, Mr Efford. Do I need to lift it up to my mouth? I thought it was good enough to carry my voice; apologies if it is not. This would be the first time it has not worked.

Two thirds of adults are overweight or living with obesity, and one in three children are classified as overweight or obese when they leave primary school. Sadly, four in 10 children with obesity may already have liver disease. One in five people are affected by liver disease and liver cancer in the UK, and as many as 12% of those—more than 1 million people—go on to develop the more severe form of fatty liver disease.

The stats for Northern Ireland are unreal. That is not the Minister’s responsibility, but it gives a flavour for the debate. Some 64% of adults in Northern Ireland were overweight or obese, a marked increase from 23% in 2010-11. My goodness me—if ever we needed a reality check, that is one for us. Shockingly, Northern Ireland has the highest rate of overweight or obese primary 1 children in the UK, with 25.3% of children fitting that category. In my constituency of Strangford, 27% of year 8 children were overweight or obese. It is estimated that 70% of adults and 40% of children who are overweight or obese have fatty liver disease, so urgent work must be done to prevent this health crisis in the making.

Shockingly, 37 million extra sick days are estimated to be taken by people living with obesity, harming economic output on a massive scale—a figure of 1% to 2% of UK GDP as estimated by the Institute for Government. The NHS alone is expected to shoulder an estimated £10 billion per year obesity bill by 2050, with obese patients costing twice as much as those of a healthy weight. Reducing obesity prevalence by 10% could save £6 billion per year in the UK economy.

Let me tell a personal story. I am a type 2 diabetic. Some 16 or 17 years ago, I realised that I needed to drastically change my eating habits. I was 17 stone. To be honest, to put it very starkly, I was a big fat pudding. I realised that if I did not lose weight for my diabetes, I was going to be in trouble, so I reduced my weight quite substantially, by 4 stone. I have managed, by and large, to keep at that reduced level. First, it was down to stress but, secondly, it was down to Chinese takeaways five nights a week with two bottles of Coca Cola. That just does not work; when it is added up, you just get fatter and fatter. I took that away and tried to reduce my chocolate intake.

My hon. Friend the Member for East Londonderry (Mr Campbell) has said that he is reducing his sugar intake—well done to him; he does not need to, but it is definitely a good purpose to have. The point I am making is that not everyone can. For those who cannot, it is important to look towards the weight-reduction injections, to which I will refer in a moment. I have been able to control my diabetes for the last 10 years by tablets. I take nine tablets in the morning and five at night to keep everything under control.

Newly released weight-management drugs such as Ozempic and Mounjaro have been shown to reduce the weight of patients by an average of 5%, reducing the risk of a variety of health effects, including fatty liver disease. However, although those drugs are available for those who obesity and type 2 diabetes, they are not for those with fatty liver disease. Making that happen would be my one request of the Minister. If someone has a body mass index of over 40, and does not yet have those comorbidities, unfortunately they will not qualify.

There is a new generation of drugs targeting advanced fatty liver disease. Resmetirom has recently been approved by the US Food and Drug Administration and is expected to be approved in the UK within 12 to 18 months. Could the Minister give us an indication of where those drugs are in the system? Those new drugs—some of which improve liver function and some of which enable weight loss—can reverse fatty liver disease and must be made available in a timely fashion to save lives. The NHS needs to ensure that services are ready to support that, as previously no treatment has been available for those patients.

The UK faces a very challenging commercial environment for drug pricing. Lilly recently announced that it will increase the price of Mounjaro by as much as 170% in response to pressure from the US Government and historic pricing inconsistencies. My second question to the Minister is about what has been done to ensure that the price of drugs is reduced or kept controlled in a way that can make a difference.

Thirdly, I say to the Minister that ICBs must have an effective pathway for the early detection of liver disease. A new nationally endorsed pathology pathway to improve early diagnosis of liver disease is essential. Every community diagnostic centre should also have a fibroscan to assess fibrosis.

Finally, I say to the Minister that patients with advanced liver disease and cancer need access to weight management services in line with access for people with type 2 diabetes. This is a ticking timebomb, but there are scientific breakthroughs there to address it. I believe in my heart that the Government need to cut that wire and stop that timebomb now.

Fuel Poverty: England

Debate between Clive Efford and Jim Shannon

Wednesday 12th February 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Normanton and Hemsworth (Jon Trickett) for leading the debate. Fuel poverty is huge and has no doubt been emphasised further through the loss of the winter fuel payment for elderly people. I commend the hon. Gentleman for Normanton and Hemsworth; I admire courage, and I admire his, because he had the guts—I could use another word, but it would not be parliamentary—to stand up and vote against that decision by his Government. Well done! We admire him for his courage and for the stand he took.

I wish to give a quick Northern Ireland perspective to back up the hon. Gentleman and the stand that he and others in the Chamber have taken. The Department for Communities back home defines a household as being in fuel poverty if it spends 10% of its income on energy costs. We are talking about a substantial section of the population. Others have outlined clearly that fuel poverty rates have fluctuated, and that is the case in Northern Ireland too, with rates of 44% in 2009 and 24% in 2021.

Yesterday, I was fortunate to have the opportunity to speak in the energy debate led by the hon. Member for Bath (Wera Hobhouse), which highlighted the correlation between the cost of energy and fuel poverty, and this debate is an opportunity to highlight that issue again. The increase in prices has meant that many are on the breadline, and that is not to mention the devastating impact that the loss of the winter fuel payment has had on our elderly generations. I have never had as many elderly people, pensioners, vulnerable people and people with complex health needs battling—I use that word on purpose, because it is the right word—the loss of the winter fuel allowance. I say this with respect to my colleagues on the Government Benches, but not supporting the winter fuel allowance for pensioners was wrong.

I wish the Minister well in her job, which she does to the best of her ability, and we welcome that. Has she had an opportunity to speak to the Department for Communities back home, which has responsibility for this issue? In his intervention, the hon. Member for Aberdeenshire North and Moray East (Seamus Logan) said that this theme starts here at Westminster, but has she had an opportunity to discuss it with the relevant Minister? Back home, we have just—

[Clive Efford (in the Chair)]

Order. This is about fuel poverty in England and you are starting to talk about back home and your constituency. There are English MPs who want to get in on this debate, and we are running out of time, so draw your comments to a conclusion.

[Jim Shannon]

I will certainly do the best I can, Mr Efford.

The issue, no matter what, starts in Westminster—it is a fuel poverty debate on England that affects everybody in this great United Kingdom of Great Britain and Northern Ireland—and decisions are made, right here, in this House. With that in mind, I ask the Minister again, will she speak to the relevant Minister on how we can do better?

--- Later in debate ---

[Jim Shannon]

In questions, urgent questions and statements in the Chamber, I have been keen to ensure that every part of this United Kingdom of Great Britain and Northern Ireland can benefit from strategies in this House and that the ripples go out to everywhere. In my contribution, I asked the Minister again whether there would be an opportunity to discuss the matter with the relevant Minister back home. I know the Minister is committed to that. Will she please update me on where those talks and discussions have gone, so that we can all benefit?

[Clive Efford (in the Chair)]

In relation to England, you mean.

Fly-tipping

Debate between Clive Efford and Jim Shannon

Tuesday 3rd September 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

That is okay—I will keep to the four minutes and I will not take an intervention either. I congratulate the hon. Member for Ealing Southall (Deirdre Costigan) on setting the scene with much information, detail and good ideas. I fully support her idea for a national strategy, which is one of the things I was going to ask for, ever mindful of where we are. It is nice to see the Minister back in her place after a short time away from the House, and I look forward to hearing her contribution at the end.

Very quickly, I want to give a Northern Ireland perspective and to reinforce what the hon. Member for Ealing Southall said—these things are mirrored all across the United Kingdom of Great Britain and Northern Ireland. Fly-tipping has become such a massive issue, including in my constituency of Strangford, where constituents report countless incidents of fly-tipping to my office almost every week. It is time for us to have a debate in Westminster Hall on how we can work together to tackle this issue.

The Northern Ireland Environment Agency has revealed that, from 2018 to 2020, it cleaned up 306 illegal waste sites across Northern Ireland, with taxpayers paying the half a million-pound bill, which is equivalent to employing 15 nurses. That is what we could do with the money if we did not have to spend it cleaning up afterwards. Fifteen nurses would be a big thing for us in Northern Ireland and a big thing in the constituency of the hon. Member for Ealing Southall as well.

Collective action is required to tackle fly-tipping. It is a serious crime, and that is without mentioning its devastating impacts on our environment. In the past, my council—Ards Borough Council, as it was then—used to have a system of skips that went around all the villages. Whenever a skip was filled up, the council brought a new one. Unfortunately, as the years passed, that seemed to fall by the wayside. New councils were amalgamated and that strategy was lost.

In 2023, the then Prime Minister’s antisocial behaviour action plan set out how councils would be supported in taking tougher action against those caught fly-tipping. That included raising the upper limit for on-the-spot fines to £1,000. In 2018, there were 74 cases of fly-tipping in the constituency of Strangford, and many fear that that will increase due to the new recycling centre booking system introduced just recently. There is no doubt that fly-tipping is wrong, and we must have a punitive system in place to ensure that it does not happen. However, we must also ensure that waste centres are accessible to constituents to ensure that fly-tipping does not become more common. If we make it illegal, we have to put something in its place.

It is important for residents to report fly-tipping, but not to touch it. I want to put out this caution: in many cases, there might be contaminated waste, such as syringes—that is the society we live in—broken glass, asbestos, or toxic chemicals and other hazardous substances that can severely harm individuals, and especially young children, or animals. In addition, it is important not to disturb a site in case there is evidence that could identify the fly-tippers and lead to their prosecution.

To conclude, it is an unfortunate reality that there are numerous incidents of fly-tipping and illegal dumping across the UK on a daily basis. Our local councils are working hard to prevent them, so I ask the Minister to do the very thing the hon. Member for Ealing Southall has referred to: introduce a national strategy covering all the United Kingdom of Great Britain and Northern Ireland—because we always do things better if we do them together—and, with that in place, ensure that all councils are given the powers to enforce tougher fines and even prosecute fly-tippers. We can do better, and we will hear shortly from the Minister on how she will do just that.

[Clive Efford (in the Chair)]

Order. I will bring in the Front Benchers at 5.8 pm. In order to do that, I have to bring the time limit down to three minutes.