Fracture Liaison Services

Lord Kamall Excerpts

Wednesday 4th December 2024 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank my noble friend Lord Black for securing this debate. As noble Lords have acknowledged, he has championed this issue in this House and outside. In fact, I recall that during one of my earliest Oral Questions as a Minister, my noble friend explained to me the vital role that fracture liaison services play in identifying and treating osteoporosis; that osteoporosis is considered a silent disease, causing over half a million broken bones each year—one every minute; and that there are as many deaths from fractures as from lung cancer and diabetes.

As my noble friend Lord Black and indeed the noble Baroness, Lady Bull, said, fractures caused by osteoporosis affect half of all women and a fifth of men over 50. As the right reverend Prelate mentioned, those from lower-income households have a 25% higher risk of fractures, a higher mortality rate and slower recovery times from hip fractures. As the noble Baroness, Lady Donaghy, said, it can be unexpected. Each year, 1 million acute hospital bed days are occupied by hip fracture patients, and around £2 billion is spent on hip fracture care. I pay tribute at this point to my noble friend Lord Shinkwin, the noble Baroness, Lady Ritchie, and others for sharing their experience. That really brought it home and made it about more than figures.

As we move to a system of preventive healthcare, FLS have a huge role to play since they systematically identify people aged 50 or over who have had a fragility fracture in order to reduce the risk of further fractures. The Royal Osteoporosis Society, to which many noble Lords have paid tribute tonight, estimates that fracture liaison services reduce the risk of a patient refracturing the same bone by up to 40%.

Unfortunately, despite the attempts of previous Governments, only 51% of trusts in England currently provide fracture liaison services, covering only 57% of the population, as alluded to by the noble Baroness, Lady Quin. Earlier this year my right honourable friend Victoria Atkins, then the Secretary of State for Health and Social Care, pledged to expand fracture liaison services to every integrated care board in England and achieve 100% coverage by 2030, a target repeated in the Conservative Party manifesto. But as the noble Lord, Lord Rennard, and others have said, there is consensus—there is no political disagreement on this issue. Indeed, the Minister used to press me from this Dispatch Box when I was in her position.

In June this year, the then shadow and now current Secretary of State for Health and Social Care said that delivering a rollout plan for fracture liaison services would be an area for “immediate action” if Labour won the election. Noble Lords understand that these are still early days for the Government, but I am sure that my noble friend Lord Black and other noble Lords who have spoken in this debate wish to understand what the Secretary of State for Health and Social Care meant by “immediate action”. I have to concede that that sounds a lot better than “in due course”—a phrase I tried to avoid when I was a Minister, but not always successfully.

Unfortunately, no plan for the rollout of these life-changing diagnostic and preventive services has yet been released by the Government. Are they working on a rollout plan for fracture liaison services and, as the noble Baroness, Lady Donaghy, said, when do they intend to publish it—preferably avoiding the answer “in due course”? Can I tempt the Minister into sharing some clues or details on what might be in the plan? I know that many noble Lords of all parties and none support expanding this vital, preventive and effective service to as many people who need it as possible. Fracture liaison services are a world-beating preventive approach that we can all be proud of. If expanded, it would be good for those suffering from osteoporosis, good for the NHS and good for the Treasury.