Health: Osteoporosis and Fractures

Baroness Bloomfield of Hinton Waldrist Excerpts

Thursday 14th September 2023 Grand Committee

[Baroness Bloomfield of Hinton Waldrist (Con)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Hayter, and I applaud my noble friend Lord Black for securing this important debate and for his work in the APPG. Like many noble Lords, I suspect—indeed like my own mother, who suffered from this pernicious disease for decades, causing her much pain, misery and distress—I speak as someone who has this inherited condition as well.

The example of my mother was actually a benefit, in that I was diagnosed very early. Spending 10 years on HRT did little, and alendronic acid has done much, although I am out of time on that, so, for now, I am successfully keeping my density levels stable with load-bearing exercise and vitamin D. However, not everyone is so lucky: osteoporosis is asymptomatic—I never suffered from any breaks—so, until fragility fractures occur, it is often not diagnosed. So I am fully supportive of any mechanism by which fellow sufferers can be identified as early as possible.

Today, we heard of the need for, and the clear benefits of, fracture liaison services. I welcome Minister Maria Caulfield’s recent commitment, in the Sunday Express, to explore setting up more fracture liaison services and to say more before the end of this year.

According to the ROS, the amount of money needed to fill the gaps in population coverage and the quality of FLS in England is very modest: just £27 million per annum. This is out of a total annual spend in the NHS of £180 billion. We can give everyone over 50 access to an FLS, and it will improve the quality of all these bodies so that they can deliver well against the quality standards monitored by the Royal College of Physicians.

We all recognise the difficult economic environment, but there is a clear need for a national catalyst to get things moving. The Royal Osteoporosis Society suggested a capped two-year transformation budget of £54 million to pump-prime FLSs to become universal across England. This will light the spark so that we can have change. Then, after those first two years, the services can be absorbed into ICSs as “business as usual” within conventional funding channels, overseen by ICBs, when the benefits materialise. This offers a pragmatic way for the Government and NHS England to catalyse the change in an affordable way. It reflects perfectly the principles in the long-term plan, replacing cash badly spent on fixing avoidable injuries with sensible investment in prevention.

The ROS also suggested several other approaches, and there are many ways to create change in this area, with a quicker pay-off than officials might expect. The Better Bones campaign has shown that the national support for FLS is only growing. Rather than going round in circles, can we now take action to make it happen? Will the Minister please meet with the ROS to discuss these proposals?