Health: Osteoporosis and Fractures

Baroness Hayter of Kentish Town Excerpts

Thursday 14th September 2023 Grand Committee

[Baroness Hayter of Kentish Town (Lab)]

I, too, thank the noble Lord, Lord Black, for introducing this debate. As has been clear, the Government have simply passed the buck on this. The Written Answer from the noble Lord, Lord Markham, told me that:

“NHS England does not have a specific budget … The Department continues to work with NHS England on the consideration and implementation of musculoskeletal policy, including Fracture Liaison Services”.


That means no national action, and it is not good enough.

It is not enough just to highlight NICE guidelines and the Getting It Right First Time programme which has led to huge gaps in coverage. As we have heard, only half of English trusts have fracture liaison services and chronic underinvestment means that, even where services exist, performance is below par. High-quality services can identify 95% of at-risk patients, compared to a quarter using other non-specialist services. The Government need to take concrete, immediate action. All involved, including professionals, know we need these specialist services, with bodies representing over 650,000 doctors and nurses supporting the Better Bones campaign.

But, as we heard, locally, commissioners have poor awareness of osteoporosis and the benefits of fracture prevention. As we heard, they often wrongly think that investment in these services takes time to pay off; in fact, they break even within two years. However, the catch is that the savings occur in a different part of the health service from where the money is spent. So, without a government mandate, money simply will not be ring-fenced and allocated.

In Wales, the Health Minister, our former colleague my noble friend Lady Morgan of Ely, mandated all seven Welsh health boards to ensure 100% coverage of fracture liaison services by this time next year, and she set up a government-led taskforce to help meet that deadline. That shows how strong leadership can improve and save the lives of tens of thousands of people, particularly older women—I had better declare an interest.

The Royal Osteoporosis Society does an amazing job, as do thousands of clinicians and carers, but this urgent issue needs government resolve and leadership. Yes, it needs resources, but it also needs investment to save not just money but pain, discomfort and the diminished quality of life that fractures cause. As the noble Lord, Lord Black, said, these are no minor inconveniences. We live longer, which is great, but we need to live longer healthier, and this issue can make a difference. A clear mandate from Westminster is needed for English ICSs to prioritise fracture liaison services.