Health: Osteoporosis and Fractures

Lord Alderdice Excerpts

Thursday 14th September 2023 Grand Committee

[Lord Alderdice (LD)]

My Lords, I also thank the noble Lord, Lord Black of Brentwood, for obtaining this debate and for his work on the APPG on Osteoporosis and Bone Health.

Osteoporosis has a huge impact, especially on women and not least as they get older. As we have heard from the noble Lord, Lord Black, fractures caused by osteoporosis affect 50% of women aged over 50 and a fifth of men. It is one of the most consequential health conditions if measured in disability and premature death. It is, in many ways, a hidden condition, since even those suffering from it may not be aware that it is the cause of some of their problems. When anyone sustains a broken bone and the trauma that caused it does not seem severe enough to have warranted a fracture, underlying osteoporosis should be considered as a vulnerability factor and addressed before more fractures and disability arise.

A friend of mine in her 60s took a relatively minor tumble during a 10-pin bowling game, yet sustained a fracture. As a doctor, she was alert to the possibility of osteoporosis and appropriate investigations showed that she was indeed suffering from the condition. This is not an unusual story and I have no doubt that many other noble Lords in this debate will rightly flag up the high incidence, especially among older women.

However, a theme that I suspect may receive a little less attention is how spinal fractures from osteoporosis affect people of working age, contrary to the misconception that it is just about hip fractures in older people. The first time I came across the situation of a spinal fracture was when I was working in Belfast in the 1970s, in what was then Northern Ireland’s only psychosexual clinic. One day, one of my patients, who in those days we described as transsexual—we would now call them transgender—arrived in a wheelchair. A previous clinician had prescribed steroids as part of their gender transition process, and the consequence was a crumbling of some of their spinal bones from the resulting steroid-induced osteoporosis. My patient was now coming to see me in a wheelchair with spinal fractures.

More recent decades have seen a massive increase—we are not really sure why—in the number of people suffering from a whole range of autoimmune diseases. These often require treatment with steroids. Both patients and their healthcare professionals need to be constantly aware not just of the symptoms of the disorders, but of the potential sequelae of their medical treatment. One of those is steroid-induced osteoporosis, resulting in fractures that lead to disability and problems in employment.

The Treasury is currently looking for ways to keep older workers in the workforce, and recently committed £400 million for the same. Apart from looking to the health budget to address osteoporosis, will the Minister explore whether some of this £400 million could be devoted to investment in diagnostics and treatment for osteoporosis, so having a significant impact on keeping people at work by raising the alert level on osteoporosis?