King’s Speech

Lord Lexden Excerpts

Thursday 9th November 2023 Lords Chamber

[Lord Lexden (Con)]

My Lords, I follow a most moving speech. Despite being the son of a superb medical practitioner and the grandson of another, I rarely speak at any length about health issues. I think this restraint owes something to my failure to master the subjects that would have enabled me to follow the family tradition and serve the community in my turn as a doctor. However, as a close observer of the many grave issues confronting our health service today, I have recently been impressed by the determined efforts of the Royal Osteoporosis Society to direct public attention to the very patchy provision of fracture liaison services in our country. It is an urgent and pressing matter that calls for action by the Government in this new Session, as the noble Baroness, Lady Donaghy, made clear in her important speech. I agree with all that she said and I support from these Benches the case that she made.

The Royal Osteoporosis Society deserves much credit for the way it has heightened awareness of the situation through its Better Bones campaign, conducted over many weeks in partnership with the Sunday Express. Thanks to this campaign, we know that fracture liaison services, the world standard for diagnosing osteoporosis at an early stage, are not provided by more than half of NHS trusts. In areas where they are not available, those with fractures generally receive treatment in A&E departments, but they are often not told that osteoporosis was the cause. That means that they do not receive the treatment they need and disappear from the system, inevitably to suffer another fracture in due course.

The royal society’s estimate of the cost of filling the gaps where fracture liaison services are not currently provided would be a not-unthinkable £27 million a year. The potential savings are large, not just in reduced healthcare costs but in ensuring that people can continue to work until later in their lives. It is a common misconception that action to tackle osteoporosis mainly involves preventing hip fractures in people over the age of 70, like me. Osteoporosis and fractures can have a huge effect on younger people’s professional lives. One in every 12 women over 55 experiences a spinal fracture, rising to one in 10 for those over 60.

We should be deeply troubled by the extent to which osteoporosis goes undiagnosed. It is estimated that some 2.6 million women and men endure the effects of undiagnosed spinal fractures. They inevitably find themselves reducing their hours of work or being pushed into early retirement due to vague back pain that is often the result of undetected fractures. This is borne out in the statistics. Every year in England, there are around 67,000 fractures in the working-age population. As a result, some 2.6 million working days are lost every year, according to the International Osteoporosis Foundation. Drug therapies can reduce the rates of refracture by up to 90% for the most common fractures.

Both business leaders and trade unions are firmly behind this year’s hugely informative Better Bones campaign in its call for universal fracture liaison services. How can that be achieved? The Government are being urged by the experts in this field to establish a transformation fund to fill the stubborn gaps in existing provision. Such a fund would enable us to keep up with the rest of the world in diagnosing osteoporosis early, before the disease has the chance to inflict grave damage on individuals and society. This is a proposal to which the Government should give the most serious consideration in this new Session, as the noble Baroness, Lady Donaghy, and I, and no doubt other noble Lords across the House, will agree.

As other noble Lords have noted, there is a most welcome reference in the gracious Speech to the need to

“strengthen education for the long term”.

Those words will attract wide cross-party support in both Houses, along with a strong desire to know more about the Government’s thinking and intentions. A succession of authoritative reports from highly respected bodies have in the last few years made major proposals for the reform of the existing education system, and a large degree of consensus has emerged about what should be done. It will be reinforced shortly by a report from a Select Committee of your Lordships’ House on Education for 11-16 Year Olds. I am a member of this committee but an infinitely less distinguished one than the noble Lord, Lord Aberdare, and indeed the noble Baroness, Lady Blower. Reform should proceed, as far as possible, on a cross-party basis to ensure that it provides the stability and confidence that schools, teachers and families need for the long term.

There is, sadly, one highly contentious matter on the education agenda: the Labour Party’s proposal to slap VAT on independent school fees. In the 1990s, the party buried this idea, which it had kept putting in its election manifestos; now it has dug it up again. It is a total myth that the independent sector of education is stacked with wealthy, well-endowed schools, educating the children of wealthy parents who can easily afford a sudden 20% fee increase. I declare my interest as president of the Independent Schools Association. Its 650 member schools are virtually unknown outside their own local communities, which they serve faithfully alongside colleagues in the state sector. The hard-working families without financial reserves who send children to these mainly small, unpretentious, but highly successful schools do not deserve to be hit by a brutal tax increase. Some will be forced to move their children to schools in the state sector. Why should they be uprooted in this way?