Since the 1990s, fracture liaison services, provided by specialist teams within NHS Trusts, have been assisting people at risk of sustaining severe fractures caused by osteoporosis, and ensuring they receive the appropriate treatment. These services are, however, only available in certain areas. The Government is committed to making them universal by 2030 - just five years away - but significant progress is not being made. Alistair Lexden has spoken on this issue on a number of occasions in the Lords. He returned to it on 16 October in a debate initiated by his fellow Conservative, Lord Black of Brentwood.
My noble friend Lord Black is a persistent person. The subject we are discussing today is one that he has brought before Your Lordships with some frequency through debates and oral questions.
Those who suffer the pain and distress that osteoporosis brings have no more determined parliamentary champion than my noble friend
Evidence continues to accumulate in support of the action for which he has long called and which he has reiterated so powerfully today: the urgent need to establish fracture liaison services throughout the country.
For some years the Royal College of Physicians has charted a steady rise in the number of hip fractures. Its latest annual report, published last month, records yet another increase.
It also showed once again how unevenly the services that could reverse the trend are spread across our country. Indeed, there could be no clearer example of that much reviled phenomenon: the post code lottery.
Curiously, there seems to be no figure for the total number of hip fractures in the UK. Scotland appears disinclined to share information. In the other three parts of the country the total now stands at some 70,000.
Without the action for which my noble friend Lord Black is calling the number will go on mounting remorselessly. Experts believe that it will double by 2060, bringing the total to 140,000.
And the bill will be crippling. Today each hip fracture costs the health and care services around £28,000.
Total expenditure, which now stands at some £2 billion, is likely to reach £3.8 billion by 2060 - virtually doubling the huge burden borne by our overstretched NHS.
The burden can, and must, be reduced. The key to this is to ensure that those who incur smaller, less severe fractures - preserving their hips intact - are correctly diagnosed as suffering from osteoporosis and are treated accordingly.
That would cut the number of hip fractures dramatically. But it won’t happen without the major change for which my NF Lord Black and others have long been pressing.
At the moment, around half of those who break a hip have experienced an earlier, less severe fracture without being correctly diagnosed and treated.
That means tens of thousands of people are being discharged from hospital at severe risk of a hip fracture - and, in due course, some of them suffer one. More than one in four of those who have a hip fracture will die within a year.
No one, I think, disputes that the most effective way this state of affairs can be remedied is through the provision of fracture liaison services which identify and treat people after their first fracture, helping to prevent a second.
Yet, as we have heard, only around half of NHS Trusts provide such a service.
Like everyone - I think - in this debate, I hope the Government, which understands the need for urgent action, will before Christmas publish its plan to extend fracture liaison services throughout the country.
