Baroness Donaghy (Lab)

My Lords, I thank the noble Lord, Lord Black of Brentwood, for his contribution, which was so stunning that it put the lights out. I will cut my speech short to allow others to get in, in the time available. As people who know about the subject know, the fracture liaison service was pioneered in Glasgow in 1999. Other countries have picked up this model very successfully to the extent that we, in England at least, are in danger of falling well behind. More than a decade ago in New Zealand, for example, the Government set out to make fracture liaison services available to everyone, backed by targeted central investment. Today, 99% of New Zealanders have access to a fracture liaison service. It is a striking example of how clarity from central government, supported by a plan, can deliver universal coverage in a short time. Japan offers another lesson. Faced with the oldest population in the world and a growing number of hip fractures, the Japanese Government introduced a simple FLS incentive scheme in 2022. In just three years, the number of services has more than doubled, and every region now has at least one FLS. It is a reminder that, when Governments set clear expectations, progress follows. In the meantime, progress in England has stalled. Just over half of NHS trusts have an FLS, meaning that thousands of people are treated for a fracture each year but never investigated for underlying causes. The Government’s commitment is welcome and, more importantly, achievable, but commitments alone will not deliver the service. As the noble Lord, Lord Black, said, a delivery plan is now urgently needed to show how that goal will be achieved. That should be this year, preferably by Christmas; otherwise, we will be halfway through this Parliament.