Baroness Hayter of Kentish Town (Lab)

My Lords, it is a great pleasure to follow the noble Lord, Lord Lexden, and to speak again in a debate initiated by the noble Lord, Lord Black. When the Government confirmed last year that they would deliver FLS across England by 2030, it was a real mark of genuine progress and warmly welcomed by all of us—not least, of course, by the noble Lord, Lord Black, himself, who has been asking for this for so long. But despite this, I share the concern of many about the slow rate of progress. The Government have said that fracture liaison services “are commissioned by integrated care boards, which are well-placed to make decisions according to local need”. Now that should be the case, but it unfortunately always tends to be the neglected health conditions, such as osteoporosis, that are overlooked without national co-ordination and insistence—and, surprise, surprise, it is usually women’s issues that are overlooked most. I was delighted to hear this week a lot on the radio about prostate cancer. However, where is the similar attention to those living with osteoporosis, two-thirds of whom will miss out on treatment? That silence is inexcusable. Luckily, we are in general living longer, but hospitals will not be able to cope with the spiralling numbers of hip and spinal fractures if we do not have that FLS to prevent these breaks. Over just the past two weeks, two of my friends have fallen and broken their hips. I do not know whether they had a particular predisposition but the pain that they are suffering, and the cost to the health service of patching them up, would probably pay for half of a local FLS in their area. The Health Secretary recognised all of this when he committed to a national rollout of FLS by 2030. Indeed, before the election, Labour’s election platform singled out a small number of health conditions for targeted action and osteoporosis was one of them. We all cheered. I know and understand that a national plan tends to jar with the move towards greater localisation but, given that commitment to implement FLSs by 2030 —only five years off now—surely we can make an exception for that national initiative here. Rather like the pledge to end new HIV transmissions by 2030, which the 10-year plan says will be set out in a delivery plan, we need this for FLS. Let us have the same in this area. Achieving these two targets on HIV and FLS would be a major boost in preventing ill health. We can help provide a better service for older people, particularly the half of women who are vulnerable. If they could all get a bone plan under their Christmas tree, I think we would all be very happy.