Bone and Joint Health
Tuesday, 13 October 2026
Contributions
Motion made, and Question proposed, That this House do now adjourn. —( Claire Hughes .)
David Reed (Exmouth and Exeter East) (Con)Conservative
It is a real pleasure to lead this evening’s debate during Bone and Joint Week, raising awareness of an issue that affects millions of people, but receives nowhere near the attention it deserves. I start by thanking Arthritis UK and the Arthritis and Musculoskeletal Alliance, known as ARMA, for their work raising awareness of these conditions, for the information they have provided ahead of this debate and for the parliamentary event they put on today. Musculoskeletal conditions or MSK conditions affect our bones and joints and the muscles and tissues that hold them together. They include arthritis, osteoporosis, chronic back pain and joint injuries. For some, these conditions are manageable. For others, they are utterly debilitating, leaving people struggling to walk, to work or to carry out basic everyday tasks. More than 20 million people in the UK live with an MSK condition. Some 10 million have arthritis, including an estimated 15,000 people in my constituency. Such conditions are the single biggest cause of pain and disability in this country, accounting for around one in seven GP consultations, yet I fear that we underestimate their seriousness, perhaps because they are rarely immediately life-threatening. While they may not kill people, however, they can slowly rob them of their mobility, independence, ability to work and quality of life. I want to explain why this issue matters to me personally. Six years ago this month, my life changed significantly, although I did not know it at the time. It is something that I have avoided talking about publicly, and if I am honest, I have struggled to accept it. However, I believe we should draw on personal experience in this place, particularly when it might help improve our country. In October 2020, I was an extremely fit and physically robust former regular Royal Marine with multiple operational tours behind me. I was also competing at the highest level of wingsuit skydiving as a member of the Team GB squad. I can see Members thinking that those activities and MSK injuries are natural bedfellows, and they are probably right, but nothing prepared me for the debilitating consequences of what happened that October. On a grey and windy day in Devon, I decided to go parachuting, which was a near weekly occurrence. As a reservist member of the Royal Navy parachute display team, I needed to keep current for the following season. I had completed around 700 jumps, and I was not frightened—this was like any other day—but I had something far more dangerous: complacency. The winds were strong and the parachute centre had restricted jumping to experienced parachutists only. I was practising precision landings and convinced myself that it would be good training. I also chose to wear trainers, rather than my usual military boots that provided ankle support. The plane took off and we climbed to 15,000 feet. The green light came on and I jumped. Everything went to plan until the landing. Rather than landing in the middle of a muddy field away from obstacles, I decided to land closer to where I would be picked up. It was a lazy decision, and it was a stupid one. As I approached the ground, gusting winds caught my parachute, lifted me and slammed me into the side of an aircraft hangar. My left foot took the initial impact, before the rest of my body smashed into the building. My parachute went over the roof, leaving me dangling from the hangar. Fortunately, I remained conscious, managed to release my harness and fell the remaining 5 feet or so to the ground. I remember lying there in shock, checking everything was still attached. Then came the searing pain in my left ankle. My wife came and picked me up and drove me straight to accident and emergency. After examinations and scans, I was told that I had suffered a severe sprain. I was advised to get the ankle moving and seek physiotherapy, because timely NHS support was unlikely to be available. Having had little experience of the NHS, I trusted that advice. Over the following months I worked hard at rehabilitation. Gradually, I regained strength, but I remained in considerable pain. I took the classic Royal Marine approach: crack on and hope it gets better. Having served alongside men who lost limbs in Afghanistan, I considered myself lucky, and I certainly was not going to complain about a sore ankle, but six months later, something was clearly wrong. My physiotherapist recommended an MRI scan, which I paid for privately—again, I was advised that the NHS process would take too long—and, when the results came back, I had to catch my breath: my ankle had been broken the entire time. The fracture had been missed at A&E and I had spent six months rehabilitating an injury that had never been properly diagnosed. I was advised to see a private consultant—again, because of the time it would take to access specialist help through the NHS. This is where I was incredibly fortunate. By complete chance, the consultant whom I went to see happened to be ex-forces himself. Having discussed my injury and background, he suggested that I see him through his NHS practice, where he could continue to oversee my treatment, and I am enormously grateful to him for doing so. After months of uncertainty, pain and frustration, I finally felt that someone understood the problem and could help me to work out what came next. I want to make an important point here: my experience has left me deeply frustrated with parts of the NHS and particularly with the difficulties in accessing timely diagnosis and treatment, but it has also shown me that there are some outstanding people working within it who go above and beyond for their patients.
Jim Shannon (Strangford) (DUP)Democratic Unionist Party
I commend the hon. Gentleman for raising this issue. I spoke to him this morning to ensure that it would be okay for me to intervene in the debate. Arthritis UK has said that there is an “escalating musculoskeletal health crisis”. In Northern Ireland, some 550, 000 people—nearly a third of the population—are now living with arthritis or a similar condition. Those living in chronic pain face long, painful waits—the very thing the hon. Gentleman referred to—with some reporting having to wait for up to eight years for a rheumatology appointment. Many are unable to work or live independently as a result, and almost 80% report that their mental health has deteriorated significantly, so it is not just a physical problem. Does the hon. Gentleman agree that while more must be done to reduce waiting lists, we must also ensure that, in the interim, patients living with chronic pain have timely access to appropriate mental health support?
I will come on to the points that the hon. Gentleman has made, but he is completely right. We must look at these problems in the round, because this is an issue of not just physical but mental health. People who were once fit lose that fitness, both physically and mentally, and then they become a bigger burden on the state. Let me return to the subject of the surgeon who helped me out. I have been fortunate to benefit from that care, but I recognise that I was lucky. At the time, I had the means to access private treatment, and through that process happened to find a consultant who could help me back into the NHS system. That should not be a matter of luck, and it certainly should not depend on someone’s ability to pay. Six years on, despite the excellent care that I now receive, I am left with osteoarthritis that can, at times, be severely debilitating. I can no longer run. I avoid activities that cause my arthritis to flare up, and I face the prospect of eventually having the bones in my ankle surgically fused. For the first few years I held on to the hope that I would recover and return to the active life that I once had, but I have now accepted that it is likely that I will not. That is difficult when physical fitness and independence have been such an important part of one’s life. At times, it has been an incredibly lonely journey. My current NHS consultant gives me hope that advances in medical technology may offer better options, but because I limp, other bones and joints are now beginning to suffer. I know that I am likely to place increasing demands on the NHS in the decades ahead. My experience has shown me a health service that can be brilliant at dealing with life-threatening emergencies, but pretty poor when it comes to conditions considered less serious, even when they fundamentally change someone’s life. I was fortunate enough to be able to afford private care, but millions of people cannot. They are left waiting, living with pain and sometimes watching manageable conditions develop into lifelong disabilities. That brings me to the wider purpose of this debate. People living with musculoskeletal conditions are about one and a half times more likely to experience mental health problems, and I understand why. When pain becomes part of everyday life and you can no longer do the things that you enjoy, it takes a toll. However, there is another dimension that we must urgently address in the House: the economic cost of doing nothing. In 2024 alone, 26.5 million working days were lost to musculoskeletal conditions. Arthritis UK estimates that working days lost to osteoarthritis and rheumatoid arthritis cost £2.58 billion in 2017, with the figure projected to reach £3.43 billion by 2030. About 646,000 working-age people claiming sickness or disability benefits cite a musculoskeletal condition as their primary reason. I am not suggesting that they can all return to work, or that every disability is preventable, but I do believe that too many people deteriorate when early intervention might have kept them healthy, independent and economically active. Let us consider someone working in construction, hospitality or healthcare. They develop a back problem or knee injury but cannot access timely treatment, so they carry on through the pain. Eventually, they cannot carry on. They fall out of work, their health deteriorates and they become increasingly dependent on public services. The taxpayer potentially picks up the bill several times over through NHS treatment, welfare payments and lost tax revenue, and the individual pays an even greater price. We focus too much on the immediate cost of treatment, without considering the potentially much greater cost of failing to treat someone early. Surely that is economically illiterate. If timely physiotherapy, imaging or specialist intervention can prevent lifelong disability or someone losing their job, we should see it as an investment, not simply another NHS cost. However, it is not all doom and gloom, and there is reason for optimism. In my constituency, the Royal Devon University healthcare NHS foundation trust held its first MSK community appointment day in Exmouth. More than 100 people attended, accessing clinical assessments, rehabilitation advice and community support together. Patients particularly valued being listened to, and early results suggested fewer unnecessary follow-ups. One pilot does not provide all the answers, but it does show what can happen when services are organised differently and patients receive joined-up support. That brings me to my questions for the Minister. First, where is the national leadership on MSK health? The previous Government recognised MSK as one of six major conditions in their major conditions strategy, yet we have not received a firm commitment that the current Government will develop a dedicated modern service framework. Will the Minister commit to establishing such a framework, with clear accountability and measurable outcomes? Will the Minister also commit to a national approach, with clear responsibility and measurable outcomes, and meet the Arthritis and Musculoskeletal Alliance to discuss it? I thank the shadow Health Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), for tabling an amendment to the recent Health Bill that calls for just such a framework. Secondly, what more can be done to improve early diagnosis and timely access to rehabilitation to prevent avoidable deterioration while patients wait? Thirdly, will the Government work across the Department of Health and Social Care, the Department for Work and Pensions, and the Treasury to properly assess the economic case for early intervention? Lastly, as a veteran, I want to raise veteran issues. MSK injuries are a major reason for medical discharge from the armed forces, and their consequences can follow people long after they leave service. Will the Minister work with Defence colleagues to improve access to rehabilitation for veterans, and examine whether the armed forces covenant properly addresses their long-term MSK needs? It cannot make sense for any one part of Government to save money by delaying treatment, only for another part to spend considerably more in dealing with the consequences. I will finish where I began. Six years ago, I was able to soldier. I could run for miles, jump out of aircraft and represent my country in sports. Today, I have to think about every physical activity and the associated cost in pain. I do not share that to seek sympathy; I share it because I understand how profoundly an MSK condition can alter someone’s life. Millions of people across this country are living with far worse circumstances than mine.
The Parliamentary Under-Secretary of State for Health and Social Care (Mr James Frith)Labour
I start by congratulating the hon. Member for Exmouth and Exeter East (David Reed) not just on bringing this debate on bone and joint health to the Floor of the House during Bone and Joint Week, but on sharing his personal insights and testimony. I thank him for his service and give him an assurance that I am very happy to talk about veterans, about the specifics and about his insights into how we can deliver on the armed forces covenant. I signed Bury’s first armed forces covenant when I was an armed forces champion, and although it was not the service level that he was accustomed to, I take very seriously our need as a country to pay our respects to the men and women who have put themselves in harm’s way or given the ultimate sacrifice in service to their country, so I thank the hon. Gentleman.
I was trying to intervene before the hon. Member for Exmouth and Exeter East (David Reed) sat down. While one door closed when he had his injury, another door opened. The door that opened was to be an MP coming here to represent his constituents, so he has an opportunity to speak up for all those who have such injuries, and that is a voice he has now.
As ever, the hon. Member sees the upside—the glass half full—of all life’s experiences. I thank and pay tribute to the charities, clinicians, researchers, carers and campaigners who support patients and refuse to let these conditions be overlooked. Bone and joint conditions are too often overlooked or dismissed as an inevitable part of ageing or frailty, but they are not; nor should we accept them as such. Arthritis, osteoporosis, fragility fractures and other musculoskeletal conditions can mean relentless pain, lost mobility, lost confidence, lost work and lost independence. In 2024, almost one in five adults in England reported a long-term MSK condition. This is not a niche issue; it is a national challenge. Our task is clear: diagnose earlier, treat faster, prevent more illness, and help people remain active and independent. The Government’s 10-year health plan is built around three decisive shifts: hospital to community, analogue to digital and sickness to prevention. For people with MSK conditions, that means simpler access and the ability to refer themselves through the NHS app to services, including physiotherapy, pain management and orthopaedics. The hon. Member for Exmouth and Exeter East sought advice on how we educate sooner and inform sooner, but the work we are doing with the single patient record, the new iteration of the NHS app and the development of NHS online—or the digital doctor, as I am calling it internally—is about providing that useful information in a timely manner. It should be as accessible as we have become accustomed to for information we consume online, whether through retail or consumer habits. That is the level of expectation we should have for services such as this, which can give future patients the certainty and knowledge they need, when otherwise they may endure pain while waiting to access services at a later point. That is an important distinction. On osteoporosis, we are acting before the fracture, not merely after it. This March, the Government invested £2.6 million in 20 new DEXA scanners across England, following £1.9 million for 13 scanners last year. Earlier scans mean earlier treatment and fewer painful life-changing fractures, especially for older people and women. Patients must also benefit from effective medicines. Since 2022, the National Institute for Health and Care Excellence has recommended Eladynos and Evenity for osteoporosis in post-menopausal women—an important distinction within the debate—both of which strengthen bones and reduce fracture risk. The UK National Screening Committee is reviewing the case for screening women for osteoporosis. Its consultation closed last week, and we will consider its independent recommendation carefully when it reports. We must be frank: community waiting lists for MSK remain the longest of any community service. Every delay can mean more pain, less mobility and a greater risk that somebody leaves work or loses independence. I agree with the hon. Gentleman’s point about having a cross-departmental approach to ensure that support is timely to prevent people going off work and losing their income, identity, self-esteem and worth, and everything that we understand comes with a forced departure from work. That is why the Getting It Right First Time MSK community delivery programme is backed by about £6 million in 2026-27. It is redesigning services, improving referrals and connecting patients to wider support. The first cohort saw waits of over 18 weeks fall by about 20% in participating systems. That is real progress and we must spread it. We are also expanding MSK physical activity hubs. They use the skills of the leisure and fitness workforce to improve mobility, reduce pain and fatigue, and help people stay in or return to work. The principle is simple: care should come to people, not force people to navigate the maze. Throughout neighbourhood health, community MSK services, physiotherapy and occupational therapy will support recovery, protect mobility and manage long-term conditions closer to home. We have set a clear national ambition that by 2028-29, at least 80% of community health services activity should take place within 18 weeks. National guidance will define a consistent core offer and bear down on unacceptable variation or postcode lottery. General practice is often the front door. We are increasing capacity so that patients are seen sooner and urgent cases are directed to the right care on the same day. Elective recovery matters. We remain committed to meeting the constitutional standard by March 2029: 92% of patients treated within 18 weeks. For bone and joint conditions, that means stronger links between primary, community and hospital care, and faster access to specialist advice. Women’s health must be central to this argument as well, not peripheral. Menopause-related hormonal changes raise the risk of osteoporosis and frailty. The renewed women’s health strategy therefore focuses on earlier recognition, easier access, better treatment and practical support at work. Bone and joint health is an inequalities issue as well. Chronic MSK conditions are a major cause of poor health and work limitation, often occurring alongside mental ill health—as the hon. Member for Exmouth and Exeter East described—and obesity, which is often concentrated in poorer communities. A postcode must not determine whether pain is relieved, mobility restored or independence protected. Reducing delays and unwarranted variation is not an optional extra; it is a matter of principle and fairness. In conclusion, let us reject the idea that these conditions are simply to be endured. Pain is not inevitable. Disability is not inevitable. A life-changing fracture is not always inevitable. Earlier identification, effective treatment, rehabilitation and prevention all change lives and save the NHS the greater cost of acting too late. I again thank the hon. Member for his service and for securing this debate, and all those working through Bone and Joint Week. The Government will work with the NHS, local government, clinicians, charities and patients to turn ambition into action: fewer fractures, shorter waits, better mobility and more people living independently for longer. Question put and agreed to.
House adjourned.
Source: UK Parliament Hansard API. Debate ID: 5415317.