Osteoporosis (Hansard, 16 January 1992)

The Viscount of Falkland
asked Her Majesty's Government:
Why osteoporosis was omitted from the targeted conditions in The Health of the Nation.

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the Green Paper—the consultative document, The Health of the Nation—is a first step in the Government's approach to targeting health needs. We recognise that osteoporosis is an important condition, but it was not considered as much a priority as the 16 target areas selected for the consultation process.

The Viscount of Falkland
My Lords, I thank the noble Baroness for that Answer. My Question was prompted by the list of specific items in the consultative document. Although they are all very worthy and deserve attention, does not this disease (which for the guidance of noble Lords I shall refer to in layman's terms as crumbling bones) take up an inordinate amount of ward space each year? Is it not reckoned in some medical circles to take as much as £1 billion a year in National Health Service costs? Does the noble Baroness agree that it would be encouraging if she could say whether it could be included in future references to the consultative document?

§ Baroness Hooper
My Lords, I should point out to the noble Viscount that it was made clear in the consultative document that the areas chosen for consultation would be narrowed down to some five or six areas in the final White Paper, because, to be effective, targeting must be very precise and fulfil the criteria that we have laid down. There are other aspects of the White Paper, including advice on a healthy lifestyle and physical exercise, which are important as regards osteoporosis; but I can assure the noble Viscount that we shall review the key areas over a period of time.

§ Baroness Macleod of Borve
My Lords, can my noble friend the Minister tell us whether any research is being done into a disease of which some of us are not perhaps as fully aware as the Minister?

§ Baroness Hooper
My Lords, my noble friend makes an important point. Research is the most effective way forward in that area. The department is currently funding a cost-benefit analysis of hormone replacement therapy, which is due to be reported on in April. We have also commissioned a critical review of screening techniques for detecting osteoporosis, which will also be reported on shortly. The Medical Research 346 Council has a major programme of relevant research and has set up a specialist group to look at the further research required in that area. We are also participating in a European Community programme on prevalence.

§ Lord Carter
My Lords, does the noble Baroness have an estimate of the cost to the nation of the condition? A figure of £1 billion has been mentioned. Does she agree that it is not only a burden in terms of the number of sufferers who take up orthopaedic beds, but that it is a longer term problem for carers if sufferers are not able to continue to live independently?

§ Baroness Hooper
My Lords, as I said, we recognise the importance and widespread nature of the condition. One of the problems is that there are no sound epidemiological statistics, and I cannot therefore give the noble Lord an exact figure. However, I can refer to the fact that in 1987–88 there were 45,000 hospital admissions for hip fractures, which can be taken as some kind of estimate in that area. Of those, 35,000 were women and 27,000 were women of over 75 years of age. The cost of hospital stays for fractured hips is estimated at about £126 million a year.

§ The Countess of Mar
My Lords, does the noble Baroness agree that, with the ageing population, it is necessary that the disease should be prevented as women in particular tend to live much longer now than they did 10 or 20 years ago? As osteoporosis has become more obvious in the fractures that women suffer, may I urge the Minister to make this a priority?

§ Baroness Hooper
My Lords, I can certainly reassure the noble Countess that we give the condition due importance. In addition to the increased awareness, we continue to use channels of education to inform and encourage people to take up screening on an individual, personal basis.

§ Lord McColl of Dulwich
My Lords, does my noble friend agree that, in preventing osteoporosis, probably the most important point is a healthy diet, adequate calcium and exercise and the cessation of smoking; in other words, that it is another DIY job?

§ Baroness Hooper
My Lords, as in so many other areas, there is clearly a certain amount of self-responsibility. The thrust of the Green Paper and the effect of the consultation process is to emphasise the importance of a healthy lifestyle and adequate physical exercise. That is also underlined in other government publications relating specifically to areas of women's health and the health of elderly people.

§ Lord Whaddon
My Lords, is the noble Baroness aware that hormone therapy and certain other therapies have proved dramatically successful in recent years in treating this appalling condition? Does she appreciate that bone density scanning is most effective in pinpointing the women at risk? Will she give the highest priority to the scanning of women who are in the appropriate age bands?

§ Baroness Hooper
Yes, my Lords. As I said, we are encouraging people to be screened on an individual, personal basis. We also encourage hormone replacement therapy in the sense that it has a role to play not only in the treatment of menopausal symptoms but also in the prevention of osteoporosis. The noble Lord may be interested to know that GP prescriptions for hormone replacement therapy have tripled over the past 10 years.

Lord Bruce of Donington
My Lords, in view of the emphasis put on the importance of this condition by the noble Baroness and its wide acceptance in the medical profession, can she now explain why it was omitted from the targeted conditions?

§ Baroness Hooper
My Lords, in my original reply, I indicated that we regarded this as an important area. Nevertheless, we considered that there were other priority areas which were even more important. Having said that, clearly some of the steps envisaged in the White Paper will be directed at the causes of osteoporosis.

§ Lord Monkswell
My Lords, the House will note the advice from the Government about the need for a healthy lifestyle. No doubt we all accept that. However, are the Government aware of the two-fold problem faced by people suffering from this condition; namely, late diagnosis and inappropriate advice given before a diagnosis has been made? Are they further aware that the recommendation to take exercise may not be the best advice to give to elderly women who suffer from this condition? What action are the Government taking to ensure that, once the condition has appeared, effective diagnosis is made and appropriate advice given?

§ Baroness Hooper
My Lords, that is not a role entirely for Government. It is also an important role for health care professionals. The Government are doing everything possible on the education front to raise the level of awareness and encourage people to take steps to try to avoid this condition.