Osteoporotic Fractures (Hansard, 1 May 2001)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the latest evidence suggests that the annual cost of hip fractures in the United Kingdom is in excess of £1.7 billion. Hip fractures are caused mainly by osteoporosis. Through the National Service Framework for Older People, the Government have signalled to the NHS the importance of addressing the issue.

§ Baroness Gardner of Parkes
My Lords, I thank the Minister for his reply. I declare a non-financial interest as joint-chairman of the All-Party Osteoporosis Group. Is the Minister aware that, according to the national service framework to which he has just referred, 14,000 people a year die in the UK following an osteoporotic hip fracture? The National Osteoporosis Society and the Central Council for Physical Recreation both stress the importance of increasing physical activity as a preventive measure for older people to retain bone strength. Does the Minister agree that there is a need for prevention and treatment and that treatment is now available for osteoporosis?

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness is right to draw attention to the number of deaths as a result of osteoporotic hip fractures. My understanding is that osteoporosis affects one in three women and one in 12 men over 50. That is a striking statistic that the NHS should take seriously. Priority must he given to providing preventive services and treatment. I certainly agree that for most people osteoporosis can be prevented through lifestyle measures such as diet and exercise. That applies to all the population, not just to older people.

§ Lord Clement-Jones
My Lords, we, too, welcome the national service framework, but in view of what the Minister has said, is not information about osteoporosis vital? Is it not time that the Government started to think about giving more money for information services, particularly its grant to the National Osteoporosis Society?

§ Lord Hunt of Kings Heath
My Lords, I certainly agree that we need to give as much information as we 552 can to the public, particularly about issues such as lifestyle preventive measures. I also acknowledge that the National Osteoporosis Society does excellent work and we have been happy to work with it. It receives some funding from the Department of Health through Section 64 grants. We are always willing to consider further applications. However, I cannot commit myself to sums of money—and I am sure that the noble Lord would not expect me to do so.

§ The Countess of Mar
My Lords, has the National Health Service followed up the work done at the Queen's Medical Centre, Nottingham, which found that young male sheep-dippers were suffering from osteoporosis of the spine, resulting in wedge spinal fractures?

§ Lord Hunt of Kings Heath
My Lords, I am not aware of the outcome of that work. Although we focus greatly on women with osteoporosis, men also suffer from the condition. Little is known about osteoporosis in men, so doctors have had to use knowledge gained from treating women, which is clearly not ideal. The department's research and development programme contains a number of research projects looking into the issue of men affected by osteoporosis.

§ Lord Colwyn
My Lords, I asked exactly the same Question three or four years ago, when the Leader of the House told me that the annual cost in 1994–95 was £742 million. It has gone up a lot since then. Does the Minister agree that prevention is far better than cure? In view of the scarcity of densitometers, would it not be more efficient to screen patients with a simple, reliable blood and urine test that identified telopeptides and other bone markers? We should look for signs that are available many years before fractures occur.

§ Lord Hunt of Kings Heath
My Lords, the noble Lord brings a great deal of expertise on the issue to the House. My understanding is that, as a result of the preparatory work for the national service framework, we have been able to produce more accurate figures on the cost of hip fractures. There has not been such a dramatic increase as the noble Lord suggested; we simply have a more accurate understanding of the cost now.
I agree with the noble Lord that if we can develop techniques for effective identification and screening, we should do so. The UK National Screening Committee, which advises Ministers on such matters, has advised us that at the moment there is not a simple, reliable test for osteoporosis that would meet its published criteria of being both clinically effective and cost-effective. However, we stand ready to review that and to ask the National Screening Committee to look at matters as they arise.

§ Baroness Masham of Ilton
My Lords, does the Minister agree that the issue is causing great concern among specific groups, such as paraplegics, as people grow older? Is there any suitable medication to stop the development of osteoporosis?

§ Lord Hunt of Kings Heath
My Lords, I believe that adopting certain lifestyle measures and ensuring the use of calcium and vitamin D in sufficient quantities are both important. As part of the national service framework and the original strategy produced by the Department of Health a couple of years ago, advice is given to GPs and consultants about the most effective form of treatment. However, while I accept the point that the noble Baroness has raised, I stress that a large part of our energies should be focused on lifestyle measures, targeting those at risk of developing osteoporosis.