Thousands of lives will be lost if Labour breaks its bone disease promise

Labour didn’t make many election pledges, no doubt foreseeing that governing would comprise a series of difficult choices.  Health minister Wes Streeting candidly said: “We’re being careful to only make promises we can keep.  The only thing worse than no hope is false hope.’

People with osteoporosis are one of the few groups to whom he did make a promise.  The question now is: will he keep it? If  not, thousands of people, mainly women, will lose their lives following preventable hip fractures.

Half of women over 50 will suffer disabling broken bones due to osteoporosis.  A cough, sneeze, stumble or hug can shatter their bones.  Preventative medications cost the NHS as little as £1 per month, but a postcode lottery for early diagnosis clinics called “Fracture Liaison Services” (FLS) means most people are untreated.

The end result of untreated osteoporosis is often a catastrophic hip fracture, which kills a quarter of sufferers within 12 months.  For survivors, recovery means three weeks in a hospital bed.  Most walk with a stick afterwards.  Many never return home. 

FLS is the world standard, used in 57 countries. Shockingly,  only HALF of NHS Trusts have them.  Catching people early is a no-brainer.  Who would deny a person who suffered their first heart attack the medication they need to prevent subsequent, bigger ones?  One man who shared our frustration was Wes Streeting, who called the delay to FLS under the Conservatives a “betrayal of patients”. 

By the General Election, all political parties vowed publicly to make these services universal by 2030.  Streeting went one better, telling this newspaper he’d make it one of his first acts in post.

But, nearly six months after he took up his post, there’s been no progress or engagement.  Officials have been silent.  People with osteoporosis feel forgotten.  Worryingly, after the election, Ministers watered down the language and haven’t yet confirmed in government the measurable target of universal services by the end of the decade.

We at the Royal Osteoporosis Society can’t square this with the kindness Streeting showed us in person in September.  At Labour conference he said “you’ve made a really well-evidenced case for a really good form of secondary prevention, which is not just good for patients but taxpayers too.  We made the promise and we’ll keep the promise”.  It was a reassuring sign our ally hadn’t abandoned us under the pressures of Ministerial life. 

But four months on there’s still no sign any initiative is in the pipeline. 

If FLS doesn’t feature in January’s Planning Guidance to NHS Trusts, things won’t change for a year, if ever. 

And for every year we delay, another 2,500 people die following broken hips which should have been prevented. 

We know Streeting is trying to move tectonic plates.  The review he commissioned from Lord Darzi set out three shifts needed in the NHS – sickness to prevention, hospital to community and analogue to digital.  We support Streeting’s vision. 

Delaying - or in the worst case – breaking the promise won’t further those shifts.  It’ll undermine them.  Late diagnosis of osteoporosis makes prevention impossible, and forces people into pain and dependency.  Fractures push people out of the community and into hospitals.

Failure to act on his promise would also mean short-changing taxpayers.  Even accounting for drug costs, an FLS will typically break even in 24 months.  Over five years, they return £1.88 for every £1 invested. 

Inaction would mean the burden on taxpayers will spiral because we’re all living longer.  Last summer, the National Hip Fracture Database reported a 9% rise in the number of hip fractures since 2021.

Women tell me people with osteoporosis are always pushed to the back of the queue.  Many suspect that, if the disease mainly affected younger men, it would have been prioritized years ago.

If Streeting does not honour his  promise it will lead to a tsunami of broken bones.  It would also shatter a lot of people’s faith in politics.  Eight parties (including Labour) and 271 Parliamentarians championed this cause.  What would it say about the ability of democratic politics to preserve lives if, even then, things don’t change?

When the Health Secretary publishes his NHS priorities in January, we need him to keep his promise to task Trusts with setting up FLS.  If he prioritizes this issue, as he said he would, then millions of women will be spared needless agony and many lives will be saved. 

By Craig Jones,

CEO of the Royal Osteoporosis Society