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Time for government to act

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06 Feb 2024

During a debate in the House of Lords on February 5, peers made the case for government action to end the postcode lottery for Fracture Liaison Services (FLS) and to make the first fracture the last.

Lord Black of Brentwood began by reminding Lord Markham – the responding Department of Health and Social Care Minister – of several previous government commitments to expand access to FLS. He listed, among others, Lords Evans’ pledge, in a previous House of Lords debate, to announce a package of prioritised measures for FLS in the Autumn Statement as an example of a government commitment which went unmet.  

Lord Black continued by highlighting the enormous cost of the Government’s failure to act to ensure everyone eligible has access to an FLS. He referenced the 90,000 people who need anti-osteoporosis medication, who are missing out on it because they cannot access an FLS, as well as the 750,000 lost NHS bed days and 31,000 unnecessary hip fractures every five years because of the FLS postcode lottery.  

Lord Black concluded his remarks by asking the Government, if they understand the benefits of FLS, “why on earth [have] these promises not been honoured?” 

Baroness Donaghy continued by asking the Government to “invest-to-save" by supporting a temporary Transformation Fund in the forthcoming Spring Budget to pump-prime FLSs. She said that if everyone eligible had access to an FLS, it would prevent 74,000 fractures over five years, helping people stay in work and relieving the pressure on the NHS.  

Lord Lexden highlighted the Government’s previous broken promises on expanding access to FLS and advocated for a Best Practise Tariff to reward the Trusts that set up and maintain these important diagnostic services.  

Lord Allan, responding for the Liberal Democrats, highlighted the lack of focus FLS enjoys on NHS England’s website. Lord Patel asked how the Government learns from the FLS audit and how it implements these learnings.  

Baroness Altmann stated that too often osteoporosis is stereotyped as a condition which only affects old women, when half of women over 50 - including 50,000 working women - will suffer fractures every year. She wondered whether this stereotype had contributed to the lack of prominence for osteoporosis in the Women’s Health Strategy.  

Baroness Merron, responding for the Opposition, asked, “when will [Health] Minister [Maria] Caulfield’s promise to establish more FLSs actually be delivered?”.    

In total, nine Peers spoke during the debate.  


Government Response 

In his responses to the points made by peers, Lord Markham, speaking on behalf of the government, stated that FLSs “are very effective in terms of what they do."

Lord Markham said that there was a very good argument to be made for FLS coverage expansion and that there was “a very strong case behind it.” Pressed further, the Minister added that there was a “good argument in terms of investment” and that FLS “is something we are looking to expand.”  


The Royal Osteoporosis Society's Response  

Responding, Craig Jones, CEO of the Royal Osteoporosis Society, said:   

“We’re continuing to campaign for national leadership from the Government so we can give people fair access to these life-changing services, wherever they live.  The chaotic postcode lottery out there today shows that Integrated Care Boards need a mandate or incentive to give people fair access to treatment.  

“We’ve tried the status quo for years and it’s led preventable disability, premature death and eye-watering expense for the taxpayer.  We obviously need a new approach through a temporary Transformation Fund and a clear signal from the government that things need to change.”  

A full recording of the debate is available here. A full transcript of the debate can be found here.  



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