New drive to combat brittle bone disease

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The Government yesterday accepted that diagnosis and treatment of the brittle bone disease, osteoporosis, which affects one in four women and costs the NHS £750m a year, is "often inadequate" and has left thousands of women suffering pain and disf igurement.

Announcing new policies for management of the disease, Baroness Cumberlege, Parliamentary Secretary at the Department of Health, said that all health authorities and GP fundholders are being urged to make osteoporosis a priority.

Women at high risk of the disease should be offered routine bone scans, and doctors will be encouraged to discuss hormone replacement therapy (HRT), which can reduce the risk of brittle bones, with menopausal women who may be at risk, Lady Cumberlege said. The disease is associated with a drop in oestrogen levels after the menopause.

National guidelines for diagnosis and treatment are to be drawn up under the guidance of the Royal College of Physicians, and greater emphasis given to preventing osteoporosis through diet and exercise.

The new policy follows a year-long investigation by the Government's Advisory Group on Osteoporosis, whose report was published yesterday. The group was set up because of concern at the rising toll taken by the disease; there are 60,000 hip fractures, 50,000 wrist and 40,000 vertebral (spinal) fractures annually due to osteoporosis. Most of these occur in older women, although one in 12 men suffers, accounting for 20 per cent of hip fractures.

Lady Cumberlege welcomed the report and accepted most of its recommendations, although a proposal to reduce the prescription charge for HRT - an average cost of £38 per year - was rejected.

She said: "Half of all women have had a fracture by the time they are 70. Osteoporosis is common and preventable and it is on the increase. It really has to be checked. We could prevent 110,000 hip and wrist fractures a year.

``We want to see fewer lives wrecked. We hope that in a few years' time this report will have had a major impact."

Lady Cumberlege ruled out bone screening for all post-menopausal women, as some scientists have suggested.

Professor David Barlow, head of the Nuffield Department of Obstetrics and Gynaecology at Oxford and chair of the advisory group, said that there was little evidence to support widespread screening.

9 Report of the Advisory Group on Osteoporosis, available from the Central Print Unit, Department of Health, Room 285D, Skipton House, London Rd, London SE1 6LW.

t There should be no absolute exclusion of any treatments from the NHS, including infertility treatment, tattoo removals and purely cosmetic surgery, an all party committee of MPs said yesterday.

And in a restatement of existing NHS values remarkable for the Health Committee, whose members include prominent right-wing Tories such as Iain Duncan-Smith and John Whittingdale, it "strongly endorses" the principles of "equity, public choice and the effective use of NHS resources".

All patients, it says, "should receive high quality health care according to their assessed need; that factors such as age, sex, ethnicity, occupation, social class and geography should have no bearing on the availability or the speed of delivery of services".