My Lords, I am very aware that the Minister has had this Question in almost identical wording, and I think there is another one soon to come from somebody else. So I will move away, if I may, and ask: does the Minister agree that the importance of these fracture liaison services is not simply to pick up fractures of the long bones, which are associated with osteoporosis, and to treat them—the fundamental purpose of the liaison service—but to establish connections between orthopaedic surgeons and geriatric medicine, so that, with other problems such as, for example, older people not getting their operations quick enough after a fracture, which Dr Mark Porter mentioned in the Times today, it will speed up the total relationship between the two departments and get better access to care for frail older people? Does the Minister agree that that is the most vital thing about these liaison services?

My Lords, I am very aware that the Minister has had this Question in almost identical wording, and I think there is another one soon to come from somebody else. So I will move away, if I may, and ask: does the Minister agree that the importance of these fracture liaison services is not simply to pick up fractures of the long bones, which are associated with osteoporosis, and to treat them—the fundamental purpose of the liaison service—but to establish connections between orthopaedic surgeons and geriatric medicine, so that, with other problems such as, for example, older people not getting their operations quick enough after a fracture, which Dr Mark Porter mentioned in the Times today, it will speed up the total relationship between the two departments and get better access to care for frail older people? Does the Minister agree that that is the most vital thing about these liaison services?

To ask His Majesty’s Government what progress they have made in developing a delivery plan to achieve national coverage of fracture liaison services in England by 2030.

To ask His Majesty’s Government what progress they have made in developing a delivery plan to achieve national coverage of fracture liaison services in England by 2030.

My Lords, the noble Lord, Lord Patel, always likes to give us a challenge when he sets a debate, and this is certainly one of the greatest challenges we have had, in terms of its widespread topic. I will just pick out a few things; so much has been said...

My Lords, the noble Lord, Lord Patel, always likes to give us a challenge when he sets a debate, and this is certainly one of the greatest challenges we have had, in terms of its widespread topic. I will just pick out a few things; so much has been said...

My Lords, I approach this topic from the point of view of someone who worked for two years, when I was a trainee psychiatrist, in a transsexual clinic for adults at University College Hospital. In those days—I am going back 45 years—men and women came to seek help usually as...

My Lords, I approach this topic from the point of view of someone who worked for two years, when I was a trainee psychiatrist, in a transsexual clinic for adults at University College Hospital. In those days—I am going back 45 years—men and women came to seek help usually as...

Recently, at a meeting about this Bill, the noble Baroness, Lady Gerada, remarked to me that she had been through at least 15 major reorganisations of the National Health Service. Well, I can beat her. I have endured at least 22. I joined the NHS in 1966 as an auxiliary...

Recently, at a meeting about this Bill, the noble Baroness, Lady Gerada, remarked to me that she had been through at least 15 major reorganisations of the National Health Service. Well, I can beat her. I have endured at least 22. I joined the NHS in 1966 as an auxiliary...

My Lords—

My Lords—

My Lords, fractures of the hip are killers for people in old age. Up to 25,000 older people die every year after a hip fracture, usually several years before their allotted time. Does it not seem to the Minister that we should give more energy to getting these fracture liaison services, which are incredibly cheap, up and running in every district? Scotland has done it. Northern Ireland has done it. I do not understand why England and Wales cannot do it, too.

My Lords, fractures of the hip are killers for people in old age. Up to 25,000 older people die every year after a hip fracture, usually several years before their allotted time. Does it not seem to the Minister that we should give more energy to getting these fracture liaison services, which are incredibly cheap, up and running in every district? Scotland has done it. Northern Ireland has done it. I do not understand why England and Wales cannot do it, too.

My Lords, I am no expert on youth justice and I am aware that I am surrounded today by people who are, but I support the Bill of the

noble Lord, Lord Oates, because I have too often experienced the results of a Government thinking that by transferring responsibilities in-house...

My Lords, I am no expert on youth justice and I am aware that I am surrounded today by people who are, but I support the Bill of the

noble Lord, Lord Oates, because I have too often experienced the results of a Government thinking that by transferring responsibilities in-house...

My Lords, I take this opportunity provided to us by the noble Lord, Lord Patel, to talk about the data for research for the greatest health challenge of our time—dementia. We need to improve the quality, accessibility and use of dementia data to support research, which is in an extremely...

My Lords, I take this opportunity provided to us by the noble Lord, Lord Patel, to talk about the data for research for the greatest health challenge of our time—dementia. We need to improve the quality, accessibility and use of dementia data to support research, which is in an extremely...

To ask His Majesty’s Government what steps they are taking to assess and prioritise investment in trials of new dementia treatments in the NHS.

To ask His Majesty’s Government what steps they are taking to assess and prioritise investment in trials of new dementia treatments in the NHS.

I am very grateful to the Minister for that update. Dementia is now the most prevalent mental disorder in the country and the leading cause of death in women. I think she will agree with me that, at the moment, only 30% of dementia cases ever get diagnosed. If we are to benefit from some of the new developments in treatments, which I recognise are not yet as efficacious as we would like, there has to

be some more investment in ensuring that people get an early diagnosis, so that patients can not only be linked into trials as they come up but get the help and social support that they—and their families, of course—will need. Does the Minister have any plans to increase the dementia diagnosis rate?

I am very grateful to the Minister for that update. Dementia is now the most prevalent mental disorder in the country and the leading cause of death in women. I think she will agree with me that, at the moment, only 30% of dementia cases ever get diagnosed. If we are to benefit from some of the new developments in treatments, which I recognise are not yet as efficacious as we would like, there has to

be some more investment in ensuring that people get an early diagnosis, so that patients can not only be linked into trials as they come up but get the help and social support that they—and their families, of course—will need. Does the Minister have any plans to increase the dementia diagnosis rate?

My Lords, I am a fellow of the Royal College of Psychiatrists, but what I am going to say this evening will, I fear, be unpopular in some quarters, including with my own royal college, which broadly says that these rising figures merely expose unmet need. I disagree. Rather, I...

My Lords, I am a fellow of the Royal College of Psychiatrists, but what I am going to say this evening will, I fear, be unpopular in some quarters, including with my own royal college, which broadly says that these rising figures merely expose unmet need. I disagree. Rather, I...

Does the Minister agree that while the current generation of drugs is not very efficacious—and, sadly, more research recently has demonstrated that it is not terribly good—the most important reason for early diagnosis, as we have said, is to get the services in that people need? We are talking about nearly 1 million people now, and usually the GP is not the person who diagnoses—it is usually the home help or the person next door. We need rapid access for people to be able to get assistance to get the diagnosis they need—otherwise, we will never get anywhere near medication.

Does the Minister agree that while the current generation of drugs is not very efficacious—and, sadly, more research recently has demonstrated that it is not terribly good—the most important reason for early diagnosis, as we have said, is to get the services in that people need? We are talking about nearly 1 million people now, and usually the GP is not the person who diagnoses—it is usually the home help or the person next door. We need rapid access for people to be able to get assistance to get the diagnosis they need—otherwise, we will never get anywhere near medication.

My Lords, I am no expert in housing, as many people in the Chamber are; if some of my questions and comments appear naive, it is because I am reflecting what many of the general public think and understand about social housing.

It is 30 years since I was on the...

My Lords, I am no expert in housing, as many people in the Chamber are; if some of my questions and comments appear naive, it is because I am reflecting what many of the general public think and understand about social housing.

It is 30 years since I was on the...

I just want to comment on some of these earlier amendments, particularly from the noble Lord, Lord Shinkwin. I think the noble Baroness, Lady Finlay—I cannot remember whether it was last week or the week before that—reminded us that people who are terminally ill, or who have discovered that they...

I just want to comment on some of these earlier amendments, particularly from the noble Lord, Lord Shinkwin. I think the noble Baroness, Lady Finlay—I cannot remember whether it was last week or the week before that—reminded us that people who are terminally ill, or who have discovered that they...

I do not know what the noble Baroness’s discussions with her patients are like, but I remember mine very well. A lot of discussion that goes on between a doctor and a patient does not get formally recorded but is part of the everyday conversation of a consultation. I think...

I do not know what the noble Baroness’s discussions with her patients are like, but I remember mine very well. A lot of discussion that goes on between a doctor and a patient does not get formally recorded but is part of the everyday conversation of a consultation. I think...

My Lords—

My Lords—

My Lords, could I make it clear to noble Lords that, in the best legislatures that have implemented similar legislation to this one—and I am thinking of Oregon, the State of Washington and so on—assisted dying is a small part, a very tiny part, of a good palliative care service,...

My Lords, could I make it clear to noble Lords that, in the best legislatures that have implemented similar legislation to this one—and I am thinking of Oregon, the State of Washington and so on—assisted dying is a small part, a very tiny part, of a good palliative care service,...

We have discussed this issue at some length before, but I wonder if the noble Lord, Lord Moylan, has considered that the Bill does not say anything about a definite diagnosis. The phrase is “can reasonably be expected”. It does not mean that anybody has to agree with a diagnosis...

We have discussed this issue at some length before, but I wonder if the noble Lord, Lord Moylan, has considered that the Bill does not say anything about a definite diagnosis. The phrase is “can reasonably be expected”. It does not mean that anybody has to agree with a diagnosis...

Is the noble Baroness, Lady Lawlor, aware that, of all the countries in Europe, it is the Netherlands where doctors are most trusted? We should consider what their legislation is and how close, often, the relationship is between the doctor and the patient who is in receipt of assisted death....

Is the noble Baroness, Lady Lawlor, aware that, of all the countries in Europe, it is the Netherlands where doctors are most trusted? We should consider what their legislation is and how close, often, the relationship is between the doctor and the patient who is in receipt of assisted death....