05 December 2002

S1M-3508 Osteoporosis

The Deputy Presiding Officer (Mr Murray Tosh): The final item of business is a members' business debate on motion S1M-3508, in the name of Fergus Ewing, on osteoporosis. The debate will be concluded without any question being put.
Motion debated,
That the Parliament notes that osteoporosis is a major public health problem which results in more than 20,000 fractures a year in Scotland, that the cost of osteoporotic fractures in the United Kingdom each year is estimated at over £1.7 billion and that one third of women and one in 12 men over 50 will suffer an osteoporotic fracture; further notes that with an ageing population profile this problem will become even more serious; is aware that osteoporosis is both treatable and largely preventable; welcomes the fact that the public and health professionals are becoming increasingly aware of osteoporosis as a major health problem but is concerned that health service provision throughout Scotland is patchy and that access to diagnostic testing and monitoring varies around the country; believes that sufficient funding can be made available so that all patients have equal access to services for both the diagnosis and treatment of osteoporosis and that all patients suffering a fragility fracture or having other risk factors for the disease should be assessed for the presence of osteoporosis, and further believes that public health campaigns should be promoting the importance of lifestyle factors as influencing bone health and preventing osteoporosis.
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Stewart Stevenson (Banff and Buchan) (SNP): I am happy to come along and support Fergus Ewing's motion and to take part in what I expect to be a consensual debate. I think that some of us at least will be old enough to remember children with rickets and the large number of older ladies in particular who were stooped and crippled in old age because of undetected and untreated fractures, among other causes.
I mention rickets in particular because it has all but been eliminated in our young. However, there is some re-emergence of it because of dietary problems that are not the result of a lack of money, but of the spending of it in the wrong way on the wrong diet.
I well remember, in the immediate post-war period, going to the Ministry of Health office to collect my orange juice and cod-liver oil. As Michael Matheson would doubtless want me to acknowledge, fish is extremely important and as Fergus Ewing would doubtless want me to want me to clarify, yes, I am that old.
Diet is important. I grew up in an area with calcium-rich water and, until I left home, I did not realise that soap was supposed to foam. All that happened when I used it was that it formed a scum around the bath, and that was due not simply to the infrequency with which my parents persuaded me that I should bathe, but to the high amount of calcium in the water, which was absorbed into my teeth and bones. Not everyone is so lucky, of course. In the west of Scotland, where the water is much softer, the opportunity to take up calcium is much reduced.
Some estimates suggest that 50 per cent of young women take up inadequate calcium in their diet and, while there is a suggestion that young men do little better, they are not exposed to the risks later in life that can lead to bone mass depletion, such as pregnancy, breast feeding and blood loss. Women have particular problems, which is why one in three of them will experience osteoporosis at some stage in their lives.
Young women and men are taking less exercise than they used to and exercise is important in building up bone mass at an early age. That is helpful because it means that any later loss of bone mass is offset against the substantial amount that was present in the first place.
Of course, there are other risks. A substantially higher number of young people than ever before suffer from asthma. When I was a bairn, I was one of only three who suffered from asthma in my year. Now, however, the proportion would be substantially higher. Much of the treatment of asthma is done through the inhalation of steroids, which are another cause of bone mass depletion, which means that, in the future, there might be an uplift in problems relating to bone mass depletion.
Furthermore, the inadequate calcium intake that I spoke of earlier means that people's teeth are not as good as they used to be. One of the results of that is gingivitis and inflammation of the gums. Again, the treatment for those problems is generally steroid-based.
I am sure that we all agree about the need to address the range of problems that are developing in our young people with regard to osteoporosis.
However, I should also mention that there is a rise in the number of auto-immune diseases of one sort or another, which affect all age groups and which are also often treated with steroids.
Just as we eliminated rickets in the young by appropriate action after the war, it is important that we eliminate osteoporosis in the old now. It has been suggested that exposing people to sunlight for 15 minutes on three occasions a week would be a help. I do not propose that the Executive send everyone to the south of Spain three times a week; an improvement in the weather in Scotland would be welcome, however.
Let us bear in mind that the cost of treating the fractures that are caused by osteoporosis is £15 a year for everyone in our population. This is an important problem. We must spend more money but we must also devote more of our attention to the problem.

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