Medical Cannabis under Prescription

Lisa Cameron Excerpts

Monday 20th May 2019 Commons Chamber

[Jeff Smith]

The right hon. Gentleman is absolutely right. That points to the issue about where we get the product from. The problems, allegedly linked to increased episodes of psychosis, are from high-THC street cannabis, which is not what we mean when we talk about medical cannabis products. As I said, there are lots of different types of cannabis products. They are very often CBD-based, but when they contain THC—the psychoactive element—it is a much, much smaller amount than in street cannabis. It is like comparing apples and pears. He makes a really important point.

We need to look at how we can learn from evidence in countries such as the Netherlands, Germany and Canada, as well as countries that have successfully introduced medical cannabis regimes, such as Australia and Denmark. What work are the Government doing to learn from the experience of those jurisdictions? There are currently at least 138 medical cannabis trials worldwide. We need to take into account that global evidence.

I would like to ask the Minister a number of questions. Why can clinicians make individual decisions on certain conditions but not others? For example, clinicians can make individual decisions on a case-by-case basis on Crohn’s disease, which my constituent’s grandson suffers from, but not on some other conditions.

We need a scoping exercise to look at how we can enable patients to get this medicine now. There are estimated to be something like 3 million cannabis users in the UK, with around 1 million of those using it for medical purposes. Those figures may be high but, whichever figures we look at, there are hundreds of thousands of people using cannabis to alleviate pain or help with a medical condition. At the moment, they get their product from the street—from the illegal trade. That is not good for them or for society. That is the key point. People are already using cannabis for medical reasons and getting it from illegal suppliers.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I thank the hon. Gentleman for giving way; he is making an excellent speech. On that point, I had a visit to my constituency surgery from one of our veterans, who had incurred an injury during his service. He was in chronic pain and felt that cannabis alleviated that, but he did not wish to buy it; he wished it to be prescribed and for Ministers to look at the research and studies, to ensure that veterans who need that assistance can have it.

[Jeff Smith]

That is not an unusual case. There are lots of people who want to use medical cannabis and do not want to buy it from the street or go to Holland to import cannabis products, and they are frustrated.

I will wind up, because I have been speaking for longer than I intended. On the funding issue, there are cases of clinicians being willing to prescribe but being blocked by trusts or CCGs. What is the Minister’s understanding of how many cases there are where funding is the issue, rather than prescription? Even where clinicians are willing to prescribe and there is new thinking, CCGs do not have budget lines for some of these products, so the reluctance is understandable. I am interested to know whether the Minister has any information on that.

It might cost more for the NHS to supply more medical cannabis prescriptions, but we have to compare that with the reduction in other costs. The estimate is that opioid costs would be 25% lower, and there would be fewer hospital admissions. Professor Mike Barnes said in his evidence to the Select Committee that we could probably introduce medical cannabis in this country on the NHS at no net cost, when we take into account the reduced costs elsewhere.

Our system is clearly too restrictive. It is not working. We need creative thinking and flexibility from the Government, and we need them to look at the different types of evidence from around the world. There are people in this country who, if they were living in Holland, Australia or Canada, would be able to get on with their lives, get their cannabis products legally and not have the worries of the campaigners in our Gallery today about them or their children and relatives having to go through chronic pain or the episodes of epilepsy that we have seen in young patients over the last year.

We all want to make some progress and are desperately frustrated that we are not able to get anywhere. I refer the Minister to the evidence given by Professor Mike Barnes. We need to look at other types of evidence to inform ourselves of a way to deliver the products that our patients need into their hands.

--- Later in debate ---

[John Howell (Henley) (Con)]

I congratulate my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) on securing this timely debate. Let me start by picking up on something that my hon. Friend the Member for Reigate (Crispin Blunt) mentioned: all we are talking about is medicinal cannabis. We are not talking about making cannabis available for general recreational use. I am sure that there are Members of the House who would have an opinion on that, and we could have a full debate on it, but we are talking only about use for medicinal purposes. The wording of the motion is very important. When I read it, I saw that it stressed the practicalities of getting cannabis medicines prescribed. It is not about the general issue—we had the debate on that and the Home Secretary reached his decision—but about the practicality of getting some sort of result.

I realise that this is not easy for the medical profession and that the Government have initiated a review of the barriers to clinically appropriate prescribing. That is a very important review to undertake. I am aware that the National Institute for Health Research is going to participate in the review, which is a positive step, and I will set out what I think are a couple of the barriers that prevent prescribing

What we are really waiting for is some NICE guidelines. I understand that they are coming, but they need to be brought along pretty quickly. We cannot wait for them forever, nor can the children who are suffering.

[Dr Cameron]

The hon. Gentleman is making an excellent point and an excellent speech, which relates to the practicalities for children in my constituency such as Cole Thomson. His mother, Lisa Quarrell, has been trying to get medicinal cannabis for him for some time. Not only does she have to battle his absolutely debilitating epileptic illness, which gives him multiple seizures every day, and to see the deterioration each day in his condition, but she has to battle the medical system, battle with financial costs and battle the Government as they take one step forward and two steps back, giving hope and then taking it away. It is too much and too traumatic for any family in that situation to cope with.

[John Howell]

I thank the hon. Lady for her excellent intervention, and I agree with much of what she said.

One of the main barriers that I see is the simple question of who is allowed to prescribe. The General Medical Council holds a list—a specialist register—of specialist doctors who are allowed to prescribe. Why do we have a specialist list, and why can only those on that list prescribe? Is it because people are nervous about their careers or other things? Why do we limit the number of doctors who can prescribe in this way? I have read claims that something like 110 patients have been prescribed the medicine, but from what has been said in this debate, I understand that only one has received it.