Medical Cannabis (Access) Bill
Debate between Tonia Antoniazzi and Katherine Fletcher(2 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text
Katherine Fletcher (South Ribble) (Con)
I commend the hon. Member for Manchester, Withington (Jeff Smith) for bringing this really important matter to the attention of the House. He has made a wonderful speech that has stepped through lots of the dynamics in the debate.
This is a genuinely difficult topic. Many people present today want to participate in the debate and demonstrate their care, compassion and concern for the individuals at the heart of it. Indeed, that is one of the themes that I want to cover today. This is a funny place; it can be quite fraught, which might not necessarily be obvious to those observing us from outside this House. Members have to balance our compassion for an individual with the office that we hold and the responsibilities that that brings. Although I want to talk about a number of the points that the hon. Gentleman has made, I also want to highlight how difficult that trade-off can be.
Since I joined the House in 2019, I have sought, where possible, to find a way of speaking English in a normal way, and I shall try to do that on this topic. When I first pitched up here, I did not really understand the nature of the trade-off. Bills on topics such as this land at the heart of the matter, which is that this is not necessarily a particularly easy or comfortable thing to talk about. I will try to stick with what I promised and use some real-world examples.
With the House’s permission, I want to highlight the real-life experiences of one of my constituents in South Ribble, a redoubtable lady by the name of Joanne Griffiths. Joanne is a wonderful individual, but this is really about her son, who she calls “boisterous Ben”. Ben has great difficulties with his epilepsy and has struggled with treatment over the years, but before I start to highlight the case and understand how it pertains to the subject, let me give a bit of clarity. Joanne does not support the Conservative party. In the past, she has been on a leaflet with the right hon. Member for Islington North (Jeremy Corbyn). I am not trying to make a party political point; when MPs from whatever party are elected, we are here to support all of our constituents, and we take that job incredibly seriously—I want to put that on the record. She will never ever vote for me, but I will speak for her genuinely and honestly and in a way that is in her best interests. In these more febrile times, that is an important point to make, but let us get back to what is really important, which is Joanne and, more importantly, her son, Ben.
I want to put her efforts for Ben on the record, and the easiest way to do that is to quote her in her own words:
“It has been three years since the law changed, and I have spent four years fighting for access to what is very much the only medication to have any effect on my son’s hundreds of life-threatening seizures per day. Medical cannabis has transformed his life and gives him seizure freedom, and we do not wish any other parent or child in the area to go through what we have, and we are still suffering.”
When I was elected back in December 2019, as MPs we could get permission from individuals to act for them and we could take on casework from our predecessors. The complexities of the system mean that that often comes in printed paper form. I was given a large pile of handouts and one file, which must have been 1.25 inches thick. When Joanne says that she has been campaigning for four years, I can tell Members that she has been campaigning for four years. I did not so much pick up that file as weigh it. If any given set of paperwork can describe the emotion and the passion that the debate arouses, it is that sense of, “There you go! Congratulations, you’ve just won an election, you can help this lady and her family.”
Within that case file are letters and notes from Joanne’s meetings with her local MP, my predecessor. She has met Ministers, pressure groups and policy researchers. She has been a tireless campaigner. She even had members of my predecessor’s staff go with her to attend appointments with medical professionals. Reading that and reading all the correspondence, I can state confidently that Ben could not have a better mother. She is not a tiger mum; she is like a proper lioness defending her son. It is really important that I put my genuine admiration on the record today. She has fought tooth and nail for him. The question that I want the House to examine is: should she have to be that lioness of a mum?
Let me give the House the highlights of what Joanne has done over the last four years—this is by no means all of it. She has fought for medical cannabis to be legalised. She has met the Secretary of State for Health—and all Members of this House know that people do not suddenly turn up with that idea on a Tuesday and then it happens on the Friday; it takes a lot of time, effort and engagement. Along with others, she has helped to secure the legalisation of certain types of medicinal cannabis. She has fought her way through a system that is not really understanding of the issue in order to see a medical specialist. In 2019, through a private prescription, she got Ben prescribed the Bedica oral solution of 20 mg/1ml with 2% THC, and the Bedrolite oral solution 100 mg/1 ml with CBD at 10%, and less than 1% THC. Joanne said:
“For years now we have had to fund raise up to £2,500 a month to fund this medicine, use all our savings and borrow money from family and friends. We are on the verge of being broken both financially and emotionally due to the stress and with Covid, our fundraising options have all but been shut down. This is on top of running a local business whilst looking after a child with complex needs”.
That speaks for itself.
Let me turn to the efficacy of the treatment. Ben’s response to the treatment was recently described by the individual funding request panel, which the hon. Member for Manchester, Withington mentioned, as “exceptional” with
“demonstrable improvements to his condition”.
That is an independent third party effectively saying that the treatment works.
Joanne is still going, because she is still getting that private prescription. She has fought through the NHS system to see a specialist and get a clinical decision to agree Ben’s prescription, with the implication that it would be funded through the NHS, but that prescription has been rejected by the local CCG and hospital trust policy. The lioness mum that she is, she is now back in my inbox and in lots of other people’s inboxes, and is campaigning to understand what has caused the blockage in prescribing and what is happening. She has got the Secretary of State for Health and Social Care to instruct the NHS to review what is causing the issue and the blockages, so the questions are being asked at the highest level of the Department. She has also written to the Health Committee.
Tonia Antoniazzi (Gower) (Lab)
As co-chair of the all-party parliamentary group for access to medical cannabis under prescription, I know very well the person and child described by the hon. Lady. Joanne deserves better. Ben deserves better. I am so pleased that we are seeing through the party politics and that you have met Joanne, because this is a ridiculous situation. You are describing four years of hurt, pain and fighting of the lioness that is Joanne Griffiths, and yet nothing has been done. It really upset me, and I am glad that the hon. Lady is on side. You—sorry; the hon. Lady is on the Government Benches, and this situation has to change.
Katherine Fletcher
I agree with you—[Interruption.] Oh crap! I agree with the hon. Lady. [Laughter.] Might as well get something decent on the record! You can take the girl out of the north of England, Madam Deputy Speaker; I apologise profusely. I agree with the hon. Lady, but I think that there are some issues that prevent immediate “do something” action, and I want genuinely to examine them.
Katherine Fletcher
I will happily take another intervention once I have been through the issues, but I just want to continue to highlight what this lady, Joanne, is having to do. She has got the Secretary of State to ask the NHS what is going on. Along with other parents, she is still talking to the Chair of the Health and Social Care Committee, whom she and Ben previously met in his role as Secretary of State. As per the advice from the local CCG, she applied for an individual funding request for a prescription with a demonstrable improvement in boisterous Ben’s condition, but it was rejected. She appealed in July and won, but on 3 November, the appeal process was deferred awaiting clarification and more information.
As the hon. Member for Gower (Tonia Antoniazzi) highlights, that must feel Gordian—how can Joanne unpick that? She is still fighting and, as hon. Members would expect, I am supporting her. To the point that the hon. Member for Manchester, Withington raised, I have also written to the Secretary of State about participating in an observation trial.
The story is distressing. I cannot see any hon. Member who is unmoved and is not thinking about what they would do in a similar position. It is complicated and I find it hard to reconcile my personal distress.
Tonia Antoniazzi
The hon. Lady says that it is complicated, which it is, but we are now in a ridiculous situation. There is something or someone in the system blocking medicinal cannabis getting to those children. Three prescriptions are already being supported, so why can the others not be supported too?
Katherine Fletcher
The hon. Lady raises an important point, which I will come to. I think that those individuals are caught in a pincer movement between scientific proof and medical ethics. I am mindful of the challenge of the hon. Member for Manchester, Withington who asked if they cannot do it, what can they do. I will make some suggestions on that.
The distress is genuine and clearly felt on both sides of the House, but the specific definition of practical actions that address the situation is a problem. If hon. Members will forgive me, I will set out the events in order. Since November 2018, the law has allowed for prescriptions of medicinal cannabis, which is no small thing. It has been an illegal drug for a long time, and it is a Conservative Government who brought that in.
That prescription is now a legal tool in the armoury of qualified doctors. Prescription medicine is rightly the preserve of highly qualified and trained doctors. No one would want me wandering down the high street saying, “Oh you look a bit poorly today—go and have a bit of that.” It takes years of blood, sweat and tears. Ultimately, when doctors have completed that technical qualification, they take the Hippocratic oath. Today’s debate hinges on the interaction between the Hippocratic oath that doctors take as individuals on qualification—I am aware that not everybody swears on the same text—and the Government’s ability to feel qualified enough to influence, or seek to influence, doctors’ decisions. I think that is where the blockage is.
Tonia Antoniazzi
Again, the hon. Lady’s generosity in giving way is noted. On that point, is she trying to say that the prescriptions that have already been written privately by experienced clinicians are unethical?
Katherine Fletcher
The hon. Lady perhaps needs to let me make some of my points. She keeps asking me, but I am genuinely trying to get there.
Katherine Fletcher
I thank my hon. Friend for his intervention, and if I do not embarrass him too much, may I also thank him for his service in hospital during the covid pandemic? It is the strength of experience and the variety of experience on these Benches that makes sure, when we do put stuff through, that the laws of this country are scrutinised by people from different perspectives, and he is a great example of that.
Joanne position’s is that she is coming to me with Ben saying, “This doctor says he can have medical cannabis, and then I have another set of doctors saying, ‘Well, we need more evidence before we can prescribe it’.”
Katherine Fletcher
No. Would the hon. Member let me, honestly, make a bit of progress? I hope she does not mind; I think I have been very fair.
We have a loving family in a state of limbo, we have medical professionals deeply concerned about whether it is the right thing to do and whether it is breaking their Hippocratic oath to prescribe, and we have someone who is not remotely qualified to make this decision being asked, in effect, to engage in a medical ethics debate when I am not qualified to do so.
I want to turn to another aspect, and this may be the point at which I have to declare my biology degree and a distinct possibility that this might get a bit nerdy. I apologise for that, but geeks may take over the world. I think we need an examination of the other side of this issue: how do the scientists, whether or not they are medically qualified doctors, and how does science provide an evidence base that gives the doctors some confidence and cuts out all of the nonsense? Effectively, I am asking for the House’s forbearance on the topic of standards of scientific proof.
To recap, the families of the children, including Ben, believe, based on the evidence of their own eyes—a No. 1 eyeball—that medicinal cannabis has an enormously positive effect on the seizures; seizures that are so distressing. I do not want to keep walking away and making this a theoretical concept, because it is not.
The family have secured the support of two medically qualified individuals, but others believe that the scientific literature lacks the evidence base—as has been pointed out, we do not have the evidence base because we made it illegal for 50 years and it became legal only three years ago—to prescribe specific compounds and drugs. There has not been enough research to understand formally, in the gold standard of a double-blind trial, whether these cannabis medicines do work.
The hon. Member for Manchester, Withington talked about the availability of different formulations of this generic thing, with different strains and different levels and ratios of THC and CBD. He mentioned a trial and error process to get these very sick children and adults a stable medicine that works for them. If it was my child, in extremis and in an emergency, I would want to go through that process, but as I scientist I think that trial and error can lead to rally big problems. It is not good enough to say, “We think medical cannabis has worked, so we’ll give you 0.5% or we’ll give you 10%”.
Tonia Antoniazzi
The problem is that we have been having this discussion for many years—ad infinitum. The hon. Lady is standing here today painting that picture. Ben has already had every single possible licensed or unlicensed medicine through the NHS. This is the only one that makes his life incredibly better. It is not a miracle cure, but it gives him a quality of life that he deserves. So do those other children. There is more than anecdotal evidence out there. I think she is insulting the families by making that case today.
Katherine Fletcher
The hon. Lady is being unfair. Listening to my words, she will understand that I have that level of emotion about a very poor and sick child, but I am trying to find a way of helping him that does not potentially put other children at risk because we are giving something on anecdote. I remind her that thalidomide was thought to be fine. If we step away from—[Interruption.] I cannot hear her chuntering at me from behind a mask. If she wants to insult me personally, stand up please.
Tonia Antoniazzi
I would not personally insult the hon. Lady because I do not think that this place is the place to do it. I will happily have a conversation with her afterwards. The issue we have here is that the word “anecdotal” has been thrown around. None of the experiences and none of the work that has been done by many of the people involved is anecdotal. this is not anecdotal. It is not about ethics. It is about getting medicine to the children who need it because the situation is now intolerable.
Katherine Fletcher
The term “anecdote” means, within a scientific context, not statistically proven. While the emotion that the hon. Lady shows on behalf of Ben’s family and other families is important, it is also important to step back. If nothing else, the pandemic has shown us the power of science to find the right answers to solve problems.