Psychoactive Substances Bill [HL]

Baroness Hamwee Excerpts

Tuesday 23rd June 2015 Lords Chamber

[Lord Bates]

That is not exactly what the amendment says and we see a risk there to the prospects for the Bill, which carries the support of the Official Opposition and was in their manifesto. It was in the Conservative manifesto that we would bring forward this legislation. Norman Baker, who was the Liberal Democrat Minister in the Home Office, wrote to the Advisory Council on the Misuse of Drugs in the following terms:

“As our response makes clear, we will explore the feasibility of a UK wide new offence(s) by which the distribution for human consumption of non-controlled NPS is prohibited, based on the approach taken by the Republic of Ireland in 2010. This would give law enforcement greater powers to tackle NPS in general, rather than on a substance by substance basis. The international experience shows that it would have the most impact on the open availability of non-controlled NPS in high street ‘headshops’ and on UK domain websites, placing downward pressure on NPS related harms”.

That was from a Liberal Democrat Minister in the Home Office, not in history but in August 2014. Lynne Featherstone, who was then the Minister at the time, said on 11 March:

“I will be working right up until the dissolution of Parliament to ensure we have done as much as we possibly can to pave the way for a general ban. This will mean the next government can act quickly to clamp down on this reckless trade”.

Those are not the comments of some distant academic but the words of another former Liberal Democrat Minister in Her Majesty’s Government.

Action needs to be taken urgently to tackle new psychoactive substances, but we have not acted in a knee-jerk way, as has been suggested. The Advisory Council on the Misuse of Drugs looked at this in 2011 and issued a report saying that we should explore legislation to introduce a ban because it was clear that temporary banning orders were not working on an individual case-by-case basis. We then said that we would set up, in addition to that, an expert panel to take a broader range of views, including from law enforcement. That expert panel came to the view that there should be a ban on new psychoactive substances. That view was supported by the Home Affairs Select Committee and by the other committees in Scotland and Wales that the noble Lord, Lord Rosser, referred to. It was also of course endorsed by action by the Government in the Republic of Ireland. This is not a knee-jerk response: it has been gathering pace over a period of some three to four years. We have been steadily building up and testing the case, listening to the police and local government, and finding out what is working and what is not working. This is what they have recommended that they want to see.

This is not the end of the matter. In the wider debate, there is no reason there cannot be ongoing exploration of the effectiveness of the Misuse of Drugs Act. The All-Party Drug Misuse Group frequently produces excellent and thorough reports looking at the effectiveness of that overall policy. The Home Affairs Select Committee has the ability to look at this, and has done so. I think that there have even been specific reviews of the Misuse of Drugs Act; for example, in 2001 under the Labour Government. I am going from memory there rather than the official note, so I have to be very careful, but I think it might have been Dame Ruth Runciman who led a review of that nature. This is about timing, and if we need something further, there are many excellent avenues through which that exploration can take place.

The Government’s response is that we have a piece of legislation—the Misuse of Drugs Act—and we have a cross-government policy, which involves health, education and law enforcement. We listened to that advisory committee, took further evidence from the expert panel and recommended the course of action which we are now taking and which this amendment would delay coming into effect. That is why we do not want this amendment to be agreed and why I urge the noble Lord to withdraw it. We have made our case and built the evidence, and we have a mandate from the electorate on the manifesto to act in such a way—as did the noble Lord’s colleagues who served in the previous Government.

[Baroness Hamwee (LD)]

My Lords, a few minutes ago in his speech, the Minister distinguished between the issue of new psychoactive substances—the substance, if I can use the word, of the Bill—and the review of the Misuse of Drugs Act. My noble friend will deal with the fact that those are linked but distinct and the fact that we are not seeking to wreck the Bill, as some have suggested.

I wanted to intervene because of the reference to the report of the expert panel. We will come on to some of these issues in later groups of amendments, but one of its recommendations was about exploring,

“the feasibility of an approach to control NPS”,

and referred to,

“taking into account the need for … a robust definition in the legislation”—

an issue we are clearly going to come to. It also referred to,

“monitoring … possible adverse implications and unintended consequences”,

which we will come to as well.

In the next recommendation it also refers to “robust” definitions and needing to build,

“on learning and evidence from countries that have already taken this approach”.

It is not quite as simplistic and narrow as perhaps some noble Lords might be thinking from the debate all round the Committee.

[Lord Bates]

I certainly agree with the noble Baroness that the wider issue is not narrow, it is very broad, but what we are trying to do here with this Bill is very narrow. It is very focused and based on the evidence. The noble Baroness says that the two amendments are linked but distinct. Now she is a lawyer and I am not, but to me if they are linked then they cannot be distinct. They are linked in the sense that if they are both moved together, then one effect will be to have a review which will delay action being taken on this menace—or mischief, as the noble Lord, Lord Condon, said—which is happening up and down this country and through which people are suffering and dying. We need to take action and we are doing that on the basis of medical evidence, law enforcement evidence and evidence from the Local Government Association.

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Moved by

[Baroness Hamwee]

2: Clause 1, page 1, line 7, at end insert—
“( ) Section (Control of Cannabis) provides for legal possession and supply of cannabis prescribed by a doctor.”

[Baroness Hamwee]

My Lords, this amendment is also in the name of my noble friend Lord Paddick, and I will speak to our Amendments 50 and 110. Amendment 50 is the substantive amendment and is about the use of cannabis for medical purposes, which was trailed in the previous debate by the noble Baroness, Lady Meacher.

I cannot pretend to be an expert on the scientific and medical details of this issue, but politicians are not expected to be experts. We are generalists, here to represent strands of opinion and concern. As I cannot pretend to be an expert, it may therefore be that I will not understand the response from the Minister, except that I will almost certainly understand what will come as a no, judging by his Answer to the Oral Question asked by the noble Baroness, Lady Meacher, last Wednesday. On that occasion, the Minister said that the steps that she was inquiring about and that I am proposing in this amendment would,

“undermine … efforts to reduce drug harms”.—[Official Report, 17/6/15; col. 1158.]

But our concern is to enable cannabis and cannabis resin to be used for good and to reduce the danger of harm—we have many other amendments aimed at harm reduction. The matter was considered in 1998 by the House’s Select Committee on Science and Technology, which noted that it was rejected by the then Government on the day of publication. There have been other reports since, and very recently a report for the All-Party Parliamentary Group for Drug Policy Reform by Val Curran, professor of pharmacology at University College, London, and Frank Warburton. I am very grateful for such a readable report. It is so readable that I was tempted to read the whole of it out because it is quite short, but I will not. I will spare your Lordships that and attempt to pick out the points that I think are particularly salient.

Professor Curran writes that the problem of,

“a significant number of people”,

who,

“are not authorised to receive medication which they believe will alleviate their condition … are compounded by: An inflexible legal framework … A stranglehold on research into cannabis”,

and, as she puts it:

“A determination when considering medical licensing to equate cannabis, a well known substance in terms of its effects on humans and used medically for around 4000 years … with an entirely new chemical introduced by a pharmaceutical company”.

Therefore, Professor Curran and this amendment propose that these substances should be moved from Schedule 1 to the Misuse of Drugs Regulations 2001, which deals with substances perceived as having no recognised medicinal use, to Schedule 2, which would allow a doctor to prescribe them. They would be in the same class as heroin or diamorphine. I understand that there is no evidence of significant diversion of heroin from medical supplies to the illicit market—to anticipate one possible argument. They would be subject to strict controls via medical regulation, so the diversion to recreational use would be unlikely—to anticipate another possible argument.

Medicinal herbal cannabis is available in the Netherlands, in 23 states of the USA, in Canada and in Israel. Its most-established uses include the relief of pain and muscle spasms or cramps associated with many diseases and conditions, including multiple sclerosis and spinal cord damage, nausea and other responses during treatment for cancer and AIDS; and to deal with nausea and vomiting associated with chemotherapy and radiotherapy used for that treatment. The particular cannabis substances are being exported from the Netherlands to eight other European states, including Germany and Switzerland.

In the exchanges on the Oral Question asked by the noble Baroness, Lady Meacher, last week, the Minister referred to the drug Sativex having been licensed here. Indeed it has been, but it is very expensive and NICE recommends that it is not used to treat spasticity in multiple sclerosis sufferers because it is not cost effective. However, specialist prescribers can and do make individual funding requests, which has led to wide variations across England, and in Wales its use is approved.

It is no wonder that, given no access to legal cannabis-based treatment in a practical sense and no access to herbal cannabis legally, an estimated 30,000 people in the UK find their own sources, with the concomitant risks of severe side-effects, greater potential harm, and no benefit because most street cannabis is skunk with a different make-up from Sativex and from the drug that is manufactured and exported from the Netherlands and elsewhere.

In the Netherlands there has been a genetic alteration to maximise the benign substance, CBD. There is no THC in the drug that is produced there. Professor Curran also reports on a “Stranglehold on research”, as she puts it, and that Schedule 2 status for cannabis and cannabis resin would “greatly facilitate research”. In her report, Professor Curran talks about the “costly obstacle course” and the delay taken by licence applications for use in research. She refers to practical problems such as the need to import cannabis, with import licences being granted for 12 weeks and expiring before all the arrangements for the import licence to be implemented can be made. She said at a meeting that I attended a couple of weeks ago that it is,

“a shame not to allow talent to fly”.

I could have suggested a more caveated amendment—for instance, starting with clinical trials—but I wanted at this stage to get to the heart of the matter. This is about facilitating and stimulating research in the UK into the drug and its constituents, above all by allowing the import of a drug that is widely used—and much less expensive—in the Netherlands, to enable patients to access it without breaking the law and without risking the harms of an unlawful drug without medical supervision or quality control. I beg to move.

[Baroness Meacher]

My Lords, I shall speak briefly to this amendment because the noble Baroness has said most of what I was going to say. The aim, of course, is to decriminalise the 30,000 patients in this country who currently take cannabis not because they want some sort of high—they do not—but because cannabis, they say, is the best drug for their particular pain, seizures or discomfort. It seems to me that that is important.

The types of illnesses that can be helped have already been stated: multiple sclerosis, Parkinson’s disease, Crohn’s disease, epilepsy, chronic pain, glaucoma, and nausea and loss of appetite caused by chemotherapy. That is a lot of illnesses—disturbing and distressing illnesses—the symptoms of which can be alleviated by cannabis, so it does seem strange that there is such a resistance to reschedule cannabis from Schedule 1 to Schedule 2. Any substance from Schedule 1 has no recognised medicinal use. I just do not understand this, but maybe the Minister can comment on how any Government—it is not this Government; it is every Government—can continue to maintain that cannabis has no recognised medicinal use when Germany and Italy make sure that people with these illnesses can gain access to it. Germany and Italy and many countries across the world know that this is important for their populations. It would be really helpful if the Minister would consider that point.

I also want to draw the attention of the Minister and your Lordships to the extraordinary case of a little seven year-old boy called Jayden. Jayden suffers with Dravet syndrome—an extremely severe form of epilepsy—where he has at least 500 fits a day. He was on 22 pills a day including benzodiazepines. These medications plus the seizures resulting from the illness were giving him hallucinations and terrors. The poor child would scream for literally eight hours at a stretch until he was exhausted and presumably would fall asleep. His mother left home because she could not take it, so he was being looked after by his father.

When the child was four and a half, the father was told that he probably would not live another week. The father asked whether he should try medicinal cannabis. The doctor said that he should try anything, and so he did. The day after the child was given cannabis that the father had found in a chemist’s—this was in the United States; it could not happen here—the child suffered no fits, and then no fits on the following day. Since then he has had a small number, but nothing like before. He is now being painfully weaned off all the drugs that he had been taking, including the benzodiazepines. Anyone who knows anything about those drugs—I do not, actually—will say that it is excruciating to come off them. The poor boy has been put through all this, but he does now smile, walk and play in the water. But, of course, after all those seizures, I imagine that his brain is very damaged.

I have a five-minute clip, and I would ask the Minister to take five minutes of his precious time to look at it. I know that that is a lot of time in a Minister’s day, but even if one child is spared from going through the hell of that illness, I would suggest that that is well worth five minutes. This is a slightly cheeky request to make of a Minister, but it may be an important piece of work that the Minister could do.

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[Lord Bates]

There was a video, which I would be keen to see. Perhaps the noble Baroness could send me the link or I will happily sit down and watch it with her. During the Bill’s passage, we have tried to have meetings with all interested Peers. We have a meeting on health and education on I think 7 July. Notices will be put out to all parties, but that would be a good opportunity for people to come forward. I am thinking particularly of my noble friend Lord Blencathra, who gave us his personal experience of living with multiple sclerosis and its effects. The point about the alternatives might usefully be made at that meeting if he can attend, as I hope he will. As I say, details will be on their way.

The advisory council has reported that there is clear evidence that cannabis has a number of acute and chronic health effects, which prolonged use can bring about. That is why the trials are important and why Sativex went through that process. The position is that it can be prescribed by a doctor, after the Medicines and Healthcare Products Regulatory Agency issued a marketing authorisation.

I do not know whether I have failed the test but the noble Lord, Lord Rosser, and the noble Baroness, Lady Hamwee, set a pretty low hurdle as to whether the Government’s position had changed since last Wednesday. Policy used to change pretty quickly under the previous coalition Government, but now it is a little more set out. Our position is our position but generally, as matter of policy, we have to remain alert and open to the medical evidence being brought forward. The correct channel for that is though the advisory council, which obviously draws on a broad body of research and evidence. I am grateful to the noble Baroness for giving us the opportunity to explore that issue again and, with that additional assurance of a meeting specifically on health matters to give Members of the House an opportunity to talk to those making the decisions, I ask her to consider withdrawing her amendment.

[Baroness Hamwee]

My Lords, I cannot be disappointed because my expectations were not high. The Minister has been very generous, particularly on the Modern Slavery Bill, in holding meetings that included people from outside the House. I wonder whether we could bring into that meeting some who can speak much more coherently on these issues than I can. I do not ask the Minister to commit himself to that now, but perhaps I could put it in his mind.

I am grateful for the support for the underlying issue from the noble and learned Lord. I have often been asked about the high points of my career in this House and I have said that perhaps the highest of them—this shows what a rotten politician I am—was when, on a Bill on family law reform, the noble and learned Lord said from the Dispatch Box of one of my amendments to his Bill, “The noble Baroness’s drafting is better than mine”. That really was the pinnacle of my achievements in your Lordships’ House.

I am delighted that the noble Lord, Lord Blencathra, has found a drug which suits him but, as I think he recognised, these are personal matters. I am quite puzzled as to the apparent differences between the physiologies of Britons—we are by no means a homogenous race—and those of people living in other parts of Europe. Clinical research is of course important and that is very much at the heart of this proposal, as the noble Baroness, Lady Meacher, said. I may have used this phrase already but Professor Curran said that research involving Schedule 1 drugs is “a massive uphill struggle”, for the reasons of time, cost and practicality mentioned in her report. Yes, Sativex is recognised but its expense, not its effectiveness, is the issue. The noble Lord, Lord Howarth, mentioned Bediol, which I think is about 10% of the cost of Sativex. Perhaps this goes against my street credibility but it is important to say that I have in mind boring pills, not getting high from a joint. I want to make that quite clear.

The issue comes down to what is harmful. Skunk is harmful and I do not want to see people continuing to be driven to it, or having to find ways of getting the drug that helps them from outside this country. As I said, my expectations were not high but I am very grateful to noble Lords for contributing as usefully as they have, and at greater length than we did previously. I certainly look forward to discussing the matter with the Minister and his colleagues from the Department of Health pretty soon because whatever happens with an amendment to the Bill, the issue has to go forward. Having said that, I beg leave to withdraw the amendment.

Amendment 2 withdrawn.

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[Lord Howarth of Newport]

My Lords, I find it baffling that the Government, presented with the evidence from the two laboratory experiments that have taken place in recent years, in Ireland and in Poland, have none the less persisted in their approach of introducing a blanket ban on the supply of new psychoactive substances. As the noble Baroness, Lady Meacher, has just told the Committee, in the four years since the ban was introduced in Ireland, following an initial dip in the use of psychoactive substances and a rapid disappearance of head shops, consumption of new psychoactive substances actually rose to higher levels than before. The Irish, it is reported, are the largest consumers of new psychoactive substances in Europe. That has followed the implementation of a ban essentially the same as the Government are now proposing to introduce in this country.

Similarly in Poland, three years after the ban was introduced, the number of what the Poles call “poisonings” has risen to above the level before the ban. The evidence is that, in the face of a ban and of the closing down of the sources of supply that users were previously availing themselves of, users have resorted to more obscure and more dangerous suppliers online. The European Monitoring Centre for Drugs and Drug Addiction has confirmed that. It also seems highly likely that, with the greater difficulty of obtaining new psychoactive substances, more people taking drugs will have resorted to taking controlled substances and, indeed, may have become poly-drug users.

There seems to be some very significant evidence available from the experiences of bans in these two countries to indicate that the Government’s approach is fundamentally misconceived. The Minister has insisted that the approach of the Home Office is always to base its policy on good science, good evidence and expert advice. How come then that, in the face of this evidence, it is persisting with the policy that it is presenting to the House in this Bill?

[Baroness Hamwee]

My Lords, I very much support what has been said on this amendment and, indeed, the amendment itself, in particular because we want to avoid driving those human beings who will go on using drugs underground. One small point I want to mention, before I forget about it, is that the impact in Northern Ireland should be looked at, because I wonder what has been happening across the border. The report by Mark Easton yesterday, to which the noble Baroness, Lady Bakewell, referred, revealed the difficulty that the police have in proving that a substance has a psychoactive effect. That seems to me to be very much at the heart of this, with only four successful prosecutions in five years.

The expert panel talked about “robust” definitions and the Constitution Committee of your Lordships’ House reported, I think yesterday, on the need for certainty. The Joint Committee on Human Rights probably does not have its full membership yet, but no doubt it would have taken points on the importance of certainty in legislation—it did so for other legislation, particularly the recent anti-social behaviour Bill. The Constitution Committee said:

“The Bill inevitably exists in tension (at least to some extent) with the principle of legal certainty since its raison d’être is the regulation of activities in respect of substances that may not currently exist and whose nature and composition cannot readily be prescribed in advance with any accuracy”.

I thought that was very honest of it. However, it then went on to comment about not making,

“unacceptably broad inroads into the principle of legal certainty”.

We may come on to some of the detail of that on later amendments, but it seems to me to be very relevant to the point that the noble Baroness, Lady Meacher, has made with this amendment.

A proper, independent assessment would mean that we had advice that was not from those defending their own scheme, which can sometimes happen. I hope that we can hear sympathetically from the Minister on this, because I have absolutely no doubt that the noble Baroness will pursue this matter throughout the passage of the Bill and she will certainly have support from these Benches when—not if—she does that.

[Lord Tunnicliffe (Lab)]

My Lords, somebody has to give the Government some support on this. Amendment 3 talks in the first proposed subsection about an impact assessment and it being used to justify the commencement of the Act. I do not understand Amendment 109, but Amendment 114 is clearly about delaying the commencement of some provisions of the Act until the report of that assessment has been considered. Amendments 3 and 114 between them would delay the commencement of the Act.

Although the balance was a little uncomfortable, we had a very good Second Reading, in which it was clear that the central debate was about whether you believed banning produces a benign effect or not. That was the essence of the debate, as it has been of the debates we have had today. The position of the Government is that effective bans are benign in their effect; the position of Her Majesty’s Opposition is that effective bans will have a benign effect; and the position of the Liberal Democrats was—at least until the election, we thought—that effective bans had a benign effect.

[Baroness Hamwee]

My Lords, I wonder whether I can quickly try to squash this. A clamp-down on new psychoactive substances, which was in our manifesto, is not the same as a complete ban.

[Lord Tunnicliffe]

I thank the noble Baroness for that clarification. As I say, we are divided between those who believe that banning has a benign effect and those who do not.

This is a simple, fairly narrow Bill to close a loophole in the 1971 Act which is growing exponentially. We believe that it is appropriate that this loophole should be closed urgently and that there is sufficient evidence to proceed to close it with this Bill, which we believe should be introduced as soon as reasonably possible. We believe new psychoactive substances are not safe and we want them to be illegal as soon as reasonably possible.

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[Baroness Meacher]

My Lords, in moving this amendment, I will also speak to Amendment 8. I apologise that these have all come one after another and I was not anticipating that, but I will speak extremely briefly, noble Lords will be pleased to hear.

These amendments seek to limit the scope of the Bill to those substances that are synthetic—produced by chemical synthesis rather than grown naturally. The Government’s manifesto commitment, if I understand it, was to ban new psychoactive substances. All such substances identified by the EMCDDA have been of a synthetic nature. To broaden the scope of the ban beyond the limits of substances that are synthetic will create far more unintended consequences than I believe the Government really had in mind.

The point behind this amendment is that the Bill as it stands is disproportionate and will engender an intolerable degree of legal uncertainty for an awful lot of people—researchers, medical people or whoever—who have no interest in consuming these substances but may be involved in handling them. Actually, one should extend that to people who are in the commercial sector trading, producing and so forth who may need to use these substances and really do not want to be questioned by the police.

It would be helpful to know why the Government have extended the scope of the Bill to include natural psychoactive substances. Are the Government aware that there are many natural substances, included in perfumes and other products, for example, which could be caught unintentionally by the Bill as it stands? We had a debate earlier about the whole business of definition and in a sense that comes up here again. Things might be a bit simpler if the Bill were limited to synthetic substances. Will the Minister explain to the House what investigations have taken place to establish the unintended consequences of the extension of this definition to include natural substances? I beg to move.

[Baroness Hamwee]

My Lords, my noble friend and I have Amendments 9 and 10 in this group. Amendment 9 presents me with a dilemma, given the comments that we have been making about what has been happening in Ireland. Amendment 9 would import into the Bill the Irish definition in terms. Given where we are and given that the definition in the Government’s Bill is more telegraphic than the Irish one, I would nevertheless like to hear what the Government have to say about the differences.

I and other members of the Committee will have received from the Minister a response to points made at Second Reading, for which I am grateful. In response to one point that I made, the Minister wrote that,

“we have retained core elements of the Irish definition but sought to refine it so as to make it more concise”—

given the length of most of our legislation, that is not the most persuasive argument that I have heard—

“by removing reference to different substances and behaviour changes, and remove the element of subjectivity inherent in … the word ‘significant’”.

I understand that the Government do not want this to be read subjectively, but can I add a thought? Different people react differently and they react differently to different drugs. We have heard that. There is something in the connection between that and subjectivity and maybe neither of us is quite right, but there is an issue there. The Minister talked about removing reference to behaviour changes. The point about the Irish definition is the impact on behaviour changes.

The second limb of Amendment 9, which is not an addition to the first because it does not qualify the first, refers to the substance having the capacity, as in the Irish definition, to,

“cause a state of dependence, including physical or psychological addiction”.

We are told that that has been removed because the Government have,

“concluded that this was captured as part of affecting a person’s mental functioning or emotional state and was unnecessary duplication”.

That surprises me. The Irish looked on it as an alternative in their definition. Perhaps the way I can best put it is to ask how the scientists look at this. I would have thought it was completely separate from affecting mental functioning or emotional state and is therefore not an unnecessary duplication.

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[Lord Mackay of Clashfern]

My Lords, when we talk about “banning”, we mean the substance being used to commit an offence under the Bill. There are two ways of reaching that conclusion. If you see someone taking a tablet or a substance and suddenly his mental state has been altered, cause and effect is likely to be demonstrated. The second way is that if you know the nature and qualities of substances, when you analyse the substance you may be able to do it that way too.

The important thing, however, is that it is not a question of the substance not being banned until you discover it: the definition applies right from the beginning. As the Minister said, when the Bill becomes law, substances with that character become the possible ways of committing the offence. The question of whether a particular substance is of that character can, I think, be approached in these two different ways, according to what is convenient in the circumstances of the individual case.

[Baroness Hamwee]

My Lords, before the noble Baroness responds, may I ask a question? It will display the depths of my ignorance, which will gratify the noble Lord, Lord Harris, who can never resist teasing me. If one has a herbal product and it is genetically modified, does that make the outcome synthetic, or does it remain herbal?