Drugs Licensing

Baroness Walmsley Excerpts

Tuesday 19th June 2018 Lords Chamber

[Lord Rosser (Lab)]

I thank the Minister for repeating the Statement made earlier in the House of Commons, and endorse the views expressed in it of sympathy for Billy Caldwell, Alfie Dingley and others like them, and for their parents, who, as the Statement says, have been under unimaginable stress and strain.

With yesterday’s Urgent Question in the other place on the medical use of a cannabis-based medicine uprated to today’s Statement on drugs licensing, this appears to be another example of the Government making decisions on the hoof, in a flap and in response to embarrassing media stories, rather than being a proactive Government who make measured, fully thought-through proposals to address developing issues before they hit the national headlines. Despite this, we still welcome the Home Secretary’s statement that the Government will look more closely at the use of cannabis-based medication in healthcare in the UK, and that they will review the scheduling of cannabis. As the Minister said, what started this off was the case of a 12 year-old boy suffering from severe epilepsy, whose cannabis-based medication was confiscated on arrival at Heathrow from Canada—a decision now modified by the Home Secretary. It contains THC, the primary psychoactive constituent of cannabis, which is illegal in this country but not in a number of other countries, including Germany, the Netherlands, Italy and much of America.

Yesterday, the Government said that the Chief Medical Officer for England had been asked to establish a panel to advise on an individual-case basis on when medicinal cannabis-based products should be prescribed. How many such cases per month do the Government anticipate the panel having to adjudicate on and advise, and against what criteria will that advice be given? What fresh instructions have been issued to officials over allowing through or confiscating cannabis oil and other medicinal cannabis products as from now at our borders and entry points in the light of the Billy Caldwell case? Through what procedure and process will an individual case reach the expert panel? How many instances have there been during the past 12 months of cannabis oil needed for medical use being confiscated at our borders and entry points, and how many of those cases were reviewed by the then Home Secretary, and with what result, under the powers which have apparently just been used by the current Home Secretary? What is the Government’s estimate of the time it will take for the two-stage review just announced by them to conclude its work?

The Statement says:

“If the review identifies that there are significant medical benefits, we will reschedule”.


In other words, the Government do not yet know whether there are such significant benefits. In which case, against what criteria or evidence will the expert panel of clinicians being set up to advise Ministers on any individual applications to prescribe cannabis-based medicines—based firmly on the medical evidence, as the Statement says—make its judgments? I ask that because the Government believe that a two-stage commission is needed to decide whether there is even a case for any change on scheduling in the light of the available evidence.

I come back to the Statement and the words:

“If the review identifies that there are significant medical benefits, we will reschedule”.


Would that apply if the Advisory Council on the Misuse of Drugs came to the conclusion that there were also significant harms from rescheduling, which is what the ACMD is apparently being asked to consider under stage 2?

Finally, a recent report in Private Eye, under the heading “Pot and Kettle” and referring to the Alfie Dingley case as does the Statement, stated:

“A UN report this month found that the UK is in fact the largest producer of legal cannabis in the world—responsible for almost half the global total … As … the drug reform think tank Transform, said: ‘The government is denying that cannabis has medical uses but at the same time licensing production of the world’s biggest medical cannabis production and export market”.


Is that report correct?

[Baroness Walmsley (LD)]

My Lords, I, too, welcome the Statement and thank the Minister for making it. I thank her also for her efforts in this cause and those of her noble friend Lord O’Shaughnessy, who is in his place. I welcome the fact that Professor Sally Davies will now review the mountain of evidence for the medicinal and therapeutic benefit of cannabis-based medicines. She will undoubtedly find that the fact that there are no legally recognised benefits is quite wrong and must change. By what means will Professor Davies hear evidence from the many patients who already know about the benefits? Their doctors know the benefits, too. If she does not already, I am quite sure that Professor Davies will soon know them as well.

I also welcome the fact that the Government will reschedule cannabis when Professor Davies demonstrates those benefits. It should never have been scheduled as a drug without any medical benefits in the first place. Can the Minister estimate how long this process will take, as thousands of patients await the outcome in pain and discomfort?

While we wait for this to be done, it is very welcome that the Government have set up an expert panel to advise Ministers on any applications to prescribe cannabis medicines. It is outrageous that the Dingley family’s heroic doctors should have been put through the wringer by the inappropriate processes which the Home Office has imposed on them during the past four months.

I cannot say how delighted I am that Alfie Dingley and Billy Caldwell will get their medicines at last. However, it should not have taken four months since the Prime Minister promised Alfie’s mother, Hannah Deacon, when she visited No. 10 with me and a group of Peers and MPs, that her son would get a licence for his cannabis medicines on compassionate grounds and speedily. During that four-month period Home Office officials were trying, mistakenly, to operate a system for licensing which was not intended for such cases but was intended for normal clinical trials. It became clear very quickly that the system they were trying to use was not fit for purpose, yet they persisted. I would like to be assured that a system that is fit for purpose will be put in place. Will the Minister give me that assurance? It should not have taken a child, Billy Caldwell, being put in a life-threatening situation for the Government to take this action but I am delighted that they now have.

During the campaign I have been convinced of the Minister’s good faith in this matter but, frankly, although she is always welcome in her place, it should be a Health Minister standing there at the Dispatch Box. I am delighted to see the noble Lord, Lord O’Shaughnessy, in his place listening to this debate. Drug licensing is a health matter, not a Home Office matter and clearly the Secretary of State for Health and Social Care agrees with that, so how will the Department of Health and Social Care be involved in the new arrangements outlined in the Statement and those that will inevitably follow?

Yesterday the Prime Minister said a system is already in place for the medicinal use of cannabis and that government policy would be driven by “what clinicians are saying”. The system has failed thousands of patients, but it is good news that the Government are now trying to put that right, and I thank the Minister for that. Can she say whether expert evidence from countries such as the Netherlands, where cannabis medicines have been safely used for some time, will be heard during the review?

[Baroness Williams of Trafford]

My Lords, I did not do it yesterday, but I welcome the noble Lord, Lord Rosser, back to his place. It is such a pleasure to be debating with him. The first question he asked me was about whether we are doing this on the hoof given the Alfie Dingley case. We are not. One of the noble Lord’s further questions was about why it took so long between Alfie Dingley’s family coming forward and him being issued with a licence today. That is because the correct process was followed. Noble Lords would expect the correct process to be followed. The reverse of this is that a child gets given the wrong drug and becomes very ill. The correct process was followed here. The Home Office and the Department of Health and Social Care have worked extensively together over the past three months to ensure that Alfie has been well cared for, and the licence for his drugs was issued today.

The noble Lord asked how many people would be on the panel. I cannot say. It was announced today, and numbers and people will be announced in the coming week. He asked about the criteria the panel will use for who will be issued with drugs. I assume that there will be clinical experts on the panel and that they will base their criteria on their clinical judgment of the benefits.

On stuff being confiscated, I hope that people do not present at the border with drugs that are not yet licensed, and will come forward to the panel for consideration and for drugs to be issued if that is appropriate. The noble Lord asked how long the review will take. Cannabis is a very complex substance, as noble Lords probably know. It will be a complex review, but the Home Secretary expects an interim report to him within three months.

The noble Lord asked about the expert panel and the advice that it will give. Again, the proper process will be followed. It will be a scientific process with clinical judgment at its heart. He also made the Private Eye point about the UK being the largest producer of cannabis. I do not think that the Government are saying that there are no benefits to be had from cannabis; they are saying that cannabis as a whole plant is currently classified as a Schedule 1 drug, as we have discussed previously. However, as we have seen, constituent parts of it have huge benefits, particularly in the areas of MS and, now, epilepsy.

The noble Baroness, Lady Walmsley, asked for details of the review. We are working through those. I certainly know, because my noble friend has just told me, that Sally Davies will be carrying out a literature review. There are findings from across the world. Much work has been done on this and that will be very informative.

The noble Baroness also made the point about the Dingley family being put through the wringer. Again, it was important that the proper process was followed, and it was. A licence application needed to be made. It was made and I am very pleased to say that Alfie Dingley’s licence was issued today. She asked for an assurance that a system fit for purpose will be put in place. The answer to that is firmly yes: the system has to have longevity. This has been a very big and important step for the Government today.