Drugs Licensing

Debate between Lord Rosser and Baroness Walmsley

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?

Immigration (Health Charge) (Amendment) Order 2017

Debate between Lord Rosser and Baroness Walmsley

Thursday 9th February 2017 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I welcome the noble Baroness to her new role. We welcome the exemptions and clarifications that she has just outlined. I should like to use this opportunity to express some concerns and ask some questions about the Government’s policy of charging foreign nationals for the use of the NHS, and how this will work.

It is right that those who are not entitled to the free use of our NHS should pay for their treatment—or it should be paid for by their insurance or their Government. Some hospitals have already introduced the policy successfully but, irrespective of its merits, the focus on collecting the equivalent of 0.5% of the NHS’s annual spend reflects the Government’s skewed priorities. It ultimately serves to mask the main challenge facing the health service—a lack of cash.

The principle that those not eligible for free NHS care should pay up front for non-urgent treatment is sound. However, there must be clear safeguards in place to prevent profiling of people who have surnames that sound “not British”, and to protect vulnerable people such as the homeless who cannot prove their right to treatment by providing the correct documents. We must also guard against any temptation to extend this policy to urgent treatment. How do the Government plan to ensure that this does not happen?

Health tourism should be properly addressed, but it is not particularly significant in terms of the overall funding of the NHS. The recent government announcement cannot mask the refusal to address the serious failures of care which are now routine across the NHS as a result of impossible financial pressures. Only this week we have heard about increases in waiting times for operations, and in unexplained deaths among those with mental health problems. One hospital trust in Kent has halted all non-urgent operations until the end of the financial year. The Government need to tackle important problems such as staff shortages and retention and a lack of social care. Recent statements reflect a warped sense of priorities. I hope that my right honourable friend Norman Lamb MP’s cross-party meeting with the Prime Minister last week will lead to a genuine consensual process to deliver a long-term settlement for the NHS and social care.

Ultimately, the NHS must not lose the humanity and compassion that are the hallmarks of an institution of which this country is rightly proud. Doctors do not see their jobs as being border guards or revenue collectors. Can the Minister assure us that clinical staff will never be expected to collect money? This would completely change the relationship between doctor and patient. Can she also assure us that hospital administrators will get funding for extra help, and if they do, will the policy be cost-effective? Talking of capacity, I heard a Minister on the radio recently whom I felt was actually encouraging people to come from abroad to use our NHS—as long as they paid for it. As waiting lists and queues in A&E and for GP appointments get longer, I would have thought the last thing we should be doing is encouraging more customers from abroad. Can the Minister say whether hospitals are charging a full cost-recovery amount—or more, or less? Does the hospital keep the money, or does it go straight to the Treasury like the rebate on drugs?

[Lord Rosser (Lab)]

My Lords, this is the first opportunity I have had to welcome the Minister to her new role. I thank her for the explanation of the purpose and thinking behind this order which we support. It brings into effect amendments to the Immigration (Health Charge) Order 2015. That order led to an annual immigration health charge, introduced, as the Minister said, on 6 April 2015, being imposed on non-EEA nationals applying for leave to enter or remain in the UK for a limited period. Those who pay it can access NHS services free of charge, apart from payments in respect of treatments or prescriptions for which UK residents have to pay.

The Minister has set out the reasons for making the amendments provided for in this order which, in essence, remove the immigration health surcharge exemption of intra-company transferees and their dependants, extend the human trafficking exemption to include victims of modern slavery and provide greater clarity in the interpretation of some rules in the Immigration (Health Charge) Order 2015.

I have two brief points. One of the amendments in respect of ICT workers has emanated from a recommendation of the Migration Advisory Committee. Are there any committees or other bodies looking at issues that might lead to further amendments to the Immigration (Health Charge) Order 2015? Or have we now reached the stage where the Government can confirm that they have no reason to believe that further amendments will be needed in the foreseeable future—and certainly not prior to our departure from the European Union?

In the House of Commons the Government said, as the Minister has reiterated today, that the immigration health charge collected £164 million for spending on the NHS in its first year of operation. These amendments could provide an additional minimum amount of £136 million for the NHS over 10 years. Can the Government give an assurance that the money raised from the immigration health charge represents additional money for the NHS which would not have been available had the charge not been in existence? The money raised must not simply be used to enable the Government to reduce the amount they provide to the NHS by the sum raised by the health charge.

Serious Crime Bill [HL]

Debate between Lord Rosser and Baroness Walmsley

Tuesday 14th October 2014 Lords Chamber

[Baroness Walmsley]

This proposal came out of a parliamentary inquiry co-ordinated by Barnardo’s and chaired by Sarah Champion MP. Two of my noble friends, my noble friend Lady Benjamin and my noble kinsman Lord Thomas of Gresford, and I were both on that inquiry. We heard first-hand what others have been able only to read: the evidence for making this change to the law. It was very interesting and moving to hear the evidence of the victims. It was also moving to hear the evidence of the police who are committed to protecting children but feel that they do not have sufficient tools to do so.

Our focus should be on prevention or at the very least on the earliest possible intervention. The police are asking for this power to be made statutory so that they can enforce it at an earlier stage of the grooming process. It was made very clear that many of these young girls are quite willingly in the company of older people who eventually abuse them. One young person who gave evidence to us said that she genuinely thought that these people were her friends and the only people who cared about her in the world. That indicates that these young people are not there because they have been physically abducted; they are there willingly. Very often, in a prosecution, they are not willing to give evidence that they have been abducted.

Passing this amendment, or something very similar, would strengthen young people’s confidence in the police. Currently, the approach has a further damaging effect because it erodes the confidence of victims and their families in the ability of the police to protect them when they see that an abuser has broken the terms of a child abduction notice but no action is taken. That is why we need to make it statutory.

[Lord Rosser]

I certainly do not intend to repeat the arguments that have already been made in Committee and on Report in favour of this amendment. As the Minister will well know, in his response in Committee, the noble Lord, Lord Taylor of Holbeach, accepted that proposals to strengthen the impact of child abduction warning notices had the support of the police, legal experts, representatives of local agencies, young people who had been affected by sexual exploitation, children’s charities and others. The then Minister undertook to consider carefully the benefits of putting these notices on a statutory footing and how such a statutory scheme might operate. He indicated that the Government were committed to examining the case for placing child abduction warning notices on a statutory footing but said that, while the Government may not have completed their review by Report stage, he would update the House on progress. I may have missed a letter but I am not aware of the Government having completed their review.

Among the issues that the then Minister felt needed to be considered were whether it was appropriate for the police to impose an order or injunction, breach of which is a criminal offence; the test for the grant of an order; the prohibitions or restrictions that might be attached to an order; the penalty for breach of an order; and the reference in the amendment requiring a child to have been found two or more times in the company of the person to be made the subject of an order. On these issues, which were raised by the then Minister in Committee, as far as I am aware, we await the Government’s conclusions. I am assured that all those groups and bodies interested in this specific issue are happy to work with the Government to resolve these points.