Drug Treatment Services

Ronnie Cowan Excerpts

Tuesday 16th July 2019 Westminster Hall

[Ronnie Cowan (Inverclyde) (SNP)]

I thank the hon. Member for Manchester, Withington (Jeff Smith) for securing this debate.

Figures released today show that in Scotland there are more than three deaths a day due to drug use. But who really cares? Who are those people who are dying? It is the homeless; the isolated; the good-for-nothing; the detritus of society. People who inject themselves with poisonous substances do it to themselves—nobody makes them do it. How often have we heard that justification? Nobody is saying it in this place, but we know some people are thinking it.

Through a lack of compassion, but primarily through a lack of understanding, society has created a sub-culture of marginalised people who are pushed to the fringes of our day-to-day consciousness. It has become far too easy to dismiss them, ignore them and exclude them from our cosy lives. Problematic drug users are not getting high for the kicks; they are self-medicating because the pain of everyday life is so great that without the drugs they could not live. The sickness is not the drug use—the pain started long before the addiction. Of the 10% of drug users who develop an addiction, the vast majority have been physically, psychologically or sexually abused. Mix that with financial and aspirational deprivation and it makes a powerful mix that it takes powerful drugs to supress. That is why the support services must be about homelessness, mental health, security, continuity, understanding and compassion—everything that counters the chaos.

When I visited drug consumption rooms in Barcelona, I was particularly struck by one facility: a health centre where people visit their GPs for everyday ailments, which is attached to a hospital that people can be referred to. One part of the health centre is for homeless people to visit and pick up clean clothes, have a shower and shave. Over time, the staff build up a relationship with the clientele and come to understand why they are homeless and what can be done. Another unit attached to the health centre is a drug consumption room; the staff there have exactly the same attitude as the staff in the health centre, the GP surgeries and the homelessness unit. They want to know, “What is your problem, and how can I help?”

That is a million miles away from the stigmatisation that is so common in the UK. The mindset of approaching problematic drug use as a health issue pays great dividends: it is cheaper than pursuing and incarcerating people for drug possession; it frees up the police to fight crime; and, most importantly, it works across the globe. It does not work for everyone; tragically, there will always be drug-related deaths, but as we look at the figures released today let us not forget that, thanks to the naloxone available in DCRs, there has never been a death due to overdose in any DCR anywhere in the world. When will the UK Government come to terms with that?

[Luke Graham (Ochil and South Perthshire) (Con)]

On the reform of drug laws, we probably have a lot in common, but today’s shocking figures show that the number of drug deaths in Scotland is not only three times the average of the rest of the United Kingdom, even though we are all under the same laws, but the highest in Europe. If the hon. Gentleman wants a health-based solution, will he explain what, after 12 years of SNP stewardship of our health service in Scotland, can be done? What should be done through the devolved and central Governments working together?

[Ronnie Cowan]

The policy is a Europe-wide one; it is proven that the methods used elsewhere in Europe have helped the situation.

Glasgow stands ready to pioneer a DCR. There is cross-party support from Glasgow Council, backing from the SNP Scottish Government, and NHS Greater Glasgow and Clyde is fully on board. What in the name of goodness is stopping the UK Government from joining us?

Medical Cannabis under Prescription

Ronnie Cowan Excerpts

Monday 20th May 2019 Commons Chamber

[Ronnie Cowan (Inverclyde) (SNP)]

I wish to extend my thanks to the right hon. Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) for securing this debate here today.

Several speakers have been quick to explain that this debate is about medical cannabis and not cannabis for recreational use, and, within the context of this debate, that is quite correct. The fact that we feel the need to explain that is a strong indication that there is, in the wider audience, a great deal of mistrust born through ignorance of what cannabis actually is. We even start getting confused when we try to differentiate between cannabis and hemp. What we have here is a mess of our own making.

This is about a plant that can be grown in the UK and, indeed, is already grown in the UK but under licence from the Home Office—more about that later. It is a plant that is good for the soil in which it grows; a plant of which almost every single part can be utilised to make bio-degradable plastics, bio-degradable cloth and, as we know, medicines; and a plant that has been cultivated for thousands of years in various forms. Why do we have an issue with it? Why has cannabis been demonised? When we mention the word cannabis, why for the majority of people does it conjure up the image of somebody sparking up a joint, a spliff, a jay, a doobie, or a roach? It is because, in the Misuse of Drugs Act 1971, this place got it horribly wrong. It fell in with the prohibitionist mantra from the USA and it made a range of drugs illegal.

Before then, we controlled their use; we tolerated that use socially; and we prescribed them as required. It was actually called the “British system”, and it worked. No criminal gangs controlled the production and distribution. There was no escalation in violence to protect the marketplace, no county lines and a lot less corruption. But with that one incredibly clumsy Act, we demonised the entire plant.

If we were talking about medical hemp today, a range of folk would be more open to the discussion, but because of one cannabinoid in the plant—tetrahydrocannabinol or THC—we have ignored the other 100-plus cannabinoids. We remain ignorant of the benefits they can bring and of how they interact with the endocannabinoid system that each and every one of us has in our own bodies.

The lack of medical research in the UK has led to an entirely unsuitable situation, and my frustration is that we seem to be in no hurry to clear it up. Why are we not moving heaven and earth to license products that are used widely in other countries? Across the UK today, people are suffering needlessly. The medicines exist and are being prescribed and used elsewhere, but the UK Government’s attitude is, “Nobody knows better than us.” We now find ourselves in a position where we are being forced to fight this issue one case at a time.

We brought Alfie Dingley to No. 10 to meet the Prime Minister. That seemed to make a difference. Billy Caldwell’s mum brought the matter to a head by attempting to bring the product into the country. That moved things on, too. And in their situation, would any of us not do the same? Would we not do whatever it took to gain access to medicine for our children? We cannot keep on fighting this on a case-by-case basis. It is cruel and heartless, and there are simply too many kids out there who could benefit now. I apologise to the many people who suffer with arthritis, multiple sclerosis and cancer, because we do not shout about them as much, and they also need to be listened to. The sad fact is that this Government have shown that it takes heart-breaking cases of kids with epilepsy to bring them to the table.

[John Mc Nally (Falkirk) (SNP)]

Would my hon. Friend confirm my understanding that, for the 10,000 people with MS who could benefit from cannabis for medical use, nothing has changed since 1 November 2018, when the Government made it legal for specialist doctors to prescribe cannabis-based medical products? Am I correct in thinking that that is true?

[Ronnie Cowan]

My hon. Friend is absolutely correct. I have a briefing from the MS Society that illustrates his point. It says that, since Thursday 1 November 2018:

“Nobody with MS has so far benefitted from the change in the law, and access to cannabis-based medicinal products remains very limited. This includes access to Sativex”.

Sativex is a licensed product. Of course, people can get it privately if they can spare £500 a month.

As I have said, the system is cruel and heartless. Let us look at one example of how stupid our current laws are and how damaging they are to the patients we are supposed to be helping. If a child suffers from certain forms of epilepsy, there is good evidence that a cannabis-based medicine called Bedrolite may be of great help. Any parent or guardian in that situation would want to access Bedrolite. I know of one child who was having 16 seizures a day and is now on Bedrolite. As of today, that child has been free of seizures for 50 days. Can we begin to imagine how great that is for the child and for his surrounding family and friends? But his supply is running out and his mother said to me yesterday, “I can’t let my boy get sick again.” What has she got to do to keep her boy well?

The good news is that people in the UK can get Bedrolite—if they are rich, if they fundraise, or if they go to a private clinic, pay for a prescription and then pay £560 per bottle. For one patient I know, that equates to £28,000 a year. And that is not the most expensive case I know of—not by a long way. I know of cases where it would cost people twice that much to medicate their children. If people are prepared to break the law to provide medicine for their child, they can travel to the Netherlands and purchase Bedrolite for £167 a bottle, reducing the annual cost to £8,100 a year, plus travel and accommodation costs, but those people risk being arrested and separated from the child they are trying to help.

I know of a wee boy in Scotland whose mum has brought back oils illegally from the Netherlands. He recently went through a bad spell of cluster seizures. Normally, he would be in hospital, unconscious, and unable to walk, eat, speak or swallow. This time, he has remained at home and has not needed any rescue medication. His mother should not have to pay thousands of pounds a month and break the law trying to help her sick child. It is no wonder that the scammers have moved into this marketplace. As a parent wrote to me yesterday to explain,

“The vultures are praying on very vulnerable desperate families and selling fake or non filtered oils which is unsupported and also very dangerous”.

This highlights another problem. When we sit back and do nothing, scammers and criminals will move in. People will say, “I’m buying a product that is cannabis, but it’s not doing me any good.” Then the Government will take another step back and say, “Well, the evidence simply is not there.”

People’s last option is to do what the Government have said they should do. To access medical cannabis, someone must have tried medical cannabis and experienced benefits, but, as I have pointed out, that involves either a lot of money or breaking the law. That is what the Government are asking parents to do. A person must have exhausted all other drugs, despite knowing they do not work and have many dangerous side effects; we are asking people to endure side effects and disappointment to justify their request. Once they have done that, they find that their GP cannot prescribe under the current system and that specialists are reluctant to do so because they are going out on a limb and fear reprisals from the medical community.

We have a situation where the UK Government say, “We have a system,” and absolve themselves of their responsibility and duty of care to the citizens of the United Kingdom. I was going to ask the Minister explain why we cannot treat any cannabis-based medical products as schedule 2 drugs under the statutory instrument where that product has been prescribed by a medical practitioner in another jurisdiction, but of course we have a Health Minister in front of us today, not a Home Office Minister. Yet again, this problem falls between two stools. The Home Office or the Department of Health and Social Care—who will take responsibility for this issue and move it forward?

While we delay, the privatised UK cannabis business grows and the privatised pharmaceutical companies are controlling the available products with an iron fist. It looks as though we are restricting the provision of medical cannabis while we evaluate a marketplace and develop products with the intention of making a lot of money out of it, but the Government would not be that cruel, would they? Not deliberately! The Government do not have a vested interest in the pharmaceutical industry, do they? They are not granting licences to their pals to grow cannabis or encouraging family members to invest in pharmaceutical companies with a vested interest, are they? Surely not. But of course, we know that they absolutely are. That is the backdrop to the photo opportunities and the sympathetic words of staged understanding from Ministers. Unless someone has a child living in these circumstances, they cannot possibly understand the need, the frustration and the anger. As politicians, we are elected to listen to the people. The parents and guardians of these young men and women are screaming at us, “Give us access to affordable, legal medication for our children, and do it now.”

--- Later in debate ---

[Seema Kennedy]

I recognise the deep pain that families are going through, and I do take the point about the great frustration and desperation of the families. What I would say is that we have asked for more evidence, and we are working with everybody necessary to try to get this done as quickly as possible. NICE is internationally recognised for its robust and evidence-based evaluations and guidelines.

[Ronnie Cowan]

I have two families in my constituency whose children are both suffering from epilepsy. They are taking Bedrolite today, and the families know it is beneficial for their kids. That is anecdotal evidence, but it is in their houses and they can see it working. The prescriptions for the sources they have will run out in June and in July. Can the Minister tell me what I should say to those parents when their kids’ prescriptions run out?

[Seema Kennedy]

I do not feel able to comment on a specific issue when I am not a doctor, a clinician or a scientist—

[Ronnie Cowan]

As a parent?

[Seema Kennedy]

Of course I could as a parent, but again, I am not a doctor, and I am not here to make that call. What I would say is that I am very happy to meet the hon. Gentleman to get more of the facts he is presenting to me.

What is needed to support such prescription is evidence of efficacy, and for public funding evidence of cost-efficacy. That is the system we apply to all medicines and medical devices in the UK, and cannabis should not be treated any differently. The current evidence base has been summarised by the professional bodies in their interim clinical guidance, and it will be further examined and reported on by NICE shortly.

Access to Medical Cannabis

Ronnie Cowan Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

Yes, the call for randomised control trials and the process evaluation are both being conducted very urgently by NHS England.

[Ronnie Cowan (Inverclyde) (SNP)]

There are lots of warm words circulating here today. My question relates to the point that was just made. We have this problem today, but clinical trials will take six months, nine months or a year. What can we reasonably do legally to get certified products that we know will work into the hands of parents with children who desperately need them today?

[Matt Hancock]

I entirely understand the hon. Gentleman’s point, and I feel the same way as he does about the urgency of these cases. The need to get a second opinion can be actioned immediately, and it will be, because the crucial point is that unlicensed medicines cannot be prescribed without a clinician. There are just over 95,000 clinicians on the specialist register, and any of those who have expertise in this area can, if their clinical judgment allows, make these prescriptions. That can happen right now.

Eurotunnel: Payment

Ronnie Cowan Excerpts

Monday 4th March 2019 Commons Chamber

[Matt Hancock]

I am sure that the hon. Lady’s constituents will need to be confident that there is medicine for them, whatever the scenario is under Brexit, and that is what this settlement is all about.

[Ronnie Cowan (Inverclyde) (SNP)]

Is the Minister aware of the number of healthcare companies that are reluctantly extending their bank credit so that they can stockpile goods and components because of the lack of forward planning by this Government? What can he do to help those companies and also to help the banks that have to lend on longer terms than they normally would have an appetite for?

[Matt Hancock]

I mentioned in my statement that the pharmaceutical industry has stepped up to the plate and acted extremely responsibly in order to put in place the stockpiling that is necessary for a contingency in the event of a no-deal Brexit. All of us in this House can do something about the potential of a no-deal Brexit: we can vote for the deal.

Oral Answers to Questions

Ronnie Cowan Excerpts

Tuesday 15th January 2019 Commons Chamber

[Ronnie Cowan (Inverclyde) (SNP)]

5. What guidance his Department has issued to clinicians on the prescription of cannabis-based products for medicinal use.

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

13. What recent clinical advice he has sought on the licensing of cannabis oil for medicinal purposes.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

The Government acted swiftly to change the law to allow cannabis-based products to be prescribed for those patients who might benefit, with advice from the chief medical officer and the Advisory Council on the Misuse of Drugs. NHS England and the CMO have written to clinicians in England highlighting the interim clinical guidance available.

[Ronnie Cowan]

When the Government announced that they were prepared to allow medical cannabis under prescription, the decision was welcomed by many people throughout the United Kingdom who suffer from a range of conditions, but the process that has been adopted has failed to deliver. When will the Government take steps to facilitate GPs to prescribe and pharmacists to provide the appropriate effective forms of medical cannabis?

[Steve Brine]

We commissioned the National Institute for Health and Care Excellence to produce further guidance that should be out by October. Doctors are right to be cautious when the evidence base remains limited and further research in this area is vital. The change to the law will facilitate that. The National Institute for Health Research has called for research proposals to enhance our knowledge in the area and I think that that is absolutely right.

Oral Answers to Questions

Ronnie Cowan Excerpts

Tuesday 24th July 2018 Commons Chamber

[Matt Hancock]

Those are really important questions. On funding, I announced only last week £487 million to improve technology and technology services to ensure that they can be as high quality as possible. On patient safety, the key is to keep improving technology so that it gets better and better. On universal access, we must use technology in such a way that patients who want to access services through technology can do so, as that frees up resources so that more can be done for those who do not want to use technology, meaning that we preserve universal access.

[Ronnie Cowan (Inverclyde) (SNP)]

2. What recent discussions he has had with the Home Secretary on policies to tackle drug-related harm.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I attended the most recent cross-Government board meeting, which was held in June and chaired by the Home Secretary, to discuss the implementation of the drugs strategy. We know that drugs can devastate lives and damage our communities. The Government’s approach remains clear: we must do everything that we can to prevent drug use and support people through successful treatment and recovery.

[Ronnie Cowan]

Given the recent statistics showing that drug-related deaths in Portugal are three per million, compared with the UK figure of 64 per million, does the Minister agree that the UK Government should follow Portugal’s example and make drug policy reform a matter primarily for Health and Social Care, rather than the Home Office?

Transforming Care Programme

Ronnie Cowan Excerpts

Thursday 5th July 2018 Commons Chamber

[Ronnie Cowan (Inverclyde) (SNP)]

Thank you very much, Madam Deputy Speaker; it was like Hobson’s choice there, but I eventually got to my feet.

I thank the right hon. Member for North Norfolk (Norman Lamb) for securing this important debate. I echo the sentiments of the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) about there being lamentably few Members present to take part; it makes my job of summarising the debate a lot easier, but I am sure that all 650 MPs have constituency cases relating to the issues we are discussing.

The right hon. Member for North Norfolk correctly pointed out in his opening remarks that the input from charitable organisations in the sector is absolutely paramount. Where would we be without the organisations that turn out in numbers to raise money for and give help and support to people in care throughout our society? Their commitment and support of the caring community is quite extraordinary. He also brought a humane touch to the debate, detailing some distressing individual cases, and highlighted the risk that individuals can be trapped in the very system that is supposed to be there to aid them.

The right hon. Gentleman also encouraged whistle- blowers, saying that they should be listened to and not shut down. He offered strong support for the nine principles on getting the right support, describing them as positive and empowering, but unfortunately had to lament the fact that they have not actually been implemented yet. He spoke passionately about keeping children out of institutions and hospitals wherever possible and caring for them in our communities.

Once again, the right hon. Member for Chesham and Amersham educated the House on matters regarding autism, and she has no need to apologise for that. Several organisations in Inverclyde, my constituency, support children and young adults across the spectrum, and at least two of them were started because parents could not find the help and support for their loved ones that they were looking for. They got up and did it themselves. The right hon. Lady expressed concern that there is still an overriding reliance on hospital care and spoke about the need for a cross-departmental taskforce, because the issues cover a range of Departments. She also highlighted how inappropriate it is to detain people with autism under the Mental Health Act 1983.

The hon. Member for Dulwich and West Norwood (Helen Hayes) was highly critical of the transforming care programme and expressed concerns that many people with learning disabilities and autism are not properly supported. She forensically analysed the case of Matthew Garnett, thereby identifying the failings in the system. That was a timely reminder that behind the statistics are individuals and their families. Thankfully, Matthew is now flourishing at Alderwood, and it is notable that the care there costs less than institutional care.

I have absolutely no desire whatsoever to turn this speech into a party political broadcast but, as the hon. Member for Strangford (Jim Shannon) said, there are examples out there from throughout the United Kingdom that can be learned from, and I hope that the UK Government will look to improve the care that they provide.

I am proud to be a member of the Scottish National party. In our 2016 manifesto, we made the following pledge:

“Our services will be designed to support people living longer, often with complex conditions. Our aim is to deliver care as close to home as possible. We will build on health and social care integration by ensuring that our NHS develops as a Community Health Service.”

The Scottish Government are continuing to work on and review our strategy, and that is key: we have to work on and review our strategies; we cannot sit back on our laurels at any point and decide that we have this matter under control. It is about learning and re-learning as we go forward.

The Keys to Life, published in 2013, is a 10-year strategy, with a focus on health issues, to improve the quality of life for people with learning disabilities. With £7.7 million of investment, we are improving learning disability services in Scotland. The strategy’s implementation plan sets out four strategic outcomes: a healthy life; choice and control; independence; and active citizenship. The delivery of the strategy is being taken forward with a wide range of partners in the statutory and third sectors, and is focused on phased priorities targeted at each of the four outcomes. The Scottish Government have been working since 2017 on reviewing progress and identifying priorities for the next phase of implementation. Reducing the stark health inequalities that people with learning disabilities face is a key priority within the strategy. Without good health, people with learning disabilities are unable to contribute to, or participate in, their communities.

Ultimately, sometimes these things do come down to money. There will never be a time when we look at the healthcare that we are provided with and say, “Well, that’s good enough.” We always want better for our friends, our family and our loved ones. The Scottish Government are committed to the twin approach of investment and reform in our national health and care services. In 2018-19, the health resource budget will increase by more than £400 million to £13.1 billion— £360 million more than the inflation-only increases since 2016-17. By the end of the current Holyrood term, we will have increased the health resource budget by £2 billion.

I have grave concern with regard to the people providing these services. Although we all seek to improve care across our communities, Brexit and the UK Government’s hesitation in guaranteeing EU national rights for those in the UK means that we face a massive threat to the NHS workforce. As a result, we face losing valued and respected workers in the care sector and beyond. The free movement of people and the mutual recognition of qualifications allow skilled and experienced health professionals from the EU and the European economic area to work in our NHS. Without that, our ability to continue to provide high-quality health and social care services for the people of Scotland will suffer, particularly for the people in Scotland’s remote and rural communities, and that will be echoed throughout the United Kingdom.

I always take great pleasure in engaging in the local carers’ week in my community. It has happened in the past three years that I have been an MP. It is a learning process. Attending such events means that we can meet some of the best people in our communities. I learn from them on an ongoing basis, and I look forward to doing so. I ask this Government to take a serious long-term look at how to fund the service, where to get the people from and how to roll out the correct and appropriate training to help some of the most vulnerable people in our society.

Oral Answers to Questions

Ronnie Cowan Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

I was very inspired by how hard the staff there are working. My hon. Friend always champions them in this House, but it was a great privilege to see that for myself. There is new leadership coming into that hospital, and I am confident that that leadership will put in place some simple changes that will enable the hospital to get out of special measures, hopefully quickly.

[Ronnie Cowan (Inverclyde) (SNP)]

T4. This morning I met the family of Alfie Dingley and members of the End Our Pain campaign. Alfie’s case, along with those of Murray Gray and Billy Caldwell—and many, many more—highlight the case for medical cannabis. Will the Minister liaise with the Home Office to introduce medical cannabis for the thousands of people who would benefit, but who do not want to be branded as criminals?

[Steve Brine]

Obviously, everybody in the House is aware of this case, and our thoughts are with Alfie and his family. The policing Minister has met Alfie’s family and discussed options that may assist him. No decisions have been made, and any proposal would need to be led by Alfie’s clinicians using sufficient and rigorous evidence.

Cancer Strategy

Ronnie Cowan Excerpts

Thursday 22nd February 2018 Commons Chamber

[Ronnie Cowan (Inverclyde) (SNP)]

I thank the hon. Member for Basildon and Billericay (Mr Baron), who cannot be with us today, for being proactive in securing the debate this afternoon. I also thank my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) who stepped in to open the debate in his absence. She raised concerns about targets not being met and the resources available to meet those targets, and reminded us all that those in receipt of treatment must be involved in the ongoing conversations. Their experience is vital in improving the process as we go forward. It is imperative that we improve end-of-life care to offer the dignity that is appropriate at that time.

The hon. Member for Bosworth (David Tredinnick) spoke eloquently about alternative therapies and the role they can play. I would include in that category—although I am not putting words into his mouth—the investigation into the use of medicinal cannabis. The hon. Member for Coventry North East (Colleen Fletcher) focused on post-stem cell transplant care and the practical support that is required and asked whether we could review the 100 day cut-off date.

The hon. Member for North Warwickshire (Craig Tracey) spoke about breast cancer, the UK’s most common cancer, with a survival rate that has doubled in the past 20 years. He went on to highlight the question of dense tissue, something that was new to me, and the need for early diagnosis, and he called for better education in this area.

The hon. Member for Scunthorpe (Nic Dakin) put out challenges about pancreatic cancer. Although progress has been made, this seems to be an area in which minimal progress has been made over the years. He drew attention to the workforce programme and asked whether NICE could possibly clarify some of its decisions.

The hon. Member for Dumfries and Galloway (Mr Jack) focused on blood cancer and the complexities around diagnosis, and called for continued clinical research. The hon. Member for Bristol West (Thangam Debbonaire) spoke about young people and cancer, and the role played by CLIC Sargent. Today I am proudly wearing my Glow Gold ribbon, given to me by a young man in my constituency this time last year.

The hon. Member for Chippenham (Michelle Donelan) highlighted the desire that the Government prioritise cancer research. We have come a long way, but we still have a long way to go. She also highlighted the need for early diagnosis, a recurring theme this afternoon. The hon. Member for Lincoln (Karen Lee) spoke movingly about the people behind the statistics, including her own daughter. She also highlighted the reality of staff shortages and what they mean for patients.

The hon. Member for Easington (Grahame Morris) spoke of his first-hand knowledge of overcoming cancer, and as many speakers have said, survivors’ experiences should be hugely influential when developing better treatments. Who could possibly have a better understanding?

The hon. Member for Strangford (Jim Shannon) mentioned that every family is struck in some way by cancer. He also mentioned the financial implications, and I shall take up that topic later.

Despite our progress cancer remains a lingering, stubborn foe and as policy makers we have to support our respective health services as they seek to improve the treatment that patients receive. We have undoubtedly taken great strides and our progress from a historical perspective is one of steady improvement, but for individuals, months, weeks and even days become precious as they grapple with the uncertainties that this illness brings to their life.

While patients come to terms with the emotional and physical impact of their diagnosis, they must also continue to manage the everyday practicalities of life. Chief amongst these is finances, and research commissioned by Macmillan Cancer Support shows that four out of five people with cancer are, on average, £570 a month worse off as a result of their diagnosis. I believe we can improve that situation by introducing a duty of care for financial services, as that would allow cancer patients to have increased flexibility when dealing with organisations such as their bank.

It is clear that more needs to be done to give cancer sufferers greater security. The introduction of flexibility of mortgage payments, interest freezes on credit cards or signposted financial advice to avoid problem debts are just some of the ways in which banks may be able to assist. I would therefore encourage the UK Government to strongly consider the introduction of a legal duty of care as a matter of urgency, so that those recovering from cancer are afforded greater support.

I hope that, where possible, the different health services across the United Kingdom have satisfactory measures in place for the sharing of best practice. The Nuffield Trust, for example, concluded in a 2017 report that Scotland had a unique system for improving the quality and safety of patient care and that other health authorities in the UK could benefit from the approaches used in Scotland. Mark Dayan, the lead author of the report, stated that Scotland had

“worked on getting its healthcare services to co-operate for longer than the other nations of the UK. So we’re urging healthcare leaders from England, Wales and Northern Ireland to think about what elements they might want to import from Scotland.”

I am sure that those in the Scottish NHS will be watching with interest as the NHS in England continues to implement the Cancer Taskforce’s five-year strategy for cancer care. Shared knowledge is a vital tool for future progress.

Earlier this year, I hosted the world cancer day drop-in event, along with the hon. Member for Cambridge (Daniel Zeichner). It was heartening to listen to Cancer Research UK’s ambassadors and to reflect on the many unsung heroes who assist cancer sufferers or have experienced cancer themselves. I hope that the Government are listening to those in the third sector, because through their effort and commitment they have gathered a huge amount of valuable knowledge.

The hon. Member for Dumfries and Galloway talked about blood cancer, and the hon. Member for Bristol West talked about cancer in children. I want to combine the two by telling a story about a young man from my constituency—a very brave young man called Nathan Mowat. Nathan is now at the ripe old age of seven. With the love and support of his mum Gillian, dad Paul and sister Annabel, he has completed three years of treatment for lymphoblastic leukaemia, which he can pronounce a lot better than I can. He has experienced 10 different cocktails of chemotherapy, six bone marrow procedures, three surgeries, 22 lumber punctures, and 16 blood and platelet transfusions. Nathan earns a “bead of courage” for every procedure that he goes through. He has earned 1,500 “beads of courage”. Where Nathan and other brave children have led, others will follow.

I hope that all Members will join me in reaffirming our commitment to three actions: considering legislation that will help to support cancer patients in different aspects of their life, including their personal finances, giving our health services the financial support that they require, and ensuring that the expertise and knowledge of academia around the globe are fully utilised to formulate Government policy.

Drug Addiction

Ronnie Cowan Excerpts

Wednesday 22nd November 2017 Westminster Hall

[Craig Mackinlay]

I could not agree more with the hon. Gentleman: I feel there is a false economy in cutting that type of service. Obviously, they are the sorts of services where we cannot always see what sort of bang we are getting for the pound spent, because the savings come about in a rather disparate way. The hon. Gentleman brings a very powerful case to the table.

The Government have spent vast sums of money over the last few years on the Frank initiative. I do not know whether hon. Members will remember it—“Call Frank”; “Tell Frank”. I have asked many youngsters of late whether they have heard of “Frank”, and they do not have a clue who he is, so I question somewhat the effectiveness of the Frank initiative, which is particularly aimed at teenagers and adolescents. I will be reporting in a detailed paper shortly, so hon. Members should look out for that.

Almost in closing, I want to look at the July 2017 drug strategy. It is a good strategy with recovery at its heart. It looks at the threats and at the actions we can take to reduce homelessness, domestic abuse and mental health issues. The strategies are the usual strategies, which I think are common sense: reducing demand through deterrence and the expansion of education and prevention information, obviously restricting supply through law enforcement responses, supporting recovery and driving international action to reduce the amount of foreign-produced drugs hitting our streets—of course, that does little to stop the ever-increasing rise of cannabis grown in the UK. I believe it is clear that drug misuse destroys lives. It has a devastating effect on families and communities.

[Ronnie Cowan (Inverclyde) (SNP)]

The hon. Gentleman is coming to his conclusion. He seems to be saying that we are spending all that money trying to penalise people for drug use and trying to cut off the international supply. He has put horrific figures in front of us today. What will he do to change and affect that outcome?

[Craig Mackinlay]

The hon. Gentleman will hear that in my conclusion.

[Ronnie Cowan]

I was too soon.

[Craig Mackinlay]

I am sure that, as any of these debates progress, there is often a clarion call: “Let’s just liberalise. Let’s just legalise.” I am very pleased that, from what I have heard so far from the Government, they have no intention of doing that, and I massively support them. Drugs are illegal for a reason, because of the clear evidence that they are harmful to human health and associated with the wider societal harms of family breakdown, poverty, crime and antisocial behaviour.

[Ronnie Cowan]

What does the hon. Gentleman say to the Portuguese Government, who decriminalised and legalised and have seen a reduction by half in heroin addiction? What does he say to John Marks, who ran a very successful clinic in Liverpool, where the local crime rate dropped by 90%?

[Craig Mackinlay]

Again, if the hon. Gentleman will hold on for a moment, I will address that point. Where we have big experience areas such as Colorado and Washington, we have not seen just a stabilisation, reduction or more sensible use. We have seen increased rates and an increase in deaths and consequential accidents and results. To address his point, in an operation in Switzerland, which I think was also replicated in London, Brighton and Darlington in 2009, an unresponsive minority of heroin users who seemed not to be affected by normal drug treatment methods were given pharmaceutical-grade heroin under daily clinical conditions. I am not averse to that; it is a way forward for a very hard core of users, to keep their criminality off the street, get them clean drugs at the right time and help them off their addictions.

We often say, “Why should we criminalise the user?” In my experience of the court system, I have never seen somebody go to prison for the use of drugs. They tend to go to prison because of the criminality that results from drugs. There is one country, Sweden, that is very stiff on these things. Sweden has probably one of the most penal criminal codes for even personal use of drugs. It is interesting that it enjoys one of the lowest rates of drug use in Europe.

I have concerns that we are facing a general institutional downgrading of possession, particularly of class B drugs, and for that reason I am not sure that we see the full spectrum of what is happening out there in real drug use, based on the figures we receive from the police. If we were to see those, we would see reductions. Arrests for cannabis possession have apparently dropped by 46% since 2010. Cautions are down by 48% and numbers of people charged are down by 33%.

[Ronnie Cowan]

Is that not symptomatic of the police force taking a different attitude? Many police commissioners have come out and said, “We have to stop arresting people for personal possession.”

[Craig Mackinlay]

The hon. Gentleman is absolutely right. That has been the outcome. I am not particularly keen on seeing youngsters receive a criminal record for the use of drugs. There is perhaps another way, such as a non-recordable early intervention, rather than a criminal record that could be with them for life and weigh seriously against their potential job opportunities for the future. We are seeing police guidelines saying that no arrests should be made for possession. I am worried that we are seeing a normalisation of drug use. If youngsters feel that that is the new norm, there will be very little deterrent and they will feel that taking cannabis is acceptable. Inquiries I have made for my report have shown that youngsters still feel that they are deterred from going into using cannabis by the threat of criminal sanction.

I will come to my conclusion, which I hope will wrap a few things up. I am particularly fearful that this side of the Atlantic will face a potential onslaught of fentanyl and other artificial opioid derivatives, and I feel the Government need to be prepared for that. Action to rehabilitate that current core of class A drug users now will save their lives in the future, should fentanyl become more of a norm on our streets. I feel that we should be upping our game in three strands of work: education in schools, colleges and universities.

I would like to see significantly increased sentences for drug supply. Under current sentencing guidelines, the maximum sentence for the category A offence of suppling 5 kg-plus of class A drugs, which is right at the high end of drug supply, is 16 years, compared with 35 years for attempted murder. As we cope, or potentially have to cope, with fentanyl and similar lethal derivatives, we should perhaps give some thought to creating a new class—class AA—for these truly lethal drugs.

But to me, rehabilitation is the key, and I would not want to see services or that type of expenditure downgraded, because of the £2.50 saving for every £1 of investment. I would like residential rehabilitation to be the norm. We could call them prisons, if hon. Members would like, but they would be prisons or centres with one primary focus, and I think the judiciary would welcome being able to make that choice. They would be abstinence-based rehabilitation centres; people would go in on drugs and come out clean.

--- Later in debate ---

[Ronnie Cowan (Inverclyde) (SNP)]

Thank you, Mr Gapes; I was hoping to have longer on my feet—I am sure you will understand that—but much of what I was going to say was elegantly covered by the right hon. Member for North Norfolk (Norman Lamb) and the hon. Member for Reigate (Crispin Blunt), so I shall skip those parts of my speech.

The important point is that no financial cost that can be attributed to drug addiction comes close to matching the human cost. The deaths of loved ones, the sufferings of addicts, wasted lives and the associated suffering far outweigh any amount of money that has been spent fighting the war on drugs. Yet we continue to pour time, effort and money into a system that emphasises criminal prosecution. Since Mexico intensified its approach to drug law enforcement, more than 100,000 people have died and 20,000 are missing. The personal testimonies from members of Anyone’s Child are heartfelt and painful. It calls on the Government

“to regulate drugs to reduce the risk they pose”.

It says that

“legal regulation doesn’t mean a free-for-all where drugs are widely available—our current laws have already achieved that”.

We need to take control away from the criminal fraternity. Across the world for more than 50 years the war on drugs has killed the innocent and made the guilty rich. It has destroyed communities and compounded the difficulties faced in addressing addiction problems. As we know, the UK Government spend around £1.6 billion a year on drug law enforcement. As was pointed out earlier, even the Government know that their drug policy has failed. Last night I attended an event hosted by Addaction. A gentleman who is in recovery said, “As humans we judge. It keeps us safe. Before you judge try to see the person”.

What can the Government do? Safer drug consumption rooms, which we have talked about, are already saving lives in eight European countries as well as in Canada and Australia. They have been endorsed by the British Medical Association. Those facilities reduce the spread of infectious diseases such as HIV and hepatitis C, and the risks of public drug use. No one has ever died of an overdose in a DCR anywhere in the world. That is the third time that statement has been heard this afternoon, and it will be heard again.

Heroin-assisted treatment is also being successfully implemented in several European countries, and is endorsed by the British Medical Association. In 2016, the Advisory Council on the Misuse of Drugs stated that

“central government funding should be provided to support heroin-assisted treatment”

for patients for whom other forms of opioid substitution treatment have not been effective. I think that there is agreement here about that, but the Government have failed to act on that request.

Specialist drug checking services can allow people at nightclubs and festivals to find out what is in their batch. Data from recent UK trials showed that one in five people found that they did not have the drug that they expected, and 80% of that group then chose to use a smaller quantity, avoid mixing it with other substances, or dispose of their batch altogether.

Perhaps a financial justification is required, rather than a humanitarian one: researchers in the US Office of National Drug Control Policy have confirmed what has already been said about expenditure on treatment being more than paid for elsewhere, as they estimate that $1 spent on substance abuse treatment saves $4 in healthcare costs and $7 in law enforcement costs. Not only does drug abuse treatment save lives—it saves billions of dollars as well.

While drug use continues across society we must note that addiction can and does affect people from all walks of life. Only 10% of drug users will develop an addiction, and addiction does not respect race, creed, colour, religion, gender or financial standing. However, as is often the case, it is the poorest who suffer the most. In 2008, the Scottish Government published the national drugs strategy for Scotland, “The Road to Recovery”. That set out a new strategic direction for tackling problem drug use, based on treatment services promoting recovery. The Scottish Government have invested £689 million to tackle problem drug and alcohol use since 2008, and education has been an important part of the strategy.

[Kirstene Hair (Angus) (Con)]

Drug-related deaths are a particular problem in Scotland, as the hon. Gentleman has outlined, including in my constituency, where they are rapidly increasing—at a faster rate than in England and Wales. Does the hon. Gentleman agree that the Scottish Government need to get serious about addressing problems in NHS Scotland, such as the staff shortages in Angus, and the problems that Police Scotland faces?

[Mike Gapes (in the Chair)]

Order. The hon. Lady is making an intervention, not a speech, and I should be grateful if the hon. Member for Inverclyde would respond to it briefly.

[Ronnie Cowan]

I shall cover that point right now: Public Health Minister Aileen Campbell has announced a refreshing of Scotland’s drugs strategy. We will not be complacent about what we have achieved, and we will continue to take an evidence-based approach, and to improve what we are doing in Scotland. We have been working on the seek, keep and treat framework, a joint initiative between the Scottish Government and the Scottish Drugs Forum, which will examine the operational implications of engaging with older drug users and how to encourage them into services and keep them in treatment.

For many people it is heroin, cocaine or cannabis that are classified as drugs; but we must not ignore alcohol. Alcohol addiction is one of the most damaging forms of drug addiction.

[Mike Gapes (in the Chair)]

Order. Is the hon. Gentleman coming to the end of his remarks? Perhaps he can give his last sentence; otherwise the hon. Member for Henley (John Howell) will not be able to make a speech.

[Ronnie Cowan]

Absolutely, Mr Gapes.

In conclusion, if we spend money to address addiction problems as a health issue, that will not only bring about better results, but will prove to be less expensive than our current strategy, which criminalises and stigmatises people with addiction problems.