Psychoactive Substances Bill [HL]

Debate between Baroness Hamwee and Baroness Meacher

Tuesday 14th July 2015 Lords Chamber

[Baroness Meacher]

My Lords, in moving Amendment 11 I shall also speak to Amendment 12, both of which we debated in Committee. I intend not to repeat anything of the arguments we used then but rather to reflect on developments since. The intention of the amendments is to ensure that all legitimate medicines and substances used for any form of legitimate research are exempted from the scope of this legislation.

I am most grateful for the Minister’s letter to the noble Lord, Lord Rosser, in which he says that the Government are looking again at the definition of medicinal products in Schedule 1 to ensure that it is fully aligned with existing medicines legislation. The question is what exactly that means. I seek only an assurance from the Minister that the definition will include all medicines prescribed on a named-patient basis and all unlicensed—or any other—psychoactive substances prescribed by a doctor on the basis that the prescription is believed by that doctor to be in the best interests of the patient. My clear understanding is that a doctor can prescribe any medication, even if it is unlicensed or not recognised, so long as they believe that it will help the patient. Many medicines come on to the market which may have been tested in other countries or in other ways but which have not been through UK systems.

Amendment 12 deals with research. It would be helpful to have an assurance that all legitimate research, including laboratory research, involving psychoactive substances in academic institutions or undertaken by industry will be fully exempted from the scope of the Bill. Alternatively, perhaps the Minister could assure the House that the Government will seek an assurance from the ACMD that whatever wording is used will achieve that objective. We just want all noble Lords to be completely satisfied that these two objectives will be achieved.

I have added my name to Amendment 24, tabled by the noble Lord, Lord Paddick. The aim here, as I understand it, would be to ensure that the regulations exempting medicines and research are in place by the implementation date of the legislation. The wording in the amendment itself is slightly different, but I am sure that that is the intention. No doubt the Minister will comment on this in her response to this group of amendments.

[Baroness Hamwee]

My Lords, Amendment 24, to which the noble Baroness has added her name, comes from my noble friend Lord Paddick and me. Like the noble Baroness, I will not spend long on this, because I am optimistic about where the Government are going with it. I was concerned that the current provisions of the Bill are too limited, because they are limited to medicines. However, I will repeat one comment that I made at the last stage. Professor Val Curran, in her report for the all-party parliamentary group that the noble Baroness chairs on regulating cannabis for medicinal use, referred to a “stranglehold on research”. She sets out, quite pithily, the “costly obstacle course” involved in undertaking any research, because of the time taken by licence applications. Import licences are being granted for so short a time that they expire before the arrangements for the research can be made, so I welcome the Government’s further consideration of this. As Professor Curran says, at the moment, UK research into this area is a “massive uphill struggle”.

Psychoactive Substances Bill [HL]

Debate between Baroness Hamwee and Baroness Meacher

Tuesday 30th June 2015 Lords Chamber

[Baroness Hamwee]

My concern is that research in that area should not be impeded.

[Baroness Meacher]

My Lords, I am grateful to the Minister for her response, which was very positive. I was particularly pleased that she agreed that these matters should be dealt with in the Bill, which suggests agreement that they are sufficiently important for them to be dealt with there, and said that the Government will be bringing forward amendments before Report on the medicinal matter and may bring forward amendments on the research matter. I understand from the experts—the scientists—that it is important that there are amendments before Report on that issue. I hope the Minister may be able to respond immediately to that point because it will be difficult to leave this one unless we have that assurance.

On the low-dose issue, her reply was interesting because I tend to agree with her that surely these things are not for human consumption. On the other hand, the matter has been raised with me by people who know about these things, and I must express my gratitude for the willingness of Ministers to meet the experts and cover that issue and the others because they are the people who need to advise Ministers about exactly what the wording should be on all these matters. I express my gratitude, and I beg leave to withdraw the amendment.

Psychoactive Substances Bill [HL]

Debate between Baroness Hamwee and Baroness Meacher

Tuesday 30th June 2015 Lords Chamber

[Baroness Hamwee]

My Lords, in moving my amendment I will speak also to my and my noble friend’s Amendments 65, 65A, 68, 68A, 85A, 85B and 85C. The first of these amendments would provide for a right of appeal against prohibition and premises notices, with judicial oversight. The amendment is based very closely on Section 46 of the Anti-social Behaviour, Crime and Policing Act, which provides for an appeal against community protection notices. I am not suggesting that a subject of the notice should have free rein to produce or supply a psychoactive substance, and so on, but it could be argued that the steps required by, let us say, a premises notice, are not reasonable.

We are talking, perhaps, about someone’s livelihood here. Whatever we might think about head shops, if what they are doing is legal, we need to be very careful about precluding someone from carrying on a business, and certainly we must be careful that we give him the opportunity to appeal when he considers that the notice is inappropriate and undeserved. I appreciate that a breach of a notice would take us through procedures to an application to the court for an order, with surrounding protections. However, an appeal against a notice seems to us to be right—and, properly, a right—and it should be available so that someone can avoid having what I could loosely call “a record”. It is not for us to argue for it; it is for the Government to explain why the right of appeal is not included.

The other amendments are all about the standard of proof for prohibition and premises orders and changing them from the civil to the criminal standard. The orders would be made by the criminal courts, and so the criminal rules of evidence, and so on, should apply. This is also the thrust of my Amendments 85A, 85B and 85C to Clause 28, which is about the nature of the proceedings—essentially turning them from civil to criminal proceedings. Again, given the subject matter of this, it is for the Government to explain why what they are proposing should not be required to meet the criminal standard of proof and be dealt with in the way that we are accustomed to through the criminal courts. I beg to move.

[Baroness Meacher (CB)]

My Lords, I will not take up the House’s time, but I wish to express my strong support for these amendments. It is eminently reasonable to have right of appeal, as the noble Baroness said, bearing in mind the considerable penalty that somebody will suffer if their livelihood is suddenly withdrawn from them. It also seems eminently sensible to set the standard of proof at the criminal level. I support these amendments and hope very much that the Minister can comply with those two proposals.

Psychoactive Substances Bill [HL]

Debate between Baroness Hamwee and Baroness Meacher

Tuesday 23rd June 2015 Lords Chamber

[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.

--- Later in debate ---

[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.

Psychoactive Substances Bill [HL]

Debate between Baroness Hamwee and Baroness Meacher

Tuesday 23rd June 2015 Lords Chamber

[Baroness Hamwee]

My noble friend and I also have in this group Amendments 19 and 22. This takes us to the exemptions from the substances which may be the subject of the commission of an offence, and the other provisions in the Bill.

Our first amendment would allow the Secretary of State, by regulation, to add other substances to the list in Schedule 1. I wondered whether that point was covered by,

“add … any description of substance”,

but I do not think that normal language would mean that, and the Constitution Committee—I suspect the noble Lord, Lord Norton of Louth, is going to mention this—did not think so either. If it is not going to be possible in the Bill as drafted for other substances to be added, then why not? That seems to fly in the face of the respect that we all pay to the scientific process.

Dealing with certainty of provision and ministerial authority in respect of exempted substances, the Constitution Committee commented—I will mention just this one paragraph—on the powers of the Secretary of State being,

“unconstrained by any explicit statement of the purpose or purposes for which that power may be exercised”,

and suggested that:

“The House may wish to consider whether it is appropriate to confer upon the Secretary of State a power … unconstrained by any textual indication as to the purpose”.

That is part of the theme of certainty, which we touched on earlier. Amendment 19 would require the Secretary of State to exercise that power to add any substance—my addition—or to add or vary any description, or remove any substance, on the basis of recommendations of the Medicines and Healthcare Products Regulatory Agency; in other words, to implement its recommendations. The Secretary of State must also use the power to include a substance where that body or the Advisory Council on the Misuse of Drugs,

“determines that the substance poses a low overall risk”.

As regards the bodies which would make recommendations or a determination under this amendment, more than respect has been paid to both those bodies during this debate. The ACMD should be at the front and centre of this debate; it seems to have been somewhat sidelined in some of the consideration of the Bill. Our amendment in the next group, which we will look at next week, addresses that point.

In proposed new subsection (2B) in Amendment 19, we refer to the determination of a substance which poses a low overall risk. I can see that phrase might be thought to be rather woolly and insufficiently tough on drugs. However, it comes straight from Section 1 of the Misuse of Drugs Act, which sets out the role and responsibilities of the ACMD, whose duty is to keep under review drugs, the misuse of which,

“is having or appears to them”—

the ACMD—

“capable of having harmful effects sufficient to constitute a social problem”.

It goes on to talk about,

“preventing the misuse of … drugs or dealing with social problems connected with their misuse”.

I take that to be very wide indeed, and to include health. We think that that phrase would properly link assessments as to what should be exempted with terminology which must now be understood in this field. I beg to move.

[Baroness Meacher]

My Lords, in speaking to Amendment 16 I will also support Amendments 14, 17, 18 and 19. Amendment 19, on low-harm substances, links very closely with Amendment 16, and I will concentrate on Amendment 16 because of that particular focus.

Amendment 16 seeks to exempt from the scope of the Bill substances deemed to pose low health, social and safety risks. One of the objectives is to take a small step towards harmonising the Bill with the EU regulation. The Government have every right to opt out of the EU regulation, and of course they did so. However, there are very good reasons for attempting to move towards a degree of harmonisation. Paragraph 1.1 of the EU regulation says that,

“national restriction measures, which may differ depending on the Member State and on the substance, can hamper trade in the internal market and hinder the development of future industrial or commercial uses”.

So there are free market issues where the UK may cause problems for our own industries, and indeed trade, if the Bill goes ahead unamended. Amendment 16 goes some way towards reducing those obstacles to trade. Does the Minister know how significant the commercial and trade implications of the Bill will be for the UK if it is not amended in the way that Amendment 16 suggests and, if not, will he have these barriers assessed before introducing the Bill?

--- Later in debate ---

[Baroness Hamwee]

My Lords, I do not know whether I missed it, but the response seemed to be almost entirely to the noble Lord, Lord Howarth. I clearly need to go back and read what the answer was to the first of the amendments and my other amendments in the group. Given the time—

[Baroness Meacher]

I feel awful intervening at this time of night. We all need to go home. I just want to raise the point that the expert panel was established, as I understood it, rather than referring to the ACMD for its advice on some of these issues. I do not want the Minister to reply right now—perhaps he can do so when we next meet—on the question of how the expert panel was selected. It seems extraordinary to me that any set of experts would advise against having a calibrated system of low, medium and high risk and risk-associated penalties and responses to drugs. At this late hour I do not wish to say more, but I would be grateful if the Minister thought about this before we meet.