Psychoactive Substances Bill [HL] Debate

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Department: Home Office

Psychoactive Substances Bill [HL]

Baroness Meacher Excerpts
Tuesday 23rd June 2015

(8 years, 10 months ago)

Lords Chamber
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Lord Blencathra Portrait Lord Blencathra
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Again, I must disagree with the noble Lord, Lord Patel. Of course, harm reduction is good and of course treatment is essential, but unless we have Customs and Excise and the National Crime Agency and all the others interdicting tonnes and tonnes of drugs, we would need a lot more treatment because we would have a lot more drug addicts in this country. Enforcement has worked. Enforcement is driving down the use of those drugs which were rapidly increasing in the 1980s and the 1990s. There is no suggestion that that trend is wearing off, and there is no suggestion that enforcement is now failing with those drugs. Enforcement is failing in the new psychoactive substances for two reasons. First, the kids find it trendy and sexy to use them because they are not using the same old drugs that dad smoked. Secondly, we do not have legislation tight enough to enable the police and the enforcement authorities to use enforcement properly against those psychoactive substances.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, I support this amendment and the comments of the noble Lords, Lord Paddick, Lord Howarth and Lord Patel, but I have to say that I cannot support the noble Lord who has just spoken. This country has some of the strongest and toughest rules and legislation relating to drugs, yet we have one of the highest levels of use of the dangerous drugs that we try to ban. The reality is that we are not succeeding. Countries with relatively liberal, harm-reduction, health-focused policies do a great deal better than we do.

I want to use this opportunity to try to get across to the Minister and to your Lordships why I feel so strongly that we need a review of the Misuse of Drugs Act. I worked in secondary mental health for about a quarter of a century on and off, working with severely psychotic patients. I would say that the majority of those patients take cannabis. Why do they take it? They have told me many times, “Because it makes me feel human”. Thankfully, I have never had a psychotic illness, but if you do and you are given antipsychotic medication, the mix of the illness itself and the medication leaves you feeling, if I may put it this way, subhuman. You do not feel that you have any feelings; you feel dead. If you take cannabis, it makes you feel human. That is the word these patients use—“human”. In my view, that is not unreasonable.

If herbal cannabis is illegal, which it is, these patients along with all sorts of young people all over the country—I am slightly less sympathetic about them, but I am very sympathetic about patients—are driven to take skunk, very high THC cannabis, which is bad for their hallucinations and voices and makes them worse. But they still take the cannabis because it is so important to them to feel human. As I say, that is not unreasonable.

While they were within our services, these people were treated as patients because they had severe health problems. However, it always struck me as peculiar that when they left our hospital, day centre or whatever it was, these very sick people could be picked up by the police and charged with a criminal offence. Why? Because of their health problem. When our Convenor, as she was then, said when I came to this House, “Molly, you must put your name down on the ballot for a debate”, I said, “Oh no”, but I did and I won the ballot. I was told to produce a subject within the hour, and it came to my head that it would have to be about drugs. I feel strongly that our laws are illogical, unjust and cruel, and they are doing an enormous amount of damage to very large numbers of children and young people. That is why I cannot say that I am against the amendment tabled by the noble Lord, Lord Paddick.

Of course I understand that this Bill is about psychoactive substances, and we will come to discuss them, but the fact is that we have only one market, and it is the market for illegal drugs. It is not a market for psychoactive substances over here and a market for controlled substances under the Misuse of Drugs Act over there. They are one market, and therefore it makes no sense to look at this market without looking at that market. That is why I believe firmly that the Government would find it very helpful to look seriously at how the market is working and to draw conclusions from other countries.

We will come to the experience of Ireland and psychoactive substances, where a ban has been in place for four years. What does the deputy chief of the drugs and organised crime branch say about the ban? It has not worked. Therefore, Ireland is thinking of going back to its misuse of drugs Acts. I think that we will be in the same position, so it is really important that we get the Misuse of Drugs Act right as well as the Psychoactive Substances Bill. If we do not, we will just go round and round in very unfortunate circles from one bad policy to another.

I have something else that I want to say. The Labour Party is worried about a delay in this Bill. It does not need to worry, because bans do not work. They have not worked in Ireland. A little bit of delay will not make any difference. We now know from scientists that, of the deaths which have been caused by psychoactive substances, maybe every single one of them—certainly 90% of them—has been as the result of young people taking banned substances, not legal highs. I want to make that point very strongly. A ban does not stop people taking a substance, and some of them will die from doing so. If low-level psychoactive substances were regulated and labelled, with the consequences of taking them clearly specified, the risks and side-effects explained and the maximum dose made clear—in the case of ecstasy, you must take water, but you must not take more than 1 litre, or whatever it is—they would be much safer. My only concern is the safety and well-being of our young people.

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Lord Paddick Portrait Lord Paddick
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My Lords, if I may assist the Committee, clearly these amendments can be taken separately and, if the Committee is minded to say that there needs to be a review and no delay in giving effect to the legislation, that is a matter for the Committee. We are talking about the Misuse of Drugs Act in that amendment rather than the Bill, if that helps the noble Lord.

Baroness Meacher Portrait Baroness Meacher
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I wonder if it might help the Committee if the noble Lord withdrew Amendment 115 simply so that we can debate the need for a review of the Misuse of Drugs Act without setting it in the context of a delay to the psychoactive substances ban.

Lord Rosser Portrait Lord Rosser (Lab)
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I acknowledge the strength of feeling of many noble Lords on this issue but I hope we can all accept that, whatever our view, we all have the interests and protection of young people in particular in the forefront of our minds when discussing this group of amendments and the Bill as a whole. That is not the prerogative of one particular point of view. The effect of this group of amendments—certainly its intention—is to put back the commencement of most of the Bill’s provisions for, in reality, probably at least 18 months after the Bill has been passed.

The proposals in the Bill for a blanket ban on new psychoactive substances have been supported by the New Psychoactive Substances Review Expert Panel, whose report was called for by one Liberal Democrat Minister and accepted by another. The ban has also been supported by a similar panel in Scotland, the Health and Social Care Committee of the National Assembly for Wales, the Commons Home Affairs Select Committee, the Local Government Association, the police and the two largest political groupings in this House, including the Opposition, at the recent general election. The Liberal Democrats said that they would clamp down on those who produce and sell unregulated chemical highs. That all these organisations, committees and parties reached their conclusion in either the face of all the evidence or the absence of any evidence—as has been implied—is unlikely.

We need to start to tackle the issue of legal highs now. The United Kingdom now has the second largest legal highs market in the world, beaten only by America. We are the top country in Europe for emerging new psychoactive substances. Over the past four years, hundreds of new internet sellers have been established in the UK, along with an estimated hundreds of specialist high street head shops. Beyond this, an unknown number of other stores, including late-night garages and takeaways, have started selling these products. In short, an entire industry became fully established under the previous coalition Government, selling and marketing dangerous drugs largely aimed at young people, many of whom would not otherwise have considered experimenting with drugs.

It also appears quite common in the legal highs market for legal high sellers to send out samples of new psychoactive substances to existing customers and use human beings as guinea pigs with no consideration of the consequences. The evidence also shows how far behind the market we currently are.

Baroness Meacher Portrait Baroness Meacher
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I thank the noble Lord for giving way. He says that head shops have no consideration for their customers. In our experience, head shops are the one outlet that do have to have some concern about their customers because, if they kill them or if they finish up in hospital, they will not come back for more and head shops will not make profits, which is what they are there to do. That is the one reason why, unpleasant though head shops are—and they are—if they were properly licensed and controlled, they would be rather better than the alternative: the black market.

Lord Rosser Portrait Lord Rosser
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I think I actually said that it is quite common in the legal highs market for legal high sellers— and there is more than one way of selling it—to send out samples of new psychoactive substances to existing customers and literally use human beings as guinea pigs, with no consideration of the consequences. I do not think that implies that everybody is doing that; it is saying that it is not uncommon for that to be the situation.

The evidence also shows how far behind the market we currently are. Substances were being banned following parliamentary debate earlier this year, when it had been known that sellers were sending out to potential customers samples likely to be toxic three years previously.

I wish to quote the Home Affairs Select Committee report, to which I referred earlier. I realise that some have already challenged this statement but it is set out in the Home Affairs Select Committee report. The report states:

“England and Wales has almost the lowest recorded level of drug use in the adult population since measurement began in 1996. Individuals reporting use of any drug in the last year fell significantly from 11.1% in 1996 to 8.9% in 2011–12. There was also a substantial fall in the use of cannabis from 9.5% in 1996 to 6.9% in 2011–12”.

That does not mean there is not still a problem, but the area where things have been going in the wrong direction, as identified in the report of the expert panel, has been as a result of the emergence of new psychoactive substances. The explosion of new psychoactive substances in the last few years is a unique phenomenon which warrants specific legislation. Some 670,000 young people in the UK were thought to have experimented with new psychoactive substances by 2013, and this is leading to an increase in deaths. To my knowledge, no new psychoactive substance which has been referred to the Advisory Council on the Misuse of Drugs has been found to be safe.

We are not in agreement with this group of amendments, which will delay the introduction of key parts of this Bill, including the blanket ban, when the need for action to address the growing issue of new psychoactive substances, including through education, prevention and treatment, is now.

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Lord Mackay of Clashfern Portrait Lord Mackay of Clashfern (Con)
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My Lords, it is wise to remind ourselves of what has been going on in relation to these substances in the past year or two. The system has been that, once a new substance is discovered, the procedures of the Misuse of Drugs Act have been used to add that substance to the prohibitions under that Act. It seems to me that the trouble with that is that it is very late in the day in relation to the emergence of the new substance. The purpose of this Bill, as I understand it, is to eliminate that particular difficulty and to make the provision operate in a general way so that you do not need to move, as in the past, during the emergence of a new psychoactive substance. So, that is what Parliament has been doing for some time. This seems to me to be a much better way to handle the problem than what has been available in the past.

Baroness Meacher Portrait Baroness Meacher
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I would like to point out that the Government introduced what I consider to be a very good instrument, the temporary class drug orders. These could be sped up. You can, or should be able to, put an order in place quickly for a 12-month period while an assessment is undertaken. If the drug is not deemed to be safe, it is placed under the Misuse of Drugs Act. There is an instrument in place.

Lord Howarth of Newport Portrait Lord Howarth of Newport
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From all his experience, does the noble and learned Lord anticipate that there may be problems in the criminal justice system over definition and establishing that a substance is indeed psychoactive; and that in the case of individuals it is their intention to supply illegally? Also, does he have any anxieties about the practicalities of enforcement? In the interests of the courts and of wider society, it is important that legislation that lays impossible burdens on the police, HMRC and other enforcement authorities is not enacted. They are going to have a large, complex and difficult additional set of tasks under this legislation, at a time of diminishing resources.

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Lord Bates Portrait Lord Bates
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The fact that it is present in the death of a young person is an absolute tragedy. The Government cannot stand idly by and have an interesting debate about general drug policy when that is happening on the streets. The Local Government Association—

Baroness Meacher Portrait Baroness Meacher
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The scientists who are advising me say that all the deaths have possibly been a result of banned substances which may be psychoactive or controlled. Four or five may possibly have been due to legal substances that had not yet been banned. A ban is not the way forward on that issue.

Lord Bates Portrait Lord Bates
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These substances are available. For example, a grandmother told me about the death of her grandchild, although it was not directly related to this. She expressed absolute despair that across the road from a school in Canterbury, 100 yards away from it, was a head shop selling “legal highs”. She believes that they are lethal highs. They are allowed to be traded, on the high street, to children way below any age of consent. There are no restrictions, as there are with alcohol and tobacco. Anyone can go in there with cash and come out with a brightly coloured package which actually says “not fit for human consumption” or “plant food”. Are we supposed to stand idly by when the Local Government Association is telling us that and when the police are telling us that they lack the powers to act? The Republic of Ireland has closed these shops down altogether. We need to get a clear and important message to young people that these drugs are not without risk.

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Baroness Hamwee Portrait Baroness Hamwee
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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 Portrait Baroness Meacher
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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.

Lord Ribeiro Portrait Lord Ribeiro (Con)
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My Lords, the noble Baroness, Lady Meacher, has demonstrated why anecdote is no substitute for good research. I heard that word used, so it is important to ensure that any use of cannabis for medicinal purposes, for which I have some sympathy, has to be on the basis of clinical research which has been properly carried out and peer reviewed. NICE is a good organisation and I am sure that it would be prepared to take that on board.

In response to a Question put by the noble Baroness, Lady Meacher, last Wednesday, I did make the point that there is evidence from America that troops coming back from Afghanistan suffering from post-traumatic stress disorder resulting in terrible nightmares about their battle experiences have improved using cannabis. However, it is still something which needs to be subject to properly controlled clinical trials.

Something that is often done during a clinical trial is to put the drug out to people on a named-patient basis. Once the clinical trials have been done, one way to institute this is to put in place legislation whereby medication can be given on a named-patient basis. However, I cannot accept it as a blanket way of dealing with these problems.

Baroness Meacher Portrait Baroness Meacher
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I should like to make one simple point, which is that I agree absolutely with the noble Lord that what we need are clinical trials on medicinal cannabis. The problem is that researchers do not want to go into this area because the substance is illegal. Getting cannabis in is a tremendous problem because it takes a long time to get the licences. I do not know, but there are problems which the noble Lord may know more about than I. However, if adults and children in particular who are in severe pain and distress could be prescribed medicinal cannabis on a named-patient basis, that would be a good option. But certainly we need to get on with a lot of work on clinical trials.

Lord Rea Portrait Lord Rea (Lab)
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My Lords, like the noble Lord, Lord Walton, who spoke last week during the supplementaries on the Question for Oral Answer tabled by the noble Baroness, Lady Meacher, on this topic, I served on the Select Committee which looked into the medicinal use of cannabis. One of the central recommendations was exactly what the noble Lord, Lord Ribeiro, has suggested. We need controlled trials. The noble Baroness has just backed up that suggestion as well. But it is very difficult to get these trials going. As she has said, because cannabis is an illegal substance, it is difficult to get people to agree to do the work. One or two trials have been carried out which resulted in the production of Sativex, but only one firm is producing it. As the noble Baroness said, it is terribly expensive and can be prescribed only on a named basis; it is very difficult for doctors to prescribe it to patients who have been shown to benefit from cannabis by getting it illegally.

One of the problems with getting cannabis illegally is that you do not know the ratio of the different cannabinoids in the illegal drug. It has been shown—this was told to us in our committee—that there is a huge range of effects from different cannabinoids. The one that gives the psychoactive effect, tetrahydrocannabinol— THC—is something that people who take cannabis for medicinal purposes do not like. But it is very difficult to find an illegal version of cannabis that contains a good ratio with more cannabidiol—CBD—which is the calming one that reduces spasms. Sometimes people have thought that it does not stimulate psychotic results but prevents them; it is an antipsychotic drug.

So there are real reasons why it should be made legal for researchers to concentrate on doing proper, controlled clinical trials to work out what cannabis can do, and what components or mixtures of cannabis components are most effective. This is crying out to be done, but as things are, it is very difficult to get scientists to agree to do it because of the illegality of the substance.

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Lord Bates Portrait Lord Bates
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I shall come to that a little further on. The point made by the noble Lord about diamorphine, which is prescribed in this country, is perfectly fair. Interestingly, in some other countries it is not prescribed. There will be a difference of view. That is one reason why, from a government and policy point of view, it is important that we have the best possible scientific advice and give due regard to it. The advisory council is specifically charged with that under the Misuse of Drugs Act 1971; that categorisation is its view. Should there be derivatives—I shall answer my noble friend Lord Blencathra’s point on that in a minute—we have the Medicines and Healthcare Products Regulatory Agency, which can offer some advice as well. Beyond that, the National Institute for Health and Clinical Excellence can decide on the deployment.

That is not a case of policymakers passing the buck but of their basing policy on the evidence that comes before them. The Government’s position, based on the advice of the Advisory Council on the Misuse of Drugs, is that cannabis in its raw form is a harmful drug and its use should not be encouraged. The advisory council has reported that there is clear evidence that cannabis has a number of acute and chronic health effects, and that prolonged use can induce dependence. Even occasional use of the drug can pose significant dangers for people with mental health problems.

Baroness Meacher Portrait Baroness Meacher
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The Minister refers to cannabis causing severe problems for people with mental health problems. I hope he agrees that Professor Curran is the top expert on cannabis in this country. She has done a lot of research on cannabis with a balance between CBD and THC, and on CBD with little or virtually no THC. She found that that form of cannabis is an anti-psychotic. She believes that it is likely to be able to be used as an alternative to some of the anti-psychotics currently used, which we know have really unpleasant side-effects. There is the prospect of an effective anti-psychotic based on the CBD element in cannabis, but we want that research to be encouraged, supporting the point that we need clinical trials. Professor Curran is very keen for this research to go ahead, particularly in the field of psychiatry. It is she who wants the rescheduling of cannabis from Schedule 1 to Schedule 2 in order to facilitate the research. That is the issue we want to crack today if possible.

Lord Bates Portrait Lord Bates
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The Institute of Psychiatry, Psychology and Neuroscience has not taken a position. As we found out last week, medical opinions, as with legal opinions, fly effortlessly across the Chamber.

I want to make sure for the record that I have got something absolutely correct, as it is an important issue. I spoke about diamorphine in response to an intervention by the noble Lord, Lord Howarth of Newport. Diamorphine heroin has internationally recognised medical uses in UN drug conventions and has UK marketing authority. I was therefore not too far off the mark in what I said, in the sense that it underscored the point that there is a process which we go through and there are conventions to help us.

The noble Baroness raised some specific cases. As a politician, I often find individual stories and experiences compelling. As a Member of the other place, along with my noble friend Lord Blencathra, I would often hear policymakers telling me one thing and then see people coming into my surgeries who were telling me something very different, so I find anecdotes a great help in understanding broader issues. I cannot find in my notes the name of the young boy with Dravet syndrome whom she mentioned.
Lord Bates Portrait Lord Bates
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There was a video, which I would be keen to see. Perhaps the noble Baroness could send me the link or I will happily sit down and watch it with her. During the Bill’s passage, we have tried to have meetings with all interested Peers. We have a meeting on health and education on I think 7 July. Notices will be put out to all parties, but that would be a good opportunity for people to come forward. I am thinking particularly of my noble friend Lord Blencathra, who gave us his personal experience of living with multiple sclerosis and its effects. The point about the alternatives might usefully be made at that meeting if he can attend, as I hope he will. As I say, details will be on their way.

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

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

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Moved by
3: After Clause 1, insert the following new Clause—
“Republic of Ireland: impact assessment
(1) The Secretary of State must conduct an impact assessment of the Republic of Ireland’s Criminal Justice (Psychoactive Substances) Act 2010.
(2) The Secretary of State must publish a report setting out whether or not the impact assessment under subsection (1) justifies the commencement of this Act in its current form.”
Baroness Meacher Portrait Baroness Meacher
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My Lords, I shall also speak to Amendments 109 and 114, which propose that the Bill should be implemented only if an impact assessment of a very similar ban introduced into the Irish Republic in 2011 is undertaken, and a report is issued setting out whether the assessment justifies the commencement of this Bill. The objective against which the Irish Act should be assessed must surely be a reduction in the use of dangerous psychoactive substances and the harms caused by them to the Irish population. I am sure that the Government’s aims in introducing this Bill are along those lines, or something similar, but perhaps the Minister could confirm that point. I hope that will not be a problem.

I certainly believe that the Government’s motives in proposing the Bill are entirely honourable. I have no doubt about that. Ministers want to see a reduction in deaths and injuries to young people resulting from the use of psychoactive substances. I am absolutely on the Government’s side in terms of these aims. I would support the Bill wholeheartedly if the evidence showed that the ban would work as intended. I therefore hope that this proposed new clause will be regarded as entirely uncontroversial, and I propose it as a helpful contribution and not as some wrecking amendment. We are very fortunate to have what must be regarded as a pilot for the Bill right next door in Ireland, where an Act has been in place and operational for four years. They have had four years of experience since their Act became operational. I therefore propose this clause as a helpful contribution.

The BBC has produced firm evidence that the Irish ban is not working. The EMCDDA also has concerns about the situation in Ireland. It talks about the levels of use of legal highs among young people. The average across the EU for 15 to 24 year-olds increased from 5% to 8% from 2011 to 2014, but the figures for Ireland are 16% in 2011 and 22% in 2014—the highest rate in Europe, despite the blanket ban introduced in 2011. I understand that there is a degree of uncertainty about the precision of those figures, but it would be sensible to be absolutely clear what has happened to use of and damage from these psychoactive substances in Ireland before we move ahead.

The other point is what has happened to the levels or numbers of deaths and serious injuries in Ireland following the introduction of that Act. Whatever the figures, we need to take very seriously the comments of the deputy head of the Drugs and Organised Crime Bureau in Ireland who, as I understand it, has said that the ban has failed and that they have not been able to operationalise it because of definitional problems. They have not got off the starting blocks, let alone explored whether the ban might work in other respects. As I mentioned at Second Reading, the experience in Poland of a blanket ban on psychoactive substances has coincided with an increase, rather than a decrease, in the harm to young people. A concern in Ireland, identified by the BBC, has been about whether they can determine if a particular substance is psychoactive or not. The noble Baroness, Lady Bakewell, mentioned this earlier. As a result of that problem, it seems that Ireland is considering moving back to its Misuse of Drugs Act. I find that profoundly distressing because of my absolute lack of respect for our Misuse of Drugs Act, particularly in relation to consumption by children and young people and their criminalisation.

The Bill also seems to have definitional problems which could undermine it catastrophically. For example, Clause 2(1) defines a psychoactive substance as one that is “not an exempted substance”. For the latter, we turn to Clause 3 and Schedule 1. We see that alcohol, nicotine products and caffeine are exempted, but only if they do not contain a psychoactive substance. However, these are psychoactive substances; how can they not contain a psychoactive substance? Maybe the Bill intends to say that substances such as alcohol should not have any other psychoactive substance within them. If so, the Bill needs to make that clear. How on earth can we justify exempting a substance such as alcohol, which is profoundly psychoactive and dangerous, just because it might have some relatively marginal other psychoactive substance within it?

This confusion perhaps illustrates the utter nonsense—a word which I use very carefully, having thought about it for a long time first—which runs through our drug laws generally, of exempting dangerous psychoactive substances while banning much safer ones. Some noble Lords have referred to cannabis as a dangerous substance. I would completely agree that skunk, high THC cannabis, is dangerous but there are other forms which are absolutely not. Professor Curran is clear about that and certain forms of cannabis can, indeed, be good for you.

Another definitional problem relates to food. Apparently, a food is a substance which is, “ordinarily consumed as food” and would be exempt. However, what about a food containing a psychoactive substance which is only consumed by rich people or an ethnic minority and not ordinarily consumed as food? Rudi Fortson QC raised this and many other issues with me and questioned how a court could decide on whether a food was a food or not, depending on who ate it. There is a genuine problem there. From paragraph 10 of Schedule 1, it seems that a food is exempt if it contains a psychoactive substance which occurs naturally in the product and which is authorised by an EU instrument. Have the Government thought through all the foods in which a psychoactive substance—using the Government’s sweeping definition—naturally subsists but which might not be covered by an EU instrument? There may well be eastern, or other different, foods which would not be covered. For example, do flavourings and spices, which are obtained by a process of extraction and widely used in food, satisfy the expression “naturally occurring” in the substance?

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Lord Bates Portrait Lord Bates
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I thank the noble Baroness for introducing this amendment. I am conscious that if I had had the opportunity it would have been impolite to have sought the advice of my noble and learned friend Lord Mackay on the amendment because, of course, it has the heading “Republic of Ireland: impact assessment”, and goes on to tie us to a piece of legislation. The problem with that is thinking back through the history lessons and what the Anglo-Irish treaty and the creation of the Irish Free State in 1921 might have made of that strong connection. It is probably more uncomfortable for the Irish than for us, but it is an interesting tool to link their legislation with ours because we are two sovereign countries and two different systems. We approach a common problem but understandably, as we do on many different things, may choose to do so in different ways—not so, of course, when it came to this piece of legislation.

I will set out the legislation in the Republic of Ireland a little because in the headline of this debate we are invited to say what assessment Her Majesty’s Government have made of the effect of introducing a ban in the Republic of Ireland. That assessment was set out in the expert panel’s review last year since the ban in Ireland came into force in 2011 following the 2010 Act. The expert panel went away and evaluated that. I have a long section in my speaking notes which I will try to avoid reading out and I will just cite it. Page 38 of the expert panel’s report sets out the basis by which it concluded that there was evidence that this was the model which should be followed. In addition to that on page 38 there was also the Scottish Government’s—

Baroness Meacher Portrait Baroness Meacher
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It may be relevant to note on the record that when the BBC journalist began interviewing a very senior official, that official said, “Oh yes, the ban has been going well”, and it was only through rather expert probing by the BBC journalist that gradually the truth came out that the ban was not working at all as anticipated. So in terms of an expert panel from Britain going over, I think we need to be aware that the Government need to do more work on Ireland.

Lord Bates Portrait Lord Bates
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I will come to that in just a minute because it is a specific point which the noble Baroness, Lady Bakewell, raised in the earlier debate on the issue of the “Newsnight” report, of which I have read a transcript although I did not actually catch it last night. I want to address some of the points in there. What I am going through is the methodology by which we arrived where we were. Taking the amendment at its word, we are effectively deciding whether we should delay the progress of the UK introducing the new psychoactive substances legislation and the blanket ban in order to undertake an assessment of how effective the 2010 Act has been in the Republic of Ireland. Our view on that is no, because that assessment has already taken place in the expert panel review and—

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Lord Bates Portrait Lord Bates
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Of course we will take it into account, but should we necessarily stop taking our own advice and implement what has been recommended to us until that time happens? Of course this is a fast-moving world in which there are very devious forces—“ingenious forces” is the correct term—using their dark methods to perpetrate these drugs, which are blighting the lives of communities. That was a key message that came out of the “Newsnight” documentary. Here was a community that was absolutely blighted. Unless I actually misread the transcript that I saw, the people there certainly were not saying, “Hey, listen, let us just have a free-for-all”. They were saying, “Where are the Gardai? Where are the police? We want them to come down, because these drugs are running rife in our community”.

Of course, there will always be chancers—we will come up with one answer to this, then people will come up with something in response, whether it is on the dark web or elsewhere. One of the wonderful things about this House is that the noble Baroness, Lady Meacher, who is an acknowledged expert in drug policy, mentioned the dark web, while behind her sits the noble Baroness, Lady Lane-Fox, who can offer her a tutorial on the dark web if required. The point is that we are all moving in the same direction.

I am conscious of the figures that have been put out in the Eurobarometer poll, which talked about the level of usage. This figure should be viewed with caution, because: the sample for each member state is relatively low, at 500 respondents; the questions used have changed over the years, making comparisons over time less reliable; and the Eurobarometer survey tends to overestimate usage when compared to more robust surveys.

As I touched upon earlier, we can say categorically that prior to the introduction of the Irish legislation in 2010, 102 head shops were operating in Ireland. After the legislation came into force, the trade virtually disappeared, and the Garda drugs unit told the BBC just last week that the head-shop trade has gone. Furthermore, no Irish-domain web pages selling NPS are still in operation. Those are examples of concrete progress. They may not address all the points, but I hope that they might demonstrate to the noble Baroness that the Government have considered this.

Baroness Meacher Portrait Baroness Meacher
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One has to think about whether the demolition of the head shops is a positive or a negative when you consider that the young people will have moved from the head shops, which do not sell very dangerous substances, into the dark web and the back streets, where they will buy very dangerous substances that are completely unknown to them, which probably do not have any kind of labelling at all.

Lord Bates Portrait Lord Bates
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We can debate what benefit labelling that says “Plant food” or “Not for human consumption” is. The fact is that the head shops are absolutely at the heart of this problem. I, for one, will be very happy if they are removed from our high streets, as will the Local Government Association and countless parents who are worried about the availability of drugs—earlier I gave an example from Canterbury. On that basis, I hope that the noble Baroness will consider withdrawing her amendment.

Baroness Meacher Portrait Baroness Meacher
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I thank the Minister for his reply. Obviously, like the noble Baroness, Lady Hamwee, my expectations are not massively high at this stage of proceedings, but I look forward to discussions with the Minister between now and Report on some of these issues. I have a great regard for the Minister with regard to his willingness to listen and certainly to learn from professionals who, with any luck, will be able to come to a meeting with us. On that basis, I beg leave to withdraw my amendment.

Amendment 3 withdrawn.
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Moved by
4: After Clause 1, insert the following new Clause—
“Monitoring
Following the commencement of this Act, the Secretary of State must publish a report annually setting out the impact of this Act, including on deaths and other harms caused by all controlled and banned substances.”
Baroness Meacher Portrait Baroness Meacher
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My Lords, Amendments 4 and 6 seek to ensure that following commencement of the Act, the Government will undertake an annual impact assessment of the Act—as the Minister has indicated he might be willing to do anyway—including an assessment of,

“deaths and other harms caused by all controlled or banned substances”.

The important points in that sentence are “all controlled”, under the Misuse of Drugs Act, and “banned substances” under the Bill. Of course there is always an interrelationship between those two groups of substances, as I mentioned in an earlier debate. In addition, the Government would have to,

“publish a report annually setting out the impact of this Act”—

again, including information about the impact on the number of deaths and other harms caused by all these controlled and banned substances.

The point behind these amendments is that, as I mentioned earlier, we do not have two separate markets: one for substances controlled under the Misuse of Drugs Act 1971 and another quite separate one for psychoactive substances that will be controlled under this legislation. The reality is that once substances are illegal, they join a single market and are purchased from the same illegal drug barons or from the web. This is an absolutely crucial point, which runs through a number of these amendments. Social media are also absolutely vital in this. It is through social media that young people immediately communicate about a banned psychoactive substance or something new arriving from somewhere, or that a traditional drug such as ecstasy has suddenly become more pure, and the young people will all rush into that area of the market rather than moving from one market to another.

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Baroness Chisholm of Owlpen Portrait Baroness Chisholm of Owlpen
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The noble Lord is right: I was rather remiss in not saying that I was sympathetic to his views on this issue, and I apologise. We will certainly consider it between now and Report.

Baroness Meacher Portrait Baroness Meacher
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I just want to explore the point in Amendments 4 and 6 that, because there is only a single market that incorporates all the controlled drugs under the 1971 Act and psychoactive substances, post-legislative scrutiny will not make any sense unless it looks at the overall impact of this Bill. For example, what we can expect to happen is that if you ban synthetic cannabis, people will move straight over to the cannabis controlled under the Misuse of Drugs Act. If you ban a substitute for cocaine, people will move straight back to the natural cocaine, if you like, that is controlled under the Misuse of Drugs Act. In order to assess the impact of the Bill, it will be essential to look at the overall consumption of illegal, banned drugs and the deaths from those drugs. The deaths may move across from one type of drug to another, as would the harms and so forth. It is essential that the Government begin to look at this as a single, illicit market for banned substances. Does the noble Baroness agree that, therefore, post-legislative scrutiny has to look right across the piece?

Baroness Chisholm of Owlpen Portrait Baroness Chisholm of Owlpen
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I thank the noble Baroness for her points, and I agree with her. However, it is important that we do not tie the hands of the committee. It is up to it to review, going forward, and we have to let it decide what it feels is right.

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Baroness Chisholm of Owlpen Portrait Baroness Chisholm of Owlpen
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I thank the noble Lord. I have a lot of sympathy for what he said, and I think that it is right for us to go away and reflect on this and come back at Report. Of course, the Home Office has every intention of reviewing the Bill once it is implemented. We just do not feel we should put such a commitment in primary legislation. It is in our interests to consider the impact of this Bill and how the psychoactive substance market is changing to ensure that both our legislative and non-legislative responses are as effective as possible. Having said that, of course we will go away and think further on this.

Baroness Meacher Portrait Baroness Meacher
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My Lords, I thank noble Lords who contributed to this debate, particularly the noble and learned Lord, Lord Mackay of Clashfern, for his helpful proposal that there should be post-legislative scrutiny by a Joint Committee. I hope that that can come about. I agree with the noble Lord, Lord Howarth, that that sort of scrutiny does not detract from the need for the Government’s post-legislative scrutiny, so I think that we are all going in roughly the same direction.

I was very pleased with the noble Baroness’s response about the recognition of the single market for these illegal drugs, because it would be an enormous step forward if we stop seeing these things as separate and start examining what is going on across the piece. That has all been extremely helpful. The timeframe is an issue: three to five years seems an awfully long time particularly as some of us do not really expect this legislation to work, especially bearing in mind the Irish experience. It is a great pity—Ireland is now four years on and still wondering what to do.

Given all of that, this is Committee and we have had a useful debate on this issue. I look forward to meeting Ministers between now and Report. On that basis, I am more than happy to withdraw the amendment.

Amendment 4 withdrawn.
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Moved by
7: Clause 2, page 1, line 14, after “Act”” insert “synthetic”
Baroness Meacher Portrait Baroness Meacher
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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 Portrait Baroness Hamwee
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My Lords, my noble friend and I have Amendments 9 and 10 in this group. Amendment 9 presents me with a dilemma, given the comments that we have been making about what has been happening in Ireland. Amendment 9 would import into the Bill the Irish definition in terms. Given where we are and given that the definition in the Government’s Bill is more telegraphic than the Irish one, I would nevertheless like to hear what the Government have to say about the differences.

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

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

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

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

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

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

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

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

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

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

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Lord Bates Portrait Lord Bates
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I am not sure at whom that question is directed. I could, of course, easily answer but I am sure that the author of the amendment would want to deal with it personally.

Baroness Meacher Portrait Baroness Meacher
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I thank the Minister. I also thank all noble Lords who have contributed to this debate. I spoke extremely briefly but it has proved a very illuminating debate. We have drawn out a number of issues, and I am grateful to the Minister for his reply and for agreeing to write to us about these matters. I hope that in that letter he may be able to answer the question of the noble Baroness, Lady Hamwee, about herbal remedies that are genetically modified, because I would not presume to take the place of a Minister in these matters.

Could the Minister also clarify whether, in tweaking the Irish definition of psychoactive substance, the Government have gone back to the Irish and to their experts to seek their opinion on whether this adjustment to the definition will overcome the apparently insuperable problems that the Irish have encountered? It is incredibly important that we accept and acknowledge that the ban in Ireland has failed and that we make sure, before this Bill is through, that it is adjusted as necessary to become a useful tool in the armoury of government drug policy. With that I am content to withdraw the amendment.

Amendment 7 withdrawn.