Disabled People

Baroness Meacher Excerpts

Thursday 9th May 2019 Lords Chamber

[Baroness Meacher (CB)]

My Lords, I too applaud the noble Lord, Lord Borwick, for initiating this helpful debate. If we want to improve outcomes in the disability field in the next 50 years, surely the best way of doing so, where we possibly can, is to prevent disability occurring in the first place. I therefore take this opportunity to speak about the potential to prevent some disabilities—obviously a limited number, but some—and to ameliorate many others, if only the UK could agree to establish a special category for medical cannabis within our regulatory framework. This sounds a narrow subject, but actually it has huge implications for many people.

First, why should cannabis be treated differently from other medications? One important reason is cost. Sativex, one of the only medications so far approved by the MHRA, went through so many expensive random control trials that NICE would not approve it on grounds of cost. The result is that severely disabled MS patients tell me that they still go to the illegal market to obtain cannabis to alleviate their symptoms. They say that the risk of arrest is worth it to feel better and have less suffering. I find that abominable, but that is what our system is causing.

I fear that a similar fate awaits Epidiolex. GW Pharma tells me that it has spent hundreds of millions of pounds on random control trials. I do not blame the companies—that is what they have to do. But NICE will surely rule that Epidiolex is too expensive to be prescribed on the NHS. The evidence from other countries, meanwhile, shows that cannabis medicines can be extraordinarily effective—much more effective than we recognise in this country—but their research is often based on outcome measures, rather than the very expensive, pukka random control trials. Of course I support random control trials and understand their point, but we have to make sense of our system for the benefit of patients. Ultimately, that is the only thing that really matters.

Epidiolex is coming on to the market, but it is already a suboptimal medicine: it is out of date before it even reaches patients. Israel has identified specific cannabinoids that are extraordinarily beneficial for treatment-resistant epileptic children, but in this country these children will, if they are lucky, be prescribed Epidiolex, if their parents can afford it. Epidiolex will perhaps help them to some extent for a short period, but that is just wrong when similar children in other countries have medication that stops their seizures. Why is this so important? We know that seizures cause brain damage and disability. Every week that we delay recognising cannabis as a medicine for treatment-resistant epileptic children, children are becoming disabled. Fifty years on, they will be suffering disability that they did not have to suffer. That is the point.

I implore the Minister to see what she can do in the department to hasten, ideally, recognition of a special category for cannabis—if only for a temporary period of five years, initially—so that these children can get hold of the medicine they so urgently need. In Germany, cannabis medicines are recognised for more than 50 conditions. Many of them will involve disability and could be alleviated. Can we not follow something similar to the German example? Across the US, Canada and much of Europe, the extraordinary medicinal value of cannabis for some people—I am not saying that it would help everybody—is recognised far more than it is here.

Another important field is pain; chronic neuropathic pain in particular. I applaud the contribution of my noble friend Lord Luce. Chronic pain is such an important issue, given the enormous number of people who suffer every day. As it happens, cannabis medicines are far less dangerous, far less addictive and have far fewer side-effects than opioid medications, which are prescribed every day to people with severe chronic pain. What is wrong with us? What is going on here? We are doing something really bad, and I fear that it has something to do with our regulatory system and the costs involved for certain medications.

I briefly mention mental health. One does not think of cannabis in relation to mental health. I spent years in the mental health services, and I used to ask patients why they took cannabis, given that it interfered with their treatment. They used to say, “Because it makes me feel human. It makes me feel alive”. I thought that that was very interesting, and that was years before I had any interest in any of these drugs. Research evidence is emerging—it is not there yet—that cannabis may alleviate some of their positive symptoms as well. If patients with severe psychotic disorders could manage with cannabis and none of the antipsychotic medications that cause such severe side-effects, it would be completely wonderful. We just have to watch this space. As someone interested in mental health, I am watching rather carefully.

Research evidence is emerging about the benefits of cannabis medicines for these and many other indications: Parkinson’s, Crohn’s disease, brain tumour, PTSD and many more. Many of those conditions cause disability. We can prevent some disabilities—most particularly, I would argue, epilepsy and brain damage—and certainly ameliorate a huge number of others, but only if we put our prejudices behind us and change our regulatory rules.