Medical Cannabis: Alleviation of Health Conditions

Christine Jardine Excerpts

Thursday 4th November 2021 Commons Chamber

[Christine Jardine (Edinburgh West) (LD)]

It is a pleasure to follow the hon. Member for Manchester, Withington (Jeff Smith). I thank the hon. Member for Inverclyde (Ronnie Cowan) for securing this debate on medicinal cannabis.

I am sure I am not alone in this place in often being asked by people, “What is it that makes you want to be an MP?, “What is it about being an MP that is rewarding?”, or, particularly after days like yesterday, “Is it not frustrating?” When I am asked that, I point them to what happened a couple of years ago, when my constituent Karen Gray came to my office with her wee boy Murray, who, up until that point, had been the subject of lots of conversation and lots of letters back and forward to the Scottish Health Minister and to the then Health Secretary about the availability of cannabis oil. She brought him into the office and he sat and explained to me all about why he liked dinosaurs. That might seem unremarkable. But before then—before he had cannabis oil—Murray was likely to have up to 100 seizures in a day. He had spent much of his life in hospital and missed much of his education, and his parents were worried for his future.

Three years ago, when the then Home Secretary, now Health Secretary, made cannabis oil legal, it gave Murray’s family hope that their lives would change, and their lives have changed, Murray’s life most significantly. But it still is not fixed, because now the specialist who was prescribing cannabis oil for Murray has retired. When they did, earlier this year, they wrote to the Secretary of State asking what was to happen, because there would now be only one clinician in the country prescribing cannabis oil for hundreds of children for whom Epidiolex is not appropriate but for whom cannabis oil does change their lives and keep them safe. I have spoken to Murray’s mum about this. She is of the opinion—and says that the specialist was as well—that many GPs and doctors in this country want to be able to help their patients with cannabis oil, and that will be possible only if the Department of Health changes its policy and encourages the profession to do so.

This is the third debate on this subject that I have taken part in in the past couple of months. Each of them was secured by an MP from a different party. Today’s debate was secured by the hon. Member for Inverclyde, who is a Scottish National party Member. Yesterday’s debate in Westminster Hall was secured by a Conservative Member. I secured the other debate, as a Liberal Democrat Member, and we had support from Labour Members. I am at a loss as to how an issue that is so emotive, and has so much support across this House and across this country, has to keep coming back. We have to keep asking the same questions. We have to keep saying that clinical trials will not work because cannabis oil is not suitable for clinical trials. Even the NHS has said so. In its report of 8 August 2019, it recommended that there should be alternative trials. By that I assume it means observational trials.

I wonder what motivated the Government and the then Home Secretary to change the law: I suspect that he wanted to do it in the best interests of a child, and children, who were suffering and could be helped by that change in the law. I also wonder how frustrated he, and other politicians who took part in that decision, including all of us who worked hard and campaigned for it, must now be that despite that significant—in some terms, massive—change by this Government, we have not made the intended progress. People are still in pain in this country. Families are spending, as we have heard, upwards of £1,000, sometimes £3,000, a month to secure legal medication for their children that they cannot get on the national health service—the national health service of which we are so proud and that is supposed to deliver free-at-point-of-delivery care from cradle to grave.

[Crispin Blunt]

A few of us have constituents with a child with epilepsy and have invested the time to get a detailed understanding of many of the issues. The problem, as alluded to by my right hon. Friend the Member for New Forest East (Dr Lewis), is that most of our colleagues think we have done it. After the decision was taken in November 2018—or when the licence was given for Billy Caldwell to get his medicine—the conclusion was that one would not be able to find anyone who was objecting, because if one can have medicine from the Asian poppy, why on earth can one not have medicine from cannabis? There was probably no opposition in this place at all. But the tragedy is that the evidence is that we have not done it. We must get back into the complexity. We will support the new Minister in fighting her corner to ensure that people can get these medicines, along with all the other interests that are engaged here too.

[Christine Jardine]

I thank the hon. Member for his intervention. He is absolutely right; I could not agree more. We all thought it was done, but more importantly, and more upsettingly, so did the families of the hundreds of children, and adults, who would benefit—adults with conditions such as multiple sclerosis for whom it would be life-changing. They all thought it had been done and cannot understand why it is not. I have to be honest: I cannot understand why it is not either, and why it simply cannot be done. Will the Government please consider using observational trials instead of insisting on clinical trials, which are not appropriate?

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

The hon. Lady and I have locked horns on a number of occasions on the radio over the European Union, but I would like her to know that she has support on the Tory Benches, particularly when she talks about children and the conditions they are facing. I hope she will take comfort from the fact that she has support from all political parties in the House in trying to change the legislation on this very important issue.

[Christine Jardine]

I thank the hon. Member for his comments, and I do take comfort from that, but more importantly, the many hundreds of families watching to see what we do will take comfort from the fact that they have support on the Government Benches as well as the Opposition Benches. I ask the Government and the Minister to take that on board. Will they consider the suggestions that have been made today, as well as using discretionary funding to support those prescriptions that families are currently paying for until we can resolve this issue? Then we can finally achieve what the then Home Secretary and the Government wanted to achieve three years ago when they made cannabis for medical use legal. They did not intend that we would be here now with only three prescriptions issued.

--- Later in debate ---

[Maria Caulfield]

I take the hon. Gentleman’s point, but many children are not accessing this medication, and this is a route to that. As I explained in yesterday’s debate, clinical randomised control trials with a placebo arm have extremely strict rules, and if one arm of the study is showing incredible progress and doing better than the other arms, the study must be stopped, patients unblinded, and everyone switched to the arm that is doing the best. In some circumstances, that has enabled people to access drugs under clinical research in a much quicker way. It does have some advantages.

[Christine Jardine]

That is all very well, but it brings us back to the fact that there are children who are already benefiting from the drugs. Even the NHS has asked whether it would not be beneficial to have an alternative trial, such as an observational one, and to use that evidence, rather than having a clinical trial with all these pitfalls.

[Maria Caulfield]

I take the hon. Lady’s point, but the MHRA, which is the regulator, and other regulators around the world have a tier of research that they will accept. The randomised controlled trial method is the gold standard, and the more randomised controlled data someone has, the more likely they are to get a trial approved quickly. Of course observational studies will be used. That is why, if researchers have a large group, want to do observational studies—we heard about the Sapphire clinic from the hon. Member for Inverclyde—and come forward with observational data, I encourage them to speak to the MHRA to see whether that is the sort of research that would be acceptable. It is important that they have those discussions with the regulating body, because it may well accept some of that evidence.

Until manufacturers, researchers, academics and those using these drugs in practice come forward with whatever research they feel would be acceptable and have those discussions, we will go round in a circle. I am keen that if observational studies are acceptable, we support them to happen. Whatever it takes, in research terms, to get a licence through, the Government are there, providing funding, advice and support. However, ultimately, they are not the body that can make that decision; but I think there is a willingness around the House to try to find a resolution.

It will take time to generate further evidence and see the results of clinical trials. The Health Secretary and I are committed to doing everything in our power to accelerate this work. There have been some helpful suggestions this afternoon that we may need to go away and look at.

I thank everyone again. Although this is the second debate on this subject in two days, I know that it will not be the last; the private Member’s Bill will come forward next month. I want to put on the record my commitment to this issue. It is extremely difficult. In yesterday’s debate, we heard constituents’ stories relayed by their MPs, including the hon. Member for Middlesbrough (Andy McDonald). They really are very moving testaments, and we want to find a way forward. We have changed the law, but that has clearly not been enough. We need to find a resolution, so that we can get these medications licensed if the clinical evidence is there, and we need to work with the regulator.