Medicinal Cannabis: Economic Contribution

Jeremy Wright Excerpts

Thursday 20th April 2023 Westminster Hall

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

It is a pleasure to see you in the Chair, Mr Stringer. I congratulate my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on securing this debate and on the way he opened it. It is of course a pleasure to follow the hon. Member for Strangford (Jim Shannon). I agree entirely that if this were a debate about the wider use of cannabis, about encouraging its use or, worse yet, about its legalisation for recreational use, neither he nor I would be speaking in favour—we would be speaking strongly against. But that is not the debate we are having today. We are talking about the prescription of medical cannabis by doctors for use by patients such as Sophia, the hon. Gentleman’s constituent. I will come on to my own constituent whose involvement in this process leads me to be here.

It is worth recognising that the debate about whether we should prescribe medicinal cannabis medicines to patients who can benefit from them has been resolved. We have had that discussion and, as my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale mentioned, my right hon. Friend the Member for Bromsgrove (Sajid Javid) made that necessary change to the law in November 2018 so that such medicines can be prescribed within the law, and medicinal cannabis was rescheduled under the law to ensure that that was a legitimate process. That was, in my view, entirely the right change to make. I argued for it at the time, and I was involved in that process.

The credit must more substantially go to the family of my constituent Alfie Dingley. Alfie is a young boy whose circumstances are very similar to those of the constituent of the hon. Member for Strangford. He used to have a number of seizures a day of very great severity, and cannabis-based medicine has had a transformational effect on him. As a result, his family campaigned effectively and robustly for the change we have seen, and they deserve huge credit for it. I am delighted that they are here in the Public Gallery today. Alfie’s mother, Hannah Deacon, has been campaigning not just for Alfie’s benefit, but for the benefit of others who can also derive considerable beneficial change from these medicines.

We have already had a change to the law to allow medicinal cannabis to be prescribed and to deliver benefits to patients who can have it, but all of us who thought that that was a good change to make had rather expected that considerably more progress would have been made by now in ensuring that medicinal cannabis products are made available to patients who can benefit from them. It is a matter of profound sadness and regret, and it should be of concern, that only three NHS prescriptions have so far been made for these types of medicines. That cannot be right. I hope my hon. Friend the Minister will recognise that the logic of the legal change made in November 2018 was that we would make these medicines available to those who need them, and we are nowhere near that objective.

As I say, we have crossed the Rubicon. We have made the decision that medicinal cannabis should be made available to those who need it, and it seems to me that we need to follow through on the logic of that decision. The logic of that decision is not just that, in a medical context, we should make these medicines available to those who need them, but that we should also support their provision domestically. Therefore, the debate that we are having this afternoon, at the instigation of my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale, is about ensuring that the logic of our decisions is followed through, and that the UK economy can derive the necessary benefit from those sensible decisions.

We know that medicinal cannabis will be produced somewhere, and of course we must want it to be in order to have those products available for prescription within the NHS and the broader healthcare architecture. Why, then, would we not encourage the production of medicinal cannabis in this country, so that there can be a direct domestic financial benefit from it? It simply makes no sense to create a demand and then refuse to allow our domestic producers to meet it, and instead to import all the products.

Doing that is not just a wasted economic opportunity, but has a direct healthcare effect. That is why it is of benefit that my hon. Friend the Minister is answering this debate. If we were talking to a Minister from the Department for Environment, Food and Rural Affairs, we could talk about the benefits that these crops bring in an sense. If we were talking to a Business Minister, we could talk more about the direct financial benefits that have been mentioned. However, since a Health Minister is here, we can also talk about the direct benefits of a more secure supply chain to those receiving these medicines.

This is not just a theoretical concern. Alfie Dingley and his family had periods of intense worry during the Brexit process. They were concerned about the security of supply of what Alfie needed, which at that point was coming from the Netherlands. The potential disruption of that supply was evident. I put on record my thanks to the Minister’s predecessors, who were able to intervene and ensure some security of supply. However, that took up a good deal of ministerial time, because we were seeking to secure supply from overseas, when we could have so much more easily had that supply domestically. This is not just an economic argument, although I support the points made by my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale about the economic benefits. There is a direct healthcare benefit to ensuring that we have a domestic supply of these products.

I support the arguments made by my right hon. Friend and the hon. Member for Strangford. It is sensible to follow through on the logic of the decisions that we have—in my view, rightly—already made. We must therefore support domestic supply and address the bureaucratic obstacles in the way of securing that supply, which my right hon. Friend rightly described. I hope the Minister will reassure us that he and colleagues in other Departments will be able to work together to achieve that security of supply and those financial and economic benefits. Most importantly, patients who benefit from these medicines should not just receive them by prescription, but be reassured that their future and their supply is secure because we have developed a sustainable domestic industry in the production of medicinal cannabis.

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[Will Quince]

I thank the hon. Member for that; I will gladly take a copy on the way out. I hope he will excuse the fact that I am not an expert in this field, but I will happily take that report as my weekend reading and read up on the subject. I certainly agree to take this up with my counterpart in the Home Office, as my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale requested, and I am sure he will, too. I will especially take away my right hon. Friend’s important points on licensing, and on how the Government can support companies that want to invest in the UK, or that are here and want to diversify their agricultural business, and want to get the licences required to grow these products.

[Sir Jeremy Wright]

All of us understand that the Minister does not speak for each of the Government Departments responsible for this area, and I know he will take away from this debate that nobody is arguing that there should not be licensing of this process. There are obvious concerns that need to be met by regulatory intervention. The concern is the fragmentation of the regulatory landscape that applies to those seeking to grow these products. I am sure that the Minister can assist us by helping to better co-ordinate the way in which regulation is applied, as we are not seeking a removal of licensing.

[Will Quince]

I thank my right hon. and learned Friend for his intervention. I think we are probably in violent agreement on this point. I cannot specifically speak to regulation or licensing from a Home Office perspective. We are talking about a controlled drug; that may come as a disappointment to the hon. Member for Inverclyde, but it is—and is likely to remain, I hasten to add—a controlled drug. I will turn later to regulation from the perspective of the Department of Health and Social Care, but it is really important that there be consistency and coherence, and that we treat these products as we would any other medicinal product. However, my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale makes his point well, and I will raise it with Home Office colleagues.

More broadly on growing a UK CBD industry, I am of course aware of the growing consumer CBD wellness market. One only has to walk down any high street to see CBD products advertised in windows, and indeed in major supermarkets. DEFRA, which I did not mention, and the Food Standards Agency are taking action to regulate this side of the market. Importantly, that will protect consumers by ensuring that only safe, high-quality products are placed on the market. That is vital. Consumers will also be protected against misleading health claims. I was recently told about CBD products that come in aluminium cans, but in fact the CBD remains on the aluminium and is not contained in the product. That is just one example. This is a very complex area that I do not want to delve too much into, as it is very much a DEFRA and Food Standards Agency lead.

The Food Standards Agency is working closely with the Home Office on how CBD products are regulated, considering their composition and the possible presence of a controlled substance. This is very much a live issue, and I am told that the Home Office has sought the advice of the Advisory Council on the Misuse of Drugs. I understand that the Government intend to respond to the ACMD recommendations on this matter shortly.

My right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale and my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) both raised a point about regulatory barriers. Not that this reminder is needed, but it is perhaps helpful if I remind the House that cannabis- based medicines are controlled drugs and are therefore regulated by the Home Office, which is responsible for all controlled drug regulation legislation. Then there is the controlled drugs licensing regime, which supports cultivation, research and, where the issue crosses over into the health sphere, clinical trials in the UK. This licensing regime enables the possession, supply, production and import and export of those controlled drugs to support industry, pharmaceutical research and healthcare. However, more and more these products are being grown in the UK, including Jazz Pharmaceuticals, for use in research.

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[Will Quince]

I do not want to labour the point, but the point is that it has not passed those tests. It is either a licensed product or an unlicensed product. To be licensed, a product must go through the MHRA process. That is something that these products have not done to date. Yes, they can be manufactured here and prescribed privately, at the risk of the doctor—the private general practitioner—but for a product to be prescribed on the NHS, it needs MHRA and NICE approval.

There are some exceptions to that, because the law was changed in 2018, as my right hon. and learned Friend the Member for Kenilworth and Southam referred to, for a specialist doctor or for some very specific conditions. He asked why there have been only three prescriptions. I did not know that that was the exact figure, but I will check; regardless, it sounds very low. I suspect that the reason is that the decisions are taken at the doctor’s own risk, and among general practitioners there is reticence to prescribe an unlicensed product that has not gone through the MHRA and NICE process.

[Sir Jeremy Wright]

The Minister is probably right, but I am sure that when he looks at this again he will also want to look at the NICE guidelines that apply, which are extremely restrictive. The risk to an individual doctor from making a decision to prescribe will be perceived to be much higher if the NICE guidelines appear to deter such a prescription. The Minister is right that there are many elements to this, but one of them is how much we encourage doctors to believe that this is the right thing to do. I go back to the point that I was making: there is some logical dissonance here. We have said already that it is right to reschedule these products as far as the Home Office is concerned. We are starting to see prescriptions in the NHS, but not in the numbers that will benefit the maximum number of patients.

[Graham Stringer (in the Chair)]

Order. We have not been short of time this afternoon, and every hon. Member has had the opportunity to speak. Interventions should be brief and to the point.