(2 years, 8 months ago)
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My hon. Friend brings up a point about responsibility. There is responsibility on those who purchase and on the breeders, but there must also be responsibility on online companies. The hon. Member for Neath mentioned databases; making sure that databases are functional is also important in this space, and it is something that I think Mr Ackers has also addressed in his work.
One of the biggest issues for the Minister and the public to understand is that if these animals were pigs or cattle, we would know exactly who the mum was and where they had been travelling. We would know all their breeding—everything about them—for the safety of our constituents. This cannot be beyond the wit of man. Just because the word “pet” is used should not mean that we cannot trace these animals. Surely we can do something.
My right hon. Friend makes a good point. Covid has meant that the movement of livestock is recorded much more online, which has shown us ways of traceability.
In addition to the duties to show the age of the animal for sale and a recognised photograph, the commercial third party sale of puppies and kittens has been banned in England since 6 April 2020. That prevents commercial outlets from selling animals in England unless they themselves have bred them. As I said before, licensed breeders are prohibited from showing a puppy to a prospective purchaser unless the biological mum is also present. There is an exemption in limited circumstances when welfare concerns must take precedence. However, as my right hon. Friend the Member for North Thanet (Sir Roger Gale) pointed out, some unscrupulous breeders rarely think of the consequences for the mother when they are doing this under the line.
Alongside the statutory regulation of commercial pet breeders and pet sellers, we support the self-regulation of online platforms that sell pets. We do this through the close working relationship we have with PAAG, which was created to combat concerns regarding the irresponsible advertising of pets for sale, or for rehoming for exchange.
(2 years, 11 months ago)
Commons ChamberFirst, I congratulate the hon. Member for Edinburgh West (Christine Jardine) on securing this debate. I agree with colleagues’ comments: it has been incredibly helpful to have time to talk about this issue. As I sat on the Front Bench, the debate highlighted to me, first, the needs of these children and their families, and secondly, the complexity of the whole situation. We can make statements, but there are no easy solutions. This issue involves the medical profession, licensing and trials.
Let me thank all those who have contributed to the debate. In no particular order, so as not to upset anybody—I have met many of those who have contributed on numerous occasions—I thank my hon. Friends the Members for South Leicestershire (Alberto Costa) and for Windsor (Adam Afriyie), and the hon. Members for Strangford (Jim Shannon), for Gower (Tonia Antoniazzi) and for South Antrim (Paul Girvan).
I thank my right hon. and learned Friend the Member for Kenilworth and Southam (Jeremy Wright), who is not in his place but with whom I have met. As is the constituency MP for Hannah Deacon and Alfie, he has contacted me and spoken to me on several occasions.
I thank the hon. Members for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and for Inverclyde (Ronnie Cowan), to whom I shall not forget to wish a happy birthday.
As my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) said, we have known each other a long time and I have carried his bags on more than one occasion—
Not no more, but I understand where his passion comes from.
I can also see in their places the hon. Member for Manchester, Withington (Jeff Smith)—we have spoken about this matter—and my hon. Friend the Member for Reigate (Crispin Blunt).
At the heart of this debate for me are Alfie; Billy; Eddie Braun, who was not mentioned; Murray; Jorja; Maya; Bailey Williams, mentioned by the hon. Member for Gower; Sophia; and others. It is about those children. I have personally met several of the families and heard at first hand how it feels not to be able to have anything more. To be honest, as a mum of four, I can say that sympathy feels a bit useless when it comes to a mother who, in some cases, can watch their child fit 100 times a day. They have explained to me the relief that applying Bedrolite under the tongue brings to their children. They have spoken about the financial challenges, but I would like to use the time available to go over some of the challenges that I am trying to wrestle with to get to a solution.
We have had an accordion debate tonight. Initially, the hon. Member for Edinburgh West said that this debate was about access to NHS prescriptions. However, many others also spoke about how much this might benefit multiple sclerosis sufferers and those with chronic pain. Indeed, Lord Field in the other place has written to me on this subject and spoken about the relief of chronic pain that I think he himself gets from using a cannabis-based product. However, there does have to be an evidence base that is more than observational.
I understand that point and I have said to those parents that I would struggle. In fact I would probably find it impossible to offer my child something else when they were already gaining relief from something. However, as we have debated here today, there are probably two issues here: the treatment of those children who are already on Bedrolite; and the need for an evidence base, particularly when we start to talk about expanding the use of cannabis medicines for those suffering from a large range of other medical issues, be it MS sufferers and so on. This is where the challenge comes. Clinicians rightly want to prescribe based on the evidence so that they do their patients no harm. Many people have said that this is the place of last resort for these parents, but we have this difficulty.
I have two points. The first is that it is not all Bedrolite. A lot of these parents do not have Bedrolite. There are myriad specialist ones with different THC levels, but they have been prescribed by a consultant. I know what my hon. Friend said, but these are consultants, and they do want to prescribe the drug and they have prescribed it, but they are not allowed to put it on an NHS prescription unless you are Alfie, Billy or any of the others. It just does not make sense.
I agree that there are other medicines, but one of the challenges is how we treat people with ongoing needs as their conditions vary, if we do not have the ability to understand how the body is responding.
I will push on a little bit. Let me provide an update on Bedrocan oils from the Netherlands. As stated previously, the commercial agreement between Transvaal Apotheek and the UK special medicines manufacturer, Target Healthcare, is progressing. The Medicines and Healthcare products Regulatory Agency and the Home Office are working with those companies to ensure that all regulatory standards for manufacturing these medicines in this country are met. We continue to work closely with the Dutch Government, Transvaal, the Home Office and the MHRA—which I have met with and which says it will look at the international evidence—to ensure continuity of supply until domestic production has been established. We have had movement; I can sense the frustration in the House tonight, but we are moving forward. I will continue to keep the House informed of progress.
On the main topic of the debate, it is undeniable that it is incredibly hard for many of the patients and their families. As many Members have said, the challenges have done nothing but worsen during the covid-19 pandemic. The Secretary of State for Health and Social Care, my right hon. Friend the Member for Bromsgrove (Sajid Javid), when he was Home Secretary, changed the law to allow unlicensed cannabis-based products for medicinal use to be prescribed by doctors on the General Medical Council’s specialist register. This removed legislative barriers to legitimate use as a medicine. However, there is still caution across specialists in their ability and willingness to prescribe. [Interruption.] Indeed. However, with respect, if the prescribing of these medicines by a clinical specialist was that seamless, we would have more of it, but we do not.
The whole thing comes back to the fact that clinicians want to rely on an evidence base, and that includes clinicians in Scotland. We recently received a letter from the Scottish Government, outlining that Dr Rose Marie Parr, former chief pharmaceutical officer, had chaired a teleconference with key paediatric neurologists from specialist centres. The clinicians had a clear and united view that, following the GMC and British Paediatric Neurology Association guidelines, they would be unwilling to prescribe CBPMs containing THC, including Bedrolite, until there is clearer, published evidence available following a clinical trial.
I am going to make a little progress, because at this rate we will go up to the end of the time. I will come to my right hon. Friend the Member for Hemel Hempstead.
While saying that it should remain a clinical decision for doctors—indeed, that was very much what I took from the hon. Member for South Leicestershire, because it would be inappropriate for Ministers in Whitehall or the Scottish Government to influence individual prescribing decisions—with the exception of three licensed medicines, cannabis-based products for medicinal use are not first-line medicines and are not routinely funded. Most cannabis-based medicines are unlicensed medicines, and that means they are yet to have their quality, safety or efficacy assured by regulators here or, indeed, anywhere else around the world. Nor has their cost-effectiveness been decided by the National Institute for Health and Care Excellence, which is how we administer medicines. Those are the foundations of NHS decisions about routine funding. The cost of treatments sought privately remains the responsibility of the patients, and I am not cloth-eared to how difficult that is and why we need to try to find a solution.
The Minister is being very generous, although we have plenty of time. I think we have until half-past 10, Mr Deputy Speaker, should we or you wish. I have two questions. The hon. Member for Gower (Tonia Antoniazzi) asked a specific question: how is it safe on the NHS for three prescriptions to be given to three children, paid for by the NHS, but not any others? Is it safe, or is it not? The Minister referred earlier to clinicians not having the confidence to give the prescriptions. Is she aware that one of the clinicians was reported to the General Medical Council for writing a prescription and was exonerated? That is why they are scared; they are scared for their careers. How can it be safe for three children, but not the other children whose lives can be saved?
I thank my right hon. Friend. I have met clinicians, as well as the families. Like just about every other area of medicine, there is divergence in how they approach it. There are those who prescribe and those who do not. I have also spoken to Alfie’s general practitioner, who was very articulate in describing the benefits that Alfie saw from taking medicinal cannabis. However, it is still fundamentally the decision of the clinician who has the child as the patient. One thing that has been said to me is that it is important, as we try to move forward and do better, to ensure that private specialists also have conversations with those who are treating the children for other issues in their NHS care, because of contraindications and so on, as was referred to earlier.