Medical Cannabis: Alleviation of Health Conditions

Lisa Cameron Excerpts

Thursday 4th November 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

I thank the Backbench Business Committee for granting this important debate and the hon. Members for Inverclyde (Ronnie Cowan), for Edinburgh West (Christine Jardine) and for Reigate (Crispin Blunt) and my hon. Friend the Member for Gower (Tonia Antoniazzi) for securing it. I also thank the cross-party campaigners in this place beyond that group, including the hon. Member for South Leicestershire (Alberto Costa), the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Manchester, Withington (Jeff Smith), for all that they have done over the years to put it on the parliamentary agenda.

Progress in making cannabis-based medical products available to those who need them has been slow, so it is right that we have the opportunity to debate the frustrating lack of progress. As hon. Members have said, this is the second debate in two days, which I hope gives those watching confidence that we in this place are taking the issue seriously.

I associate myself with the remarks of the hon. Member for Inverclyde in his opening speech about the families who are dealing with incredible, unthinkable challenges and who handle themselves with such dignity and make such powerful cases. I hope—I feel—that we have done them justice today and will continue to do so. In particular, I hope that the Minister will touch on his points about the limiting factors in research.

The speech of the hon. Member for Reigate was a characteristic tour de force. I always stop to listen when he is talking about the issue, because he speaks with such power. He made the point that it is unacceptably cruel to take effective medicines away from a child, which we all agree with. He linked that to palliative care, and I share the view that we want people at the end of their life to get whatever treatment might make their final days the best that they can be. Actually, that applies to adults throughout their lives: if people are living in pain and do not have to be, I would want to do anything I could to avert that.

The hon. Gentleman spoke about the 2018 regulations and the sense that we thought they had solved it, as the right hon. Member for New Forest East (Dr Lewis) also said. The hon. Member for Reigate gave us a hopeful way forward by concluding that we need to be creative and solution-focused. The Opposition share that view—I do not think there is a lot of politics on this issue—and support coming together to find a practical, effective, safe and risk-aware solution.

My hon. Friend the Member for Manchester, Withington spoke in that spirit. He is fortunate to have been drawn in the private Member’s Bill ballot, which is precious for any right hon. or hon. Member. He is keen to work with the Government. I know him well and know the spirit in which he will work with them, so I hope the Minister will take that up. That private Member’s Bill would be a perfect vehicle to move the issue forward. His point that it is about not just epilepsy was well made. I double underlined the phrase that we need to give clinicians the “comfort to prescribe”, which was elegantly put. I completely support that goal and will come back to it.

The hon. Member for Edinburgh West spoke about her constituency case of Murray. Many right hon. and hon. Members will recognise similar cases in their surgeries. The daftness of that story is that the UK’s prescribing could grind to a halt on the basis of a single person retiring. Where else in the health service would that ever be the case or tolerated? It is an absurd set of affairs.

My hon. Friend the Member for North Tyneside (Mary Glindon) kindly facilitated the opportunity for me to meet her constituent, who is a doughty campaigner, as she says. To hear the impact on her constituent’s life, it is hard to understand why we are not doing everything we can to make sure that she can live with as little pain as possible. I will get on to the counterargument about the lack of evidence, but she is that evidence, because we know what her life was like before and after, so I find that argument hard to accept.

The common theme of the contributions has been frustration or, more positively, a desire to redouble our efforts in this area, which cuts both ways. There are opportunities in research, which I hope the Minister will talk about, with regards to epilepsy, long-term pain relief and mental health. We also need a stronger position on the regulation of products such as cannabidiol, which proliferate on the internet and can be found in various shops, in all sorts of forms, promising all sorts of things that are hard to establish. We need better regulation in that space.

When the Government accepted the therapeutic use of cannabis, it was met, as we have heard, with much relief from campaigners, such as the families of Billy Caldwell and Alfie Dingley, who has now gone 508 days without an epileptic fit thanks to his medicinal cannabis treatment. It has changed his life, but not everyone has been so lucky.

Bailey Williams has been denied access to medicinal cannabis for his epilepsy and his parents are forced to raise £1,200 a month for his treatment. The mother of 11-year-old Teagan Appleby spends about £2,000 a month to treat her daughter’s Lennox-Gastaut syndrome, as she has not received a prescription. In the time that she has been taking that treatment, she has to go to hospital only once—when it ran out. That is the impact on her life.

I think of my constituents and how few, if any, could spare £2,000 a month. Of course, all of them, and I daresay all of us, would go to whatever lengths necessary for our children—that is the tragic paradox—but it is not acceptable. We are letting people down on an issue that we thought we had resolved.

In 2018, cannabis-based products were rescheduled. Guidelines were produced by the National Institute for Health and Care Excellence and three products got through: Epidyolex for rare forms of epilepsy, Nabiximols for multiple sclerosis-related spasticity and Nabilone for side effects from chemotherapy. The regulations said that initial prescriptions must be made by a specialist medical practitioner and, in all cases, would be considered only when other treatments were unsuitable or had not worked.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

The hon. Gentleman is making an excellent point. Does he agree that the psychological pressure and stress of having to campaign constantly and raise money at that level is simply unfair? My constituent Lisa Quarrell has had to raise thousands of pounds for her child Cole Thomson and has been under that stress continually for years. It is time for us to work collectively to overcome any hurdles to achieving success.

--- Later in debate ---

[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.

[Dr Cameron]

I know that the Minister is committed to this issue. Could the Government perhaps appoint a lead clinician for this issue, to give clinicians across the United Kingdom confidence, and to drive the issue forward at pace, so that we see movement in the short term?

[Maria Caulfield]

The hon. Lady makes a good point. If there are clinicians who want to take a lead on this, there is obviously scope to look at that, but we must be clear that we have to license and support research for this medicine in the way we would any other. I have given a commitment today to working with hon. Members on both sides of the House to demonstrate how seriously the Government take this issue.