Medical Cannabis under Prescription

Ronnie Cowan Excerpts

Monday 20th May 2019 Commons Chamber

[Ronnie Cowan (Inverclyde) (SNP)]

I wish to extend my thanks to the right hon. Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) for securing this debate here today.

Several speakers have been quick to explain that this debate is about medical cannabis and not cannabis for recreational use, and, within the context of this debate, that is quite correct. The fact that we feel the need to explain that is a strong indication that there is, in the wider audience, a great deal of mistrust born through ignorance of what cannabis actually is. We even start getting confused when we try to differentiate between cannabis and hemp. What we have here is a mess of our own making.

This is about a plant that can be grown in the UK and, indeed, is already grown in the UK but under licence from the Home Office—more about that later. It is a plant that is good for the soil in which it grows; a plant of which almost every single part can be utilised to make bio-degradable plastics, bio-degradable cloth and, as we know, medicines; and a plant that has been cultivated for thousands of years in various forms. Why do we have an issue with it? Why has cannabis been demonised? When we mention the word cannabis, why for the majority of people does it conjure up the image of somebody sparking up a joint, a spliff, a jay, a doobie, or a roach? It is because, in the Misuse of Drugs Act 1971, this place got it horribly wrong. It fell in with the prohibitionist mantra from the USA and it made a range of drugs illegal.

Before then, we controlled their use; we tolerated that use socially; and we prescribed them as required. It was actually called the “British system”, and it worked. No criminal gangs controlled the production and distribution. There was no escalation in violence to protect the marketplace, no county lines and a lot less corruption. But with that one incredibly clumsy Act, we demonised the entire plant.

If we were talking about medical hemp today, a range of folk would be more open to the discussion, but because of one cannabinoid in the plant—tetrahydrocannabinol or THC—we have ignored the other 100-plus cannabinoids. We remain ignorant of the benefits they can bring and of how they interact with the endocannabinoid system that each and every one of us has in our own bodies.

The lack of medical research in the UK has led to an entirely unsuitable situation, and my frustration is that we seem to be in no hurry to clear it up. Why are we not moving heaven and earth to license products that are used widely in other countries? Across the UK today, people are suffering needlessly. The medicines exist and are being prescribed and used elsewhere, but the UK Government’s attitude is, “Nobody knows better than us.” We now find ourselves in a position where we are being forced to fight this issue one case at a time.

We brought Alfie Dingley to No. 10 to meet the Prime Minister. That seemed to make a difference. Billy Caldwell’s mum brought the matter to a head by attempting to bring the product into the country. That moved things on, too. And in their situation, would any of us not do the same? Would we not do whatever it took to gain access to medicine for our children? We cannot keep on fighting this on a case-by-case basis. It is cruel and heartless, and there are simply too many kids out there who could benefit now. I apologise to the many people who suffer with arthritis, multiple sclerosis and cancer, because we do not shout about them as much, and they also need to be listened to. The sad fact is that this Government have shown that it takes heart-breaking cases of kids with epilepsy to bring them to the table.

[John Mc Nally (Falkirk) (SNP)]

Would my hon. Friend confirm my understanding that, for the 10,000 people with MS who could benefit from cannabis for medical use, nothing has changed since 1 November 2018, when the Government made it legal for specialist doctors to prescribe cannabis-based medical products? Am I correct in thinking that that is true?

[Ronnie Cowan]

My hon. Friend is absolutely correct. I have a briefing from the MS Society that illustrates his point. It says that, since Thursday 1 November 2018:

“Nobody with MS has so far benefitted from the change in the law, and access to cannabis-based medicinal products remains very limited. This includes access to Sativex”.

Sativex is a licensed product. Of course, people can get it privately if they can spare £500 a month.

As I have said, the system is cruel and heartless. Let us look at one example of how stupid our current laws are and how damaging they are to the patients we are supposed to be helping. If a child suffers from certain forms of epilepsy, there is good evidence that a cannabis-based medicine called Bedrolite may be of great help. Any parent or guardian in that situation would want to access Bedrolite. I know of one child who was having 16 seizures a day and is now on Bedrolite. As of today, that child has been free of seizures for 50 days. Can we begin to imagine how great that is for the child and for his surrounding family and friends? But his supply is running out and his mother said to me yesterday, “I can’t let my boy get sick again.” What has she got to do to keep her boy well?

The good news is that people in the UK can get Bedrolite—if they are rich, if they fundraise, or if they go to a private clinic, pay for a prescription and then pay £560 per bottle. For one patient I know, that equates to £28,000 a year. And that is not the most expensive case I know of—not by a long way. I know of cases where it would cost people twice that much to medicate their children. If people are prepared to break the law to provide medicine for their child, they can travel to the Netherlands and purchase Bedrolite for £167 a bottle, reducing the annual cost to £8,100 a year, plus travel and accommodation costs, but those people risk being arrested and separated from the child they are trying to help.

I know of a wee boy in Scotland whose mum has brought back oils illegally from the Netherlands. He recently went through a bad spell of cluster seizures. Normally, he would be in hospital, unconscious, and unable to walk, eat, speak or swallow. This time, he has remained at home and has not needed any rescue medication. His mother should not have to pay thousands of pounds a month and break the law trying to help her sick child. It is no wonder that the scammers have moved into this marketplace. As a parent wrote to me yesterday to explain,

“The vultures are praying on very vulnerable desperate families and selling fake or non filtered oils which is unsupported and also very dangerous”.

This highlights another problem. When we sit back and do nothing, scammers and criminals will move in. People will say, “I’m buying a product that is cannabis, but it’s not doing me any good.” Then the Government will take another step back and say, “Well, the evidence simply is not there.”

People’s last option is to do what the Government have said they should do. To access medical cannabis, someone must have tried medical cannabis and experienced benefits, but, as I have pointed out, that involves either a lot of money or breaking the law. That is what the Government are asking parents to do. A person must have exhausted all other drugs, despite knowing they do not work and have many dangerous side effects; we are asking people to endure side effects and disappointment to justify their request. Once they have done that, they find that their GP cannot prescribe under the current system and that specialists are reluctant to do so because they are going out on a limb and fear reprisals from the medical community.

We have a situation where the UK Government say, “We have a system,” and absolve themselves of their responsibility and duty of care to the citizens of the United Kingdom. I was going to ask the Minister explain why we cannot treat any cannabis-based medical products as schedule 2 drugs under the statutory instrument where that product has been prescribed by a medical practitioner in another jurisdiction, but of course we have a Health Minister in front of us today, not a Home Office Minister. Yet again, this problem falls between two stools. The Home Office or the Department of Health and Social Care—who will take responsibility for this issue and move it forward?

While we delay, the privatised UK cannabis business grows and the privatised pharmaceutical companies are controlling the available products with an iron fist. It looks as though we are restricting the provision of medical cannabis while we evaluate a marketplace and develop products with the intention of making a lot of money out of it, but the Government would not be that cruel, would they? Not deliberately! The Government do not have a vested interest in the pharmaceutical industry, do they? They are not granting licences to their pals to grow cannabis or encouraging family members to invest in pharmaceutical companies with a vested interest, are they? Surely not. But of course, we know that they absolutely are. That is the backdrop to the photo opportunities and the sympathetic words of staged understanding from Ministers. Unless someone has a child living in these circumstances, they cannot possibly understand the need, the frustration and the anger. As politicians, we are elected to listen to the people. The parents and guardians of these young men and women are screaming at us, “Give us access to affordable, legal medication for our children, and do it now.”

--- Later in debate ---

[Seema Kennedy]

I recognise the deep pain that families are going through, and I do take the point about the great frustration and desperation of the families. What I would say is that we have asked for more evidence, and we are working with everybody necessary to try to get this done as quickly as possible. NICE is internationally recognised for its robust and evidence-based evaluations and guidelines.

[Ronnie Cowan]

I have two families in my constituency whose children are both suffering from epilepsy. They are taking Bedrolite today, and the families know it is beneficial for their kids. That is anecdotal evidence, but it is in their houses and they can see it working. The prescriptions for the sources they have will run out in June and in July. Can the Minister tell me what I should say to those parents when their kids’ prescriptions run out?

[Seema Kennedy]

I do not feel able to comment on a specific issue when I am not a doctor, a clinician or a scientist—

[Ronnie Cowan]

As a parent?

[Seema Kennedy]

Of course I could as a parent, but again, I am not a doctor, and I am not here to make that call. What I would say is that I am very happy to meet the hon. Gentleman to get more of the facts he is presenting to me.

What is needed to support such prescription is evidence of efficacy, and for public funding evidence of cost-efficacy. That is the system we apply to all medicines and medical devices in the UK, and cannabis should not be treated any differently. The current evidence base has been summarised by the professional bodies in their interim clinical guidance, and it will be further examined and reported on by NICE shortly.