Medical Cannabis (Access) Bill

Debate between Rosena Allin-Khan and Kieran Mullan

Friday 10th December 2021 Commons Chamber

[Dr Mullan]

All I would say is that those discussions need to be had with NICE, the NIHR and the Department of Health and Social Care and many other people, but to use primary legislation is not the appropriate way to do it, I am afraid.

[Dr Allin-Khan]

Without doubt, no one in the House wants anyone to suffer unnecessarily. However, most of us understand, as I am sure the hon. Member does, that in this case a randomised control trial would be immoral. The recipients of these medications are in such dire need that to find a group of children in as dire need and deliberately withhold treatment from them would be immoral. I respect him for his clinical and professional practice and as a Member of Parliament, but what is his alternative? The Bill, which has already gone through several stages with cross-party agreement and understanding, seeks to take this forward in unusual circumstances, where an RCT would be immoral.

[Dr Mullan]

As you know, I respect your experience—

--- Later in debate ---

[Dr Mullan]

I agree. We have talked about observational studies and RCTs, and there are a number of different ways in which the evidence base can be developed.

[Dr Allin-Khan]

Having a number of research degrees, I am very aware that there are many different types of trials and that a randomised control trial is not the panacea in all cases. That exactly speaks to the importance of the Bill, which considers a number of other options. It talks about looking at evidence from a widely cast net—it is in agreement with the hon. Member. If he does not agree with the Bill’s suggestions, which he is speaking to, what is his alternative?

[Dr Mullan]

I will go on to talk about what I think you need to do—when I say “you”, of course, I mean the clinical community rather than the hon. Member—to advance these issues. I am afraid that very difficult work needs to be done across many parts of the clinical community, involving engagement with individual clinicians. The last thing we should be doing is creating a new mechanism for the appraisal of a clinical treatment in the NHS. I cannot support that when there are already well-established, well-developed mechanisms for the purpose which do not rely on any particular randomised control trial, for example. We know that, because several treatments have been approved, although it has been argued that cannabis-based treatments cannot be approved in the existing frameworks.