Medicinal Cannabis

Tonia Antoniazzi Excerpts

Monday 6th September 2021 Commons Chamber

[Christine Jardine]

The right hon. Gentleman makes an excellent point. We do have that overwhelming body of observed evidence of the efficacy of cannabis oil. I have seen at first hand the difference that medicinal cannabis has made to Murray Gray’s life—it has transformed his life. When his mum, Karen, first came to see me, he was a very unwell wee boy who was, as I mentioned, constantly in and out of hospital with dozens of seizures a day, and his family were worried that they could lose him. Since being prescribed cannabis oil, he is seizure-free and a happy youngster who plays football with his dad. When he came to visit me in my office, he explained everything I have ever need to know about dinosaurs. It was a joy to see him so happy. The medication has given him a life that he may not otherwise have had.

It is time for the Health Secretary—just as he did when he was Home Secretary—and his team to intervene to make the case that the medical profession should put its shoulder to the wheel. It is time to close the huge gulf between what the Government promised—and, I believe, wanted—and what has been delivered.

[Tonia Antoniazzi (Gower) (Lab)]

The Secretary of State for Health and Social Care is the best-placed person to move the debate forward, because he was the one in government in the Home Office who changed the law. Does the hon. Member agree that we need action now?

[Christine Jardine]

I agree 100% with the hon. Lady that we need action now—it is actually overdue—and that the Secretary of State for Health and Social Care is the very person who can give us what we need.

Because this is not a political football kicked between party politicians—it never has been and never should be; we have always resisted that—a little over a year ago, more than 100 MPs across the House from the Liberal Democrats, Conservatives, and Labour and Green parties wrote to the former Health Secretary to demand action.

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[Sir Mike Penning]

I completely agree on the medical profession and know exactly where the Home Office stood when I was at the Department. I would love to say that the whole of the Home Office and my civil servants in the narcotics part of it were thrilled by what I said in Westminster Hall all those years ago, but I can assure colleagues that they certainly were not, to say the least; fortunately, I had covered my back with the Home Secretary.

We need to move on from this, however. This is not about reform of the 1971 Act. It is about whether there is a group of children who we know get benefit from this, and whether, as we all know from our constituency postbags, there are other conditions that could also benefit from this type of oil with a THC product in it. That is where we are struggling.

We need to roll back this debate and talk, as I did at the start of my speech, about children—children who deserve the best possible start in life and just happen to have been born with a medical condition that the medical profession, in its infinite and great wisdom, has not quite got an answer for. This product is part of the answer, although it only alleviates the condition. As parents have said to me on many occasions, it does not take away the condition but it does let the children live a life as close to normality as possible; it is not normal, because it involves dropping oil on a little boy or girl’s tongue on a daily basis, but it is as normal as we can get.

[Tonia Antoniazzi]

It was a pleasure to serve with the right hon. Gentleman as co-chair of the all-party group on medical cannabis under prescription. On the point he makes about children, we have Bailey Williams in Cardiff, a constituent of my hon. Friend the Member for Cardiff West (Kevin Brennan), and that case highlights that these children are no longer classified as children after four years; they become adults. Bailey Williams is now 18, and the question arises of how things will change for him in a different health system with different rights. What would the right hon. Gentleman say on that?

[Sir Mike Penning]

The hon. Lady was a brilliant co-chair with me for all those years; we agreed on most things even though there is a tiny number of things we do not agree on. The hon. Lady is absolutely right. I have a constituent who has now turned 18, although it is not the THC but another medical component that particularly helps her. People come out of the care of one part of the health service and there is a little bit of a transition period but there is very little research on the evidential base going forward, and we need to do that research.

Let me touch for a second on what has been said to me by senior medical people in the Department of Health and Social Care. They said, “We need to do trials, Mike. We need to use placebos. We need to find out whether this actually works or whether it doesn’t work.” What parent on this planet is going to take their child off a medication that actually works, with the risk that they may get a placebo, have a seizure and die? Is that where we are in the 21st century, really and truly?

We had a statement earlier from the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). We are a world leader in doing medical things. We have done things in this country around the vaccines that no one dreamed possible, yet we are talking about giving placebos—and those people were serious. I can tell the House that the parents were very serious, too. I cannot repeat some of the comments I got from some of the parents, but they quite rightly said—I will speak politely on their behalf—“Not in a million years.” Let us put it in those terms.

I know that the Minister will do her level best, but this is not about the Government taking over Epidiolex. Yes, they need to pay for research—I absolutely agree with the hon. Member for Inverclyde (Ronnie Cowan) about that—and research in this area could change the whole way that pain is addressed and perhaps get us away from using so many opioids, but this is actually just about having trust in the expert who has written the prescription for a child who may well die if he does not get that oil with the THC component on prescription.

[Tonia Antoniazzi]

I am sorry for intervening on the right hon. Gentleman again. The NHS keeps asking experts, but those experts are not experts in medical cannabis; they are experts in the condition of epilepsy but have no insight into that. Where is the foresight and vision to help these children with intractable epilepsy?

[Sir Mike Penning]

I alluded earlier to the narrow-mindedness of people who have taken an oath to protect people and protect children. No one, I would have thought, goes into the medical profession to hurt people, but at the end of the day, we have a group of children—not thousands, but a small group—whose parents are crying out, “Please listen to my specialist. Please listen to me, as a parent trying to save my child’s life.”

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[Jim Shannon]

I thank the hon. Lady for her intervention. That is exactly how I feel, and I think it is exactly how we all feel as elected representatives on behalf of our constituents. I can well recall the bad old days of the pressure that was on the family: the pressure on the parents, the pressure on the child and the pressure on their friends, with all the multiple issues they had to address. There is an evidential base. It is as clear as a bell. I can see it in that wee girl Sophia. I can see it in the improvement that she has quite clearly made. That is why I totally support this product. I believe the evidential base is overwhelming. I can vouch for that, as I see that lovely wee girl and the improvements she has had.

My hon. Friend the Member for Belfast East (Gavin Robinson) sent me a letter, which I will record for Hansard if I can, written by his constituent, a fellow called Robin Emerson, whose daughter is a wee girl called Jorja. There is also an evidential base in her improvement. My hon. Friend very kindly gave me a copy of the letter last week, which refers to

“an important intervention to enable a number of children suffering with epilepsy to receive a treatment containing Cannabidiol (CBD) and Tetrahydrocannabinol (THC). This has made a crucial difference to their quality of life over the past two years”.

In some cases, quite honestly Mr Speaker, I believe they save lives. They definitely do. In my heart I believe that, which is why I am here tonight to speak on this matter. I feel it is so important.

[Tonia Antoniazzi]

I thank the hon. Gentleman for giving way on that point. Does he agree that there is no other medical intervention suitable for these children? It is intractable epilepsy. Nothing else has been found to give them that quality of life. Does he agree that we have to move forward in this debate?

[Jim Shannon]

The hon. Lady is absolutely right: we do have to move forward, and that is the message from us all in the Chamber tonight. I know that Robin, on behalf of Jorja, and Darren and Danielle, on behalf of Sophia, tried almost every other thing that they could before they came to medicinal cannabis, and they have seen the difference almost right away.

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[Crispin Blunt]

I was delighted to take that intervention from my hon. Friend. He is absolutely right: this is about science and technology. It is about finding a route to a Government who can deliver policy based on evidence. We have heard very clearly why randomised controlled trials and placebos are not going to work in this case and are a completely inappropriate way of providing proof, and that there is a vast amount of observed evidence out there. What we need to do is understand the context. The case is unanswerable for these epileptic children—of course it is, and of course their treatment should be should be paid for privately if it cannot be provided by the NHS because all these barriers have appeared—but behind them sit a vast number of other people who are not being served by our system of developing drugs that will work for their conditions.

[Tonia Antoniazzi]

The hon. Gentleman has made some very valid points about the wider issue of drug reform, and I agree with much of what he has said. As he well knows, when I first came to the House the late Paul Flynn, then Member of Parliament for Newport West, was a doughty campaigner for medicinal cannabis. I had many conversations with him about it, and much account was taken of what he said. He advanced valid arguments about people with multiple sclerosis, many of whom were our constituents, and I believe that the hon. Gentleman too has a genuine argument in that regard. Tonight, however, we are focusing on the cost of medicinal cannabis to end the pain of epileptic children, and our real ask of the Government is a fund to provide them with money immediately, although we will work together on the wider debate.

[Crispin Blunt]

I wholly agree with the hon. Lady, whose leadership of the all-party parliamentary group on access to medical cannabis under prescription, along with that of my right hon. Friend the Member for Hemel Hempstead, adds to the whole discussion and illuminates the fact that our drugs policy is in a serious state of strife. It is not based on evidence, and we have to drag it in that direction. Behind the hon. Lady sits my friend the hon. Member for Manchester, Withington (Jeff Smith), with whom I have the honour of co-chairing the all-party parliamentary group for drug policy reform. We took over from the hon. Member for Brighton, Pavilion (Caroline Lucas) and from Paul Flynn. My objective, as the first Conservative to take his place, was to drag this conversation into the mainstream, which is where it belongs.

However, we need to remember just what got this over the line in the first place. The Dingley family behaved perfectly within the rules. They made applications and everything else, and indeed we had an urgent question on the subject. I remember my right hon. Friend the Member for Hemel Hempstead interrogating the then Policing Minister, who had taken on the responsibility, about when this was going to happen, particularly for Billy Caldwell.

What got this over the line, however, was the fact that Bill Caldwell’s mum, Charlotte, was brave enough to obtain the medicine in north America, present it to customs and have it confiscated. Her son was then hospitalised and was fitting, and within three days the overseeing consultant was on the steps of the hospital saying, “I do not care about what is going on here; it is unbelievably cruel to take a medicine that works away from a child.” The following day, the then Home Secretary—now, wonderfully, the Health and Social Care Secretary: what a brilliant repositioning that is—authorised the return of Billy’s medicine, or at least some of it, from customs so that he could receive his treatment.

[Crispin Blunt]

This is where we come to the cost, to which the hon. Member for Gower (Tonia Antoniazzi) drew my attention. In order to get Alfie Dingley’s prescription over the line, it would have taken £5,000 for the person who was going to make the application, who happened to be on holiday in the Galapagos Islands and who then had to be interviewed by Home Office officials before he was allowed to make the application; £5,000 for the pharmacy to get a licence to bring it in; £5,000 for the pharmacy then to hand it out to the doctor; and then £5,000 for the licence for the prescribing doctor. I mean, I ask you! It might have been possible to pay in that case, but behind the case of Alfie Dingley, there is not just a score of epileptic children.

[Tonia Antoniazzi]

On that point, I made two journeys to The Hague with families—out of my own pocket, which was absolutely fine; it was not funded by anybody—because they needed the support to go over and get those medicines. They do not have the extra money and they do not have the time, which is why we stand by them and why we have to help them.

[Crispin Blunt]

The hon. Lady has behaved as the best of constituency MPs would. Indeed, I am sure that all of us, faced with the opportunity to help people in that way, would want to do so.

I say to my hon. Friend the Minister that, despite the legalisation in November 2018, the system remains broken. It remains broken in respect not only of cannabis but of the psychedelics. A wave of interest came into medicine as a result of cannabis; it came from North America where a significant amount of investor money was going into the new industry because people could see the opportunities that were available there. However, we could not do the research here because it was a schedule 1 drug, and hardly any universities had a schedule 1 licence to do that research. The level of oversight was far greater than that for heroin, as the hon. Member for South Antrim (Paul Girvan) said, so it is no wonder that there has been almost no research on all this down the decades.

As far as I can see from the 1960s, the psychedelics got shoved into that group as well because pop stars used them. Then, in 2008, we managed to dismiss the chairman of the Advisory Committee on the Misuse of Drugs because he had the presumption to say that riding a horse was a damn sight more dangerous than MDMA. That is what we do to the scientists who produce the evidence: we refuse to listen to the evidence because it will be politically inconvenient and subject to misrepresentation in the media. We owe our constituents way more than that, and it would be remiss of us if we do not examine this whole area on the evidence. I implore my hon. Friend the Minister to listen to it.

I have spoken about MS, and the hon. Member for South Antrim and others have referred to pain relief. As an alternative to opiate-based medicines, given all the difficulties of the opiate crisis in the United States, cannabis-based medicines offer a serious group of advantages if they can be deployed properly. Meanwhile the psychedelics still sit in schedule 1, making research incredibly difficult and expensive.

Let us consider depression, addiction and trauma. Of the veterans who have come back from their service in Afghanistan and Iraq in recent years, 7,500 have post-traumatic stress disorder, about a third of whom are beyond treatment within the current treatments available. However, the evidence is that the prescribed and overseen use of psychedelics can get to the relevant part of the brain and enable the psychotherapy to take hold and teach people to acquire the tools with which to manage and deal with their trauma. That can also work for depression and addiction. We are potentially talking about millions of people, if we enable the research to happen. Are we a country that will be on the frontline of bioscience? Are we serious? There is an opportunity for our pharmaceutical industry to get this to scale, and millions of people can be helped.

A huge cost is currently imposed on our economy by these medical conditions, so surely it makes sense to enable my hon. Friend the Under-Secretary of State for Health and Social Care, as Minister for medicines, to draw on evidence-based advice. Sitting alongside the MHRA ought to be some kind of cannabis authority, as has been done in Denmark, Holland and Germany, for Ministers to get the advice they need to be able to advance policy confidently, and it needs to be within a wider office for drug control that engages all the relevant Departments. A Department of Health and Social Care lead would be good, but a Cabinet Office lead that brings together everyone who has an interest in this area would be a fine thing, too.

[Crispin Blunt]

I largely agree with my hon. Friend, apart from on the views he imputed to me. He decided what my views are on the legalisation of drugs, but I simply want policy based on evidence.

All I will say is that the current situation is a catastrophe, not just here but around the world. It is the basic reason why we were run out of Helmand province. The farmers around Didcot were growing poppies for the legal medical morphine market, but we did not allow the farmers in Helmand to grow poppies, so they were driven into the heroin market. We then decided to go and burn their crops, reducing them to penury. And we wonder why they changed sides and were against us. We were run out of Helmand, even with 20,000 American troops coming to the aid of our soldiers.

This issue permeates the world. It is a global issue. We simply need to proceed on the basis of the evidence, so we need to create the institutions that can give us that evidence. There should be an office for drug control, promoting all the science and bioscience of which this country should be capable, within which ought to be a cannabis authority of some kind that could give the Minister and her colleagues the advice they need. The opportunity for the Department of Health and Social Care is huge, and the opportunity for the Department for Business, Energy and Industrial Strategy in sponsoring our science is enormous. The opportunity for the Treasury is not exactly minuscule either, and there is an opportunity for the Home Office to have a policy that contributes to the whole of the public interest, not just a very narrow part of it that has done so much damage. The policy of preventing things from happening has been in the lead in the drugs policy area, so this proposal is long overdue.

I beg the Minister to have this discussion with me and the think-tank I have established. I have no financial interest to declare, as I take nothing from the Conservative Drug Policy Reform Group. I set it up to give me research and scientific evidence on which to help advance these arguments. I am passionate about this issue, and it is one of the issues on which I wish to use my remaining time in public life. Having seen what I have seen as Prisons Minister and in my own experience, I know the opportunities are as great as the opportunity to end the terrible mess of our wider drugs policy. If we can grasp the science opportunity, the medical opportunity follows. There would be a huge advantage for patients in the United Kingdom.

[Tonia Antoniazzi]

The work the hon. Gentleman does with his think-tank is brilliant. How much would this cost? How much does he think the Government need to put aside—we are talking about the cost of medicinal cannabis—to reform policy? Are there any figures? Are there any plans to put that in place?

[Crispin Blunt]

The machinery of government changes can be made at very little cost. This is about getting the right advisers and the machinery of government advice. Obviously, we would then have to recruit the people into the cannabis authority who understand the issue, and allow them the authority and space to be able to advise Ministers and the office of drug control. However, the up-front cost would be minimal. The opportunities and the number of people we can really help by having far better drug provision in the UK are huge. All of us have a duty to engage properly with that and to be able to disaggregate all the issues and negative connotations associated with the use of cannabis and heroin. Let us focus on the evidence and get this conversation into the mainstream as a means by which we can make huge advances for our country. I look forward to the ongoing conversations with the Minister, who as the Minister for medicine could make a huge impact if she were able to deliver on this part of her agenda.

[Ronnie Cowan (Inverclyde) (SNP)]

Thank you very much for calling me, Mr Deputy Speaker. I just jumped up quickly before you changed your mind! [Laughter.]

I thank the hon. Member for Edinburgh West (Christine Jardine) for securing this debate, which has been great; we were looking forward to a 30-minute Adjournment debate, a battle through and a quick exchange of views, but because nobody cares that much about national insurance contributions amendments, we have been given this extra time. I will not take too much more, because a lot has been covered by the previous speaker and there is no point going over old ground. I would genuinely like to say that at 9.10 on a Monday evening there is nothing I would rather be doing on my birthday than fighting the cause of something I truly believe in.

On 19 March 2019, the then Secretary of State for Health and Social Care said that medical cannabis “would be made available”. If I had heard those words as the parent of a child who would have benefited, I would have been thinking that it was going to be made available. I would not be expecting to jump through hoops or to have to raise thousands of pounds to pay for it. My hopes would have been raised. A child with such a condition would, typically, have 30 seizures a day and so over 900 days we are talking about 27,000 seizures. If they had had medical cannabis, we could be talking about zero seizures. However, it will be made available some day. After this time, the general frustration in this Chamber is, “Why are we still talking about it?” We have said this a number of times in Westminster Hall, and here and there, and we know everything that has been said today.

I am genuinely glad that the Minister has informed us that we are now manufacturing some of these medicines here in the UK, as that is a big step forward. However, we are still reliant on private prescriptions and, as was pointed out earlier, the main provider of those is about to retire. Yet again, if I was a parent in that situation, would the sword of Damocles not be hanging over me? This is the same idea as what happened when we left the EU—we could not get the medicines in and we had to have an extension to January, to July and now to next year. That is a ticking timebomb hanging over those young lives that we just do not need to have there. The long and short of it is that people who cannot afford it or cannot raise the funds for it—during covid, raising funds for many a charitable cause has been incredibly difficult—simply go without. They go without and so there are 27,000 seizures because they have to go without a medicine that they know is available and know would do the job for their child. It should not be this way. In less time, we have developed, tested and rolled out a covid vaccine throughout the United Kingdom. The vaccine did not exist, it had to be tested, and we have done it. It concerns me that these kids are less of a priority.

What are the UK Government going to do? How will they finally going create a legal framework in which GPs are comfortable writing prescriptions for cannabis-based medical products? If we could do that, it would be a game-changer. I am not playing politics with this issue, but I have contacted the Scottish Government, and in Scotland if people get an NHS prescription, the Government will pay for it. The same thing has to apply down here, so let us facilitate that. Let us go to doctors, explain what it is we are asking them to do and give them the confidence to stand up and do it. If a senior clinician can do it, a GP can do it.

[Tonia Antoniazzi]

The point the hon. Gentleman is making is really interesting. With covid, we have seen so many families really struggle and their children have been hospitalised—we are talking about such vulnerable children—so his point is so valuable. I thank him for all his work on this issue because together, across party lines, we will take this issue forward.

[Ronnie Cowan]

I thank the hon. Lady very much. The point that this is very much a cross-party issue should not be missed. We are not going to split down party lines or fall out over this. We will fall out over other things—I am absolutely sure of that—but this issue has strong cross-party support. I look around the Chamber at the Members present and I know the different politics we have, yet we are united behind this cause. The Government should take real note of that. I know they have a working majority of 80 or so, but people in the Conservative party are rightly backing this issue.

I shall not keep the House any longer. I fully acknowledge that the past 20 months have been incredibly demanding for the Department of Health and Social Care. We all get that—we all appreciate what has been done during that time—but the time for talking is well and truly over and the time for action has well and truly arrived.

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[Jo Churchill]

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.

[Tonia Antoniazzi]

There has been a lot of talk about randomised control trials this evening, and I understand the difficulty that the NHS has with this. We have had numerous meetings with NHS England and with pharmacists on this. The issue is that the RCTs are a no-goer. They are just a no-goer. I would never take my child off a drug if I knew that it could possibly kill them in order to enable the NHS to prescribe. We have to overcome that hurdle. I would like to see a push from the Minister to make that change happen. We have seen it with covid and we have seen it with the vaccine. What the NHS has done is incredible. I would really love to have the Minister onside to be able to push the NHS forward to change its mind over the RCTs.

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[Jo Churchill]

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.

[Tonia Antoniazzi]

rose—

[Christine Jardine]

rose—

[Jo Churchill]

All three Members rose at the same time. I will make my next point before I take interventions.

While the evidence base remains limited, I am sure that everybody, including clinicians in this place, will agree that decisions on whether to prescribe, as with any other medicine, have to remain clinical decisions. A doctor would not appreciate me in their consulting room telling them that they did not know their job as a doctor.

[Tonia Antoniazzi]

I thank the Minister for giving way again. I would just like to point out to her that that is not the case. There are three NHS prescriptions. If the law was changed, why are there those three NHS prescriptions? Either these medicines are safe or they are not. They must be safe. I understand what she is saying about the clinicians, but let us look at the risk-benefit for the particular group of children we are talking about. We know that “First do no harm” is how our clinicians treat their patients, but they have to move forward. Hannah Deacon is a classic example. She is continuing to campaign because she sees the unfairness and injustice that Alfie has his prescription but other children do not. Please, Minister, help us to move this debate forward.

[Jo Churchill]

Hannah has said those exact words to me. That is why I say that we have to look at this in a selection of doable, achievable pieces, because it is not possible to look at it for every condition. We are talking about those children with refractory epilepsy, and trying to find solutions there is my main focus currently.

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[Sir Mike Penning]

rose—

[Tonia Antoniazzi]

rose—

[Jo Churchill]

I will give way first to my right hon. Friend.

[Jo Churchill]

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.

[Tonia Antoniazzi]

I thank the Minister for being so generous with her time. The right hon. Member for Hemel Hempstead (Sir Mike Penning) has made a real point about there being a culture of fear within the NHS and with clinicians, who are too scared to prescribe because they do not know what the consequences are. The Minister has a role to play here in enabling them to have the confidence to prescribe and work with the drug that we refer to as cannabis. In this House, we should not be using the word “cannabis”, because it strikes that fear into the hearts of many, many people across the UK. Most other drugs have a single active ingredient; medical cannabis has many. If the Minister does not accept that randomised control trials are not applicable, we are in a Catch-22 situation and we are forever stuck. This is not acceptable.

[Jo Churchill]

I do not believe we are stuck, but we should proceed with caution. I think that is a totally acceptable way to go on. I think it was the hon. Member for Edinburgh West who asked why it is any different from insulin or the other drugs she listed. It is different, so we must proceed with caution.

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[Jo Churchill]

I am obviously very cognisant of the latter point, and my right hon. Friend the Member for Hemel Hempstead mentioned a court case. This adds to the need to find solutions to the problem. On adult steroids, that is a clinical decision by a doctor, and my hon. Friend would not expect me to comment on that, because we are dealing here with incredibly poorly children, and our heart goes out to them.

[Tonia Antoniazzi]

rose—

[Jo Churchill]

The hon. Lady is looking at her phone intently and jumping up again, so I will give way.

[Tonia Antoniazzi]

I thank the Minister for her generosity in giving way, and she is right that I want to make yet another observation.

One of the reasons why we all came into this House was to make change happen, and I know the Minister feels exactly the same. Maybe her hands are tied, but under the Health and Social Care Act 2012 the Secretary of State has the power to commission an investigation and research into new medicines. End our Pain has shown this to her officials several times; it has even been cited by a Queen’s counsel, whose opinion is that this is possible. This would be a great way to run an observational trial at no cost to parents; why will the Minister not take this option?

[Jo Churchill]

It is not in my gift to take that option, but I will take that comment back to the Health Secretary and have further discussions. As I said, in our very first meeting he highlighted this as an area where he wanted to see movement, and we are determined to get some movement.

We need the evidence base and we need trials to be ongoing to help inform future commissioning decisions. NHS England has also established a patient registry to collect uniform outcome data from licensed and unlicensed products. The refractory epilepsy specialist clinical advisory service has been established to provide expert impartial advice for clinicians treating complex cases while we await the outcome of clinical trials.

I hope I have managed to convey how committed I am, because I do believe that we ought to be able to find the solution for these children, and I was very aware of the hon. Lady’s point about what happens when they reach adulthood. My right hon. Friend the Member for Hemel Hempstead has spoken to me about the fact that as children move through and medicines gets better they thankfully survive longer, but then we have the added complexity of having to look at the system, which is why we want to make sure we find a solution. Finding the right solution is what we are after, because it will take time to generate further evidence and see the results of clinical trials. I do understand, however, that patients and families continue to access these medicines privately, and that the cost of doing so is very high. There are no easy or quick solutions, but I am committed that the Department will reconsider what action the Government may reasonably take with regard to access to unlicensed cannabis-based products for medicinal use where clinically appropriate.

The health of the children and adults dealing so courageously with these difficult-to-treat conditions is of paramount importance. I think it was Hannah who said to me that for every time Alfie does not end up in hospital having fitted repeatedly, there is a saving to the system.