21 MAY 2019

Speech on medicinal cannabis

John Howell (Henley) (Con)

I congratulate my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) on securing this timely debate. Let me start by picking up on something that my hon. Friend the Member for Reigate (Crispin Blunt) mentioned: all we are talking about is medicinal cannabis. We are not talking about making cannabis available for general recreational use. I am sure that there are Members of the House who would have an opinion on that, and we could have a full debate on it, but we are talking only about use for medicinal purposes. The wording of the motion is very important. When I read it, I saw that it stressed the practicalities of getting cannabis medicines prescribed. It is not about the general issue—we had the debate on that and the Home Secretary reached his decision—but about the practicality of getting some sort of result.

I realise that this is not easy for the medical profession and that the Government have initiated a review of the barriers to clinically appropriate prescribing. That is a very important review to undertake. I am aware that the National Institute for Health Research is going to participate in the review, which is a positive step, and I will set out what I think are a couple of the barriers that prevent prescribing

What we are really waiting for is some NICE guidelines. I understand that they are coming, but they need to be brought along pretty quickly. We cannot wait for them forever, nor can the children who are suffering.

Dr Cameron

The hon. Gentleman is making an excellent point and an excellent speech, which relates to the practicalities for children in my constituency such as Cole Thomson. His mother, Lisa Quarrell, has been trying to get medicinal cannabis for him for some time. Not only does she have to battle his absolutely debilitating epileptic illness, which gives him multiple seizures every day, and to see the deterioration each day in his condition, but she has to battle the medical system, battle with financial costs and battle the Government as they take one step forward and two steps back, giving hope and then taking it away. It is too much and too traumatic for any family in that situation to cope with.

John Howell

I thank the hon. Lady for her excellent intervention, and I agree with much of what she said.​

One of the main barriers that I see is the simple question of who is allowed to prescribe. The General Medical Council holds a list—a specialist register—of specialist doctors who are allowed to prescribe. Why do we have a specialist list, and why can only those on that list prescribe? Is it because people are nervous about their careers or other things? Why do we limit the number of doctors who can prescribe in this way? I have read claims that something like 110 patients have been prescribed the medicine, but from what has been said in this debate, I understand that only one has received it.

Sir Mike Penning

My hon. Friend gives me a great opportunity to correct Hansard—I have received the message that there are two, both prior to the 1 November decision. In other words, the Home Office specialist team gave it to two, whereas none has had it since the Department of Health and Social Care took this over.

John Howell

My right hon. Friend makes a valid point. The question is: why have so few—as he says, only two—actually received their medicine? Why has nobody else received them?

Michael Fabricant (Lichfield) (Con)

I have discussed this matter with Helen Stokes-Lampard, the chair of the Royal College of General Practitioners, and she makes the point that there is not training available for GPs to feel confident enough to prescribe this medicine themselves.

John Howell

I will come to the point about training in a moment, if my hon. Friend will be patient, but he makes a valid point.

I appreciate that we have to go carefully, in view of the harm that the unrestricted use of cannabis might do, but the number of people who have received their drugs is a mere pinprick on the surface of those who need them. I am not surprised people go abroad to get their drugs, because it is the only source.

Sir Mike Penning

A person can only go abroad if someone is paying for it—if they have reserves or a benefactor, if Grandma or Grandad is paying. If they do not have those things and are relying on the NHS, nul points—they don't get it.

John Howell

I accept that point. In cases of children who need cannabis oil, I am aware of it being crowdfunded, which can be a valuable way of proceeding, but it seems a complete nonsense in a country that is proud of its NHS that people should have to go into the public arena to crowdfund a drug.

I have some questions about this short list that the GMC maintains of doctors who can prescribe medical cannabis. How accessible are these doctors, and what is the waiting time to see one? These are practical barriers to people getting the drugs they need.

A young girl in my constituency—her name is not important—has intractable epilepsy and there is a great hope that medicinal cannabis would improve the quality of her life. Many women who suffer the sort of pain and discomfort she suffers during her menstrual cycle take birth control pills, which eases the pain considerably, ​but she cannot do that because it reduces the efficacy of her epilepsy medication and leads to a radical increase in the number of serious fits. For Hannah—that is her name—her epilepsy is life-threatening, as she is in a high-risk group of epilepsy sufferers who could experience sudden unexpected death in epilepsy syndrome, and we ought to think about how we can make it easier for her to obtain these drugs and so make her life easier. I mention that because to make these points we need to bring this debate back to examples of real constituents.

My second point is that raised by my hon. Friend the Member for Lichfield (Michael Fabricant) about the availability of guidance and training. In respect of both, there is a great lack of information, and it is not just us who lack information; so does the medical profession. We should do all we can to increase doctors' knowledge and awareness so that, among other things, we can broaden out that list and GPs and family doctors can have the information they need to make decisions. I have no problem with this being a clinical decision rather than a political decision.

Crispin Blunt

We are where we are only because a politician, when faced with the inhuman cruelty of taking away from two children medicine obtained overseas when they returned to the UK, in the end refused to do so and issued a special licence. If this medicine is outside the scope of conventional medicine and the conventional assessment of molecular-based medicines, something will have to give if we are to get the benefit.

John Howell

I agree with my hon. Friend. The in-principle decision has been taken and the practical decisions now have to be taken by clinicians who are willing and fully trained to prescribe. The press releases and parliamentary answers are full of talk about finding the limit to the use of cannabis as a medicine. I listened to an exchange—I cannot remember who it was with—on its use to treat pancreatic cancer. From memory, I think the Minister gave a rather mealy-mouthed response. We need to think about extending the limits to other diseases.

In conclusion, I go back to where I started and congratulate my right hon. Friend the Member for Hemel Hempstead on securing this debate, but the matter will not rest here. I do not think this will be the last time we have this debate. I hope we see some progress soon.

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