Sir Mike Penning asks an Urgent Question on Medical Cannabis

8th April 2019

Following a seizure of medical cannablis from the mother of a child with extreme epilespy at Southend airport at the weekend, Sir Mike Penning secures an Urgent Question from the Secretary of State for Health and Social Care.

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the return of medical cannabis that was seized from Emma Appleby at Southend airport on Saturday 6 April and which is needed to treat her very ill daughter Teagan’s extreme epilepsy, and to take steps to make sure that medical cannabis is available for prescription around this great country.

My sympathies go out to the patients and their families who are desperately seeking to alleviate their symptoms with medicinal cannabis. We are working hard to get the right approach. The law was changed on 1 November last year to ensure that it is now legal for doctors on the specialist register of the General Medical Council to prescribe cannabis-based products for medicinal use in the UK.

Whether to prescribe must remain a clinical decision to be made with the patients and their families, taking into account the best available international clinical evidence and the circumstances of each individual patient. Indeed, prescriptions have been written for the products that the family attempted to bring into the country and these have been supplied to patients. Without clinical authorisation, it is of course not possible to import controlled drugs, which is why the products were seized by Border Force on Saturday. However, we have made available the opportunity for a second opinion and the products have been held but not destroyed, as would normally be the case.

In relation to childhood epilepsy, the British Paediatric Neurology Association has issued interim clinical guidance. NHS England and the chief medical officer have made it clear that cannabis-based products can be prescribed for medicinal use in appropriate cases, but it must be for doctors to make clinical decisions in the best interest of patients, to balance the risks and benefits of any proposed treatment—including cannabis-based products—and to make a decision with patients and their families on whether or not to prescribe.

To date, research has centred on two major cannabinoids, tetrahydrocannabinol and cannabidiol. There is evidence that CBD may be beneficial in the treatment of intractable epilepsy, and over 80 children have already been supplied with CBD products in the UK on the basis of a specialist doctor’s prescription. I entirely understand how important this issue is to patients and I have met and listened to families. I know just how frustrated they are. Therefore, after meeting parents, I have taken the following actions.

First, I have asked NHS England rapidly to initiate a process evaluation to address barriers to clinically appropriate prescribing. Secondly, to improve the evidence base and to get medicinal cannabis to patients in need, I have asked the National Institute for Health Research and the industry to take action to produce that evidence in a form that will support decisions about public funding. The NIHR has issued two calls for research proposals on medicinal cannabis and I look forward to the responses to those consultations. That is in addition to the training package being developed by Health Education England to provide support to clinicians to enable them to make the best decisions with their patients.

This is a very difficult area, with some heart-rending cases. I look forward to working with all Members of this House to ensure that patients get the best possible care.

I thank you for granting this urgent question, Mr Speaker, on behalf of constituents around the country who need help from medical- prescribed cannabis, and I thank the Secretary of State for coming to meet the families and their loved ones who feel that medical cannabis on prescription may help.

Some of these young children—though we are not talking only about children—have 300 seizures a day. They are given drugs that do not seem to work at all. There is not a cure, but these medical oils can and often do reduce the number of seizures. Many colleagues in the House will know of the case of Alfie Dingley—the only young boy that has an NHS prescription for the medical use of cannabis oil. He is now a relatively naughty boy. He has learned to ride a bike. His sister has a brother she has never really experienced before.

This is not a cure, but these parents are absolutely desperate. When the Government did the right thing and changed the law, they thought the situation was going to get better. In my capacity as joint chair of the all-party parliamentary group on medical cannabis under prescription, I warned them that this was just the start of the journey, and that it would be a long one.

Anyone who saw the footage from Southend airport at the weekend—any father, any parent, anyone who has a loved one in their family who suffers—would understand what that family were trying to do. Cannabis had been prescribed by a consultant abroad because it could not be obtained in this country. Many families are relying on charity to raise the money—in some cases, £1,500 a month—to obtain it on prescription. As the Secretary of State knows, prescriptions are being issued by the relevant experts, but the clinical commissioning groups and the trusts are refusing to honour those prescriptions. It is a disgrace that that should happen in this country, and we should all be ashamed.

I welcome the trials and I welcome the review, but, sadly, people need these medicines now. Can we unlock the door? The Border Force staff at Southend airport were very polite and very helpful. They thought they were doing their duty. We should do our duty, and get that medical cannabis back to Teagan.

I pay tribute to my right hon. Friend and the all-party parliamentary group for their work in bringing this issue to the attention of the House and the country, and in supporting the parents involved. My right hon. Friend has been characteristically emphatic and reasonable in providing that support, and I entirely understand his concern. Meeting some of the parents as part of the APPG delegation was a very emotional experience.

Of course the Border Force staff were doing the right thing—and I am glad that they were doing it in a reasonable way—according to the existing rules, under which if a controlled drug is to be imported it needs a licence, and the import of an unlicensed controlled drug therefore requires a prescription from a specialist doctor. There are just over 95,000 registered specialist doctors in the UK. Any one of them who has the relevant experience can prescribe the drug, and it will be then allowed in. That can happen now. The guidance is not a barrier, and it is not a barrier to prescription. However, it is clear to me that this process is not working. I have therefore initiated a process evaluation, which is NHS language for looking at exactly why it is not working and what we need to do about it.


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