Sir Mike Penning leads a debate in the House of Commons on medical cannabis under prescription

20th May 2019

Sir Mike Penning calls for urgent action in the case of severely epileptic children, for whom medicinal cannabis has helped to reduce their seizures, and condemns the failure of the NHS to issue prescriptions to patients, despite the law being changed six months ago.

I beg to move,

That this House reaffirms its welcome for the change in the law that allows access to medical cannabis under prescription, but notes that only a handful of prescriptions for whole-plant-extract medical cannabis have been issued on the NHS, which has left a significant number of patients, many of whom are children with intractable epilepsy, with no access to medical cannabis and experiencing severe distress; and calls on the Government immediately to act to ensure that medical cannabis is available to appropriate patients and in particular to children suffering severe intractable epilepsy, such as Alfie Dingley whose plight and campaign did so much to secure the change in the law.

It is a real privilege to stand here and represent families from across the country, alongside colleagues from across the House who I am sure will scamper into the Chamber in all haste when they realise how fast the previous business has been dealt with. This gives us a suitable amount of time—some five hours—in which to debate this really serious matter.

On 8 April, Mr Speaker granted me, with support from other colleagues across the House, an urgent question on the medical use of cannabis. This followed the removal of a young lady’s medical cannabis from her family’s possession as they came through customs at Southend airport in Essex. The young lady’s name was Teagan, and her family are ardent campaigners on this issue. They know, because they have been abroad to get medical cannabis oil for Teagan, that it has a really helpful effect on her.

What had an even more dramatic effect on Teagan’s family was that, perhaps not unexpectedly, Border Force confiscated the oil. I do not blame Border Force or the Home Office—we will go into the history of how we got to this position in a moment—who were doing their jobs However, after long conversations on the phone that evening and conversations with the Speaker, I was really pleased to be granted the urgent question.

The urgent question meant that the House could come together to ask why an oil that had been prescribed—admittedly it was prescribed abroad; nevertheless it was prescribed—should be taken from a young lady who desperately needed it because of the seizures that she suffered as a result of her epileptic condition.

The oil was taken away, and the family were promised, quite rightly, that it would be kept in a safe place and not damaged.

On the Saturday a week after the urgent question, the prescription was eventually accepted by the Department of Health and Social Care and the Home Office. I say “eventually” because there is such confusion surrounding this prescribed medical product. It is fascinating to me and even to those within the medical profession.

The first prescription was rejected, and Teagan was not allowed to have the oil back because the prescription did not mention the word “oil”. Even though the description of the product was completely accurate, it was rejected because it did not contain the word “oil”. A new prescription was issued that included the word “oil”, and the oil was released. Believe it or not, conversations then took place about who was going to pay for the transportation of that medical oil to Teagan.

I congratulate the right hon. Gentleman and my hon. Friend the Member for Gower (Tonia Antoniazzi) on the work they have done on behalf of the all-party parliamentary group on medical cannabis under prescription, and on behalf of my constituent Bailey Williams and his family. His mother has written to me about today’s debate, which unfortunately she cannot attend, to say that Bailey really needs urgent access to medical cannabis because of the continuing effect that his constant seizure activity is having on him. Does the right hon. Gentleman feel as frustrated as I do that, many months after the Government first indicated that this medicine could be prescribed, he is still having to speak about it today and I am once again having to raise Bailey’s case on the Floor of the House?

I thank the hon. Gentleman for his intervention. That is what we are here for. Yes, we are frustrated and angry, but actually we are here to do something very important. The only reason the Home Office deregulated this drug and we are in this position today is that this House came together and, more importantly, because the families came together. Those families have young children—I am a father myself, like lots of colleagues in the House—and we all came together to say that the situation was fundamentally wrong. We asked why medical cannabis was illegal if we knew that it helped our children.

Am I right in my assessment that Ministers have bent over backwards and we have acted in the Chamber to ensure that these products are now available, but that the problem is in the medical profession? What more can we do now? I know that this is interfering in the medical profession, but, frankly, that is now becoming necessary.

My right hon. Friend is absolutely right. The Secretary of State for Health and Social Care stood at the Dispatch Box during the urgent question and laid out in plain English that it is not illegal for a suitably qualified person to prescribe these medical products, so how are we still here?

May I interrupt the right hon. Gentleman?

I will give way in a second.

It relates to that very point.

I will give way.

I thank the right hon. Gentleman very much. When we heard the Home Secretary speak about this initiative, we all thought that those whose children’s lives were being ruined by fits would from now on find solace. That was not the case for those whose children were beyond help at that stage, but we thought that it would apply in the future. Given that we want it, given that the Home Secretary wants it, given that the parents want it, and given that individual doctors want to prescribe it, some group at a regional level in the Department of Health and Social Care is clearly preventing prescriptions from being issued in a way in which they can be delivered.​

I will touch on many of the right hon. Gentleman’s points later in my speech. The Home Secretary was ever so helpful, as was the Health Secretary, but the Prime Minister played an absolutely diamond role, and we took Alfie Dingley and Hannah Deacon to No. 10 with the petition. I know that we are not supposed to refer to the Gallery, but they are up there watching us, and they were scuttling up the stairs very quickly.

It is vital that we have a proper debate over the next five hours, without worries about time limits. I am not fussed about whether the Government lose their business later.

There is no business tomorrow.

There is Government business later on, but I do not care about that. We need to try and flush out and identify the blockages, which is what the Health Secretary tried to do.

Will the right hon. Gentleman give way?

I will, but I will then try to make some progress.

In response to another intervention, the right hon. Gentleman indicated that there is a degree of resistance within the NHS and among clinicians, but does he agree that this is about more than that? This is also about the Government’s regulatory framework, which is restricting access to this medication. Many people in acute pain are resorting to opioids, which are highly addictive and potentially fatal, while being unable legally to access cannabis, which can often ease their pain.

The right hon. Gentleman and I often debate health issues. We were both shadow Health Ministers at the same time, and we agree on most things, including on the prescribed medical use of cannabis. The other area to which he was alluding is not for this debate. It is not referred to in the motion. The reason we have managed to get such huge cross-party support and support from families around the country is that we have stuck to the specific issue of prescribed medical use without going into casual use.

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If I can, I will make a bit of progress, because there is plenty of time for colleagues. I am really chuffed that the Backbench Business Committee gave us this opportunity. When has the Backbench Business Committee ever had five hours for a debate on a Monday afternoon? I am simply thrilled, and I intend to use as much of that time as possible. I got a little note from the Clerks saying, “You should speak for 12 to 15 minutes, Mr Penning”—yeah, in your dreams. [Laughter.]

There is a blockage in the NHS if someone cannot pay for the prescription. There are consultants both within the NHS and outside, but if someone can pay for it in the private sector, private prescriptions are being honoured. The product is available in this country, perfectly legally, to those who can afford it, and that sticks strongly in my throat.

At the conclusion of the urgent question, although it is not in Hansard, I clearly heard Mr Speaker tell the Secretary of State for Health and Social Care that, whatever happens, we will not leave it—he was referring to me. We will go on and on about this until we get justice for these young people.

Looking beyond the small cohort of desperately ill children, there are others in the country who would clearly benefit from medical cannabis. I am not a doctor, but hundreds and hundreds of families have come to ask me whether this means they can get some help. The MS Society has sent an excellent briefing to colleagues today, and the Brain Tumour Charity and many others have also provided briefings.

Constituents come to my surgery, and I tell them that we need to make sure that their specialists, the experts in their area, are saying that they need medicinal cannabis, and then we can fight their corner. We have such specialists in the sector now who are saying that children and young people with epilepsy—my constituent has just turned 18, so their mum will want me to talk about post-18, too—get a tangible benefit from treating their seizures with these prescriptions, prescribed by a suitable specialist.

We know exactly what are in those pharmaceuticals, yet we still have a crazy situation in which hospitals are telling parents that if they bring these products on to a ward when their child is ill, as part of their ongoing medication, social services will be called to look into what they are doing with their family—for a product prescribed by a consultant.

My constituent has just turned 18. When I wrote on behalf of the family to her GP and the clinical commissioning group, which was blocking the prescription, they said, “We are not interested in homeopathic products.” What on earth is going on inside the medical profession in this country? If they do not know what it is, they should go and ask someone before they write stupid letters back to people and break their hearts. I had to send the letter on.

We should look carefully at what we can do to help. It is not for any politician in this House who is not suitably qualified to say to anybody that they deserve to have this product. What we must do is break down the blockages—that is what the Secretary of State alluded to in his answer to the UQ—and find out the reason for them.

My right hon. Friend and I share a passion for this subject. Does he agree that the absurdity lying at the heart of it is that heroin is legally prescribed as morphine, which has been well understood for many years, but that a medical prejudice kicks in when using cannabis for medical purposes? Does that not highlight that there is an inconsistency that needs to be addressed—and addressed quickly?

I completely agree with my hon. Friend. I have been referring to Teagan, and he is her MP. As he knows, she got her medication seven days late, and I am convinced that she would not have got it if we had not secured the urgent question, which is why such debates are important.

I used to be a Minister, and I always panicked about UQs. I always asked, “Why don’t we just do a statement? It is a damn sight easier, and we can control the agenda going forward.” The business managers did not always agree with me on that point.

I might be wrong, but as far as I am aware from our investigations the only NHS prescription that has been issued was through the Home Office. Alfie Dingley got his medication through the panel the Home Secretary set up with the expert group in the Home Office. As far as I am aware, since we changed the law in November no NHS prescription has been honoured. We have had trusts clearly threatening consultants not to do this and we have had their professional bodies do the same—I have seen some of the correspondence. As I alluded to earlier, families have been threatened with social services for bringing the product into the hospital where their child was being treated, even though this was a prescribed drug that is perfectly legal in this country today.

The real issue is: why can only those who have the money, those who have a donor and those who have crowdfunded, or, as in the case of my constituents, those to whom one of the manufacturers has given it for free—there is no way in the world they could afford this, and I thank the manufacturer for doing that, particularly for the family—get this? In the country that is so proud of the NHS, how on earth have we got into a situation where those who are poor do not get it?

I agree with the points the right hon. Gentleman is making, but the fact that the one prescription that has been issued has been through the Home Office raises an important point: the Home Office should have nothing to do with a health issue and this should be transferred, without delay, by the Government to the Department of Health and Social Care?

To be fair, it has been, and that was before we changed the law in November. The Home Office set up a panel while we looked at the changes of the law. This does not really matter, but a Health Minister is at the Dispatch Box today and a Health Secretary was there for the urgent question, so this is clearly sitting in that Department, but the connotations are still there in respect of, for instance, bringing this into the country—

And licensing?

I understand that point, but this drug has been moved out of its category into the Department of Health and Social Care and it can be prescribed. The issue is not prescription. Even though there were a limited amount of private prescriptions, they are being issued. I thank the consultants who have met me and my colleagues from across the House who have been campaigning on this. They are willing to do this. As far as I can work out, the blockage is that this was moved too fast to help the families whom we wanted to help; the Department of Health and Social Care and the Home Office were not ready.

That fascinates me, because four and a half years ago— it is that long since I have been a Minister—I stood in Westminster Hall as the Minister responsible for drug policy and said then that the Government were minded to allow the medical use of cannabis under prescription. Do they not read our debates? Do they not listen to what Ministers have to say? I do not know whether they thought I was having a flier and as a Minister of State was just doing this because I felt like it on that day. But the then Home Secretary is now the Prime Minister, and of course I did it with her permission.

What did Ministers do after the right hon. Gentleman made that point in Westminster Hall? He says that that was four years ago. Why did it take until last year for the Government to do anything?

You should have seen the reaction of some of my civil servants when I got back to the Department after making that comment in Westminster Hall! You would understand then why this went exactly nowhere, even though I pushed and cajoled. Sadly, or fortunately, I was moved to the Ministry of Defence after the 2017 election.

So why are we here today? Why have colleagues come into the Chamber, which was completely empty 10 or 15 minutes ago, when they could probably go, as I do not think there is going to be a vote? I say that because the Government have indicated to me that they have accepted the motion, which is votable, if we needed to do that. I have indicated to the Whips that if we needed to do this, I would push it to a vote. I do not think we need to, simply because, after listening to the debate, the Minister will realise, “Hey, we’ve got to move faster.”

Are we moving fast? No. Are we moving faster than we were? Yes, but more needs to be done. Why is that? Because young people are having massive seizures that are affecting their lives and those of their loved ones. They are affecting their families and their quality of life in this country today.

We can do something about that. We are on the journey of doing more about it, but I ask more as a father than as a politician: why do they have to find the money and go to Holland or to Canada? If they cannot find the money, they are not going to get it, unless someone donates it to them or they crowdfund. In the 21st century, why are we allowing these children to be given drugs that are not working and that were never designed for the use for which they are being given, while we have products out there that the pharmaceutical companies are producing, and we know exactly what is in them? It may not help—it may not stop those seizures—but for some people it clearly does. It is morally wrong for us to sit back and allow those children to suffer, and I have no intention of doing that.

On the unsatisfactory position that the right hon. Gentleman has described, with desperate families going to Holland to buy these drugs, could the Home Secretary not say today that he has instructed Border Force not to prevent anybody from bringing the drugs back into this country?

I forgot to do so earlier, so I pay tribute to the right hon. Gentleman. We both asked some questions in the House prior to the Home Secretary’s changing his decision, and the right hon. Gentleman kind of goaded me into some of the things that I wanted to do. The right hon. Gentleman and colleagues might remember that an important debate on Europe was due to take place on the Wednesday, when Alfie Dingley and his family were going to Holland, and on the Monday I said that the right hon. Gentleman and I would go to Holland with Alfie Dingley and bring it back, and if we were arrested, so be it. I think the Government might have lost that vote on the Wednesday had we not changed the law in time. I do not think that matters; what matters is that Alfie got his medication.

On the right hon. Gentleman’s specific point, the answer is yes, if it has been brought back with a prescription. We are still in Europe and, as I understand it, European prescriptions are as good as ours—I am told they are, but who knows?—and if they have been over and brought it back with the prescription, it is seriously wrong to take that product off a young child.

Hansard

Speech at the end of the debate

 

Not only was I enormously proud when I went before the Backbench Business Committee to ask for this debate last Tuesday, but I was a bit shocked to get the debate this afternoon—at least we have not had to go home early. We have had an absolutely brilliant debate.

To be honest with the Minister, I am not sure how far this has taken us. Fundamentally, I have an issue with the fact that there are families who, through crowdfunding, or however they fund it—I understand that some parents have had to remortgage—are getting this drug for their children perfectly legally, and qualified consultants and specialists are issuing prescriptions on the NHS, but they are not being honoured. That is something that the Department of Health and Social Care is wholly responsible for. I fully accept that there are other issues to do with the Home Office.

Many people have been marched up to the top of the hill. I accept that for many years, when Paul Flynn was campaigning on this and a Government of a different colour were in office, it did not happen because it was in the “too difficult” pile called schedule 1. We are not in that position now; we are in a position where this House—we have now debated this issue for four and a half hours—can tell the country and the Government that what is happening now, with people who can afford it getting this medicine and those who cannot afford it not getting it, has to stop. This Government have to stop that.

I know how difficult it is. I was the Home Office Minister responsible when this was discussed. I was the Minister who stood at the Dispatch Box. I know the blockages. I have sat with my APPG co-chair, the hon. Member for Gower (Tonia Antoniazzi), and the NHS chief pharmacist. We know that we need to unblock this. We need to believe that the NHS, free at the point of delivery, will deliver for these young families, and that the cheque book is not going to win.

I will raise money and crowdfund, because I will do anything I possibly can to help, but we should not have to do that. The medical evidence is there from other countries. We are going to have to make exceptions, as has been said, because this situation is different. We cannot put one of these children on a placebo, because we know that it will make them really ill when they withdraw from what they have already been given.

The children who have been given this product, and some adults, as in my constituent’s case, need to have confidence going forward. They do not need to beg, borrow and steal to get their lives back on track—and they will not be put back on track fully, because this is not a cure, it just eliminates some symptoms for some people with some conditions. We really do not know the full position yet because, as the Minister has said, we have to do more work. However, in quite a lot of specific cases of paediatric epilepsy with seizures, it appears that cannabis oil makes a difference to the quality of people’s lives. We were sent here not to chat for the sake of it, but to make a difference to people’s lives, and I hope that is exactly what the Minister will do.

Finally, I will clearly not get another urgent question for a while, but Mr Speaker said to the Secretary of State for Health and Social Care that we will persist. He was referring to me, but I say that on behalf of the all-party group, which now has over 100 members. This is what this House is good at, and if we get it right we are very good at it. This has been an excellent debate.

Question put and agreed to.

Resolved,

That this House reaffirms its welcome for the change in the law that allows access to medical cannabis under prescription, but notes that only a handful of prescriptions for whole-plant-extract medical cannabis have been issued on the NHS, which has left a significant number of patients, many of whom are children with intractable epilepsy, with no access to medical cannabis and experiencing severe distress; and calls on the Government immediately to act to ensure that medical cannabis is available to appropriate patients and in particular to children suffering severe intractable epilepsy, such as Alfie Dingley whose plight and campaign did so much to secure the change in the law.

Hansard

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