PARLIAMENTARY DEBATE
Medical Cannabis - 20 February 2018 (Commons/Commons Chamber)

(Urgent Question): To ask the Home Secretary if she will make a statement on the case of Alfie Dingley, whose parents and doctors are seeking access to medical cannabis to treat his epilepsy.

I, personally, and the Government sympathise deeply with the situation faced by Alfie Dingley and his family. I think that everyone on both sides of the House and outside it will understand and respect the desire of the family to try to alleviate his suffering in any way possible. I assure my hon. Friend that we want to help to find a solution within the existing regulations.

As my hon. Friend will know, the current situation is that cannabis, in its raw form, is not recognised in the UK as having any medicinal benefits. It is therefore listed as a schedule 1 drug under the Misuse of Drugs Regulations 2001. This means that it is unlawful to produce, supply or possess raw cannabis unless it is for the purposes of research. Products must be thoroughly tested in the UK to provide the necessary assurances of their efficacy, quality and safety.

We have a clear regime in place that is administered by the Medicines and Healthcare Products Regulatory Agency to enable medicines, including those containing controlled drugs such as cannabis, to be developed, licensed and made available for medicinal use to patients in the UK, as happened in the case of Sativex, as my hon. Friend knows. The Home Office will consider issuing a licence to enable trials of any new medicine under schedule 1 to the Misuse of Drugs Regulations 2001, providing that it complies with appropriate ethical approvals. Cannabis-based products should be treated in the same way as all other drugs, meaning that they should go through the normal testing procedures applied to any other medicines.

The current situation is that outside of research we would not issue licences for the personal consumption of cannabis because it is listed as a schedule 1 drug. However, we are aware of differing approaches in other countries and continue to monitor the World Health Organisation’s expert committee on drug dependence, which has committed to reviewing the use of medicinal cannabis. We will wait until the outcome of the review before considering any next steps. [Interruption.] I am also aware—before the hon. Member for Newport West (Paul Flynn) starts chuntering—that the private Member’s Bill on the legalisation of cannabis for medicinal purposes introduced by the hon. Gentleman will give the House a further opportunity to debate the wider policy.

The whole House will understand that it is a natural desire for parents to do everything they can to make sure that their children do not suffer unnecessarily, but we also need to make sure that cannabis is subjected to the same regulatory framework that applies to all medicines in the UK. We must ensure that only medicines that have been tested for their safety to the correct standard are prescribed for UK children.

I thank my right hon. Friend for saying at the beginning of his response that he is determined to find a solution to this. That will also be welcomed by my right hon. Friend the Attorney General, Alfie Dingley’s MP, who has been working hard, if necessarily privately, on his behalf.

I hope that the Home Office is going to find a way to cease standing behind a 1961 UN scheduling of cannabis as having no medicinal benefit whatsoever. My right hon. Friend mentioned Sativex. However, there are now 12, soon to be 15, states of the European Union and 29 states of the United States of America, and the District of Columbia, that have all found a way to license the medicinal use of cannabis. Is he aware of the position of the Republic of Ireland, which, with a legal framework very similar to ours, gave its Health Minister the explicit power to license use of the medicine in cases such as Alfie’s?

My right hon. Friend’s position, and that of the Government, currently flies in the face of the popular view in the United Kingdom, where 78% of people think that we should find a way of using cannabis-based medicine. Out there, most people instinctively understand the pain and symptom relief that is available from cannabis-based medicines. Here, we know from the Barnes review of 2016, commissioned by the all-party parliamentary group on drug policy reform, that there is good, peer-reviewed medical evidence of the effectiveness of cannabis-based medicines for conditions associated with multiple sclerosis, the side-effects of chemotherapy, and epilepsy.

Failure by the Government to move from their current position will sentence Alfie to the steroid-based treatment he was receiving before he went to the Netherlands, which is likely to give him early psychosis and a premature death. Their position also means that British citizens are being denied all the potential medical and symptomatic benefits that could come from a properly licensed, regulated and researched access programme to cannabis-based medicines. If we do not give people the licences to do the medical research, we will not get the products. Granting the licences would mean that we would not have to rely on the wisdom of crowds and illegally sourced and unreliable products, and would have peer-reviewed, evidence-based treatments produced to pharmaceutical standards.

I urge my right hon. Friend, who is very far from being cruel and heartless—as indeed are the rest of his colleagues in the Home Office—to help either the manufacturers of the drug that will save Alfie’s life, or his doctors or the family to find a way through to get a licence to treat him, and to instruct his officials to assist. It is an indication of just how messed up our management of this issue is that my right hon. Friend from the Home Office is answering this urgent question and not a Health Minister. On health grounds, this is an open-and-shut case.

I thank my hon. Friend. I totally respect his position. I should place it on record that the Under-Secretary of State for Health, my hon. Friend the Member for Winchester (Steve Brine), is sitting next to me, very much in listening mode.

I reassure my hon. Friend, and my right hon. Friend the Attorney General, who has made many representations to me on behalf of Alfie Dingley and his family, that there are clearly some special circumstances in this case that need to be respected. I have undertaken to meet the family, and I will do that as quickly as possible. I also undertake to explore every option within the current regulatory framework. I give that undertaking with sincerity.

I know my hon. Friend well enough to know that he will understand the importance of proceeding on the basis of evidence, particularly when it concerns the safety of drugs and of children. We have our position—he is right that it has been established for a long time—and it is supported by expert opinion. However, we are aware that the position is shifting in other countries, and we monitor that closely.

We are also aware that cannabis is an extremely complex substance, and the WHO quite rightly is looking at it from every angle to get an up-to-date view on its therapeutic use. We are monitoring all that closely. Our current regulatory position is what it is. However, I have undertaken to explore every option within the regulatory framework to see whether we can find a solution to this extremely emotive case.

There has been a call to allow a licence for administering medical cannabis to Alfie Dingley, but the Government must thoroughly examine the evidence in this area—both the stated benefits and the supposed risks of medical cannabis. Our policies must always be based on evidence and not frightened of scary headlines or chasing favourable ones. Only in that way can the House come to an informed decision on the wider issues.

Alfie Dingley is a six-year-old boy whose life is blighted by epileptic fits, and it is understandable that his family want him to have whatever medication they feel will help him. They look to us as politicians to facilitate that, but we are constrained by laws. Members supportive of drug policy reform would like the Home Secretary to issue a licence so that Alfie can continue taking the medication, but the Home Office has responded that the drug

“cannot be practically prescribed, administered or supplied to the public”.

Cannabis use is illegal in this country—we do not dispute that. However, we need assurances from the Minister that all the evidence relating to Alfie’s case has been looked at and that all avenues of treatment are being considered. We need confidence that the Minister and his colleagues are doing everything in their power to ensure that Alfie has the best possible quality of life.

This case is the latest in a long line of prominent examples that have led to more calls for legislation to permit the medical use of cannabis. Is it now time for a review of the law, to look at how we can better support those living in chronic pain, those with long-term degenerative conditions and those in the final stages of life?

I agree with the hon. Lady that policy should be evidence-led, and I support entirely her point that we need to think very carefully about the implications and consequences of everything we do.

As I said in my statement, outside of research we would not issue licences for the personal consumption of cannabis because it is listed as a schedule 1 drug. However, as in the case of Sativex, the Home Office will consider issuing a licence to enable trials of any new medicine under schedule 1 to the Misuse of Drugs Regulations 2001, providing it complies with appropriate ethical approvals. I repeat that I personally undertake to explore every option within the existing regulations to see if we can find a solution.

I support the medical use of cannabis and think the Government should be more fleet of foot on this issue. A sensible proposed amendment to the law in a free vote in this House would, I think, be carried.

I thank my hon. Friend for his comment. I dispute the allegation that the Government are not fleet of foot on this. As I said in my statement, we are aware that things are changing in other countries and that the WHO is reviewing the evidence, and we will follow that very closely indeed.

We would have to have a heart of stone if any of our children or grandchildren were in this position and we were told by a stubborn bureaucracy that they had to turn blue up to 30 times a day and have seizures because our law says that that is the situation. Twenty-nine American states have legalised cannabis for medicinal purposes, and in every one of them the use of deadly, dangerous opioids has gone down. Every alternative to natural cannabis is worse. It is not just one case; thousands of people have the choice of suffering terrible pain and seizures every day or criminalising themselves by breaking the law. I urge them to break the law, because the law in this case is an ass, and it is cruel and lacks compassion.

I do not have a heart of stone, and I say that not just as a parent of six children. Anyone with or without children could not fail to be moved by this case, but, as the hon. Member for Swansea East (Carolyn Harris) said, we have to look at this through the lens of its implications across the system. We have to look at this through the lens of the existing law, which is set on the basis of expert advice, not least from the Advisory Council on the Misuse of Drugs. It is very clear that

“the use of cannabis is a significant public health issue”,

and, in its words, can

“unquestionably cause harm to individuals and society.”

We cannot ignore that advice. However, as I have said, we are monitoring closely the work done by the WHO and other countries, and precedents elsewhere, and, as I have undertaken to do in this particular case, we will explore every option within the existing regulations.

As the hon. Member for Newport West (Paul Flynn) said, it is not just Alfie; thousands of people have such conditions. I have a constituent, Vicky Clarke—now just 5 stone in weight—in St Giles hospice in my constituency, suffering from the very final stages of multiple sclerosis. Her husband has found that the only drug that alleviated her pain was cannabis, and he has twice been investigated by the police. We are not talking about the general administration of cannabis; we are talking about the medical prescription of cannabis. If a doctor says that cannabis is the only cure or a medical professional says that it is the only way to alleviate pain, surely they should be legally allowed to prescribe that drug.

Well, they still have to operate within the law. The law does permit the development, licensing and marketing of medicines, including those containing controlled drugs, such as cannabis. I have used the example of Sativex, which I believe provides relief to patients with MS. My hon. Friend talks about lots of other cases like this one. It is worth noting, however, that in the case of Alfie Dingley, I think only nine other children in the world suffer from the same type of epilepsy as he does. That is why I have undertaken to explore every option on his behalf. I make it quite clear that the Home Office and the Government are keeping this area under review, because this is fast moving. The House will of course have the chance to debate it along with the private Member’s Bill.

The Scottish National party is in favour of the decriminalisation of cannabis for medicinal use, given the evidence of the benefit it has in alleviating the symptoms of many serious conditions, such as that suffered by young Alfie Dingley. In 2016, our party conference heard evidence from a multiple sclerosis sufferer, Laura Brennan-Whitefield, who called for “compassion and common sense” on this issue. She said:

“I’m not advocating the smoking of cannabis, what I’m advocating is a progressive and reasonable, compassionate society where you can access pain relief”.

We urge the UK Government to look again very seriously at decriminalising the use of cannabis for medicinal use. If they are not prepared to do so, we ask them to devolve the power to Scotland, so that the Scottish Government can take appropriate steps. However, we would like to see this for everybody in the United Kingdom.

I thank the hon. and learned Lady for her contribution, and this issue will be debated with the private Member’s Bill on Friday. Again, I come back to the point that we have the existing regulatory framework, and we will not issue licences for the personal consumption of cannabis because it is listed as a schedule 1 drug. However, it is possible to consider issuing licences to enable trials of any new medicine under schedule 1 to the Misuse of Drugs Regulations 2001, and there is precedent for doing so.

Order. Just before I call the hon. Member for Beckenham (Bob Stewart), can I ask him whether he was present at the start of these exchanges?

He was. Very good.

Thank you, Mr Speaker. I certainly was here, just silent. I support the medical use of cannabis, particularly in this case. If the Bill sponsored by the hon. Member for Newport West (Paul Flynn) passes with a sufficient majority on Friday, might the Government fast-track it through the House?

We look forward to the debate on Friday. We will see what the will of the House is.

The Minister has heard support from those of us on these Benches, but does he not support the views of his colleagues in the Scottish Parliament, where the health spokesman Miles Briggs said:

“it is time for a comprehensive, UK wide review…and for Parliament to look to reform access to cannabis for medical and scientific purposes”?

Does he recognise that there is widespread support in all parties?

There are good reasons for the Government’s current position. As I made clear in my statement, we are looking very closely at the approaches being taken by other countries. We have a keen eye on what the global experts, the WHO’s expert committee on drug dependence, conclude in relation to the therapeutic and medicinal benefits of cannabis.

It is Bill number three on Friday. There is not going to be a debate, is there?

That depends on what happens to the first two Bills.

I have had a number of constituents in the past eight years who have suffered from different illnesses, such as epilepsy and multiple sclerosis. They told me that conventional drugs have not worked for them. Often, they have had to travel abroad, especially Holland, to obtain and use cannabis, which has helped them significantly. I therefore urge the Minister and the Government to please consider allowing the medicinal use of cannabis.

I totally understand the hon. Lady’s point, which underlines why the WHO is undertaking its work. I am sure she will agree, however, that cannabis products must be treated in the same way as all other drugs. That means going through the normal testing procedures that apply to any other medicine.

May I help the Minister and suggest that he speak with his colleague the Secretary of State for Health and ask about the extensive trial, known as delta-9, which took place in the Royal Marsden hospital 40 years ago? Cannabis was found to be an excellent prophylactic against nausea caused by ontological medicine. The data is there. The empirical evidence is there. Why does he not save time and trouble by having a word with the Secretary of State and drawing this information to the attention of the House? Let us resolve this matter once and for all.

The hon. Gentleman will understand why I approach any offer of help from him with caution, but in this case I will certainly discuss the evidence he mentions with my colleagues in the Department of Health and Social Care. We need to proceed on the basis of evidence, because of the need for safety.

The Government have heard several times that cannabis for medicinal use is available in many countries. It is clear that the evidence is there. It is allowed in other EU countries. One of the benefits of being in the EU, while we are still there, is collaboration. We are able to review research that is available elsewhere and come to a quick decision. Will the Minister confirm that there are no barriers at the top level of the Government preventing that?

I am not aware of any barriers. What I am aware of is the current regulatory framework, underpinned by expert advice, which continues to be that cannabis in its raw form is not recognised in the UK as having any medicinal benefit. The situation is evolving in other countries and the WHO is looking at it. It is right that we keep an open mind and that we continue to look at the evidence and the precedence from other countries.

I declare an interest as the chair of the all-party group on epilepsy and as the daughter of an epilepsy sufferer. In addition to the cost in human misery, can the Minister advise on whether any attempt has been made to estimate the net cost of continuous ineffective treatment for epilepsy sufferers who are denied access to cannabis for medicinal purposes?

I think that question is best answered by the Department of Health. What I am keen to register with the House is our determination to try to explore every option within the boundaries of the existing regulations to see whether we can support this case.

I am certainly happy to meet that group, or a more appropriate Minister could, so the answer is yes.

I wonder whether the Minister knows the book “The Boy in 7 Billion”, by Callie Blackwell, the mum of Deryn Blackwell who, at the age of 10, was diagnosed with a very rare cancer and then, through the use of cannabis oil, made a miraculous recovery. If he likes, I can lend him my copy. I got one over recess at THTC, a company in my constituency that makes hemp t-shirts—sorry, it does not make them; it supplies them. It is not allowed to make them in this country. It also pointed out that in Mexico, where the medicinal use of cannabis has been legalised, violent crime has dramatically dropped. Does the Minister not think that those things are more than a coincidence, and will he not investigate?

The hon. Lady is taking us beyond a UK scope. I do not know the book and I am grateful to her for her offer, but I come back to what I said at the start. The Government have a position based on the listing as a schedule 1 drug and the view of experts, but we review, and keep under review, what is happening in other countries and, most importantly, the WHO’s position.

We seem to be in some kind of Alice in Wonderland world where words mean the opposite of what we imagine. The Minister said that he is being fleet of foot, yet we have established that we are dragging our feet behind 15 EU member states and 29 US states. I have lost count of the number of times that he has talked about the importance of evidence, yet will he not accept the overwhelming evidence that there are no downsides to the kind of policy change that we are talking about, no matter how hard he looks for them? Why will he not commit at the very least to trials of the regulation of medical-based cannabis? That could, for example, answer questions about how best to distinguish between different types of use and facilitate research that might otherwise be hindered.

We are fleet of foot in the sense that we keep abreast of the evidence as it develops. I made it very clear in my statement that the Home Office will consider issuing licences to enable trials of any new medicine under schedule 1 to the Misuse of Drugs Regulations 2001, providing that it complies with the appropriate ethical approvals.

Alfie’s mother said that any one of the 30 seizures that he has a day could be life-threatening, so there is incredible urgency. I have heard the Minister say that he is very sympathetic and I do not doubt that for a minute, but I have not heard him say when he will make a decision to help Alfie because of that urgency.

I totally accept the point about urgency, and I totally accept the point made by others that we cannot look at policy entirely through the lens of one case. However, I have undertaken to meet the family as quickly as possible, and we are exploring every option inside the existing regulatory envelope.

I have heard the Minister say that he is going to monitor the situation and that he is looking for evidence, but we have had that situation for decades. This place created the problem with poor legislation as far back as the Misuse of Drugs Act 1971. We are in a situation where we know that medicinal cannabis is available that will particularly help Alfie. He has been taking it in the Netherlands. It is not beyond the wit of man to facilitate the continuation of that supply, if the will is there.

As I said in my statement, the UK has a view, which is that cannabis in its raw form is not recognised in the UK as having any medicinal benefits. As I also said, I recognise that there may be special circumstances in this case, which is why I am absolutely determined to look at every option inside the existing regulatory envelope.

As a Welsh MP, I am very proud of the Welsh Assembly, which recognises the need to legalise cannabis for medicinal use. Sativex is a very unpleasant, alcohol-based medicine that is unsuitable for many patients, and I hope that the Government will recognise that. However, we as a country are light years behind other countries, so the excuses today are just not valid. Why does the word “cannabis” scare the Government so much? We need to stop hiding and stop making excuses. Can the Minister tell the parents of children such as Alfie and all the other people who need access to medicinal cannabis legally across the UK when that is going to happen?

What the Government do is listen to the independent, statutory Advisory Council on the Misuse of Drugs, which has been very clear that

“the use of cannabis is a significant public health issue. Cannabis can unquestionably cause harm to individuals and society.”

We cannot just ignore that expert advice. As I said in my statement, there is a precedent for medicines, including controlled drugs such as cannabis and Sativex, to be issued with a licence to enable trials.

Order. I intend no discourtesy to the hon. Member for Isle of Wight (Mr Seely), but he was certainly not in that place some minutes ago. Whether he has just entered the Chamber, or has beetled there from another part of the Chamber—

He has beetled around the Chamber. It is slightly confusing for the Chair when people perambulate around the Chamber. Nevertheless, I am sure that the hon. Gentleman has important thoughts to volunteer, so let us hear them.

Looking around the world, it seems to me that the case for medical cannabis is somewhat overwhelming, although I understand that the Minister is in a difficult position at the moment. Does he think that there will ever be a time when medical cannabis is legal in this country, so that its benefits can be felt by those who need it?

Of course, policy must be evidence-led, so Governments of all colours must keep the evidence under review. I think that the next critical milestone will be the output of the WHO review. Cannabis is a highly complex substance, and the review is looking at it from every angle to try to give us the most definitive, up-to-date view on its medicinal and therapeutic benefits.

The Minister says that public health concerns are a key driver of policy making, but, as we have seen with the case just for piloting safe drug consumption rooms, the Government stubbornly refuse to acknowledge the overwhelming body of evidence that shows that public health would benefit. Is this not just another example of the Government putting the inertia of the criminal justice system ahead of an urgent public health issue, with drug-related deaths at epidemic levels? Will the Government not change the emphasis in policy making to matters of public health, rather than the inertia of the criminal justice system, which for 40 years has had an obsolete and arbitrary method of regulating drugs in this country?

I do not recognise that description of “inertia”. I have tried to give a flavour of the fact that this is a highly complex area that we keep under constant review.