argyrotsipi/train-dataset huggingface dataset:
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): My hon. Friend paints a picture that I recognise in part, but I am sure that he would welcome recent innovations and changes in the law, such as the Government allowing psilocybin—magic mushrooms—to be used in research on clinical depression. Does he welcome the fact that there is movement in this space despite, I grant you, more than a century of ignorance in the area?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Crispin Jeremy Rupert Blunt (Conservative, Centre-right): I fear that I missed what my hon. Friend refers to, because it still sits in schedule 1. When my team first presented the case for moving psilocybin out of schedule 1 so that we could actually do some research at scale, I thought that the case was so blindingly obvious that it would take about five minutes to speak to a Minister and get it done; indeed, I had a conversation with a Minister that rather implied that. But then we ran into what colleagues might in other circumstances call the blob—the endless circuit on which the family of Teagan Appleby have found themselves, as my hon. Friend the Member for Dover (Mrs Elphicke) explained I simply say to colleagues, given the data that I will publish through the Conservative Drug Policy Reform Group next week, that it is a substantial majority position in this House that our drugs policy is not working and we need to do something about it. The worst signal that we could send would be that we are not going to continue the conversation about the proposal in the Bill by sending it into Committee. If we do not give it a Second Reading, that is what we will be doing. Let us get it into Committee and continue to have the conversation. Whether it is fit for Third Reading, or for the Government to support, is a decision we can take later.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I want to make it clear that we said there are approved and allowed uses of this treatment, and I do not doubt that it helps in some circumstances, but today we have ended up having a general debate about types of evidence, with Members almost criticising RCTs and pumping up observational trials as an effective way forward. I caution Members to remember that the MMR scandal, which we now know led to the deaths of children because of how medical practice was changed, was based on an observational study of a small number of people—[Interruption.] It is not rubbish; it is true. Those parents were absolutely convinced that the MMR vaccine had caused autism in their children. They were very passionate about it and, when we looked at it properly with a longer lens, we saw that it was wrong. Be cautious about talking down RCTs and talking up observational studies. [Interruption.]
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): On the NICE guidelines and the clinical evidence, does my hon. Friend agree that all medication, whether cannabis-based, heroin-based or cocaine-based medication, must have rigorous testing through clinical trials so that we understand the possible side-effects and everyone—GPs, all doctors and patients—has full knowledge in making the ultimate decision on whether a drug should be prescribed?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Selaine Rachel Saxby (Conservative, Centre-right): I agree with my hon. Friend: it is vital that we fully understand the side-effects of these drugs that we know, when used in the wrong way, have clinical downsides The Government continue to support the establishment of clinical trials with NHS England and the National Institute for Health Research, but they have been clear that the law enables lawful access where deemed clinically appropriate. The most significant barrier to access on the NHS is the lack of evidence on the quality, safety, and clinical and cost-effectiveness of these products. That sounds uncaring, but I want to revisit the black-and-whiteness behind the terrible emotion tied up with these individual cases I understand that the Royal College of General Practitioners is supportive of the Government’s position that, until the evidence base has developed further, GPs should not be asked to initiate prescribing these products independently of a specialist. I suspect that trust in doctors in this particular area is well placed, which in my mind makes clauses 1 and 2 hard to support There is indeed clear merit in understanding, then overcoming any barriers to accessing unlicensed cannabis-based medicines on the NHS. That is why in March 2019 the then Health Secretary commissioned NHS England and NHS Improvement to review NHS systems and processes and identify and recommend any actions necessary to addressing barriers to clinically appropriate prescribing of unlicensed cannabis-based medicines on the NHS The findings of that review were reported in August 2019 and the majority of recommendations have now been implemented. Since this work has been undertaken recently and the recommendations acted on, I find it hard to support clause 3 of the Bill, as so much has already been achieved by non-legislative means. I very much hope that trials will progress to enable more families to access this treatment, and I take this opportunity to thank the hon. Member for Manchester, Withington for introducing his Bill.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Lia Nici-Townend (Conservative, Centre-right): The way the discussion is going at the moment is that we are talking about going backwards. The reason my hon. Friends are having those discussions is that the law has already changed, and I do not believe we need to legislate. We need to say, "We need to get these medicines that are approved already on the NHS."
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Lia Nici-Townend (Conservative, Centre-right): When we talk to members of the public and our constituents about the debates we have, we explain that we learn a lot by having this exchange of views. It is wonderful. Every school and business should have such debates in this collegiate way. It is not that we are against the Bill, but that we believe the law is already in place. We just need action on NHS funding and to get more of these approved, tested medicines on the lists.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Christian Wakeford (Conservative, Centre-right): As another science geek with a chemistry degree, in which I specialised in drug design and synthesis, I completely agree with the hon. Member’s point. That is part of the concern. It is about having not just the product right now, but the right product, and about making sure that we have efficacy and safety. I completely appreciate all these points. That is why I do not necessarily agree with the perspective on the commission, but I have a lot of sympathy for clauses 1 and 2, which will go some way to help. However, the main stumbling block is the financing. We have already legalised the product. Every time it falls down, is it because it has not been licensed? Maybe, but finance seems to be the stumbling block at every single level.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
James Barry Daly (Conservative, Centre-right): The hon. Lady is being extremely generous with her time; she will please forgive me for intervening, but I want to call on her expertise. The specific intent of Parliament was to allow medical professionals to prescribe non-licensed cannabis-based products. It cannot be any clearer than that; that is where the law is now. I agree with the point that was made—the fact that there have been only three prescriptions is ridiculous. However, perhaps she can address this question: the medical professionals who are considering such matters can see the evidence that we have talked about—it has been incredibly well articulated by all hon. Members—so why are they not referring those matters on and saying, "This patient needs this treatment" The other question that I want to ask—very inarticulately—is about the two-stage process of the clinical referral and then the money within the CCG. Is the problem that it is getting through the first bit—the clinical referral—but the money in the CCG is stopping it? I wonder if she could address those points in her remarks.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Lia Nici-Townend (Conservative, Centre-right): On that point, which I was going to raise later, quite often the issue is semantics. There is a fear about the word "cannabis", be it medical or not, and we need to get over that. One of my concerns about the Bill is the use of the broad term "cannabis". I think that my hon. Friend’s constituent has been fighting with that issue.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Elliot Colburn (Conservative, Centre-right): My hon. Friend has taken the words right out of my mouth. When talking to Carshalton and Wallington residents, I have found that there is a sense of stigma, and a stereotype, associated with the word "cannabis".
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Christian Wakeford (Conservative, Centre-right): Earlier this week, we started talking again about drugs from a public health perspective. We need to tackle the stigma of not only drugs, but alcohol addiction. No one chooses addiction. There are many things that we can do, including removing the exclusion of addiction from the Equality Act 2010, and properly funding addiction and rehabilitation services, but, again, this comes down to the financing.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Ben Everitt (Conservative, Centre-right): My hon. Friend is being very generous with his time. A point that occurred to me earlier is that one of the problems that we have when we debate this issue in Parliament and elsewhere is the conflation of national drugs policy and policy relating specifically to medicinal drugs—in this case, specifically medicinal cannabis. In many ways, it is deeply unhelpful when those two matters are conflated, because people come at them with strong opinions. However, the case study that my hon. Friend is outlining today shows the relationship between the two, and I am grateful to him for bringing that to the attention of the House. May I make a plea to everybody here—I hope that he agrees—not to fall into the trap of conflating the two issues, because although they are very important and we should have a discussion about both, they are vastly different?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Lia Nici-Townend (Conservative, Centre-right): The case that my hon. Friend is outlining highlights real concerns about the side effects of smoking recreational drugs, including potential mouth cancer, potential throat cancer and potential psychosis, as well as the unpleasant social activities. I have had constituents who have had to live next door to people who take recreational cannabis, and it really is not a pleasant situation to be in—and then we get into the issue of potential secondary smoking and all those kinds of things. That is why constituents such as my hon. Friend’s should not have to go through that route.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
James Barry Daly (Conservative, Centre-right): Does my hon. Friend agree that the law is very clear that medical professionals can prescribe non-licensed cannabis products, but the question is why clinical commissioning groups are not funding that? That is what we have to address, to force them to fund it.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Elliot Colburn (Conservative, Centre-right): I totally agree with my hon. Friend. I have experience of working in what we might call a super CCG, which is now an integrated care system, looking at commissioning at a strategic level across six London boroughs, which is by no means a small footprint—we commissioned services for more than 1 million people when I was there, including for four of London’s biggest hospitals. I agree with the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), that practitioners were screaming from the rooftops that they wanted to be able to give such prescriptions and, indeed, felt confident about that. I will not say that they all were—a lot of the colleagues I used to work with in the NHS were not—but a significant amount were confident. From a commissioning perspective, when we were sat in our offices in Wimbledon, talking about commissioning services and looking at the health of the six south-west London boroughs we were tasked with dealing with, there was a clear sense of nervousness and even confusion among commissioners. That obviously needs to change and there needs to be some way to support commissioners to make the positive decisions to deliver the funding. I hope that when the Minister responds we will hear a little bit about what the Government can do about that In bringing my remarks to a close, I emphasise that the constituent experiences we have heard about in this debate, including from the constituent who was kind enough to allow me to read out their story, have been profound. That should be in the back of all our minds when we discuss this issue, because there are real-life implications that we do not always see when we pore over the details of text. I look forward to hearing from the Minister what we can do to unlock some of the issues we have explored in this debate.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): I welcome this important debate brought by the hon. Member for Manchester, Withington (Jeff Smith). Since 1 November 2018, cannabis-based products for medicinal use have been listed in schedule 2 to the Misuse of Drugs Regulations 2001. The change in law was based on expert advice from the chief medical adviser to the UK Government and the Advisory Council on the Misuse of Drugs, both of whom said that the rescheduling of such products would facilitate the development of clinical evidence All of us in this House have enormous sympathy with individual cases. I pay tribute to the hon. Member for Middlesbrough (Andy McDonald) for telling his family story, which I heard with great sadness and compassion. We also have a wider duty to safeguard through clinical evidence. I feel strongly about safeguarding A change has also occurred in that specialist doctors included on the General Medical Council’s specialist register can now prescribe cannabis-based products for medicinal use where clinically appropriate and in the best interests of patients. GPs may prescribe licensed cannabis-based medicines subject to any restrictions under the product’s marketing authorisation, but the law prevents GPs from prescribing unlicensed cannabis-based products for medicinal use unless it is done under the direction of a specialist doctor. That, at the moment, until we have more licensed cannabis-based products, is there for safeguarding purposes There are licensed cannabis-based products—not very many, but I think there are two or three—already routinely available on the NHS, and access to those licensed products has been promoted. For example, the chief pharmaceutical officer recently issued a reminder to clinical commissioning groups and the NHS trusts in England, highlighting that Sativex, for example, is recommended by NICE and available on prescription. There is also cannabis-based epilepsy medication available On Sativex, I wonder whether that sort of cannabis- based medication would have helped my aunt, who died aged 38 from multiple sclerosis. By the time she died at 38, she was practically blind and wheelchair-bound, so I feel very strongly that the right medication must be clinically looked at and evidenced in order for the right prescriptions to be made.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): I thank my hon. Friend for that comment. Very often in political debate we are driven by emotion, and that is right, because we have that emotion driving us forward to make change. However, that emotion must be tempered sometimes by evidence. When we are trying to get legislation through Parliament, we all know that there must be a good evidence base for us to work with to drive that legislation through In addition to the licensed cannabis-based products, since the change in regulations, doctors on the GMC’s specialist register have been able to prescribe unlicensed cannabis-based products for medicinal use if clinically appropriate for their patients. The law allows GPs to prescribe those products under the direction of a specialist, as part of a shared care arrangement If a GP decides to accept ongoing shared care responsibilities and prescribing, they must be competent to exercise their share of clinical responsibility and confident and happy to accept the associated legal and professional responsibilities of doing so. It is right that we put those decisions in the hands of specialist clinicians, those with the best knowledge of all the treatments available for the conditions they are specialist in However, the law did not relate to funding those products within the NHS, which is governed by a range of processes and procedures to ensure equitable distribution of funding, prioritising funding for those medicines that have proved their safety, quality, whether they work and their cost-effectiveness. This is where the evidence base is vital Currently, almost all cannabis-based products for medicinal use prescribed by specialist doctors are unlicensed medicines, which, unlike licensed medicines, have not undergone rigorous tests for quality, safety and efficacy. They are treatments of last resort, and patients will be at a stage in their treatment pathway where they will be under the care of a specialist doctor who has expert knowledge of their field and of all treatment options and will take responsibility for prescribing. Prescribing is limited to specialist doctors because it is important that that restriction forms part of the checks and balances that the Advisory Council on the Misuse of Drugs asked the Government to put in place when rescheduling cannabis-based products for medicinal use to minimise the risk of misuse and diversion. No matter how much we all want to see a change made, we are all aware that unfortunately there are people out there who would use medical cannabis as an excuse for recreational drug use. We have to avoid that at all costs.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Ben Everitt (Conservative, Centre-right): On specialist prescribers, perhaps the barrier is not just the fact that prescription is limited, but the stigma around it. GPs are reluctant to engage with anything to do with cannabis because they almost feel that they might get professional blowback as a result of prescribing it.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): My hon. Friend raises a very good point. I would add that perhaps the reason why GPs are not forthcoming when it comes to working with specialist doctors is that they want to prescribe medicines that they know have been rigorously tested and to be aware of the possible side effects. We have to be aware that GPs take an oath, as my hon. Friend the Member for South Ribble (Katherine Fletcher) said, and part of that oath is that they will not do anything that will damage a patient. If a GP cannot be sure of the side effects or sure that drugs have not been rigorously tested with clinical evidence, they will be less inclined to offer those drugs.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Neil Peter Hammerton Hudson (Conservative, Centre-right): There has been a lot of commonality today in the quest for increased knowledge about what is going on and for improving the evidence base, but also for the confidence of practitioners in being able to prescribe. Does my hon. Friend agree that it would unite us across the House if there were a renewed impetus from the Government to increase the information for medical practitioners about what can be done, so more of them can be confident in doing it, as well as a renewed impetus for the funding for research trials? That would give us a common momentum towards what we are all hoping to achieve.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): I thank my hon. Friend for his points. I have now forgotten his first point—I apologise for that—but I will come on later to clinical trials and the funding for them. Could he repeat his first point?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Neil Peter Hammerton Hudson (Conservative, Centre-right): It was about renewed impetus from the Government to improve the outreach of information to medical practitioners so that more of them are aware of the licensed products, their capabilities and the clinical indications. As a veterinary surgeon, I feel very sympathetic to my colleagues in the medical profession, who want to be able to treat their patients with the best evidence base and the best information possible. Ministers could renew the impetus for more information for practitioners, as well as more funding for research. Those were my first and second points.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): I thank my hon. Friend so much. I just want to reiterate that the chief pharmaceutical officer recently issued a reminder to clinical commissioning groups and NHS trusts in England, highlighting the fact that cannabis-based drugs are available. What my hon. Friend is suggesting is that GPs need to be given even more regular information.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Sally-Ann Hart (Conservative, Centre-right): I thank the hon. Gentleman for his comments. I retract the statement that "we all know", but there is a risk that some people may use medicinal cannabis as an excuse for growing cannabis for recreational use.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
James Barry Daly (Conservative, Centre-right): My hon. Friend is making a very good speech. I fully accept the points that other hon. Members are making, but when the law was changed in 2018, it was not changed with a proviso that there had to be a certain amount of medical evidence to support the use of non-licensed cannabis treatments. It gave specialist practitioners the right to suggest that those products should be used. The problem a lot of the time, as my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) said, is that the clinical commissioning group—the people with the money—will not financially support such a recommendation. There are two sides to this, but a lot of practitioners do want to make sure that these medications come in and are used to support treatments at the earliest opportunity.