argyrotsipi/train-dataset huggingface dataset:
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): I am delighted to have given way to my hon. Friend to allow him to pay that tribute to our visitors today I have received two letters from a constituent of mine, who has asked me to keep his name confidential. I am happy to give it to the Minister on a confidential basis. My constituent first wrote to me on this issue last September, after the Government accepted the principle that we should be able to prescribe medical cannabis, because the aim had not been fulfilled. He wrote: "I have a grandson who suffers from a severe form of Crohn’s disease. He is in constant pain and finds that his present regime of opiate-based pain killing has difficult side effects. He tells me that his consultant doctor is willing to prescribe the cannabis-based alternative as soon as it is permitted. My grandson has never obtained cannabis illegally and does not intend to do so." My constituent wrote again to me in April. Things had moved on, but this probably illustrates the problem. In the second letter, he wrote: "The position in my family is now relatively fortunate. Left in limbo for a long time by the NHS, and enduring frequent nausea and serious debility, my grandson used his own initiative. He found a private doctor specialising in pain control, a highly respectable man, formerly an NHS consultant, who gave him a prescription for a cannabis product. This has been successful. His symptoms are under control, his general health and capacity to eat are much improved, and he is being phased back into his job, which he had been likely to lose. I am meeting the financial cost to the tune of £695 per month currently. By tightening my belt I can do it, at least for a reasonable time to come. I never spent money to better effect in my life, and I am so grateful for medical science. But some of the sufferers on the TV programme have no financial resources. And for an old Socialist like me it goes against the grain to use private medicine." Madam Deputy Speaker, you do not need to be an old socialist to think that this is an unacceptable situation.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): The right hon. Gentleman, who set out the case very well, is certainly not an old socialist. As we heard from him, there are multiple examples of patients who want to access medical cannabis, and whose doctors want them to access it, but are not able to do so. These are patients who last year were given hope that their pain, anxiety and seizures would end, only to have their hopes dashed and frustrated.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Karen Patricia Buck (Labour, Centre-left): Like many hon. Members, I have had parents contact me recently who are desperate to obtain treatment for their children. They have said to me that, if anything, the situation has got worse since the guidelines were issued and they completely fail to understand how that can be. Is that my hon. Friend’s experience? Can we convey to the Minister today that there is a powerful sense that hope was raised and has been dashed?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): I am about to come to that point, which is the key question. The root of the problem is that we are not talking about an illegal prescription; these are legal prescriptions, but our NHS is unwilling or unable to make them and deliver on them. The question we need to ask today is, what can Ministers and the Government do to help to sort out the situation? What can we do? It is clearly not good enough for us to say, "Well, Parliament has legislated so we’ve done our bit. It’s now all down to the medical establishment." The system clearly is not working At the root of the issue is evidence. The Government have issued a call for research on this, which is fine as far as it goes, but we need to look creatively at that because research and evidence take different forms. After writing to the Department, I received a letter from a Minister saying that cannabis is legal to be prescribed, but should only be prescribed where there is "clear published evidence of benefit". That little phrase is difficult. Cannabis has been listed under schedule 1 until very recently. When a drug is in schedule 1, it is incredibly difficult to do research on it.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): My right hon. Friend makes a good point The Minister’s letter said that cannabis should only be prescribed where there is "clear published evidence of benefit…and need…and where established treatment options have been exhausted" My question to the Minister is, do we really think all those hurdles are correct? If cannabis is the best treatment for a condition, we should not have to exhaust all those other options; we should be able to trust our clinicians to prescribe in such circumstances The root of the problem is clinicians’ lack of confidence to prescribe. The biggest barrier is concerns over the evidence. The Government have issued a call for evidence and research, but they are insisting on randomised controlled trials, which bothers me greatly. I am really concerned about the insistence on evidence from randomised controlled trials, to the exclusion of other ways of gathering evidence. I strongly advise Ministers and others to go back and look at some of the evidence recently given to the Health and Social Care Committee by Professor Mike Barnes, who is a noted expert on this subject. He has produced a study on the evidence for the efficacy of cannabis for a variety of medical uses. There is plenty of evidence around the world for the efficacy of cannabis for medical use. However, we are not accepting that evidence because it has not been produced in randomised controlled trials In his evidence to the Health and Social Care Committee, Professor Barnes said that we are trying to force cannabis into a particular pharmaceutical route with regards to trials, when that is not an appropriate way to go. He said, "cannabis is not just cannabis…Cannabis is a whole family of plants" and "it does not lend itself very well to the standard pharmaceutical approach. It is not a single molecule that we can compare against a placebo. There are over 2,500 varieties of cannabis, each with a different structure…each with subtle differences He told the Committee that each variety interacts with the others differently. So which one of those varieties do we pick for our randomised controlled trial for a standard pharma model Professor Barnes said that we need to take a range of other evidence into account, including anecdotal evidence. When there are tens of thousands of anecdotes that build an evidence base, there is substantial anecdotal evidence for the efficacy of cannabis for medical approaches around the world.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Alexander Gordon Martin (Labour, Centre-left): First, is it not also the case that we are talking not just about therapeutic uses, but about pain control? There are many conditions where pain control is actually the most important use of a medication. Secondly, may I add my recognition of the work done on this issue by the former Member for Newport West?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): Yes, what is the phrase about standing on the shoulders of giants? I think that we all admire the work on this issue carried out by Paul Flynn over many years I do not understand why the Government will not, at the same time as calling for randomised controlled trails, also look at observational trials, whereby people can actually take the medicine they need and we can see how effective it is. We need an audit of those already using the medicine to see what is happening to them. There is nothing wrong with randomised controlled trials, but the complexity of cannabis as a product makes them very difficult to carry out. We can have them, but there are lots of other ways in which we can gather evidence that will enable us to move forward.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Lloyd Russell-Moyle (Labour, Centre-left): Is it not the case that we have been flexible on trials with other diseases and drugs? I think particularly of the flexibility on HIV after campaigners fought to get the drugs to people who were terminal before trials had finished because there was an understanding that the harm of the disease was far greater than any side effects could possibly be. That is how we should be treating this issue as well. We understand that the risk is relatively low, although there might be some, but the potential gain is rather great.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): My hon. Friend makes an excellent point. Yes, there may be risks, but we should look at the risks of some of the other treatments that people are using. Opiate treatments are much more risky than cannabis We need to find another way forward. We need to take into account the different types of evidence. We need, really, a bespoke medical response to this. I ask the Minister, how can we use the different types of evidence to get an evidence base that will satisfy Government and satisfy clinicians? How can we use, for example, the Access to Medical Treatments (Innovation) Act 2016? We also need a bespoke regulatory response. The question for the Minister is, why not? Other countries have done this, such as the Netherlands, Germany and Canada. They all treat cannabis differently from other products and other treatments. Holland has set up an office for medical cannabis to deal with the complexity of the issue and I do not see why we cannot do something similar.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Kevin Denis Brennan (Labour, Centre-left): To follow up on the excellent point made by my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle), in many of these instances, as with my constituents, we are talking about children who are suffering multiple seizures that are impacting on their mobility, weight and muscle tone through muscle wastage, and this is putting their lives at risk. Is it not therefore quite strange that the balance of risk does not seem to be taken into account when considering prescribing this treatment?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): My right hon. Friend makes an excellent point. He is absolutely right. I am not aware of any evidence of the product making a condition worse. People have been using cannabis for thousands of years. If these worries about side effects were really justified, I think we would probably have seen them by now.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): The right hon. Gentleman is absolutely right. That points to the issue about where we get the product from. The problems, allegedly linked to increased episodes of psychosis, are from high-THC street cannabis, which is not what we mean when we talk about medical cannabis products. As I said, there are lots of different types of cannabis products. They are very often CBD-based, but when they contain THC—the psychoactive element—it is a much, much smaller amount than in street cannabis. It is like comparing apples and pears. He makes a really important point We need to look at how we can learn from evidence in countries such as the Netherlands, Germany and Canada, as well as countries that have successfully introduced medical cannabis regimes, such as Australia and Denmark. What work are the Government doing to learn from the experience of those jurisdictions? There are currently at least 138 medical cannabis trials worldwide. We need to take into account that global evidence I would like to ask the Minister a number of questions. Why can clinicians make individual decisions on certain conditions but not others? For example, clinicians can make individual decisions on a case-by-case basis on Crohn’s disease, which my constituent’s grandson suffers from, but not on some other conditions We need a scoping exercise to look at how we can enable patients to get this medicine now. There are estimated to be something like 3 million cannabis users in the UK, with around 1 million of those using it for medical purposes. Those figures may be high but, whichever figures we look at, there are hundreds of thousands of people using cannabis to alleviate pain or help with a medical condition. At the moment, they get their product from the street—from the illegal trade. That is not good for them or for society. That is the key point. People are already using cannabis for medical reasons and getting it from illegal suppliers.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Jeffrey Smith (Labour, Centre-left): That is not an unusual case. There are lots of people who want to use medical cannabis and do not want to buy it from the street or go to Holland to import cannabis products, and they are frustrated I will wind up, because I have been speaking for longer than I intended. On the funding issue, there are cases of clinicians being willing to prescribe but being blocked by trusts or CCGs. What is the Minister’s understanding of how many cases there are where funding is the issue, rather than prescription? Even where clinicians are willing to prescribe and there is new thinking, CCGs do not have budget lines for some of these products, so the reluctance is understandable. I am interested to know whether the Minister has any information on that It might cost more for the NHS to supply more medical cannabis prescriptions, but we have to compare that with the reduction in other costs. The estimate is that opioid costs would be 25% lower, and there would be fewer hospital admissions. Professor Mike Barnes said in his evidence to the Select Committee that we could probably introduce medical cannabis in this country on the NHS at no net cost, when we take into account the reduced costs elsewhere Our system is clearly too restrictive. It is not working. We need creative thinking and flexibility from the Government, and we need them to look at the different types of evidence from around the world. There are people in this country who, if they were living in Holland, Australia or Canada, would be able to get on with their lives, get their cannabis products legally and not have the worries of the campaigners in our Gallery today about them or their children and relatives having to go through chronic pain or the episodes of epilepsy that we have seen in young patients over the last year We all want to make some progress and are desperately frustrated that we are not able to get anywhere. I refer the Minister to the evidence given by Professor Mike Barnes. We need to look at other types of evidence to inform ourselves of a way to deliver the products that our patients need into their hands.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Mary Theresa Glindon (Labour, Centre-left): It is an honour to follow the hon. Member for Reigate (Crispin Blunt), who is so impassioned—that was evident in his speech—and has done so much work on this issue. I think everyone would pay tribute to what he has done I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Gower (Tonia Antoniazzi) on securing the debate and on the work they have done, alongside the End Our Pain campaign, to highlight the importance and urgency of this issue. It is heartbreaking to hear the stories of families who are trying to access medical cannabis, and especially parents whose children are so poorly. I am sure we all pay tribute to them for their persistence in standing up for their children.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
James Dolan Cunningham (Labour, Centre-left): I pay tribute to the right hon. Member for Hemel Hempstead (Sir Mike Penning). For a long time, he has been campaigning very strongly on this issue—in fact, we met some families he brought down to the House of Commons last year—as, of course, has the hon. Member for Reigate (Crispin Blunt). If my hon. Friend the Member for North Tyneside (Mary Glindon) watched the news over the weekend, she will have seen a family who had to go to Holland and pay over £1,000 to get the medical relief that their kids need through medical cannabis. The question therefore is: why can we not do the same in this country? Why are we being so slow? A lot of kids are suffering, and some could go into a fit and die if we are not very careful. Does she not agree that the Government have to treat this with urgency?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Antonia Louise Antoniazzi (Labour, Centre-left): I thank my co-chair of the all-party group on medical cannabis under prescription, the right hon. Member for Hemel Hempstead (Sir Mike Penning), for securing this Back-Bench debate and the Backbench Business Committee for granting it on the Floor of the House. It is an honour to follow the hon. Member for Henley (John Howell) I am committed to campaigning for medical cannabis under prescription not only for my constituents but for everyone in the UK who would benefit from access to whole-plant medical cannabis. Whole-plant cannabis contains CBD and THC. It is the interaction of both extracts taken together that provides significant relief from symptoms such as seizures, because it provides the entourage effect. The two extracts interact with the human body and produce a stronger influence than any one component alone. We must remember the number of desperate families passed from pillar to post and blocked at every turn. Is the Minister going to sit back and watch them continue to suffer? We have families watching us from the Gallery, and their turn is now.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Antonia Louise Antoniazzi (Labour, Centre-left): The hon. Gentleman is absolutely spot on. The issue of the law and people who are using cannabis as a medicine to relieve their pain is especially relevant to those with multiple sclerosis My very good friend Chris Reilly has progressive MS, and this week he had to go to hospital. His wife Beth called an ambulance, and it took an hour for the paramedics to be able to give him the correct amount of pain relief so that he could be taken to hospital. He is in touch with me all the time. When I was selected as the parliamentary candidate for Gower, he was the first person to contact me and tell me that this was a subject very close to his heart, and that he wanted me to become involved with it. I thank him for that, but it makes me cry that I cannot help him and cannot provide the medical cannabis for him. I know that I am standing here and making comments as a politician, and that I am not a medical expert, but we all know that when our constituents and their families visit our surgeries we share their pain and their tears because they cannot access something that would, quite simply, make their lives a lot better.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Antonia Louise Antoniazzi (Labour, Centre-left): I completely agree. The families of children with intractable epilepsy are in exactly the same position, as are so many other people throughout the United Kingdom. My friend Chris is a very good example of how wrong it is that people with MS or epilepsy have no access to whole plant medical cannabis. As we know, it will never be a cure for everyone, but, as Chris told me yesterday, it provides the chance of a better quality of life. That is what people want. It is what the parents of children with intractable epilepsy want. They are at the end of the road. They have tried everything from the ketogenic diet to unlicensed drugs, which make the children unreceptive and do not improve their quality of life.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Antonia Louise Antoniazzi (Labour, Centre-left): I do agree. It just does not make sense, which is infuriating, because I like to apply sense and logic to most situations, and the current situation is not logical Not being able to access medical cannabis leads people such as Chris and the parents of children with epilepsy to consider alternative ways of accessing cannabis, which—as has already been pointed out—is fuelling a dangerous online trade in which, for all we know, they could be buying anything. That is dangerous and wrong. Clinicians to whom I have spoken often ask parents what they have given their children in addition to over-the-counter drugs. Access to CBD alone has great health benefits that are not recognised by many in the medical profession. The right hon. Member for Hemel Hempstead has referred to its being described as homeopathy. When I say that one of my interests lies in medical cannabis, there will always be someone—even a politician—who will make the pun about wacky baccy, and it is really not appropriate. ‘ There seems to be a theoretical concern about the exposure of children to THC, but that is about recreational use; it is not about medical cannabis. Discussions about the legalisation of cannabis for recreational use and about the rescheduling of cannabis for medical use under prescription must not be conflated in the House. Let me put the position into perspective. The law changed because of one boy, Alfie Dingley, and the campaign spearheaded by his mum, the fantastic Hannah Deacon, who is in the Visitors’ Gallery today.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Antonia Louise Antoniazzi (Labour, Centre-left): And Billy Caldwell, yes Alfie’s life has been transformed. He has been seizure-free for as long as 300 days, riding a bike and riding a horse. Hannah continues to campaign for parents who cannot gain access to medical cannabis for their children, who need the same treatment for their intractable epilepsy. The fact is that although the law has changed, the rules on access to medical cannabis are even more stringent as a result. Under the guidance provided by the British Paediatric Neurology Association, Alfie would not be eligible for his prescription, which beggars belief. The Government were aware that they were opening the floodgates by providing access for Alfie, but the push-back from certain areas of the medical profession is what is preventing any advance. We have seen that with a number of patients, and it is extremely unfair The medical cannabis that is being prescribed is in line with manufacturing practice, which means that it meets European standards. However, these products will have to be subjected to trials that could take three to four years, which is not acceptable to the families with whom we work at End Our Pain. It is not acceptable to the parents of Bailey Williams, who are also in the Gallery. They cannot wait any longer. They did use a CBD, and I think that they are still using it, but it is not working; it has worn off. That is why they need the THC These products are available, and they need to be made available to everyone now. There is currently a two-tier system. There are those who have access to medical cannabis because they have the funding, and those who do not because it is not available on the NHS. We must change that.