argyrotsipi/train-dataset huggingface dataset:
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Luke Patrick Graham (Conservative, Centre-right): My hon. Friend makes a strong point about consistency. Policy on the legalisation and decriminalisation of drugs is a reserved matter, in contrast to the delivery of health and social care, which is devolved. Does he agree that there should be consistent training and delivery programmes across the United Kingdom, so that people get the same standard of access to help for themselves and their families whether they are in England, Scotland, Wales or Northern Ireland?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Brett Charles Anthony Elphicke (Conservative, Centre-right): I completely agree. The whole House knows that my hon. Friend is a true champion of his constituency and of the Union in which we live. It is important to have consistency so that anyone can go and practise, whether they are in England, Wales, Northern Ireland or Scotland. He makes an important point about the need to ensure that level of consistency It is also important to have consistency in the NHS, so that when the necessary evidence on drugs is available, the NHS takes action. It could, for example, look at the issue of naproxen and ibuprofen, rather than just carrying on regardless. It says that evidence is important, so it should be doing something about that. Indeed, in America, naproxen is not a prescription drug at all. People can just go and get it in their local drug store. In the same way, the NHS will not prescribe, or make it easy to prescribe, cannabis oil, yet it is easy to get codeine. For those with a bit more pain, it is easy to get tramadol, and for those with even more pain, there is morphine as well. Those opiates are legal and easy to get on prescription, yet we seem to have a mental barrier about cannabis and cannabis oil It is really important that we understand the importance of pain management and take it more seriously. We need to look at what can be done to ease pain for all people with all conditions, and we need to act swiftly and consistently on the evidence and without delay. That is why it is right that we should act to "End Our Pain." We should act to help people such as Teagan and our many other constituents who are suffering. We need to act to end that suffering and pain, and to make it easier for them to get the medicines that they need to make a difference to their lives.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Michael Penning (Conservative, Centre-right): In the spirit of this cross-party consensus, I say to the hon. Gentleman that this is not a dig. This matter is devolved in Scotland, Wales and Northern Ireland. These medicines have been prescribed privately in Northern Ireland. Progress was made there. Scotland could do this; we could do it; and Wales could do it. I know that discussions are going on within the Department, but we must not take this in isolation. This must happen across the United Kingdom. I passionately agree with devolution, but no child should suffer because one area is devolved and people are playing catch-up with the other parts of the United Kingdom.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Alberto Castrenze Costa (Conservative, Centre-right): Does my hon. Friend agree that the points he is making are further evidence for why the conclusions of the interim report of the NHS’s review of the situation, as requested by the Secretary of State, should be published as soon as possible? The report will help us to identify answers to my hon. Friend’s points, and it may help my constituents Evelina Lukoševičius, who is two years old, and Maya Fairlie, who is seven years old, to access this life-saving medicine—if, indeed, that is what the review concludes.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
James Roger Cartlidge (Conservative, Centre-right): My hon. Friend makes a good point. I would just be cautious about using the term "life-saving", because this is about easing pain. These medicines are not cures; they relieve the pain of seizures. However, I understand my hon. Friend’s point, as we all did The meeting that I organised was instructive for me in many ways. Since then, I have obviously continued to correspond with my constituents to try to explain to them the powers that I have in this case and the next steps that they need to take. When this debate came up, they emailed to ask me to put one question to the Minister. Remember, they are not being prescribed THC-based compounds; they have been offered Epidiolex, which is a CBD-based medicine. They want me to ask whether any other children with epilepsy, or any other condition—of course, it is primarily complex epilepsy—have been prescribed THC-based medicines That information is in the public domain in the form of a written answer. As I understand it, 110 items—items, not people—of CBD-based medicine have been prescribed, along with 16 items of THC-based compounds, six of them on the NHS. That is an important point, as my constituents want to know whether others have been granted such medicines, and clearly they have. Where is the consistency? That is the confusion. Of course we cannot know the unique personal medical facts of each case, which must always be down to the clinicians, but we now know that THC-based solutions have been prescribed.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Michael Penning (Conservative, Centre-right): It is fantastic that we have the time to talk these things through. We do not have one NHS because, as my hon. Friend says, some people have been prescribed this. My constituent has been completely refused CBD, and the letter came back saying, "No, Mr Penning, we don’t give homeopathic therapies." The fear for those who use CBD is whether the European Commission will consider banning not the prescription but the public purchase of CBD. Apparently the Commission sees it as a novelty food, which we need to discuss because a lot of our constituents use non-THC products, which are perfectly legal, to ease their pain. My constituent has just texted me to say thank you because the medical company has given her some more oil, which the CCG has refused and thus her GP cannot write a prescription.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
James Roger Cartlidge (Conservative, Centre-right): I am sure my right hon. Friend’s constituent is very pleased by that intervention. He underlines the key challenge, which is that these medicines are what is known as "artisanal". They are unlicensed, and they are not standardised pharmaceutical medicines, which can be a problem for doctors who want to know their standard chemical make-up. Doctors feel they cannot entirely rely on these medicines. The nub of it is to what extent we in this place should be pressing those who have to make clinical decisions My hon. Friend the Member for Henley (John Howell) said that this has to be a clinical decision, and my hon. Friend the Member for Reigate (Crispin Blunt) made the brilliant point that, if not for us, we would not be in this position and what has been prescribed so far would not have been prescribed. Let us be honest about it: this has been the result of campaigning, which is why I congratulate all those who have campaigned Nevertheless, this ultimately has to be clinically based. We cannot have political prescribing. It may be that applying maximum pressure has resulted in some prescription decisions. I hope that is not the case but, in reality, it may have been. We must have a consistent, transparent system that we have faith in and that leads to clinical decisions delivering the best outcomes for our constituents.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Michael Penning (Conservative, Centre-right): That is exactly why NHS England is reviewing the blockages in the signing of prescriptions. The Minister can confirm this, but I understand that the interim report will come out by the end of this month, and I believe the full report will go to the Secretary of State by mid-June, which is very quick for the NHS There has to be a level playing field. It is not for us to tell the doctors but, if a suitably qualified doctor is prescribing it, what is the blockage for my hon. Friend’s constituent and for the rest of them?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
James Roger Cartlidge (Conservative, Centre-right): That is what I have been trying to understand. If I were to hazard a guess, I think there has been institutional resistance to CBD in general, but particularly to THC. In a sense, we have helped to force an open-mindedness towards it. When people say there is no evidence, what they mean is that there is no evidence from standard clinical tests. The idea there is no evidence is not true, because the evidence is our constituents’ lives and what they are seeing every day. My constituents do not go to Holland, having crowdfunded all that money, to buy something that does not work. They are parents, and we must have faith in them—by the way, all the doctors put a lot of store in that—but nevertheless, the institutions whose guidance lays the foundations for medical decisions ultimately need clinical trial evidence for it to be sustainable, in addition to individual circumstances I welcome the Minister to her position, which she very much deserves. My appeal to her is that we put everything we possibly can into getting that empirical evidence and undertaking those trials so that we can say to our constituents that everything is being done to ensure that clinicians can make decisions with the greatest confidence and without the nervousness we have all encountered Finally, and this needs to be said, I was asked in my meeting, "You do realise we are being trolled?" We have had debates in this Chamber about the horrible abuse we receive—some of us, particularly female colleagues, have received obscene abuse—but members of the medical profession are now getting the same thing. I understand the frustration of a parent who has done everything they can to support their child and who feels that the system is not helping them. That is why we are having this debate, because we want them to be supported by the system, but there can be no justification for people in the medical profession being subjected to trolling and the sort of abuse I know they have received because they feel they have to make an objective decision. They have the best interests of the patient at heart, and I have faith in the medical profession. It is nervous because of the lack of evidence, so we need to move on with trials as quickly as possible. We need to be able to give our constituents confidence that the system is fair, transparent and consistent, and is not acting in an ad hoc fashion.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Michael Penning (Conservative, Centre-right): Every other country that has done this has done it in a bespoke way. The fear is that if we introduce a bespoke system for a product or drug, everybody else will jump on the bandwagon, but most countries in Europe have addressed this. It has to be bespoke, not least because cannabis was illegal as a schedule 1 drug in this country for so long, but the evidence is here in the mums and dads and the children.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): My information is that there are six and I will happily write to my right hon. Friend with more information As the House heard last month, the Secretary of State for Health and Social Care has met many of the families and patients who Members know through their work on the APPG or their constituencies. All of us could not help but be moved by these distressing cases and the continued efforts of those who support loved ones. The Secretary of State asked NHS England to conduct a process review to identify any inappropriate barriers to clinically appropriate prescribing. I am pleased to say that the review is under way, and NHS England is working with my right hon. Friend the Member for Hemel Hempstead, the all-party parliamentary group on medical cannabis under prescription and patient representative bodies to identify cases that might best illustrate the experience of a range of patients.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Michael Penning (Conservative, Centre-right): We have lots of time, but the Minister is being generous in giving way. Can she confirm when the interim report will be issued on the blockages and when the final report will be made to the Secretary of State? It was indicated to us at a meeting with NHS England only last week that there would be an interim report by the end of May and a report to the Secretary of State in June. Would the Minister like to confirm that?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): I will come on to timelines later in my remarks. NHS England is currently obtaining patient consent and scheduling the necessary interviews with clinicians, decision makers and their patients. The first interviews were held today I want to touch briefly on devolved matters. Health is a devolved matter, but officials across the UK have been working closely on the development of this policy. The law is exactly the same in all four countries of the UK and only funding is devolved. Members have said that clinicians might be nervous about prescription and that we need to improve training. I will talk about this later, but the training package that has been commissioned from Health Education England will be made available across the UK.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): I thank the hon. Gentleman for his comments. Prescription is in the hands of the clinician. Whether the prescription is paid for is ruled on locally and I will talk about that later I would like to tell my right hon. Friend the Member for Hemel Hempstead that a report, including any recommendations, is expected shortly. We will carefully consider any further action we might take to improve access in the light of that report and the clinical guidelines that are due to be issued by NICE. Members are rightly frustrated with the slow pace, because of the distressing cases and because of examples they have seen from abroad. NICE guidelines have been expedited. They would normally take two years to produce, but these guidelines will come out in half that time, this autumn Members have said that patient expectations are not being met and that clinicians are taking an overly cautious approach. With new medicines, we need a strong evidence base. That base is still in development, partly because of the historical overhang.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Crispin Jeremy Rupert Blunt (Conservative, Centre-right): The Minister was probably going to pick up the point I made about the assessment of the risk-reward ratio. Humanity has goodness knows how many thousands of years of use of this plant, and it may need a different risk-reward assessment base from the classic medical variety. Sitting in the background for all the people who regulate our medicines is thalidomide and their anxiety about what might happen. We might need a different framework for this.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): My hon. Friend raises an interesting point, as he always does. The normal NHS medicines governance systems apply, and they are being used to support good clinical practice and safe and effective prescribing, but we could of course do more to educate and support the health profession I want to pick up another point raised by my hon. Friend the Member for Henley, about who does the prescribing of these medicines. These are not frontline medicines, and it is right that specialists who have detailed knowledge of all the treatments available for these particularly difficult cases are the ones who should be responsible for prescribing. Cannabis-based products would not normally be considered until a patient was at the stage in their treatment pathway when they were under the treatment of a specialist On education, Health Education England has been commissioned to develop an online training package. The aim of the package is to familiarise those working in the health sector with the change in the law provide and straightforward information about the products and what is known about their mechanisms of action. It will support and underpin the knowledge and understanding gained by specialists as experience in prescribing these products grows.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Brett Charles Anthony Elphicke (Conservative, Centre-right): My hon. Friend is being generous in taking interventions. She has set out the risks, but may I pay tribute to her and the Secretary of State, who have not simply looked at all the risks and roadblocks that medics put up, but have said how important it is to produce answers, find solutions and take things forward? I urge them to continue with this excellent work to make sure that progress is made, and to continue to push forward.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): I thank my hon. Friend. That is why, after the urgent question last month, the Secretary of State issued the process review. As I have said to my right hon. Friend the Member for Hemel Hempstead, that review will be reporting shortly We cannot be sure that cannabis-based products are safe or effective. There is a body of anecdotal evidence of therapeutic benefit, and the chief medical officer concluded that the evidence was sufficient to recommend that these products be considered for rescheduling from schedule 1 to schedule 2 under the Misuse of Drugs Regulations 2001, and that their medicinal benefits be further examined. All products in schedule 2 can be prescribed; cannabis-based products for medicinal use are no exception I want to talk quickly about the evidence base. Some people have talked about randomised controlled trials, which are what we normally use when there is anecdotal evidence. As hon. Members have said, parents are arbiters of this evidence. The normal procedure is that we do not base prescribing decisions on anecdotal evidence, which is why we have asked the NIHR to stimulate further research. We need to build up the existing evidence base, including through observational trials.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): I recognise the deep pain that families are going through, and I do take the point about the great frustration and desperation of the families. What I would say is that we have asked for more evidence, and we are working with everybody necessary to try to get this done as quickly as possible. NICE is internationally recognised for its robust and evidence-based evaluations and guidelines.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): Of course I could as a parent, but again, I am not a doctor, and I am not here to make that call. What I would say is that I am very happy to meet the hon. Gentleman to get more of the facts he is presenting to me. What is needed to support such prescription is evidence of efficacy, and for public funding evidence of cost-efficacy. That is the system we apply to all medicines and medical devices in the UK, and cannabis should not be treated any differently. The current evidence base has been summarised by the professional bodies in their interim clinical guidance, and it will be further examined and reported on by NICE shortly.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): I apologise to the hon. Lady, because she did ask me that, and I am afraid I forgot to send a note to the Box. I am happy to write to her about whether that analysis has been done Many hon. Members, including my hon. Friend the Member for South Suffolk, talked about funding. Funding decisions are local decisions with clear local procedures. The process review is looking at this, and as I have said, it will report shortly. I call on the industry to invest in more trials, and to publish the results and the full underpinning data, because we all want to see licensed products that doctors can use with confidence Where there is supporting evidence, the Government and the NHS will work with companies to make the products available. Indeed, more than 110 patients are now being treated with a pure CBD extract product—Epidiolex, which numerous hon. Members have referred to—on an early access programme, ahead of a licensing decision by the European Medicines Agency. In developing a licensed product, the evidence has been generated on the safety profile and effectiveness of the product. It is this that provides clinicians with the confidence to prescribe and the system with the evidence it needs to make decisions on routine funding. The NHS does not routinely fund any new medicine until it has been through a process of evaluation to ensure that it is safe, effective and represents value for money On another point that the hon. Member for Gower brought up, about one of her constituents going on the Epidiolex trial, the specialist centres around the country are referring patients to GW Pharmaceuticals. There are certain criteria and a certain number of places, but if she wrote to me, I would be happy to meet her and we could discuss that further We need to develop further our knowledge base on these products. That is why good-quality clinical trials are imperative. We need to know more about the scale of the benefit of cannabis-based products across a wide range of indications. We also need to understand how this compares with existing treatments and, indeed, other promising new drugs that may be as effective.
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
James Roger Cartlidge (Conservative, Centre-right): The Minister is obviously aware that Epidiolex is a CBD-based medicine. Many parents believe, based on their anecdotal experience, that those compounds do not have as much impact on reducing seizures as THC, so can she assure me that the trials will also look at THC-based products?
Medical Cannabis under Prescription — House of Commons, 2019-05-20
Topic: Health
Seema Louise Ghiassi Kennedy (Conservative, Centre-right): I cannot say what will be in the trials, because I am not a scientist running them. What I can say is that we have made the call and want everybody who can to take part in the trials so that we have a much fuller picture and can get to a situation where we have licensed products that doctors feel safe prescribing I will conclude by thanking all hon. Members who have taken part in this useful debate. This is an extremely difficult area, and hon. Members have spoken movingly about heart-rending cases. I hope that I have shown that the Government take this very seriously. We are committed to ensuring that policy is implemented in a safe and sustainable way, making cannabis-based products available to patients where clinically appropriate.