argyrotsipi/train-dataset huggingface dataset:
Budget Resolutions — House of Commons, 2021-11-02
Topic: Defense
John Luther Mercer (Conservative, Centre-right): The hon. Lady can shake her head, but I did actually review the nuclear test programme medical settlement for them, and I improved it Nuclear test veterans are a part of this, but no one wants more than me to get away from the narrative that we do not treat veterans particularly well in this country. We are all incredibly proud of them, but this requires action and commitment. The Office for Veterans’ Affairs gave us the opportunity to do that, and I urge the Chief Secretary to the Treasury to do it. I know that he and everyone else on the Front Bench believe in this stuff, but we have to get away from giving money to military charities as though that will make us feel better. We have to develop a professional and profoundly different level of veterans’ care in this country, working with the third sector and others, to make people feel as though things are really changing for veterans in this country. I urge the Chief Secretary to take that forward.
Budget Resolutions — House of Commons, 2021-11-02
Topic: Health
Simon Richard Clarke (Conservative, Centre-right): Again, I thank the hon. Lady for raising that point. I do take this point seriously. We have committed in this Budget to the national living wage increase, which is a major increase—6.6%, rising to £9.50 an hour. That money comes as a complement to the extra funding that the Government have committed to help with labour shortages, and I believe it will make a real difference. Obviously we can continue to monitor the situation closely with the sector If I may make a little progress, I want to return to the core theme of today’s debate: our public services. As the Chancellor outlined last week, this Budget increases total departmental spending over this Parliament by £150 billion. That is the largest rise this century, with spending growing by 3.8% a year in real terms. We are taking forward plans to deliver more than £600 billion of gross public sector investment over this Parliament, meaning that public sector net investment will be at its highest sustained level as a share of GDP for nearly half a century. This is funding that can and will make real change possible for communities throughout the country Last week, my right hon. Friend the Member for Maidenhead (Mrs May) reminded the House when talking about the NHS that increased spending is not enough on its own and that we must strive to deliver value for taxpayers. I could not agree more. The measure of a Government’s compassion is not how much they spend, but the outcomes they deliver. In making these investments, the Government are committed to ensuring that every pound is spent well and makes a difference To take healthcare, we are building 40 new hospitals and upgrading 70 more, as well as funding 50,000 nurses and 50 million more primary healthcare appointments. We are working closely with the NHS to roll out a stream of innovative developments that will reduce backlogs, help cut waiting times and transform healthcare for good. Some 100 community diagnostic centres, rightly praised by my hon. Friend the Member for Bishop Auckland (Dehenna Davison), will help people to obtain tests close to home. New surgical hubs will cut waits for elective operations, and we are making a record investment in R&D to support the health technologies of the future.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
James Barry Daly (Conservative, Centre-right): The hon. Gentleman is making an excellent speech on this important issue. From my research it seems that the manufacturers and producers of cannabis-based products are not investing in the clinical trials and evidence that would be necessary, or at least proportionate in comparison with what happens for other medicines. Will he say why that is not the case, or will he point to evidence of such trials being undertaken by the producers of these medicines?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Thomas William Randall (Conservative, Centre-right): The hon. Gentleman is making an excellent speech, which I am following with great interest. As I understand it, he is proposing the creation of a new body to look into this matter. We often talk about NHS bureaucracy and so on. Before he goes on to the other part of his Bill, could he explain why he thinks the creation of a new body would particularly resolve the ongoing issue that he has outlined very well? Could the matter be addressed within existing NHS structures?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): I will happily take another intervention once I have been through the issues, but I just want to continue to highlight what this lady, Joanne, is having to do. She has got the Secretary of State to ask the NHS what is going on. Along with other parents, she is still talking to the Chair of the Health and Social Care Committee, whom she and Ben previously met in his role as Secretary of State. As per the advice from the local CCG, she applied for an individual funding request for a prescription with a demonstrable improvement in boisterous Ben’s condition, but it was rejected. She appealed in July and won, but on 3 November, the appeal process was deferred awaiting clarification and more information As the hon. Member for Gower (Tonia Antoniazzi) highlights, that must feel Gordian—how can Joanne unpick that? She is still fighting and, as hon. Members would expect, I am supporting her. To the point that the hon. Member for Manchester, Withington raised, I have also written to the Secretary of State about participating in an observation trial The story is distressing. I cannot see any hon. Member who is unmoved and is not thinking about what they would do in a similar position. It is complicated and I find it hard to reconcile my personal distress.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): The hon. Lady raises an important point, which I will come to. I think that those individuals are caught in a pincer movement between scientific proof and medical ethics. I am mindful of the challenge of the hon. Member for Manchester, Withington who asked if they cannot do it, what can they do. I will make some suggestions on that The distress is genuine and clearly felt on both sides of the House, but the specific definition of practical actions that address the situation is a problem. If hon. Members will forgive me, I will set out the events in order. Since November 2018, the law has allowed for prescriptions of medicinal cannabis, which is no small thing. It has been an illegal drug for a long time, and it is a Conservative Government who brought that in. That prescription is now a legal tool in the armoury of qualified doctors. Prescription medicine is rightly the preserve of highly qualified and trained doctors. No one would want me wandering down the high street saying, "Oh you look a bit poorly today—go and have a bit of that." It takes years of blood, sweat and tears. Ultimately, when doctors have completed that technical qualification, they take the Hippocratic oath. Today’s debate hinges on the interaction between the Hippocratic oath that doctors take as individuals on qualification—I am aware that not everybody swears on the same text—and the Government’s ability to feel qualified enough to influence, or seek to influence, doctors’ decisions. I think that is where the blockage is.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Neil Peter Hammerton Hudson (Conservative, Centre-right): I am grateful to the hon. Member for Manchester, Withington (Jeff Smith) for bringing forward this important debate. He spoke with power and passion about a very important issue. I want to touch on the comments that my hon. Friend the Member for South Ribble (Katherine Fletcher) made about the difficulties in decision making for clinicians on the frontline. I speak as a veterinary surgeon, cognisant of the difficulties in making rational, evidence-based decisions in our profession when we are looking at licensed products for the species we are treating and having to make tough decisions about when we go off-licence. I am very sympathetic to my colleagues in the medical profession wanting a large evidence base to make them feel comfortable about making those decisions. Does my hon. Friend agree that it is welcome that NICE has made some recommendations about some trials that can take place and that there are trials under way? That will try to help us improve and increase the evidence base to help clinicians on the frontline make rational decisions.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): My hon. Friend anticipates a couple of points I was about to make. I am talking not just about the individual who is prescribing, but about the medical system. There are rightly in our wonderful NHS medically qualified people engaged in lots of layers—my hon. Friend the Member for Gedling (Tom Randall) talks about bureaucracy—but they are people who have taken the Hippocratic oath. That is not just the person on the one-to-one with patients; it goes all the way through the system, and that is what I am worried about, basically.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Crispin Jeremy Rupert Blunt (Conservative, Centre-right): Where my hon. Friend talks about the challenge that faces us, she is absolutely on point. The medical profession of course wants a reliable pharmacopeia to be able to turn to, with all the supporting evidence and the rest. The problem that our profession has inflicted on our constituents is that we are 50 years behind in the research. Outside the regular pharmaceutical assessment there is all the knowledge that is on the streets. It is unreliable, but it is there, so people believe that the medicine works in all sorts of ways. We have a responsibility in this place. People are obviously turning to the criminal supply chain to get such products. That is our fault, and the hon. Member for Manchester, Withington (Jeff Smith) is trying to find a way through so that we can get the service to patients that they deserve. That is why I think this Bill at the very least deserves a Second Reading, so that these issues can be pursued in Committee.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): I am not sure I completely agree with my hon. Friend on the translation between the two. He almost makes my point for me. He talks about the ubiquity of cannabis on the streets, which I recognise, and the normalisation of that being within people’s purview.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Crispin Jeremy Rupert Blunt (Conservative, Centre-right): There is a wholesale difference between people using cannabis for recreational purposes, which we have made illegal and is one for debate, and people using medicines—medicines that we have made illegal and stopped the research—for therapeutic purposes. That is a quite different issue.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I think it is very important for Members to remember that, at various stages through medical evidence building, there have been occasions when people have said very strongly that something, anecdotally, was working, yet further down the line we have discovered that that was not the case. There is therefore hesitancy when it comes to that kind of observational medicine as evidence, because I am afraid it is not reliable.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): I thank my hon. Friend for his intervention, and if I do not embarrass him too much, may I also thank him for his service in hospital during the covid pandemic? It is the strength of experience and the variety of experience on these Benches that makes sure, when we do put stuff through, that the laws of this country are scrutinised by people from different perspectives, and he is a great example of that Joanne position’s is that she is coming to me with Ben saying, "This doctor says he can have medical cannabis, and then I have another set of doctors saying, ‘Well, we need more evidence before we can prescribe it’."
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): No. Would the hon. Member let me, honestly, make a bit of progress? I hope she does not mind; I think I have been very fair We have a loving family in a state of limbo, we have medical professionals deeply concerned about whether it is the right thing to do and whether it is breaking their Hippocratic oath to prescribe, and we have someone who is not remotely qualified to make this decision being asked, in effect, to engage in a medical ethics debate when I am not qualified to do so. I want to turn to another aspect, and this may be the point at which I have to declare my biology degree and a distinct possibility that this might get a bit nerdy. I apologise for that, but geeks may take over the world. I think we need an examination of the other side of this issue: how do the scientists, whether or not they are medically qualified doctors, and how does science provide an evidence base that gives the doctors some confidence and cuts out all of the nonsense? Effectively, I am asking for the House’s forbearance on the topic of standards of scientific proof To recap, the families of the children, including Ben, believe, based on the evidence of their own eyes—a No. 1 eyeball—that medicinal cannabis has an enormously positive effect on the seizures; seizures that are so distressing. I do not want to keep walking away and making this a theoretical concept, because it is not The family have secured the support of two medically qualified individuals, but others believe that the scientific literature lacks the evidence base—as has been pointed out, we do not have the evidence base because we made it illegal for 50 years and it became legal only three years ago—to prescribe specific compounds and drugs. There has not been enough research to understand formally, in the gold standard of a double-blind trial, whether these cannabis medicines do work The hon. Member for Manchester, Withington talked about the availability of different formulations of this generic thing, with different strains and different levels and ratios of THC and CBD. He mentioned a trial and error process to get these very sick children and adults a stable medicine that works for them. If it was my child, in extremis and in an emergency, I would want to go through that process, but as I scientist I think that trial and error can lead to rally big problems. It is not good enough to say, "We think medical cannabis has worked, so we’ll give you 0.5% or we’ll give you 10%".
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): The hon. Lady is being unfair. Listening to my words, she will understand that I have that level of emotion about a very poor and sick child, but I am trying to find a way of helping him that does not potentially put other children at risk because we are giving something on anecdote. I remind her that thalidomide was thought to be fine. If we step away from—[Interruption.] I cannot hear her chuntering at me from behind a mask. If she wants to insult me personally, stand up please.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): It is very important that we do not allow our compassion and our concern about individual cases to cloud our judgment about the fact that the NHS, the Department of Health and Social Care and the MHRA have to put systems in place that apply to every medicine across all the many treatments that are used. Questions like this arise repeatedly about many medicines. We should not use one case or one example to change the whole approach, which overall—as my hon. Friend has explained—aims to keep people safe.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): I made the comparison with thalidomide because it was an inappropriately researched product that had hugely deleterious effects, because people were not looking properly. I am happy to clarify for the record that I am in no way suggesting that medicinal cannabis could have the same side effects as thalidomide. I am talking about the scientific method.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): Let me make a little progress. I am trying to defend science, but I am incredibly conscious that others want to speak and have other perspectives on the matter August bodies such as the British Paediatric Neurology Association, the General Medical Council, the National Institute for Health and Care Excellence and the Royal College of Physicians have all issued guidance around the original change in the law, which was initially cautious. NICE has recently updated its guidance to state: "There is no recommendation against the use of cannabis based medical products." However, it still does not address the issue of a positive evidence base for the safety and effectiveness of these drugs. How do we do that?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): I thank my hon. Friend. I reassure the House that it is not only a surname that we have in common I think we are getting somewhere. We need a scientific evidence base that we can prescribe to doctors or the system more broadly that will give them more confidence—or, as the hon. Member for Manchester, Withington suggests, effectively a bypass mechanism that says, "I know we haven’t got any evidence, but on this we’ll have to look at the very compelling but relatively small numbers." There is an implication that we should just throw out what is working very well This is where the hon. Member might welcome what I am trying to get at—well, he might. The gold standard randomised controlled trial requires a very strongly controlled placebo. There are two cohorts of people who absolutely do not know whether they are on the placebo or the real thing, because there are a series of cognitive biases that can kick in if they think they are receiving a medicine and are not. I agree 100% with, and understand why, anybody whose child is currently taking medicinal cannabis and is stable and happy, would never put themselves in a position where they would have a one in x chance of receiving a placebo as opposed to the medicine. I spoke with Joanne Griffiths directly about that and I understand that However, during the covid pandemic the scientific establishment has changed trial design and its ways of doing things, so it has to be possible to find a placebo cohort of children with similar conditions who are not taking additional cannabis medicine. There are a number of reasons why people might choose to not use it. The UK is not an island. The other problem is that the numbers are fantastically low, so there is a relatively low pool of people to play with. However, the UK has shown itself to be a leader in global science. I think it would be possible to find, in other countries where they have not taken the progressive steps we have taken in the UK to legalise medicinal cannabis, a group of children with similar medical conditions and use them as the placebo. There is an opportunity for the scientific community to maintain the gold standard of a double-blind trial, but not necessarily put people in the position where they need to come across My call to Government would be to speed up the current observation trials and to engage with scientific leadership—remember, it is this Government who are putting extra billions into research and development because we are a science superpower—on a more creative RCT trial, looking for the placebo that proves or disproves it over a series of numbers on a global scale I will draw my remarks to a close. It is in the pincer between medical ethics and standards of evidence where, tragically, young men like Ben sit, and we see the distress. There are potential solutions. I see the sense of measures in the Bill, but they come back too much to the idea that by voting for the Bill as an MP and as an unqualified individual, I will be telling a medical professional what to do. That is how I read the Bill.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): I am very conscious that others want to come in, so I am going to crack on While I am a nerd and I can understand the science, I think we are on shaky ground if elected individuals get into a position where we are strongly incentivising the system or telling medically qualified people who have taken an oath what to do. I do not think it is possible for us to say, "Okay, I know we do not have peer review evidence that that particular drug x on that percentage formulation can work, but the family says it does and I can see it does, so off you go and prescribe it." Simply put, I do not think we can tell doctors what to do. I say that with a genuinely heavy heart I hugely commend the hon. Member for Manchester, Withington for bringing the Bill before the House today. I thank the hon. Member for Gower for her passionate contribution. I know she will continue to stick pins in me to make sure I continue to work behind the scenes. [Laughter.] My final message to Joanne is this: "I know you think I don’t care. I do. I just cannot support the Bill today."
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I think we need to understand that this is not just about whether a treatment works for a particular patient. There are plenty of treatments that work, but with more study and better understanding we come to recognise that there are many side-effects, and that problems that might crop up among a small number of patients could turn out to be devastating. We must be careful about what we mean when we say that a treatment is effective. We have all just experienced the process of approving a vaccine which we know works, but which we also know has severe side-effects. We must look at a bigger picture than what happens in the case of any one individual patient.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Natalie Cecilia Elphicke (Conservative, Centre-right): My hon. Friend clearly has considerable practical experience in medicine, and, as I have said, the subject of medical cannabis and the treatment of children is very much a specialist area. However, it would be perverse indeed for people to be ordered to have a medicine that they do not want—my hon. Friend has raised the question of research and the covid vaccines—while others are prevented from getting medicines that they do want when they know that they work.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
James Barry Daly (Conservative, Centre-right): My hon. Friend is making a powerful speech, and I ask this question with the aim of developing my own knowledge of the subject. According to what the hon. Member for Manchester, Withington (Jeff Smith) said about the two-stage process of being referred for treatment, there is a clinical referral which is then considered by the clinical commissioning group. In Teagan’s case, after the clinical referral did the CCG cause the blockage? If so, were clinicians at a CCG level or non-medically qualified people making that decision?