My Lords, I shall speak on health issues in the Queen’s Speech and in principle on a pressing problem that needs government action but does not appear in the Government’s agenda.
I welcome the Health Service Safety Investigations Bill, with its focus on learning and not attributing blame or finding fault. This could transform morale in the NHS, which is fundamental to staff retention and high-quality care. However, it will achieve these benefits only if the blame culture of the many other NHS monitoring bodies is adjusted accordingly. I applaud the Government for that initiative.
The social care proposals, unfortunately, do not reflect the urgency of the situation for older people, those with mental health problems in particular, others and the NHS itself. Several other noble Lords have referred to this problem, in particular that there is no timeframe for the substantive proposals and legislative plans in this area to respond to this problem. Can the Minister give the House some assurance on that issue if at all possible?
I welcome the commitment to issue a mental health reform White Paper by the end of the year, which will pave the way for reform of the Mental Health Act. Can the Minister assure the House that legislation in that field will come forward in this Session?
I hope to contribute to work in these areas, but today I will focus on a health issue that could save the NHS billions of pounds and precious consultant time and which, in my view, should have been included in the Queen’s Speech. On 1 November 2018 medical cannabis was rescheduled and recognised as a medicine for the first time in 50 years, having been used as a medicine for thousands of years before then. However, the job to make medical cannabis available to patients has hardly begun. A year on, only two patients have an NHS prescription and 30 have a prescription from the private sector. In Germany, in marked contrast, medical cannabis was legalised in 2017 and in the following year 95,000 prescriptions were written—not 30 but 95,000—and public health insurers are required to provide cover for cannabis medication. Not in the UK. In Germany, 66 conditions are covered by medical cannabis compared with only one—it could be two by now—in the UK. In Italy, 13,000 patients receive medical cannabis prescriptions; in the Netherlands, 20,000; and significantly, in Canada, which has a much smaller population than we do, 400,000. I could give figures for other countries. We hear no reports of the ill effects of medical cannabis—unlike morphine, which is highly addictive and kills people, but we merrily prescribe that every day.
In the UK, the average cost of medical cannabis for a child with epilepsy is about £2,000 per month for the family, despite medical leaders in the field, such as Dr Mike Barnes, taking no fee for their work. Dr Barnes
has spent hundreds of hours hacking through bureaucratic red tape and inertia for no fee. The high cost is due to the crazy rules which require medical cannabis to be imported on a named-patient basis for just one month at a time. The Government need to address this urgently. Bulk importation would slash costs. Cultivation licences are urgently required so that the medicine could be supplied locally and, again, more cheaply.
The Government need to remove cannabis medicines from the “specials” category and enable GPs to prescribe. Only then will the UK begin to come into line with the 50 other countries where medical cannabis has been legalised and patients are rapidly gaining access to the medicine they want and need. In all 50 countries, epilepsy sufferers are prescribed medical cannabis and in 49 countries pain sufferers benefit.
Another major problem in the UK has been the incredibly restrictive NICE guidelines. In its review of medical cannabis, NICE considered 19,491 research studies but dismissed all but four of them because they were not double-blind placebo-controlled trials. However, these trials are not appropriate to assessment of these plant products. I appeal to the Government to raise this issue with NICE so that the hundreds of thousands —probably close to 1 million—patients who suffer the unpleasant side-effects of approved drugs, or risk arrest by buying cannabis in the illegal market, can go to their doctor, get and prescription and improve their health.
In the meantime, drug science is doing its bit to tackle the problem. Professor David Nutt, notoriously sacked as chair of ACMD for telling the truth about the UK’s destructive drug laws, is one of the great experts on medicines and, in particular, medical cannabis. Drug science is doing some important work which will be launched in a couple of weeks’ time.
The NHS could save billions of pounds if medical cannabis was available at realistic prices at GP level. Hospital bed days, consultant appointments and costly medications could be saved. I hope the Minister can give some assurance about the Government’s determination to bring the UK into line with our leading European neighbours, Canada and others.
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