As reported by Cannabis Health
In its latest report on drugs, the UK Home Affairs Committee recommends that the government widens access to cannabis medicines on the NHS, but cites ‘concerns’ over non-medical use.
The new report, published by the Home Affairs Committee on Thursday 31 August, sets out a number of recommendations for the government on current drug policy.
As part of its findings it expresses ‘concern’ around the lack of NHS access to cannabis-based products for medicinal use (CBPMs) and urges ministers to address this before the end of the next parliament.
Earlier this year, the Minister for Health and Secondary Care, Will Quince MP, outlined the number of private and NHS prescriptions for medical cannabis in England since the legislative change, stating that fewer than five had been issued on the NHS.
Cannabis Health can confirm, following an FOI request in August 2023, that there are still fewer than five NHS prescriptions for unlicensed CBPMs.
Meanwhile data from NHS Business Service Authority (NHSBSA) shows that between November 2018 and November 2022, over 140,000 private prescriptions for CBPMs were dispensed in England.
Barriers preventing wider access
Submitting evidence for the report, UK drug advocacy groups, Volteface and Cancard highlighted the significant number of patients still accessing their medication through the illicit market.
Cancard argued that the current pathways for accessing medical cannabis are ‘restrictive, costly and suffer from supply chain issues’.
While Volteface said a general lack of awareness around the legality of medical cannabis may also have a role to play. Surveys conducted on behalf of private cannabis clinics suggest that around half of the UK population is still unaware that medical cannabis is available on prescription.
“We are concerned that there is currently a lack of access on the NHS for patients with a genuine medical need,” the report states.
“Access continues to be a problem despite the high-profile cases of Billy Caldwell and Alfie Dingley –two children with severe and rare forms of epilepsy who have received medical cannabis to treat their condition.”
The committee also acknowledges the evidence for the potential therapeutic value of CBPMs in the treatment of chronic pain, recommending that the government supports researchers in carrying out randomised control trials (RCTs) in this area.
“If the evidence base supports this, and it is deemed to be cost-effective, we recommend that the Government enables the use of CBPMs for this purpose and works with clinicians to ensure that it is a treatment option in appropriate cases,” the report adds.
However, it fails to give any indication or guidance on how the government should approach either of these recommendations.
“It is very positive to see the recommendations around expanding access and reducing barriers to cannabis-based medicines, as well as the recognition that the number of patients going to the illicit market to access their medicine is something that needs to be addressed,” said Katya Kowalski, head of operations at Volteface.
“However, they don’t provide any detail on how this should be done, so it feels like something of a throw-away comment.”
Peter Reynolds, a long-time drug reform advocate and president of CLEAR, agreed that the recommendation does little to help advance the current state of access.
“There is literally nothing on medical cannabis of any value or that makes any progress,” he told Cannabis Health.
“All the requirements for evidence walk straight into exactly the same RCT demands that the cannabis-illiterate medical establishment has been making since the year dot. It doesn’t advance the current position one jot.”
Welcome recognition of the issues
However, others welcomed the findings of the report, saying that it recognises the challenges still facing many patients in the UK.
Professor Mike Barnes, founder of the Medical Cannabis Clinicians Society (MCCS) and the first doctor to obtain a full licence to prescribe cannabis to Alfie Dingley in 2018, commented: “The committee report recognises the real problems of access for many people who would benefit from medicinal cannabis but who cannot access it on the NHS and cannot afford a private prescription. Let’s hope the government listens and takes action.”
Matt Hughes, co-founder and director of Medcan Family Foundation, which is campaigning for children with epilepsy to be able to access the treatment on the NHS, added: “Despite the growing body of evidence supporting the benefits in childhood epilepsy, current guidance is still an obstacle preventing patients from accessing medicinal cannabis via the NHS.
“We agree on the wants of medical bodies in the need for further research, but it shouldn’t be at the expense of access today, in particular when a child has shown benefit or there is an unmet clinical need. We are pleased to see the committee have recognised this and we hope the government acts swiftly on its recommendations.”
A ongoing campaign, led by the Cannabis Industry Council (CIC), is calling for GPs to have the same rights to prescribe as specialist consultants, which some argue would be one step towards increasing access to cannabis medicines.
Co-chair of the CIC Prescription Cannabis Working Group, James Smith, said: “The Cannabis Industry Council supports the Committee’s recommendation for the Government to widen the accessibility of unlicensed CBPMs on the NHS before the end of this Parliament.
‘Concerns’ over the non-medical use of cannabis
While the recognition of the issues around medical cannabis is welcome, drug reform advocates have expressed disappointment regarding the committee’s position on wider cannabis reform.
The report states it ‘does not believe cannabis should be legalised and regulated for non-medical use’ due to concern over the ‘harms this may pose’.
Evidence submitted by Dorset Police and Crime Commissioner (PCC), David Sidwick, claims that ‘cannabis can be harmful and therefore should remain a controlled drug’, while the Home Office is quoted as saying, ‘there is clear scientific and medical evidence that cannabis is a harmful drug which can damage people’s mental and physical health, and harm individuals and communities’.
“It’s disappointing to see that there is a lack of support for further cannabis reform,” said Kowalski.
“While of course there is evidence that this can be true, as is the case for any drug, this has been taken out of context. The vast majority of negative effects associated with the non-medical use of cannabis are due to it being criminalised and sold illegally. These comments from the PCC and Home Office only take into account cannabis use currently in the UK and doesn’t consider the reduction of these effects in jurisdictions that have legalised recreational use.”
Representatives for Cancard have also echoed these thoughts.
Its head of partnerships, Kirsty Morrison said: “Contributing to the Home Affairs committee on Drugs this summer was really important for Cancard to help highlight the daily struggle patients still face accessing vital medication, and the inequality of the current situation in the UK.
“The call to improve NHS access is very welcome, however we echo our community in the drug policy reform space in the view that the UK desperately needs cannabis laws reformed to reduce the criminal impact on society and protect vulnerable patients.”
While Reynolds described the position as ‘completely ludicrous’.
He added: “It acknowledges the harms of cannabis in a criminal market, but says let’s do nothing and maintain the status quo. The very definition of irresponsible.”