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Medicinal Cannabis

Volume 643: debated on Monday 18 June 2018

(Urgent Question): To ask the Home Secretary if he will make a statement on the granting of an emergency licence to allow the return of medical cannabis for Billy Caldwell.

Over the weekend, my right hon. Friend the Home Secretary issued an emergency licence to allow Billy Caldwell’s medical team to access cannabis-based medicine. This was an emergency procedure, led by a senior clinician with the support of the medical director at Chelsea and Westminster Hospital. I am sure that the whole House will want to join me in expressing genuine concern for Billy’s health, and that they will be pleased with the news that he has been discharged from hospital today.

The course of action in this case was unprecedented. I should explain that our guiding principle is that any process in this context must be clinically led and evidence based. To date, Home Office policy has been to permit the production, supply and possession of raw cannabis solely for research purposes under a Home Office licence. The cannabis-based medicine Sativex is currently the only one that can be prescribed in the UK, because there is a proven case for its safety and efficacy. However, this case and that of Alfie Dingley and others have shone a light on the use of cannabis-based medicine in this country and highlighted the need for the Government to explore the issue, and our handling of these issues, further.

I recognise the need to ensure that the approach to licensing works more effectively. As a first step, I can announce today that the Government are establishing an expert panel of clinicians to advise Ministers on any individual applications to prescribe cannabis-based medicines. This is consistent with the principle that a clinician must be at the heart of the process. I have asked Dame Sally Davies to take forward this important work. Let me be clear that both the Home Secretary and I have, as fathers, been profoundly moved by Billy’s story and others like it, along with the rest of the House and the rest of the country. I want to reassure the families and the public that the Home Secretary and I are working together to do all we can to take forward the necessary steps at pace, and that more announcements will be forthcoming.

I would like to thank the Minister for coming to the House today to discuss this urgent question. The Home Secretary has now conceded that cannabis has medicinal benefits by granting the emergency licence for Billy Caldwell on expert advice. When can we expect to see more import licences to make medicinal cannabis available to all who would benefit from it? Moreover, will the Government support the Bill introduced by my hon. Friend the Member for Newport West (Paul Flynn) on the legalisation of cannabis for medicinal purposes, when it returns on 6 July?

On 20 February, an urgent question was raised by the hon. Member for Reigate (Crispin Blunt) about Alfie Dingley’s case. Billy Caldwell is now in exactly the same situation. At that time, the Minister told the House that he would undertake

“to explore every option within the current regulatory framework.”—[Official Report, 20 February 2018; Vol. 636, c. 25.]

Now, 119 days later, the Government have still not granted Alfie Dingley his medicine. That medicine is available in 37 other countries. The Prime Minister met Alfie in Downing Street on 20 March and he was told that the Government would do all they could to help him. Billy Caldwell was hospitalised last week after his prescribed medical cannabis was taken away by customs officers, so it is excellent news that he left hospital today, but hon. Members will have been alarmed to hear the Health Secretary say this morning that it will be months before a system is in place to get medicinal cannabis to such children, and other patients who require it. Will the Minister give an assurance that Alfie Dingley will have had his medicine by the time he comes to Parliament with his mother on Wednesday?

Moreover, I also have two children in my constituency—the only two in Wales and two of just 15 in the United Kingdom—who have the rare genetic disorder NKH, which is a serious, life limiting condition. Charlie Jones, who is six, and Jace Newton-Sealey, who is just one, both suffer from frequent debilitating cluster seizures. According to their consultant neurologist, to whom I spoke earlier, both would benefit hugely from using medical cannabis. Charlie’s grandad, Ian Gilmore, has been in contact with the Home Office since 2014, when he learned of the benefits of cannabis for Charlie, but he has been given conflicting advice, pushed from pillar to post and fobbed off.

Will the Minister say when his Department will get a grip on the situation? Why the delay until now? Why is an announcement not being made today that this medicine will be available now to all who need it? Many patients—this is what I have a problem with—are illegally accessing cannabis, which opens them up to using the wrong form of the drug. The Government have a duty to protect patients and sufferers, so when will the Minister act? Why—

Order. I granted this question because it is urgent, but the hon. Lady has already exceeded her time by 50%. I assume that she is drawing towards a conclusion.

I will conclude right now. Why are the Government stuck in the dark ages? What will the Home Secretary do to speed up the process? In response to, “When?” the answers, “Next week,” “Next month,” or “In due course,” are simply not good enough.

I thank the hon. Lady for that long list of questions, and I will do my best to answer them. She asked about the recognition of the medical benefits of some cannabis-based medicine but, as I said in my response, they are already recognised by the fact that, for example, Sativex can be prescribed in the UK. Its safety and efficacy have been proven, and it has been rigorously tested. She will know the responsibility of the Government and everyone involved in the process to ensure that medicines are safe, but the system allows for medicines to be licensed once they are established and tested.

The hon. Lady mentioned the case of Alfie Dingley, with which I am familiar, and I made it clear that, however we may feel about the current rules, I undertook to try to find a solution for Alfie within the existing rules. Again, it is an unprecedented situation, because this is the first time that we are considering a personal licence, so this is new ground for everyone. I can confirm to her, as I confirmed to the family, that the process of applying for a licence to find a long-term sustainable legal solution for Alfie is well under way. It is clinically led, and I have given assurances that we will drive the process as hard as possible. Indeed, a date has been set for a compliance visit, which is a necessary part of the process. We are pushing things as hard as possible, and I want to place on the record my thanks, appreciation and respect for the dignity and patience of Alfie’s family in this difficult situation.

The hon. Lady challenges the Government to change fast, and I think I have made it clear that, as the Prime Minister said this morning, we have to look hard at our processes for handling such situations. We must ensure, as the Health Secretary made clear today, that our policy is fully up to date with the best possible understanding of the most recent and relevant evidence. As I am sure the hon. Lady will appreciate, the Government have to take a bit of time to think things through. We have to get the detail right. We do not have the luxury of opposition; we have to work through the detail to get this right. My statement recognises not only that we are taking immediate steps to improve our processes so that they become more clinically led, with the introduction of a new clinically-led panel of experts to advise Ministers, but that we are taking a wider look at policy processes and will be making a forthcoming announcement.

I welcome my right hon. Friend’s statement. I am by no means a supporter of recreational cannabis use. However, a woman I know, Amelia Powers, was given two weeks to live with a diagnosis of a tumour of the brain. There was nothing more they could do, and she took to using a form of this and, for the last seven or eight years, has not just reduced the tumour but has got rid of it. She now runs her own company, which she started.

The point I would make is somewhat wider. The biggest problem the Minister faces is that in the Department of Health and Social Care it is still not considered a good thing to investigate the medicinal properties of this particular drug. I urge him, if at all possible, to try to get a coalition on getting this investigated, because clearly there are medicinal preparations that could be used. It would be helpful if he drove that.

I suspect that every Member has personal knowledge, directly or indirectly, of people who swear by the benefits of cannabis-based medicine that has helped them in very difficult circumstances. I completely understand that.

My right hon. Friend talked about building a coalition across Government on updating the evidence, and I signalled in my statement that that is exactly what is happening. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), is sitting alongside me, and I refer my right hon. Friend the Member for Chingford and Woodford Green (Mr Duncan Smith) to this morning’s comments by the Secretary of State for Health and Social Care, which make it clear that the Government are seriously looking again at our processes and how we handle these cases.

Is the Minister aware that the public are increasingly dismayed by the Government’s handling of the question of cannabis oil for medical use? I remind him that the concentration of the relevant compounds in cannabis oil is so small that nobody could possibly get any recreational use from it.

I accept that the Home Secretary moved swiftly to allow a short-term supply for Billy Caldwell but, overall, the Government’s management of the current system of issuing licences for cannabis oil has been lamentable. It has left people in pain and suffering, and it has left families anxious and distraught. It seems to Opposition Members that the current system, even with the expert panel to which he refers, is simply not fit for purpose.

That is why a Labour Government, mindful that this oil is legal in many other jurisdictions, will move towards a legal framework that allows the prescription of cannabis oil for medical use. We believe that such a move, taken with all due care, tests and so forth, would have support on both sides of the House and would be welcomed by the British public, who are weary of the chaos, confusion and personal tragedies caused by the Government’s current management of the system.

I thank the right hon. Lady for recognising the speed of movement by the Home Office this week in response to an emergency request from clinical leads at the Chelsea and Westminster Hospital. The Home Secretary overruled nothing in this process. We worked together very closely this week and responded, as I said, very decisively to an emergency request for a limited licence in a direct call from the senior clinician and the medical director at the Chelsea and Westminster.

I understand the right hon. Lady’s point about public sentiment on this. People are unsettled by what they have seen, and we totally understand that. What I regret is that she is trying to make a party political point. Of course, she was in power and Labour was in power for a long time, and they did the square root of very little in this context. The system we are now trying to work with is basically the rules we inherited from the last Labour Government.

I do not think anyone in politics is in a position to take a high moral stand on this issue. We need to give an undertaking that the policies and processes will be informed by the most up-to-date evidence, and we challenge ourselves harder to make sure these processes are more clinically led than they have been in the past.

I refer Members to my declaration of interest, as a consultant paediatrician. Some compounds within cannabis have anticonvulsive properties. Cannabidiol has been shown in animal studies to have an active anticonvulsant compound, but THC, the one that is illegal in certain concentrations, has been found to have both anticonvulsant and proconvulsant properties in animal studies, and there are concerns that it may also be responsible for causing significant psychological problems, such as psychosis, if used over a longer period. Epidiolex is a pharmaceutical grade, quality-assured product that contains cannabidiol but less than 0.1% THC, and it is both legal and used in clinical trials in this country, including with children. The oils available on the internet or at health food shops are not subject to that sort of scrutiny, do not have the same level of quality assurance and have variable levels of concentrations. Does my right hon. Friend agree that there is a huge difference between these two products—the quality-assured one and the not quality-assured one—and that we need to investigate the best possible scientific evidence on the usage and benefits of cannabis-based medicines, so that they can be used safely and properly to the best effect for our patients?

I defer to my hon. Friend’s medical knowledge, and her intervention just reinforces the point I am trying to make about the need for this process to be clinically led, as far as is possible. She is making the point about there being certain cannabis medicines and certain conditions, and the evidence is at best mixed on this. She makes the fundamental point about our responsibility, as regulators, being to make sure that people are accessing and using products that are tried and tested, and as safe as possible. Let us imagine the consequences of prescribing an unregulated medicine that goes wrong—imagine the scene in this House at that point. In our, understandably, emotional response to recent events, we must also make sure that we do policy right and get it right. That is why we require a little more time to come back to this House with more detailed plans.

The Scottish National party is in favour of the decriminalisation of cannabis for medicinal use, given the evidence of the benefits it has in alleviating some serious conditions, such as that suffered by young Billy Caldwell and young Alfie Dingley. We would like the Government to look seriously at the evidence for decriminalising the use of cannabis for medicinal use. If they are not prepared to do that, we would like them to devolve the power to Scotland to do it, so that the Scottish Government could take steps. However, I stress that we would like to see this done for everybody in the UK. I therefore have two questions for the Minister. First, when can we expect the Government to look seriously at the evidence and to bring forward these matters for proper debate in this House? Secondly, if that is not going to happen, when will he allow the Scottish Government to take the appropriate steps for people in Scotland?

I thank the hon. and learned Lady for that question; she is right to insist on the importance of an evidence-based approach. Of course, the Home Office regularly keeps the evidence under review. As I have said at this Dispatch Box before, one key milestone in this process is to review what the World Health Organisation feels about this issue, because it is conducting a major review of it. We are actively considering whether there is an argument for taking a more urgent step in terms of reviewing the evidence, the processes and the way we handle these cases, and I will keep the House informed on that.

Does my right hon. Friend accept that there is nothing new, and no inherent contradiction, in having available for medicinal use addictive drugs that one would not allow for recreational use? May I illustrate that by describing my personal experience of 32 years ago? When recovering from severe back surgery, I was given a rather pleasant drug and I asked for a repeat prescription, only to be told that as morphia is related to heroin, there were limits on how much they were going to give me. So why can common sense not prevail in the case of marijuana, as occurred in that case?

I thank my right hon. Friend for sharing his personal experience and bringing back what were clearly some happy memories for him. I understand the point he makes and come back to what I was saying: we are absolutely serious about reviewing urgently our processes and policy in this area, to make sure that we are as consistent and up-to-date as possible. I have signalled today that we recognise, as did the Prime Minister this morning, that we need to make some changes to the way we handle these cases, which is why I have introduced the first step that we have taken today.

Is it not utterly shameful that in this country we continue to criminalise people who use cannabis in various forms for medicinal purposes, including the relief of pain, thereby pushing people into the hands of criminals who have no interest at all in their welfare? And what on earth is a Home Office Minister doing responding to an urgent question on a health issue? Surely it should be the responsibility of the Department of Health and Social Care.

The right hon. Gentleman and I go back a long way and I have a great deal of respect for his position and experience. I simply make two points. First, the rules are as they are and, as a former Minister, the right hon. Gentleman knows that Ministers are bound by the rules. We can debate and challenge in this place—as we are beginning to do—whether the rules are fit for purpose, and that is the right thing to do in a representative Parliament. Secondly, in respect of my role, I have today signalled clearly that we are looking again at our processes and how these cases are handled. I have signalled clearly that we believe strongly that the handling of such cases needs to be more clinically led, hence the appointment of a panel. As to which Ministers decide and where the decision sits inside the system, that will be part of our consideration of how we handle these cases more effectively than we have done in the past.

Will my right hon. Friend assure the House that, with the Government having taken this important initiative, other similar cases will now be treated with similar leniency and that we will not have to wait for the wheels of Government to grind along slowly?

I do not think that the wheels of Government moved slowly this week at all—far from it. In response to an emergency request, we issued an emergency and limited licence very quickly, in recognition of the very difficult situation that we were in. I assure my hon. Friend that we will always seek to treat cases as consistently as possible, and that goes for Alfie Dingley and Sophia Gibson and the others. It is important that we are consistent, but in this case we were dealing with an emergency request for an emergency licence.

Alfie met the Prime Minister eight weeks ago and she instructed the Home Office to act; on Saturday, he had 30 seizures. Will the Home Office give the right hon. Member for Hemel Hempstead (Sir Mike Penning)—who is seeking to catch your eye, Mr Speaker—Lady Meacher and me the authority to go through border control with the drugs that Alfie needs? If the Minister will not act, may we?

I do not think that that will be necessary. With respect to the right hon. Gentleman, he is a lawmaker and should not be a lawbreaker. On the Alfie Dingley case, we have made it quite clear that we will do everything that we can, within the existing law, to find a solution. We have had a bit of a stop-start process because this is new ground and it is very complicated. It has to be clinically led. The right hon. Gentleman possibly does not know the underlying details, but I assure him that I am assured that the process is now firmly on track. I hope that we will be in a position to make a positive decision as soon as possible.

My constituent’s two-and-a-half-year-old son was having 300 seizures a day. He described each one as resetting his son’s brain like a computer hard drive being wiped. Following the use of CBD, the seizures have been reduced to between 30 and 50 a day. Will the Minister meet me to discuss this case, and will he perhaps meet my constituent, because he has an outstanding application for a medical licence for his son?

I can certainly give my hon. Friend that assurance. I will of course offer to meet her constituent, as I have met every single family who have come forward, because we are absolutely serious about trying to help, as far as we can, because these cases are deeply difficult. I come back, though, to the point that I am sure my hon. Friend will absolutely respect, which is that it should not really be down to politicians to make these decisions; it has to be a clinically led process. When the clinicians came forward this week on Billy’s behalf, we were able to respond to the request for emergency help, but it has to be a clinically led process.

The fact is that, had Billy Caldwell’s family not taken this to the limits at the weekend, the Government would still be sitting on their hands. The good news is that, for the first time, the Government have acknowledged the therapeutic value of medicinal cannabis. I ask the Government to expand this to people suffering from multiple sclerosis, Parkinson’s and certain cancers. It is happening in 30 American states, and 12-plus countries in Europe are already doing this. I ask this Government to legislate to bring forward medicinal cannabis under prescription in the United Kingdom.

The hon. Gentleman is expressing the view, which is held in many places across the House, that legislation needs to be revisited and that this is the right place in which to debate that. I refute what he was saying about the Government sitting on their hands in relation to the Billy Caldwell case. We worked very hard during the week to try to find solutions to a very difficult situation. The Government will always be bound by the rules of the day whatever people think about them. I am just very glad that we could find a temporary solution for Billy and I hope that it is a step towards the long-term solution that he deserves.

Will my right hon. Friend ensure that this process, even if clinically led, is not administered by a bureaucrat, but is electrified by a politician alive to the need to be re-elected?

Of course this process must be driven at pace, as it was this weekend by the team at the Home Office. I wish to place on record my thanks to the officials who worked extremely hard to find a solution and respond to this emergency. I come back to the point that this needs to be clinically led. In asking Dame Sally Davies to take forward the important work of setting up this panel, I am not talking to a plodding bureaucrat.

Further to the question from the right hon. Member for New Forest East (Dr Lewis), does the right hon. Gentleman agree that it is unfathomable that medicinal opiates, which are the same family as heroin, can be prescribed for medical reasons—usually for pain relief—yet medicinal cannabis cannot be despite the strong evidence base that it should be? Crucially, can the Minister give us the evidence base that is informing the Government’s position?

The evidence base comes from the official advice from the advisory council and others and it has been set for some time. The rules that we are having to work with have been around for a while under successive Governments. If this is the moment to revisit and challenge those rules, that is the role of a parliamentary democracy. What I am saying is that the Government have reflected deeply on the events of the past few weeks. They are constantly updating the evidence from the World Health Organisation and others, and are actively discussing changes to the way in which we handle these cases. I have made one announcement today and expect others to follow.

I thank my right hon. Friend for the way in which he personally intervened on Friday afternoon as the deterioration in Billy Caldwell’s condition became clear, and the Home Secretary for his response within hours of his becoming aware of the situation. My right hon. Friend knows that he has received advice from me, as co-chair of the all-party group for drug policy reform, about how the Government should navigate their way out of this. I offer to assist in the review that is going on. Will he also take advice from Charlotte Caldwell, whom I have met a number of times before this week? She is a redoubtable campaigner and, of necessity, an expert in this field. I hope that he will take up her offer of engaging with her in this process.

Finally, I do have an anxiety that the framework of this review, if it is within the current law, could end up with the wrong answer. The problem is that the current law is based on the wrong premise, which is that there is no value in this medicine.

I thank my hon. Friend for his comments and his extremely constructive approach to a very difficult situation. He will get a reply to his helpful letter. I fully undertake to engage with him and with anyone who has strong views, opinions, and particularly expertise in this area. As I have said, we must make sure that policy and process are up to date and informed by the best and most up-to-date evidence, and that is what we undertake to do.

The Minister has referred to the role played by the Advisory Council on the Misuse of Drugs, and he announced an expert body to look at the matter. Will he tell us what the advisory council is currently saying to the Government about this issue?

The advisory council’s advice on the lack of evidence around the medicinal benefits of cannabis and cannabis-based medicines has not changed, but the process needs to be reviewed constantly in the light of the evidence, and that is what we do. I should clarify that the clinical panel that I have announced today will advise Ministers on specific claims and applications that come to us.

The Minister knows that I was at No. 10 with him and the Prime Minister, Alfie and his family. I cannot see why there should be a difference between the wonderful news that Billy has been given his drugs on clinical advice, and the advice in the cases of Alfie and others. The reason for the difference is that these medications come under schedule 1 of the Misuse of Drugs Regulations 2001. That is why the issue is being dealt with by the Home Office, but it should not be in the Home Office; it should be in the Department of Health and Social Care. I am sure that Alfie will get his drugs very soon, but it is not soon enough for many others.

I understand my right hon. Friend’s point. He has been a tireless and persistent campaigner for Alfie and others in this situation. I share his hope that we can process Alfie’s application as quickly as possible; it is now on a much better track. This is complicated and it is new ground for everyone, not least the clinical and medical community, but we are finding our way towards a legal, sustainable, long-term solution, as well as reviewing our processes in the handling of such cases, as I have outlined today.

Is it not the case that it is becoming policy by public outcry? It should not take such desperate cases for the Government to revisit and relook at their policy. A constituent of mine has relapsing-remitting multiple sclerosis, and suffers serious pain every day. Her specialist thinks that medicinal cannabis is the way forward for her pain relief. Will the Minister look at her case if I write to him, and will he look seriously at expediting provisions as quickly as possible for all our constituents?

I hope that I can do better than that by inviting the clinical panel, once it is set up, to look at the case raised by the hon. Lady. The point is that, within the rules at the moment—as we are trying to demonstrate through the Alfie Dingley application—we are prepared to look at individual licences in exceptional cases. Will it be as quick as I, or anyone, would like? No, but this is new and difficult. We need to get it absolutely right, not least to ensure that these licences stand up to scrutiny and legal challenge. I hope that we are going to get there very soon. I have given the family my absolute assurance that we are going to drive this process as hard as possible, as we will with other applications in the new system that we are setting up.

As the former Minister for medicines regulation, may I welcome the intervention of the Home Secretary and the Policing Minister this week? When I tried to look at this issue as a Minister, the message that I got was that it was the Home Office that was so tough on cannabis law that it would not countenance changes. I welcome the fact that Ministers are looking at this issue and, more importantly, the Prime Minister’s announcement today that she is supporting a review. I urge the Minister not to overcomplicate this. Patients around the country are suffering from acute conditions. It should not be beyond the wit of Ministers to put together a simple licensing and registration scheme so that those people are able to possess appropriate cannabis oil in a way that does not open up the market for recreational use.

I thank my hon. Friend for his comments and recognise his passion and leadership on the subject. I come back to this point: it is all very well for politicians to express their passionately held views on this subject but, at the end of the day, the people we have to hear from are the clinicians.

I welcome this first step from the Government, but the Minister has just said that the Government recognise the medical benefits of cannabis, so the question is: why on earth is cannabis still a controlled drug under schedule 1, which is for drugs with no medical benefit? It is time for an urgent rescheduling of cannabis, which would make life easier for the Government and for patients.

As I was at pains to point out in my opening remarks, cannabis-based Sativex is prescribed in the UK because there is a proven case for its safety and efficacy. I am sure that the hon. Gentleman, like me, will not want to have the market full of unregulated or untested products if we do not know their long-term impact. We have to proceed with some sense of responsibility and get the detail right. We have shown at the Home Office that we are prepared to be flexible on these issues out of compassion for exceptional cases.

When will the commission start work, how will it operate, and how will it speed up the process of delivering these drugs?

We have only announced it today. I have only just asked Dame Sally Davies to take forward this important work. There is a lot of detail to be filled in, in consultation with her and others. We will return to the House to fill in some of the detail that my hon. Friend asks for.

I thank the Minister for his help so far. I thank him, in particular, for the meeting that we had with my constituent Danielle Gibson about her daughter, Sophia. The Minister will know, and the House needs to know, that Darren and Danielle Gibson took their daughter Sophia to Holland to receive cannabis oil, under prescription and controlled. During the three weeks they were there, she had only one seizure instead of the dozens that she has every day. In the past 48 hours, she has not eaten or slept. At this moment in time, there is six months of cannabis oil available for her, paid for, sitting in Holland for her to collect. What will I tell my constituents? How long will the process take?

As the hon. Gentleman and I have discussed before, and in the presence of Danielle, there is a mechanism—a process—that can lead to a legal, sustainable solution to this through a licensing process that needs to be clinically led. In this case, it is devolved to the Northern Ireland Administration, as he well knows. There is a process. We are feeling our way. We all want to drive this fast, but it does need to be done properly. In the situation that we had this week with Billy, we were responding to an emergency situation where clinical leads inside an institution came to us and said, “We need this on an emergency, limited-duration basis.” The long-term solution for Billy now has to be clinically led, but we were responding to an emergency situation.

I am sure that many will agree that the great British public are very much behind the emergency decision taken by the Minister to secure the cannabis oil for Billy Caldwell. Will the Minister now look at whether other children like Billy should, with clinical support, be allowed to legally access cannabis oil?

As I have said in my previous answers, there is an active discussion about a review of how we handle these types of situations. Again, the core principle, as it was this week in the case of Billy Caldwell, is that this must be clinically led.

Does the Minister accept that the UK is behind the curve on public opinion on the matter of medicinal cannabis? How does he explain the fact that Ireland introduced a purpose-designed special licence for little Ava Barry back in December 2017, yet the UK Government appear to be dragging their heels?

I do not necessarily agree that we are behind the curve on public opinion. We moved very fast this week under extremely difficult circumstances. I wholly agreed with the Health Secretary this morning that we need to make sure that our policy is up to date in terms of the medical evidence and the best interests of patients. That is why, as I said, there is an active discussion within Parliament about changes in process and policy. The first announcement in that process was made today. I am sure that as those discussions are finalised, there will be more announcements to follow.

This is a personal licence that has been issued. What liability, if any, is there for a clinician who believes that this is the right treatment to be provided, given that this drug has not been authorised in the UK?

My hon. Friend makes an important point. As part of the licensing process for the exceptional, limited-duration licence for Billy, the paediatric consultant at the hospital specifically stated that decision making about Billy’s long-term care with regard to medication and supervision of his treatment should be undertaken by the paediatric neurologist. We agree with that.

It seems to some of us that the biggest problem with the legalisation of this drug is the fact that it is called “cannabis”. Some of us share the Government’s view that cannabis should not be legalised for recreational use, but this is a totally different situation. While there is delay, children and adults are in serious suffering and, in some cases, may die. Given that organisations such as the MS Society are fully in favour of this legalisation, how long will it take the Government to act?

I understand the hon. Lady’s point, but I want to reassure her that the Government are very clear that this is a discussion about access to cannabis-based medicine and nothing else.

There is clearly a consensus in the House for a review of policy in this area, but neither this House nor public opinion is expert, so can the Minister assure me that we will always proceed on the basis of clinical evidence? Will he look particularly closely at the good, the bad and the ugly examples from North America, where medicinal cannabis has been legalised?

I thank my hon. Friend for his question. I come back to the point that we have to proceed on the basis of good evidence and the most up-to-date information. Some of the evidence in this area is mixed, and therefore we need to be very careful about how we proceed. That sounds bureaucratic and a bit plodding, and I apologise to anyone who feels that way, but it is the responsibility of Government to think things through and get things right, and we will proceed on the basis of evidence and introduce more clinical leadership to this process.

The many constituents who have contacted me who have MS, seizures and chronic pain will no doubt welcome the moves that the Government have made, albeit not as fast as they would like. Can the Minister confirm whether this is a change in approach from the Government, to stop treating drugs as a criminal issue and start treating them as a medical issue? He mentioned that he is taking advice from the Advisory Council on the Misuse of Drugs. The ACMD also supports supervised drug consumption rooms, which help to make this a medical, not a criminal, issue. Is he willing to meet me to discuss that?

I am happy to meet all Members with an interest in this subject. I should say that the Government have not formally changed their position on medicinal cannabis. We have responded to an exceptional case and issued a licence to ensure that emergency treatment can be accessed, but I have signalled that we are looking again at the way in which we handle these cases.

I support the legalisation of cannabis for medical use and understand the need for a clinical lead on this issue, but given that a large number of countries have already legalised this drug, there must be a mountain of internationally accredited research already being undertaken that clinicians in the United Kingdom could access.

My hon. Friend makes an important point, and I thank him for the emphasis he places on the need to move ahead on an evidenced, clinically-led basis. He talks about international evidence, and he is absolutely right. That is why we are taking great interest in the WHO’s updating of its research, evidence and guidance on this extremely important, complicated and difficult subject.

Given that the Minister has said that clinicians must take the lead on this, when will he reschedule cannabis to allow clinicians to use their professional judgment in the provision of medicinal cannabis to children such as my constituent Murray Gray, who suffers from a very similar condition to Alfie Dingley? Will he meet me to discuss that?

I have met all the families I know about who are going through these incredibly difficult situations. Everyone understands that parents would do absolutely anything for their children in these circumstances, and I have huge respect for that, so of course I will meet the hon. Lady. The straight answer to her question is that we have demonstrated today—it is not yet completed with Alfie Dingley—that we are prepared to look at licences in a new way, but it needs to be clinically led, and that is the fundamental point.

An advisory vote in the Senedd in support of legalising cannabis for medicinal purposes was hailed as a victory for common sense and compassion by Arfon Jones, the police and crime commissioner for north Wales. Only two AMs voted against it. Considering the political support in Wales and the fact that health is a devolved issue, why will the British Government not allow the National Assembly to make decisions on this issue on behalf of Welsh patients?

It is not a devolved matter at the moment. I am more than happy to have those conversations, but we deal with the system as it is.

The right hon. Gentleman can try and—I will even be helpful to him, because my generous spirit is getting the better of me—if his point of order relates to the matter with which we have just been dealing, I feel that we can on this occasion indulge him.

If you do not try, you never know, do you?

During the urgent question, the right hon. Member for Birkenhead (Frank Field) asked whether it would be okay if Members went abroad and brought back such a prescribed product, and the Minister for Policing and the Fire Service quite rightly said that we are lawmakers not lawbreakers. However, we are also here to protect our population and our constituents. I say this with an open heart and a genuine understanding of what the Minister is going through, because I tried to deal with this when I was in his position, but if Alfie Dingley does not get his drugs by Wednesday, a delegation from this House will go abroad to get them for him.

I am very grateful—or at least I think I am very grateful—to the right hon. Gentleman. Manifestly, that was not even an imitation of or an approximation to a point of order. Nevertheless, I am sure it was extremely important. He has unburdened himself of his opinions, and they are on the record for the people of Hemel Hempstead, the nation and possibly even the world to study.

Before we proceed to the second urgent question, I will take this opportunity to inform the House that Gina Martin, who was herself a victim of the loathsome practice of upskirting and has subsequently led the campaign to outlaw the practice, has joined us in the Gallery today. Gina, we welcome you here and we thank you for coming.