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May 24, 2019

ECH Chief Medical Officer key to UK Parliament debate on medical cannabis

During last week’s Backbench session in the UK Parliament, Mike Penning opened another vital debate into the subject of patient access to medical cannabis on the NHS.

The session came in the context of a further period of unsatisfactory progress with regard to the matter, despite positive indications from government during the April Urgent Question to the Secretary of State of Health and Social Care, Matt Hancock, that patients would see access improved.

There is overwhelmingly political agreement that, where appropriate, patients should be able to access medical cannabis with the support of the NHS. Here, MPs sought out solutions for what continues to be a distressing situation for families unable to secure private funding for medicines that wealthier patients can access with relative ease.  

The problem, as identified by MPs, falls upon a lack of clinical education, combined with an overly stringent focus on the criteria of randomised control trials (RCTs). Since November 2018 there have been no actual legal barriers to clinicians prescribing medical cannabis.

Professor Mike Barnes, ECH Chief Medical Officer and the first UK doctor to successfully prescribe medical cannabis for his young patient Alfie Dingley, has been close to the issue for years.

His recent contributions to the discussion, during the March Health and Social Care Select Committee hearing, were frequently cited, as they support the progression of medical cannabis access with the understanding that, outside of RCT rigors, medical cannabis does in fact have a strong evidence base when accounting for qualified testimony based on clinical experience and patient outcomes.

Jeff Smith MP commented, “I strongly advise Ministers and others to go back and look at some of the evidence recently given to the Health and Social Care Committee by Professor Mike Barnes, who is a noted expert on this subject. He has produced a study on the evidence for the efficacy of cannabis for a variety of medical uses. There is plenty of evidence around the world for the efficacy of cannabis for medical use.

Professor Barnes said that we need to take a range of other evidence into account, including anecdotal evidence. When there are tens of thousands of anecdotes that build an evidence base, there is substantial anecdotal evidence for the efficacy of cannabis for medical approaches around the world.”

Crispin Blunt MP added, “In 2016, the all-party parliamentary group commissioned a report from Professor Mike Barnes – we have already heard about his research in this debate – to identify which conditions medicines derived from cannabis had been established to a medical standard to help treat.”

Andy McDonald MP said, referring to Professor Barnes, “It is funny how our paths have been intertwined. When I was a lawyer representing the victims of serious injuries—particularly brain injuries—and their families, Professor Mike Barnes was a terrific fount of knowledge and expertise. It comes as no surprise to me that he has decided to devote his entire career to this critical issue, and no finer advocate or expert could we have in this cause.”

Within the direct experience and knowledge base of clinicians like Professor Barnes, is a practical evidence base to support the use of medical cannabis in therapies for a number of conditions. Globally, patients have been treated with cannabis for decades, and there is a clear impetus and responsibility for UK clinicians to understand these medicines.

The Academy unequivocally supports Professor Barnes’ message. By educating themselves as to the breadth of all evidence available, doctors should be able to consider the issue beyond the restrictive demands of RCT-based evidence.

Beyond the invaluable contributions of Professor Barnes, the Academy actively collaborates with numerous clinicians with outlying degrees of experience in successfully treating patients with medical cannabis. Our learning content therefore represents a research, evidence and clinical practice-based education for doctors.

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