OQ.12/2018 The approval of cannabis products for medicinal use

4.6   Deputy M. Tadier of the Minister for Health and Social Services regarding the approval of cannabis products for medicinal use: [OQ.12/2018]

What cannabis products, if any, have been approved or shortlisted for approval for medicinal use and what criteria must a medicinal cannabis product meet in order to be put on the list?

Senator A.K.F. Green (The Minister for Health and Social Services):

Bedrocan and other associated similar products produced by Bedrocan company in Holland under licence from the Dutch Government for medicinal cannabis is going to be approved. An importation will come from Holland. Tilray oral solutions containing various strengths of T.H.C. (tetrahydrocannabinol) and C.B.D. (cannabidiol) produced by a Canadian company, currently importation would be from Canada, however we do know that there is a European country setting up under good manufacturing practices in Portugal. If they come online we may be able to get those products from there. A key recommendation of the Misuse of Drugs Advisory Council was that if cannabis-based products were going to be used for medicinal purposes, that they should be quality assured and to the same degree as other licensed medicines. In practice, this means, as I have referred to before, that they must be produced to good manufacturing practice and must be certified producers. The product must meet those standards consistently. Any manufacturer who is not G.M.P. (Good Manufacturing Practice) certified, or any other product from any other manufacturer that cannot demonstrate G.M.P. standards has been discounted.

1. Deputy M. Tadier :

The question then has to be when will this come into place. We have known about Bedrocan for years. I brought a proposition to the States and to the Minister asking him to licence Bedrocan for somebody who needed it. We have known that it is a pre-authorised and credible medication in other places. Can the Minister explain why it has taken so long to source these and when he expects these to be able to come into the Island to be prescribed for those in great medical need?

Senator A.K.F. Green:

The Deputy is right insomuch as he brought this to us before. But what he fails to mention is that there was not the medical evidence to support what he wanted to do. There was not medical support. The Barnes report last year for the first time showed that there was evidence to support some of these people, and I have met some of them, so I understand the suffering that they are going through. I am keen to do this but I want to get it done right. I do not want to just produce a list of things that might be available that we cannot either get across the borders or we cannot source in a clinically safe way.

[11:45]

What I can say, is that from next week - and I know Sativex has been available for some time on private prescription - but from next week Sativex will be available from consultants only; consulted in the hospital-only prescription at no charge.

2. Deputy M.R. Higgins:

Is the Minister aware that one of his ministerial colleagues has been having discussions with some local businessmen who wish to produce cannabis in the Island?

Senator A.K.F. Green:

I am aware of that. It is something that I support, providing it is done to good standards and clinically safe. It is something I would welcome. I read somewhere recently of a place in Europe where they are using an old bunker because they need to have a secure place to grow clinically produced cannabis. If someone wants to come up with such a plan I would support it.

3. Deputy G.P. Southern :

I rise to my feet on hearing 2 European countries, Holland and Portugal, being described as a source of safe supply of these sort of materials. I wonder to what extent we are dependent on a U.K. list of approved drugs and not an E.U. (European Union) list and whether that approval will be affected by Brexit, in whatever shape or form that occurs to us. Especially if it is crashing out of Brexit, of Europe, whether supply of drugs might be affected.

Senator A.K.F. Green:

If we were dependent on the U.K. list it is very simple to say none of these products would be available apart from Sativex because the U.K. do not intend to acknowledge the Barnes report. I have spoken to the Minister directly on that.  What we need to do is to ensure that we can get clinically produced product over borders into Jersey so that consultants can prescribe it, if appropriate to do so, to help those people who genuinely have long-term pain and I am keen to help, as I know the Members are.

4. Deputy G.P. Southern :

Can I just push the Minister slightly and say, in a general sense, will Brexit, does he believe, affect our supply of what is acceptable drugs in Jersey especially if we crash out of Europe?

Senator A.K.F. Green:

Difficult for me to answer that one completely, but I will have a shot at it insomuch as in some jurisdictions now the use of cannabinoid products is still illegal and therefore it has been difficult to find companies that were prepared to come through those countries to deliver the product to us. So it is difficult to answer whether Brexit will make a difference. I do not think it will but I cannot say definitively.

5. Deputy L.M.C. Doublet :

I think the Minister touched on this briefly. I just wanted to confirm about prescription charges. Will there be any prescription charges applied to any of these products?

Senator A.K.F. Green:

The plan is at the moment that they be available only by hospital consultant but there will be no charge.

6. The Deputy of Grouville :

As the Minister knows, constituents of mine have been holding out for medicinal cannabis, as he has met them, and it has been a great disappointment that it was not available by Christmas as promised. If the issue is bringing it into the Island, which I can understand, then surely it should be something that this Council of Ministers should be pushing to have it grown on Island, albeit securely. What sort of backing has he got from the Council of Ministers?

Senator A.K.F. Green:

The manufacture of any medicinal products, whether it cannabinoid or any other medicinal products, requires investment of millions and millions of pounds. I am aware that one of my ministerial colleagues is in discussion with someone who is looking at the possibility of putting that investment in and I support that. I have had a lot of support, including support from officers who have met with the Ministry of Justice to discuss our challenge in getting this product into Jersey. I think we have solved the problem now. As I say, Sativex, which was available before only private prescription, will now be available from next week free but only prescribed by hospital consultants.

7. Deputy M. Tadier :

I will want to follow up personally with the Minister on why these products, if they will be prescribed, are not available on free prescription, only available at the hospital. That seems illogical to me. I will ask the Minister whether he knows that in the U.K. currently and since 2016 a pharmaceutical company called CW Pharmaceuticals have been growing and do grow 30,000 cannabis plants for medicinal use in Kent. It seems to me that there is some scope for the U.K. who already have these products growing on their land. Will the Minister confirm that in fact when it comes to importation it is just as simple as getting a plane from Holland, putting the medicinal cannabis  on that plane, flying it directly to  Jersey, unloading the medicinal cannabis and that is the issue solved?

Senator A.K.F. Green:

I totally understand where the Deputy is coming from because until I got involved in this I might have had that view, but it is not as simple as that. It has taken a long time to even get companies that are clinically safe - so we know consistently what we are getting - to even speak to Jersey, but we are nearly there.