MPs' reflect on 5 years of medical cannabis prescriptions

Shifting politics

Central to this conversation were our elected officials - the MPs. Members of Parliament represent the citizens of their local constituency, which they are voted into. Patients from all over the country contacted their MPs to plead for support, but this did not guarantee their delegate would voice their concerns in parliament. 

MP's and the plight of UK medical cannabis patients

Thankfully, a brave few MPs made it their mission to draw attention to the plight of patients living in their part of the country and challenged the existing policy for harming, rather than protecting, their constituents. 

Not only was it highlighted as inhumane to withhold life-saving medicine from patients in need, but the competing interests of some MPs, who were profiting from medical cannabis produced in the UK whilst suggesting that it had no medical benefit, were exposed. 

Releaf thought it would be good to touch base with some of the MPs vocal about medical cannabis reform during the campaign to find out if they think the law change has succeeded in helping solve patients' problems with access. 

Competing interests in Downing Street 

The legalisation of medical cannabis was an uphill battle for several reasons. There had been a long-running anti-cannabis media campaign in the UK that demonised high-THC cannabis, making the subject emotive. However, some more systemic issues were eventually brought to light, which helped shift the public narrative and political opinion. 

Crime Minister Victoria Atkins and her husband Paul Kenward, the CEO of British Sugar were subject to media scrutiny regarding their commercial interest in medical cannabis. Now Secretary of State for Health and Social Care, Victoria Atkins has announced that she will recuse herself from matters relating to medical cannabis due to this conflict of interest.

Ground to gain 

Recently, there have been a few little wins for the medical cannabis sector. Medical cannabis prescriptions can now be written using digital prescriptions, helping to streamline the logistics behind the scenes for clinics and pharmacies. It is also possible to prescribe, allowing patients to pay for products in a manner that suits them best. 

Even with these gains, larger, more complex advances must be made. Industry leaders with experience winning these challenges in other countries are also keen to make improvements in the UK.

As such, the medical cannabis campaign in the public eye and politics presses on looking to amend some elements of the policy that are creating restrictions to the cost and prescribing to greater numbers of patients. 

The push for wider medical cannabis prescriptions

The Cannabis Industry Council is lobbying the government to allow GPs to prescribe medical cannabis, and there are calls for a broader range of conditions to be accepted. Patients are also keen to receive their cannabis prescription on the NHS. Still, the kind of clinical evidence asked for has yet to appear. Whilst cannabis is a Schedule 2 drug, to many in the industry, this feels inappropriate and still too restrictive, raising calls for the scheduling to be further reduced. 

But how do MPs who campaigned for the medical cannabis laws we operate under now feel about the way the industry is working? In their opinion, has the law fixed the problem, or do they agree with the professionals in the industry that there is still a long way to go? 

Let’s hear who had what to say.

Ronnie Cowan, Scottish Nationalist Party

Ronnie Cowan has served as the SNP Member of Parliament for Inverclyde since 2015. As an MP, Ronnie has been involved with multiple drug policy reform initiatives and is the Vice Chair of the All Party Parliamentary Group on Medical Cannabis Under Prescription and Drug Policy Reform. Alongside this, he is also Co-Chair of the Industrial Hemp and CBD Group, a Trustee for the children's epilepsy charity Intractable and an ally to the Cannabis Industry Council. 

Being one of the most vocal MPs on the issue of medical cannabis has earned Ronnie Cowan a trusted reputation among medical cannabis patients who have struggled to gain the support of their own MPs. Rather than allowing policy to be bent around what other politicians think it should be, he campaigns for policies that adhere to the very important needs of patients. 

Releaf asked Mr Cowan how effective he thought the law was at serving patients' needs five years later. 

How did you feel when the announcement was made that patients could get a legal prescription from a doctor? 

I was elated; this was the breakthrough we had been campaigning for. It felt like the UK government finally got it, and the future for those requiring medical cannabis was going to be a better one. 

Has the law worked as well as you thought it would? 

It has been an unmitigated disaster. The UK government clearly didn't understand the problem, and their idea of a solution has let down many people and sadly led to a great deal of confusion regarding this matter. We now have politicians and medical professionals blaming each other for the lack of NHS prescriptions, and the patients continue to either go without or face substantial monthly bills for private prescriptions. 

What improvements could be made to the current policy? 

I am currently investigating amendments to the bill along with the Cannabis Industry Council. Politicians need to create an environment where the necessary research can be done. This may involve rescheduling cannabis, and then academia can develop its knowledge and possible outcomes. Then, we need the medical profession to train people to understand the uses of medical cannabis and finally be prepared to prescribe it on the NHS. 

What can people out there do to try and help get these changes implemented?

Personal stories of use and benefit are always helpful politically; notably, they give hope and guidance to many. Unfortunately, while cannabis remains illegal, many people will still live in the shadows when it comes to telling their stories for fear of prosecution. 

On November 8th at Westminster in Portcullis House, I sponsored a room for the charity Intractable Epilepsy, of which I am a trustee, to present their stories to MPs. Many children suffering from epilepsy will be present. Hopefully, we can bring cross-party pressure to bear on the UK government. 

Norman Lamb, Former Liberal Democrat MP for North Norfolk

Norman Lamb retired from politics in 2019 after 18 years serving his local constituency. Once a Home Office Health Minister during the Conservative-Lib Dem hung parliament, Lamb used his position to try and further discussions about medical cannabis. 

He became one of the most prominent voices in the campaign to legalise medical cannabis between 2015 and 2018. Using his position in parliament to speak on behalf of patients who were denied a prescription through the NHS but were being criminalised for self-medicating earned the Norfolk MP a great level of respect. 

Norman went to Canada as part of a BBC documentary looking into medical cannabis regulation, even trying a tincture to help with sleep. In 2019, he gave a speech at Cannabis Europa and discussed the hypocrisy surrounding medical cannabis legislation in Westminster. 

Since parting ways with electoral politics, Norman has started a consultancy, founded the Sir Norman Lamb Mental Health and Wellbeing Fund in Norfolk, and is Chair of the South London and Maudsley NHS Foundation Trust. He continues to campaign for improvements in mental health care. Releaf caught up with him to find out his feelings about medical cannabis five years on. 

How did you feel when the announcement was made that patients could get a legal prescription from a doctor? 

I felt, at the time, that this was a very significant breakthrough in policy terms for the United Kingdom. I took the view, then and still do, that there should be general legalisation of cannabis following the lead taken by Canada and several US states. However, I felt that the announcement that patients would be able to get a legal prescription from a doctor was, in itself, an important step which could potentially relieve suffering and improve wellbeing for many people.

Has the law worked as well as you thought it would? 

 
No, the law has not worked as well as I thought it would. My understanding of the position is that there are now several private clinics which will prescribe medicinal cannabis. But accessing cannabis products via the NHS is almost impossible. I understand that the number of NHS prescriptions for cannabis products has been tiny, benefitting literally a handful of people. 

So we have a situation now where those with money can access help with a range of conditions from private clinics, but those who are unable to afford the cost of a private prescription are left without the help that we believed would be available when the announcement was first made. 

What improvements could be made to the current policy? 

 
I have no expertise on ways in which change could be made to ensure that people could get access to products via the NHS. However, I believe that policymakers should look to Canada, in particular, but perhaps also some other European countries, for precedence for how a policy could work which could give widespread access at an affordable price to people who could benefit from cannabis products.   

What can people out there do to try and help get these changes implemented?

 
I would encourage anyone who wants to see practical help for those who cannot afford private prescriptions for cannabis products to lobby their Members of Parliament to demand change. The logic of the position is that I am sure when the announcement was first made, the expectation of both the government and the public was that cannabis products could be accessed via the NHS for medicinal purposes, and the fact is that that has not been delivered. So, changes are necessary in order to make good on the intention of the original announcement. 

What are your thoughts on how the Police have changed their approach since medical cannabis was legalised? Are you aware that some patients with valid medical prescriptions have had their medication taken from them? 

 
I am concerned that there appears to be a lack of knowledge on the part of the Police in many parts of the UK as to the legality of prescribing medicinal cannabis. It would seem to me, therefore, necessary for there to be education and training for police officers to ensure that they all have an up-to-date understanding of the law.

FAQs

How many people are prescribed medical cannabis in the UK?

While there is no definitive answer to this question, estimates suggest that at the end of 2023, there were roughly 47,000 patients receiving legal medical cannabis in the UK.

Can cannabis be prescribed by GP?

In the UK, only specialist doctors listed on the General Medical Council’s Specialist Register can sign off on prescriptions for medical cannabis. These doctors must have proven expertise in the condition they are prescribing for and follow strict guidelines set by the Royal College of Physicians (RCP).

However, GPs can and do work for medical cannabis clinics in the UK. GPs and registered nurses can hold follow-up appointments with patients in the UK under shared care agreements, issuing repeat prescriptions when appropriate, which are then signed off by a specialist. 

What can we take away from this?

The MPs we spoke to were pleased that the law had changed in 2018. However, the MPs who campaigned for the change are aware that it hasn't been the silver bullet solution that they thought it would be and that the most vulnerable patients whom the law was supposed to be changed for are the ones least able to access it. 

The restrictions mean access to NHS prescriptions is severely limited and children with epilepsy are still waiting for the NHS to approve access. The NHS is still waiting for clinical trials to provide the evidence to support prescribing to children. There is broad support for the government to allow GPs to prescribe cannabis to their patients to widen access. 

Police officers still being unaware of the law, and mistreating patients who have paid for a private prescription is worrying to MPs, who urge for police training to be updated.

Releaf understands the importance of medical cannabis in treating various medical conditions. With our tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, you can access the treatment you require without worrying about the stigma.