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Mr. Burns: I am sorry, I do not have the time to give way.
In 1995, following requests by a number of bodies that information about beta interferon would be helpful, the NHS executive issued circular EL(95)97 and clinical advice from the Standing Medical Advisory Committee to help the NHS plan for and manage the introduction of this new treatment. The guidance--a central framework to help the NHS reach decisions at local level--was developed with a number of key bodies, including the Association of British Neurologists, general practitioner representative bodies and the Multiple Sclerosis Society.
Briefly, the guidance suggested that, because of clinical considerations--that is, because beta interferon 1b was a new treatment--to ensure that it was targeted at those people who were most likely to benefit from it and to help monitor and evaluate its effectiveness, the treatment should be prescribed only by hospital neurologists where it was judged to be clinically appropriate, and within local agreements between health authorities and hospitals.
Arrangements are in place for assessing patients and, where appropriate, prescribing treatment. More than 300 patients in England are receiving beta interferon
1b through hospitals. That includes approximately 30 patients in East Lancashire health authority, which covers the constituency of the hon. Member for Pendle.
I am not aware of any health authority which is refusing to purchase or prescribe beta interferon. However, as with any procedure--but particularly when the procedure is new and still relatively untested--there is no single view within the NHS about the precise circumstances in which the treatment should be available. Consequently, prescribing across the country will not necessarily follow a uniform pattern. That is consistent with the arrangements for setting priorities and reaching decisions within the NHS.
It has been suggested that the Government should spell out at a national level precisely what treatments the NHS should provide. We do not think that that would be right. No list of treatments could ever hope to accommodate the range and complexity of the different cases that individual clinicians face all the time. Such a course would be too inflexible to take account of the different needs of individual patients, and would prevent clinicians and managers from carrying out different alternative approaches that could be of benefit to patients.
The Government have, however, made it clear that health authorities should not, as a matter of principle, decide not to use any clinically effective treatment. Even when the effectiveness of a procedure is not in general judged to be high, it might be both effective and appropriate in certain circumstances for an individual patient. That message was repeated in our recent White Paper, "The National Health Service--a Service with Ambitions".
I shall deal briefly with the point about the therapeutic use of cannabis. I shall write to the hon. Member for Pendle in the next few days about the issues with which I am unable to deal because of the time. My ministerial colleagues and I are aware of, and concerned about, the distress experienced by people suffering from multiple sclerosis, and we have carefully considered the representations made to us that cannabis should be made available for medicinal use.
The therapeutic use of cannabis is a complex issue, and it may be helpful if I address some of the most important considerations. Under section 7 of the Misuse of Drugs Act 1971, cannabis and certain other drugs are controlled, because it is in the public interest for their production, supply and possession to be either wholly unlawful, or unlawful except for the purpose of research or other special purposes; or for it to be unlawful for doctors to supply them except under licence from the Home Office. The controls imposed by the Act conform with the international restrictions covering those drugs.
We are committed to ensuring that patients receive the drugs they need to treat their clinical conditions. Before a cannabis-based medicine could be prescribed, a company seeking a licence would have to present the supporting data--which would have to demonstrate the medicine's safety, efficacy and quality--to the Medicines Control Agency, in the normal way. The MCA would then evaluate it, and, if it were able to approve it, notify the Home Office.
We understand the desire of people with multiple sclerosis to explore every avenue to seek relief. It would, however, not benefit those people if we were to disregard the procedures that have been set up to ensure the safety, efficacy and quality of prescribed drugs. We have to take account of all the considerations, including the potential risks associated with short and long-term use of cannabis, and consider whether any benefits--which must have been proven scientifically--outweigh those risks. We already know that there are side effects from the use of cannabis.
We have received a wealth of anecdotal evidence of the efficacy of cannabis in treating some of the symptoms of multiple sclerosis. A matter as important as people's health, however, should not be taken lightly, and hard, scientific, research-based evidence is required. The conclusions of available research are not very convincing, due to the limited scope of the projects, the use of small cohort groups, or the lack of suitable scientific methodology.
I understand that the Multiple Sclerosis Society has taken positive steps to encourage trials, by offering support to researchers. The main agency through which the Government sponsor medical research is, of course, the Medical Research Council, which is always willing to consider scientifically sound proposals.
Current legislation does not prevent research into the medicinal use of cannabis, provided that a Home Office licence has been obtained for that purpose. For the purposes of a clinical trial, which involves sale or supply of medicinal products and various other specified activities, a clinical trial certificate or clinical trial certificate exemption would also have to be obtained from the Medicines Control Agency.
We are therefore not in a position to allow the therapeutic use of cannabis. It is up to researchers and companies wishing to market a cannabis-based product to supply the necessary scientific evidence of its therapeutic value, if any, in the first instance. They would also have to consider the form in which cannabis could be made available for use as a medicinal product in a controlled dose. As long as we have no evidence, on the grounds that I have just outlined, it is not possible to allow the therapeutic use of cannabis.
Once again, I thank the hon. Member for Pendle. I appreciate, as he will know, that I have not dealt with every issue because of the shortness of time.
Mr. William O'Brien:
Hear, hear.
Mr. Burns:
There is no point in the hon. Gentleman saying, "Hear, hear," because it is not his debate; I was concentrating on the speech of the hon. Member for Pendle, because I appreciate the sincerity of his concerns about those who suffer from MS. The Government are equally concerned, and we are all determined to do all we can to alleviate the suffering that they sadly have to go through.
Question put and agreed to.
Adjourned accordingly at half-past Ten o'clock.
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