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Home > Dail Eireann. Leaders questions [Medicinal cannabis].

[Oireachtas] Dail Eireann. Leaders questions [Medicinal cannabis]. (06 Dec 2018)

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Deputy Mick Barry

This Sunday a 34 year old mother will leave her home in Wilton in Cork city and travel up to Dublin. On Monday she will head out to the airport and take the 7.50 a.m. Ryanair flight to Barcelona. Her name is Noreen O'Neill. She is the mother of a two year old boy, Michael, her first and only child. Michael will not be going on the trip as flying is not good for him. He was born with bilateral frontal polymicrogyria, a drug-resistant epilepsy. The condition caused Michael to suffer up to 20 convulsions per day before he even reached his first birthday. The Irish health service offered Noreen ten different anti-convulsive medications for Michael but, unfortunately, none of them worked. In January of this year Noreen began treating Michael with cannabidiol, CBD oil, which served him well and for four full months he was seizure free. When the seizures returned in the summer Noreen increased Michael's CBD dosage. He is now at maximum dosage but the seizures, far fewer than before the treatment began, have not gone away. Noreen tried to get a licence for tetrahydrocannabinol, THC, under the licensing system introduced by the Minister for Health, Deputy Harris. However, each one of the three neurologists she approached declined to apply for the licence, which left Noreen with two choices: watch her son stay gripped by seizures, as they possibly worsen, or go to Barcelona. Barcelona is the home of the Kalapa Clinic, which has been overseeing Michael's CBD dosage in recent months via Skype. It is at the Kalapa Clinic that Michael's first prescription dosage of THC is now being made up. Noreen O'Neill will fly back into Dublin Airport at midday next Wednesday with enough THC to last Michael until the end of January.


Does the Tánaiste feel any sense of shame that he is a Minister in a Government which forces Irish women to go abroad for healthcare for their children? Does he accept the very fact Noreen has to make this journey is a sign that the licensing arrangement is at best inadequate and falling short for many people? Will the customs officials take Noreen to one side next Wednesday and confiscate her child's medicine? Does the Tánaiste agree that the law should not be an ass and must change so as to provide for the healthcare needs of the population and to prevent this kind of situation from happening in future?


The Tánaiste

I am not familiar with the individual case to which the Deputy refers but I am familiar with the issue and I have been personally involved with other families affected by it. The cannabis for medicinal use access programme the Government is to implement aims to facilitate access to cannabis-based products or preparations that are of a standardised quality, and which meet an acceptable level of quality assurance under the manufacturing process. The programme will provide access for patients who are under the care of a medical consultant for the following medical conditions which have failed to respond to standard treatments: spasticity associated with multiple sclerosis, intractable nausea and vomiting associated with chemotherapy and severe treatment-resistant epilepsy, which appears to be the issue to which Deputy Barry refers in relation to Michael.


An expert reference group has drawn up operational, clinical and practice guidelines for healthcare professionals treating patients through the programme and has advised that cannabis oils should be used for the purpose of achieving accuracy and consistency of dosage for patients. Departmental officials are working on secondary legislation in the form of three statutory instruments which will underpin the access programme. The Government and I do not think it is appropriate that politicians are the ones making decisions as to what is appropriate health treatment for children or adults.


Deputy Ruth Coppinger

We did last night.


The Tánaiste

That was not in relation to drug treatment. What we are trying to do here is ensure that medical practitioners - consultant doctors - can work with families, like the family mentioned by Deputy Barry, to ensure that children are getting appropriate treatment and that we can import where appropriate treatments that are not available in Ireland. The Minister has shown more than willingness to facilitate the licensing for that on application. I am not aware of a single application that has come from a consultant to import medicinal cannabis that has been refused. There is a process here. A number of Deputies have repeatedly raised the issue to try to ensure that we have a streamlined system that works with families. That means mothers do not have to travel abroad, to Amsterdam, Barcelona or elsewhere to bring back products, and that we can have a system where in certain circumstances children can access drugs that need to be imported from abroad. However, that does need to be in the context of the supervision and recommendation of a consultant doctor, who is trained to make medical decisions in the interests of patients.


Deputy Mick Barry

There is a system in place but the system is not working. There are thousands of people in this county who need medicinal cannabis, sometimes for their children. How many have got the licence? Only 12 have got the licence, which means that less than 1% of people who need it have got it, and 99% of people who need it have not got it. One of the reasons for that is there is a chill factor for neurologists. THC is still illegal below a very low dosage and neurologists are nervous about that. THC is a schedule 1 drug that is not prescribed for medical purposes. That needs to change to the way it is in the Netherlands.


The Tánaiste said that people should not have to go abroad under the system but people still have to go abroad even if they have the licence. Vera Twomey has to go to the Netherlands in order to get the treatment for her daughter Ava, as do other people who have licences. Even if one is lucky enough to be in the 1% the Government still forces people to go abroad for the healthcare needs of their children. This is going to be a big issue in the next week. Noreen will post reports on her Facebook page, including videos of her travel experience and her journey. People will watch that and they will look very carefully to see what the customs officials do next Wednesday, whether they take her aside and confiscate medicine that her child needs or recognise reality and allow her back into the country with the medicine that is needed for her son.


The Tánaiste

I put it to the Deputy that these issues need to be resolved in a way that prioritises the healthcare of the children. By and large, it is children we are talking about. Only 12 applications for import licences have been made and they have all been granted. The Minister has shown a willingness to try to ensure that when a doctor seeks an importation licence for a patient in his or her care, that licence is given quickly. We are also trying to ensure neurologists understand that these products are available, although they are somewhat limited in terms of where we can source them from. My understanding is that only Netherlands and Canada are licensed to export these products. Department of Health officials are working intensively to try to ensure that we can streamline the process for appropriate drugs or cannabis products to come into Ireland so that children can get the treatment they need when then need it. That is perhaps a different thing from what Deputy Barry is asking for. The only focus of the Government and the Minister is to ensure that appropriate products of the right standard are being used by patients in Ireland under the supervision of doctors. We are working with the families concerned to ensure the process operates in a timely and streamlined manner.

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