Wednesday, 13 March 2019

Questions (4)

Gino Kenny

Question:

4. Deputy Gino Kenny asked the Minister for Health the steps he will take to address the issue of those with a licence to use cannabis medicinally having to travel to the Netherlands regularly to obtain their prescription; if the establishment of a distributive system similar to that in the UK and Northern Ireland (details supplied) will be considered; and if he will make a statement on the matter. [12082/19]

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Oral answers (8 contributions) (Question to Health)

I am disappointed the Minister for Health, Deputy Harris, is not here. He seems to be the Scarlet Pimpernel of the Dáil these days. My question relates to the families who have to leave the jurisdiction to fill a medical cannabis prescription in Holland. It is an onerous and unworkable imposition. I await the reply.

I have already addressed the absence of the Minister for Health who is out of the country. The Minister is working towards the introduction shortly of a cannabis for medical use access programme. While the arrangements to enable this programme to begin are being finalised, it is open to a registered medical practitioner to apply for a ministerial licence under the Misuse of Drugs Act 1977. Such a licence, if granted, enables a practitioner legally to prescribe medical cannabis for a named patient. It is important to note that the decision to prescribe such treatment is a clinical decision for the prescribing doctor. Until acceptable medical cannabis products are available for use in Ireland, patients who are the subject of a licence are obtaining their cannabis products from a pharmacy in the Hague. Under the policy of the Government of the Netherlands, cannabis oil products are not permitted to be commercially exported from that country. Notwithstanding the fact that such cannabis products might eventually be listed as products that may be accessed under an Irish programme, anyone who is prescribed these products will have to travel to the Hague to obtain them, unless the Dutch export barrier is removed.

The Minister for Health is aware that a UK company may provide a service which involves it collecting cannabis products from the Netherlands for persons authorised to use it under the UK's medical cannabis regime. While this company can import medical cannabis products into the UK from the Netherlands, the UK authorities do not currently allow re-export from the UK to other countries, including Ireland. I have been informed that the UK company may be acting as patients' nominated representative in the collection of their personally-prescribed medical cannabis products. No similar Irish entity is known to provide this service, but it is certainly open to any patient to engage a representative to act on his or her behalf.

I am sure the Minister of State will agree that this situation which requires people to leave the jurisdiction to obtain a prescription is ludicrous. I cannot think of any other medicine in respect of which a patient or nominated person must travel to another jurisdiction to bring a filled prescription back. It becomes even more ludicrous. A family in Newtonards in County Down who have given me permission to speak today do not have to go to Holland as a distribution company brings the medicine to a named pharmacy for them. In the case of Vera Twomey, however, her husband Paul has travelled to Holland in the last two months. The pharmacy there told him the prescription could not be filled for the next six months. It is a completely unworkable scenario in both the short and long term.

I appreciate the Deputy's consistency on the issue and his diligence in raising the difficulties families are experiencing. We want to introduce a medicinal cannabis access programme to address those difficulties. In the meantime, however, we must deal with the difficulties and challenges presented by the law of the Netherlands on exports. We recognise the difficulty that presents to families, but until we get our own programme up and running, we have to operate in that context.

Most people listening to this discussion will not understand this. Given that 16 licences have been granted to 16 individuals in the State, one would think the State would intervene to provide a distribution company to go to Holland and bring the product to those 16 individuals' pharmacies. That would be the logical thing to do. Currently, the cost of reimbursing the travel and the inconvenience are very stressful for the families. The substantive issue is the cannabis access programme which has been mooted for the last two years but is still not up and running. Individuals continue to have to go their specialists who will say in the majority of cases that they do not know enough about the product and situation to prescribe it. It is an unsustainable situation. The access programme must be implemented so that people do not have to leave the jurisdiction but can get the medication in their local pharmacies while being reimbursed by the HSE.

I agree wholeheartedly with the Deputy. We share the same desire to have our own medical access programme implemented in its entirety, not in a piecemeal way. We can divert our attention to address the issue in a piecemeal way or we can implement our own programme in full, which is a much more sustainable solution. The latter is where we are putting our energies, focus, time and effort.

When will the programme be up and running?

We do not have an end date. As the Deputy will appreciate, there are a lot of issues to address to bring the programme about. It is not that it is not being done. It is mentioned every month at our management meeting in the Department of Health.

We get updates on progress but I do not have a timeline for when we hope to have the programme established. The Deputy will appreciate the number of issues and challenges involved in establishing it for this country.