Gibraltar closely monitoring UK changes on cannabis medicines

The GHA will conduct a detailed study of new UK regulations relaxing the rules on prescribing unlicensed cannabis medicines to patients, before considering whether to follow suit in Gibraltar.

Any subsequent recommendations will be referred to Gibraltar’s Drugs Advisory Committee within the next few weeks, a Gibraltar Government spokesman told the Chronicle.

This follows the publication of new regulations in the UK which alter the rules about the circumstances in which the products can be given to patients.

The move means medicines can be prescribed by a specialist doctor - not a GP - on a case-by-case basis.

New NHS guidance says a decision to prescribe cannabis products should only be made where other treatment options have been exhausted.

And yesterday, the GSD urged the GHA to consider the regulations ‘in detail’.

Setting out its position on the subject, the GSD said: “These medicinal products should be available to alleviate the suffering of specific patients who are identified by doctors could benefit from these.

“It is essential therefore that these decisions are led by clinicians and taken within a well-regulated system of medicinal products,” the party said in a statement.

But this drew a stinging rebuke from the Gibraltar Government yesterday evening, which described the GSD’s statement as “both misleading and contradictory to their previous position on this important matter”.

The Government said: “In their hurried attempt to jump on the medicinal cannabis bandwagon, the GSD have misunderstood an important fact: the UK legislation which commenced today allows Specialist consultants registered on the GMC Special Register to prescribe the use of unlicensed cannabis medicines, albeit under very restrictive conditions, as long as they are satisfied that it is safe to do so, where there is a clinical need which cannot be met by a licensed medicine and where established treatment options have been exhausted.”

“Therefore, the UK’s new legislation falls well outside the remit of a ‘well-regulated system of medicinal products’ that the GSD advocate for,” it added.

Additionally, Independent MP Marlene Hassan Nahon has reiterated her call to Government to take serious action on making derivatives of the cannabis plant available for medicinal use in Gibraltar.

The GHA said it has been closely monitoring developments in UK for some time and had noted the change of guidelines, which were announced yesterday.

“As is to be expected, these new guidelines are highly restrictive,” the Government spokesman added.

“They contain numerous detailed checks and new procedures, including the need for relevant clinicians to be registered in the GMC’s Specialist Register.”

In February last year, the Gibraltar Government changed drug regulations to allow doctors to prescribe the cannabis-based medicine ‘Sativex’.

The cannabis-based oral spray treats symptoms of Multiple Sclerosis and had been approved for healthcare use in the UK.

The UK decision to relax the rules on the prescribing of these products follows several high-profile cases, including that of young epilepsy sufferers Alfie Dingley and Billy Caldwell, whose conditions appeared to be helped by cannabis oil.

Alfie's mother Hannah Deacon welcomed the move when it was announced, saying: "I have personally seen how my son's life has changed due to the medical cannabis he is now prescribed.

"As a family we were facing his death. Now we are facing his life, full of joy and hope which is something I wish for each and every person in this country who could benefit from this medicine."

Billy's mother, Charlotte Caldwell, said she wept tears of joy at the move.

She said: "Only relatively recently did our Government and country really start to appreciate just how many wee children and people of all ages were affected by the difficulties associated with accessing medicinal cannabis.”

"But once it became clear that it wasn't just about what was perceived to be a small number of very sick children, and that medicinal cannabis could make a life-changing or life-saving difference to more than a million people, the overwhelming support of the public and the incredible speed of reaction of the Home Secretary has delivered an utterly amazing result."

The decision to reschedule the products came following a specially commissioned review.

An initial review by chief medical adviser Dame Sally Davies concluded that there was evidence medicinal cannabis can have therapeutic benefits.

The Advisory Council on the Misuse of Drugs (ACMD), which carried out the second part of the review, then said doctors should be able to prescribe medicinal cannabis provided products meet safety standards.

The new law will not limit the types of conditions that can be considered for treatment and it means doctors will no longer need to seek approval from an expert panel in order for patients to access the medicines.

LOCAL REACTIONS

The Gibraltar Government said it has been closely following the developments in the UK and has been taking clinical advice on this matter from the GHA.

“Now that the UK’s position is clear and enshrined in law, the GHA and the Drugs Advisory Committee will carefully consider how to proceed in Gibraltar.”

“The UK’s guidance will be meticulously scrutinised to assess their suitability for application to Gibraltar.”

“The extremely restrictive conditions that the UK impose on such prescriptions will require further careful consideration as to whether it would even be possible to apply exactly the same law to Gibraltar as the GSD propose.”

It added that the safety of patients is, as always, the paramount concern.

“There are a number of complex clinical and regulatory issues that arise, and the UK’s legislation will need to be very carefully considered before any decision can be made as to the feasibility of allowing medicinal cannabis prescriptions in Gibraltar, and on what grounds.”

“Once again, the GSD have jumped on a bandwagon without doing their due diligence and without even comprehending how the new UK legislation actually goes against their own stated position,” the Government said.

For its part, the GSD said it believes it would be beneficial for Gibraltar to very seriously consider the evidence and studies undertaken in the UK in order to establish how such an initiative can be adapted here.

Shadow Minister for Health Lawrence Llamas said: “Essentially, a lot of the ground-work has been done in the UK. GHA clinical management should consider the guidelines in detail and see how best to allow medical professionals the ability to prescribe medicinal cannabis under the GHA GPMS scheme.”

In setting her views on the UK move, Mrs Hassan Nahon took a swipe at the GSD and its stance on the topic.

She said: “I am pleasantly surprised if not a little perplexed to read the GSD’s official statement today on this issue in light of my campaign for the last two years where I have been the lone political voice and where my position has been mocked and criticised by the GSD.”

“This was especially the case during my motion to Parliament where I called on Government to change the rules.”

She added that the GSD’s U-turn is welcome, “…despite the late stage in the debate and once, as usual, others have led on it.”

“Nevertheless, the GSD’s position is still highly contradictory because they have always been against the provision of unlicensed cannabis products -something they made clear in Parliament- and this guidance from the UK, once the safeguards have been absorbed, allows medical professionals to issue totally unlicensed products,” she said.

Ms Hassan-Nahon said the party would do well to re-read the new guidelines and ensure their new campaign is consistent with their party’s position on this matter in order to avoid confusing the public any further.

“At the motion I tabled and debate we had in Parliament, where both the GSD and GSLP shot down my motion calling for a change in the law, the Government did stand by a nuanced position in connection with patient safety, implying a solution could be reached once this was achieved,” she said.

“Now that the guidance has been issued, I call on Government to urgently review the position so that guidelines can be modified, bringing in the necessary legislative changes, and check and balances for our local circumstances.”

“Every day that passes, is another day that many of our local patients in extreme pain could benefit from medicinal cannabis. I therefore urge the Health Ministry to address this issue as a matter of priority.”