Mr. Eugene Lennon:

Yes. We have informed both health professionals and patients that this continues to be the case when they contact us. The reluctance comes from the fact that many consultants are not happy with the state of the clinical evidence.

Deputy Durkan asked the difference between medicinal cannabis and cannabis, which is interesting. Sometimes the terminology can be used to distinguish between street cannabis and cannabis that people wish to take for medical purposes. Sometimes the cannabis is the same in the sense that it is the same dried cannabis material that is grown. It is the whole-plant cannabis that Deputy Gino Kenny referred to. It is available in certain countries, such as Canada or the Netherlands, and one can get a tub of leaf cannabis. It is the same material that people might smoke illegally in a recreational way. In other cases, what people refer to as medicinal cannabis has been processed further into an oil, powder or some other form. It is the same constituent material and there are different strengths to cannabis, as there are with recreational or illegal cannabis. There are different strengths of THC and CBD when cannabis is used for medicinal purposes. It is the same material and the purpose can be different. Sometimes the form is also different. There is an cannabis product, Sativex, which is authorised for treatment of multiple sclerosis and there are synthetic cannabinoids that are authorised, including Nabilone. There is a pure CBD product going through clinical trials now that is called Epidiolex. It is at phase 3 trials and some of the health professionals working in the epilepsy are quite interested in seeing the results of the next stage of those trials.

There is the question of indemnity. We checked with the State Claims Agency and it indicated that if a consultant is prescribing cannabis, either under licence from the Minister or part of the access programme, he or she will be covered by the clinical indemnity scheme in those cases. I suppose in the way it is operating currently, the treatment must be endorsed by a consultant in either through licence or the access programme.