Oireachtas Joint and Select Committees

Wednesday, 5 April 2017

Joint Oireachtas Committee on Health

Cannabis for Medicinal Use Regulation Bill 2016: Discussion

1:30 pm

Photo of Rónán MullenRónán Mullen (Independent)
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I thank the witnesses. I also thank my colleagues because I am approaching this from a lower knowledge base, I suspect, than other people present. I told Deputy Gino Kenny when we discussed this privately that I have no skin in this game, so I wish to give the Bill the fairest hearing and consideration. Anything that purports to bring relief to people who are suffering deserves serious consideration. However, I will ask devil's advocate questions, because it is the only way I can understand what is happening here.

It is not usual for campaigns for improvements in the provision of medicines to be as political as this campaign appears to be. Dr. O'Grady and Deputy Gino Kenny are well known for their socialist political activity and that is absolutely fine. It does not mean that anything they have said here today is untrue. However, it strikes me, as an outsider, that it invites scepticism when the push for change does not appear to be coming from the people we usually trust as the arbiters of what constitutes good medicine. I doubt that Dr. O'Grady or Deputy Gino Kelly will disagree that this is, as it were, a public relations problem for a campaign starting among, and led by, politicians. The case for the prosecution, unfair though it may be, will be that there is a group of politicians coming from a particular political wing and, critics will say, holding out false hopes for people and gathering another constituency, the better to march forward and so forth. That is not my view, but the case for the prosecution. The case for the defence appears to be that the witnesses have spotted something that other countries have noticed but which the medical establishment in Ireland has not yet noticed.

Is Professor Finn free of any political skin in this game? Is he coming to this as an academic professional? Has he, for example, received research funding in this area? I have looked at his biography and it is very impressive. Has he received research funding for his work with cannabinoids? Can he tell us about that? What do his peers say? Professor Finn is involved in the Irish Pain Society, but what do other people in pharmacology in this country and abroad tend to say? Is Professor Finn in a minority or in an emerging majority? He said a little about why things are as they are in terms of the lack of support. What is the position of the Irish Medical Organisation, IMO, the Irish College of General Practitioners and the Irish Pharmacy Union on this? The Irish Pain Society dissented respectfully from the HPRA report and I saw the three circumstances where it says that if permission is to be given, it should be along those lines. The concern of the Irish Pain Society is that chronic pain is not included.

The witnesses referred to the countries that have made changes, which included Germany.

Is that on the back of the medical establishments the witnesses have not quoted in terms of their support? Have the equivalent medical establishments in those countries changed their views or has it happened without prejudice to what they may or may not believe? In other words, are the recognised bodies in Ireland, namely, the Pharmaceutical Society of Ireland, the Irish Medical Organisation, IMO, and the others I mentioned, out of step with their equivalent organisations in the other countries where this has been legalised?

Given that the pharmaceutical industry is massive and well-funded, are we talking about legalising products people can smoke? I think I understood from what Dr. O'Grady said that it is not primarily that but that it is tablets. Are these tablets made by well-known, recognised pharmaceutical companies? Are they on sale internationally but not in Ireland or other countries that have not changed the law?

I am not comfortable with individual cases being mentioned as the lever with which to get change because whatever care and concern one might feel for those cases, one wants to arrive at a decision about the legality of certain products as medicines in a more dispassionate way. I am concerned that it appears to be a problem that a consultant is required. Whether a consultant has legal status or not, if there is controversy about whether certain products should be provided or allowed as medicines, and there is controversy, surely one should seek the reassurance that, say, a consultant holding a recognised post would be required to sign off on certain items. That would appear to be more in step with the precautionary approach one would normally take in such matters, asking as a non-medical person.

The point was made that since it is not legal in Ireland we cannot know, but does that not point to the need to establish legality for research projects which seeks to establish first whether the case for such medicines is beyond doubt, one presumes on the balance of probabilities? As opposed to the "legalise and let us see" approach, should we not be talking about providing in law for the carrying out of certain research? Has that gone on in other countries and has it led to named products emerging onto the market of the kind the witnesses would like to see available across the counter in Ireland?

I believe the witnesses have no problem with there not being a cannabis regulation authority. Their case is that this should be regulated like any other drug. They used the word "certificate" so presumably they have no problem with this being a prescription drug and that it is a defence in law then to say that these drugs are being used on foot of a doctor's prescription. I presume none of that would be controversial to them.

Is Professor Finn in total agreement with everything that has been said by his colleagues here, up to and including the case for this Bill?