Violet-Anne Wynne (Clare, Independent) | Oireachtas source

I am delighted that this Topical Issue was selected and thank the Office of the Ceann Comhairle for facilitating this important discussion. It is an issue I am very passionate about and I hope to shed a bit of light on what the medical cannabis access programme, MCAP, and the ministerial licence mean.

As we all know, the MCAP was established in 2019 as a five-year pilot scheme. However, the programme has shown limited reach. Data released to me shows that in the first quarter this year, a mere 53 patients have managed to secure access. Alarmingly, there were zero enrollees for the first three months of this year. I believe since March, a further two, or possibly four, have managed to enrol, but for a programme that was intended to ensure accessibility for patients, I am sure the Minister of State will agree the numbers are stark.

In contrast, the ministerial licence, also established in 2019 as an alternative means of obtaining medical cannabis, has witnessed a markedly higher uptake of 319 accepted applications, with one accepted in the first quarter of this year. This shows that there is a much greater need and demand for what the MCAP currently allows and the programme must be expanded immediately. The ministerial licence has its complexities. The HSE stated it commits to reimburse patients for cannabis products obtained via this route, but that is only if prescribed for one of the three qualifying medical conditions recognised by the programme. That is a bit of a contradiction in itself that I will refer to later in my contribution. It is imperative that I outline the three conditions. They are spasticity associated with multiple sclerosis, MS, intractable nausea and vomiting associated with chemotherapy and severe refractory epilepsy. I will focus on these three conditions.

Access for patients with spasticity, but not patients with MS more generally, seems very specific. I know of patients with MS who have relayed huge frustrations to me about this. Intractable nausea and vomiting associated with chemotherapy, but not cancer patients, is covered by the scheme. Again, that is very specific and restrictive. That the definition of the final condition includes the word "severe" seems unnecessary, as refractory epilepsy already implies that medicines have not worked or do not work at all to control seizures.

Whether the Government intended to do so, it ensured access for only those three specific conditions. We were all optimistic when the programme was first announced. However, five years on it is disappointing that the numbers show just how restrictive it is. It is concerning as all of those patients who access the ministerial licence are doing so because they are not eligible for the MCAP pathway and are excluded from applying.

The absence of an eligibility criteria for the ministerial licence reflects a broader demand and necessity that exceeds the MCAP provisions. There is a pressing need for the expansion of the scheme, underscored by the higher patient numbers utilising the ministerial licence. That indicates that the current MCAP is overly restrictive.

Patients accessing the ministerial licence worked tirelessly with their medical professionals to complete what is called the ministerial licence. There are issues with the scheme, however, and the main one I want to point to is the fact that patients get no financial assistance. Medical cannabis is by no means cheap for patients who are trying to obtain treatment. The numbers speak for themselves. In light of these findings, these numbers are not just statistics but rather a testament to the urgent need for reform and the voices of patients calling for change.

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