Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I thank the Minister of State for taking the question. The Minister for Health, Deputy Simon Harris, recently met the parents of Ava Barry and called for a review of cannabis-based medicines. Sativex is a cannabis-based product which was approved in 2014 but is still not available to multiple sclerosis sufferers. I understand the Minister's hands are tied, up to a point, by the existing law. The Cannabis for Medicinal Use Regulation Bill 2016 will deal with the long-term effects of the grey area of cannabis-based products. In the short term, I will try to untie the Minister's hands by asking him to facilitate compassionate access under the exempt medicinal products statutory instruments and any other means at his disposal, particularly in the cases of Ava Barry and Ronan Gaynor.

Ava is a beautiful six year old child who has Dravet syndrome, which involves intractable epilepsy, often with dozens of seizures a day. The condition is known to respond well to cannabis-based products. Ronan Gaynor is a four year old boy with a very rare form of brain tumour called diffuse intrinsic pontine glioma. It is a very rare and aggressive form of childhood cancer, involving severe pain and distress. It responds to cannabis-based products. If a recognised doctor writes to the Minister on behalf of Ava and Ronan to apply for permission to prescribe cannabis-based medicines, will the Minister consider the doctor's application and ensure these children gain access to the cannabis-based medicines which they medically need?

I note the report by Professor Michael Barnes.

It was the unanimous view that medical cannabis has huge medical benefits for a range of illnesses. We need to step into the 21st century in this country. Children like Ava and Ronan are at an extremely difficult point in their short lives, as are their parents. These products can help. The research and data are available and we need to import these products under the guidance of a doctor to help these children. I plead with the Minister of State because I am the voice of those children and their parents in the House today. Will he help these children?

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for rasing this important issue, about which he cares passionately. I share his concerns and his ideas.

I very much appreciate the difficult situation that Ava and her family are in and how painful it is for any parent to see his or her child suffering with a condition such as this. Many patients with a variety of medical conditions believe that cannabis should be a treatment option. However, with the exception of Sativex, cannabis-based preparations are not currently authorised as medicines in Ireland. Cannabis has not gone through the normal regulatory procedures for medicines, which are designed to protect patients and ensure that treatments are supported by good evidence of their effectiveness. However, the Minister for Health is committed to urgently reviewing policy on medicinal cannabis and I support that position. He met the parents of Ava Barry last week and updated them on his stance.

The Minister has requested the Health Products Regulatory Authority, HPRA, to provide him with expert advice on the issue of medicinal cannabis. The HPRA's statutory role is to protect and enhance human health by regulating medicines and other health products. It has the necessary clinical and scientific expertise to provide advice on this issue. The Minister has asked for a report on recent developments in the use of medicinal cannabis in other countries, including an overview of emerging research. The HPRA may also propose changes to legislation in respect of the use of cannabis for medical purposes. Separately, the Minister understands that the Joint Committee on Health will also begin to examine the issue of medicinal cannabis later this month. He hopes to receive the report from the HPRA and the output from the committee early in the new year. He will then be in a position to consider and progress any legislative changes that may be recommended.

In the meantime, it must be emphasised that treatment options are a matter to be discussed between patients, their carers and their doctors in the first instance. Cannabis-based preparations intended for treatment of certain types of epilepsy are currently undergoing clinical trials. It may be possible for patients to access these products on an individual basis, but this is something for discussion with their doctors. This is one of the options we should examine. Cannabis-based preparations are strictly controlled under the Misuse of Drugs Acts. However, it is open to the Minister to consider an application from an Irish registered doctor for a licence for such products for a named patient. The appropriateness of any particular treatment is a matter between the patient and their doctor and the Minister has no role, and it would be entirely inappropriate for him to involve himself in this process. My understanding is that many doctors would be quite cautious about recommending a cannabis-based treatment for a patient in the absence of robust clinical evidence that underpins authorised medicines. However, it is open to any doctor to make an application.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I understand that next week a doctor will visit Ronan in Galway and Ava in west Cork and will correspond with the Minister early next week recommending cannabis-based products for them. These children cannot wait and they need these products as soon as possible. Hopefully, the Minister will see common sense and that these children need these products as soon as possible. Under licence, the doctor will prescribe that medication to them with the guidance of their parents and, hopefully, it will have medical benefits for them. I welcome the Minister of State's reply. He is saying it is ultimately up to the Minister to grant the licence for these children. That application will happen over the next week and, hopefully, the Minister will look favourably on it.

Finian McGrath (Dublin Bay North, Independent)
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It is important to acknowledge that most of us want to do our best for patients in these cases and that we need to do something to assist them. That is my priority as well. Medicinal cannabis is available in countries such as the Netherlands, the Czech Republic, Canada, Australia, Malta and Croatia and the medical profession is aware of this. The key response to the matter raised by the Deputy is that it is possible for the Minister to consider granting a licence to an Irish-registered doctor for a named patient. No applications have been received from doctors in Ireland and it is understood from contacts with families that doctors are reluctant to get involved. However, the Deputy has raised these cases and it is open to the Minister to consider granting a licence and that is the road we should go down.

It is not up to us, as politicians, to interfere with the doctor-patient relationship but there is a great deal of sympathy for the Deputy on this issue. He published a Private Members' Bill in late July, which provides for the establishment of the medicinal cannabis regulatory authority. The Bill is being considered by departmental officials. Some amendments may have to be made but the initial view is that we are seriously considering the legislation. The door is open for some sort of movement on the cases raised by the Deputy and I wish him well.