John Curran (Dublin Mid West, Fianna Fail)
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635. To ask the Minister for Health if consultants must send a letter of application for each prescription for medicinal cannabis; and the time in which it takes to process same. [54410/18]

Simon Harris (Wicklow, Fine Gael)
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Irish-based medical practitioners who wish to prescribe cannabis-based products containing Tetrahydrocannabinol (THC) require a Ministerial licence issued under the Misuse of Drugs Acts 1977 to 2016 in order to do so.

The Chief Medical Officer has advised that the granting of such a licence must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a medical consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.

Ministerial licences are time limited. The initial licence is valid for a period of twelve weeks and subsequent licenses in respect of the same patient are valid for 24 weeks.

It is also important to note it is unlawful for a prescriber to issue a prescription for a controlled drug unless it complies with the requirements for controlled drugs prescriptions specified in the Misuse of Drugs Regulations.

The Deputy may be aware that the Department of Health website contains detailed information on medical cannabis, including clinical guidance on the use of medical cannabis and details on how a medical practitioner may apply for a Ministerial licence. This information can be found at:

health.gov.ie/blog/publications/cannabis-for-medical-use.

John Curran (Dublin Mid West, Fianna Fail)
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636. To ask the Minister for Health if consultants choosing to prescribe medicinal cannabis under the existing licensing system are assuming personal liability for possible negative side effects on their own personal insurance; and if the HSE does not accept possible liability in relation to same. [54411/18]

Simon Harris (Wicklow, Fine Gael)
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Under existing arrangements consultants in public hospitals are covered by the Clinical Indemnity Scheme (CIS) in respect of the prescription of tetrahydrocannabinol (THC) based products for a patient under their care provided that the consultant is permitted to do so under a licence granted by the Minister for Health under the Misuse of Drugs Acts and where he/she has exhausted all other treatment options for that patient.

In relation to private consultants the CIS covers the excess over the indemnity ceilings (or CAPS) set by the State for private indemnifiers of consultants working in private practise settings. Effectively, the private indemnifier's liability in respect of any claim is capped at the relevant indemnity ceiling and the State assumes responsibility for any amount in excess of the cap. Consultants in private hospitals should check with their Medical Defence Organisations to establish that such organisations will cover them up to the Caps limit in cases where they are considering prescribing THC-based medicines for a patient, under licence from the Minister and where he/she has exhausted all other treatment options for that patient.

John Curran (Dublin Mid West, Fianna Fail)
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637. To ask the Minister for Health if in order to apply for a licence for medicinal cannabis a consultant is required to go through an exhaustive list of conventional medications (details supplied). [54412/18]

Simon Harris (Wicklow, Fine Gael)
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Under the Misuse of Drugs legal framework, it is open to a medical practitioner to apply for a Ministerial licence for medical cannabis for the treatment of a patient under his or her care.

It is important to note that the decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.

In late 2016 I requested the Health Products Regulatory Authority (HPRA) to carry out a review of the scientific evidence of the potential medical use of cannabis. The HPRA report was published in February 2017. In this report the HPRA advised that cannabis should only be made available for the treatment of patients with specified medical conditions which have failed to respond to all other previous treatments, and where there is at least modest evidence that cannabis may be effective and such patients should be under the direct supervision of an appropriately trained and experienced medical consultant.

I would strongly advise that the Deputy and any persons interested in the use of cannabis for medical purposes to consult the Department of Health website which contains detailed information on the matter, including information on the types of cannabis products and the specified medical conditions for which they may be used to treat, as well as clinical guidance on its use. This information can be found at the following website:

health.gov.ie/cannabis-for-medical-use.