“Because while parents struggle to raise the thousands of pounds required just to keep their kids alive, this government has ignored them. But once we start highlighting the potential for making money, the UK government’s ears prick up. […] If that’s what it takes to get the government to engage then so be it, because engage they must, because people are suffering needlessly”.
So said Ronnie Cowan MP during the debate on the ‘Economic Contribution of Medical Cannabis’ at the end of April. Hearing such a powerful statement, with such a ‘no nonsense’ delivery, has urged me to consider whether medical cannabis campaigners need to try a different tack when it comes to the liberalisation of current policy.
Although moral arguments were, rightfully so, effective during the campaign for medical cannabis legalisation, is a new approach needed to align future campaigning with our current political climate?
As most articles on the topic do, it’s important to outline the context against which medical cannabis was legalised in the UK in 2018. The decision in November of that year was surprising, but greatly welcomed, not least from the families who had led the campaign – parents of children with severe epilepsy who needed access to medical cannabis treatment.
Their heartfelt and emotive stories made the moral case for legalisation, and helped to both shift public perceptions and increase support for the law change.
However, there was concern that the decision to legalise medical cannabis in 2018 was a quick ‘knee-jerk’ reaction. Due to this reactionary approach, we didn’t see the same gradual build up of stakeholder engagement as has been seen with other jurisdictions that have legalised cannabis. As a result the ground work wasn’t laid for a fully realised and profitable medical cannabis industry in the UK. Nowhere is this more evident than in our lack of progress nearly 5 years post-legalisation.
Medical cannabis access via the NHS still remains a near impossible route for almost all patients. Currently, the NHS only prescribes three licensed medical cannabis products, due to, among other reasons, a perceived ‘lack of clinical evidence’.
Equally concerning is the fact that there still remains only 4 NHS prescriptions for unlicensed medical cannabis products, and a reluctance to increase this number means that patients are often forced to fund their own medication via the private clinic route. This concern is shared by advocates and experts across the industry, including Hannah Deacon:
‘We have spent nearly five years campaigning on the important issue of patient access, and whilst a small number have got NHS access, including my son Alfie, there is still an urgent need for all patients to be able to access NHS funding for legal medical cannabis. We must also ensure where clinicians wish to prescribe they have the tools and funding to do so.”
The current policy exacerbates this barrier due to rules that prevent GPs from prescribing cannabis medicines to their patients. Instead, only specialist medical practitioners may do so. This has unnecessarily restricted medical cannabis prescribing, and has added to the 1.8m people who are currently accessing the illicit cannabis market for medical reasons. Fortunately, campaigns are being organised to address this, such as the Protect Our Patients Campaign, which is seeking to directly target the issue of GP prescribing.
🇬🇧#ProtectOurPatients: 1.8 million people in the UK access the illicit cannabis market for medical reasons.
🥼One of the key barriers to patients in the 5 years since legalisation has been GPs not being able to prescribe cannabis medicines.
— Volteface (@VoltefaceHub) May 9, 2023
Campaigns such as these are needed now more than ever, particularly considering that much medical cannabis campaigning to date has focused on niche issues within the current policy, keeping the focus narrow. To properly broaden the debate and work towards a more realised medical cannabis industry we must turn our focus to more general issues, such as the restrictions placed on GP prescribing.
Of course, underpinning a number of problems with the UK medical cannabis industry is the fact that so many people are still unaware that it’s even legal. Almost every article I’ve read since joining the medical cannabis space pulls on the same statistic from Mamedica – that 84% of people are unaware that cannabis flower is legal and over half of the UK population doesn’t realise they can access cannabis on prescription at all.
And since that information came out last summer I doubt that figure has changed. The legacy market still remains strong as ever, and for many the price of a private prescription, regardless of access schemes, remains prohibitive.
So, what can be done to help liberalise the current policy?
There’s no denying that the moral arguments surrounding medical cannabis should be enough to convince anyone to make the changes necessary to the current policy, and it’s unfortunate that I should have to advocate otherwise. It’s clear that those who supported and continue to support the campaign, such as Ronnie Cowan MP, feel the same:
“Clearly we were wrong in our approach, and I apologise to those children and their parents for my shortcomings. I appealed to the moral and ethical need, and I appealed to this government who repeatedly tell us they have a compassionate approach to governance. What I found today is that what I should’ve done […] is made the economic argument instead.”
Given our current political climate, and the increased centering of the opposition, it appears that a different approach is now needed. Given that, could now be the time to make the case for the economic benefits of liberalising medical cannabis policy, as an attractive offer for the UK government?
In short, I would argue that (almost) all signs point to yes.
If we look at the theory behind the moral compass of the political left and right, it makes sense to engage alternative approaches such as the economical arguments. Jonathan Haidt’s work suggests that the ‘moral mind’ is governed by six foundations: harm/care, fairness/reciprocity, in-group/loyalty, authority/respect, purity/sanctity and liberty/oppression.
However, he states that both sides of the political spectrum do not prioritise these channels in the same way. Whilst more liberal individuals have an approach that is focused on the harm/care, fairness/reciprocity and liberty/oppression principles, conservative individuals appear to adopt an approach where each moral principle is given the same weight.
Therefore, this would suggest that the approach to cannabis reform (a traditionally left-of-centre issue) needs to be different when appealing to a more conservative audience. The moral arguments made thus far are encompassed within a harm/care framework which, although sits within both sides of the political spectrum, is prioritised much more by left-leaning individuals. In taking an economics approach to liberalising medical cannabis policy, appeals are made to other aspects of morality. In theory, this should allow us to make more progress when dealing with a right-of-centre government.
Furthermore, analysts suggest that the UK is set to become the second largest medical cannabis market in Europe, with the European market itself estimated to be worth £3.2bn by 2025. Rightfully so, many suggest that the economic opportunity of broadening medical cannabis policy is one that the UK government should not pass up.
In lingering on that point for a second, surely the fact that debates around the economic contribution of medical cannabis are beginning to be placed on the parliamentary agenda signals the government’s interest in such an approach. The most recent debate aptly took place on the 20th April 2023 and featured submissions from 5 MPs to which Will Quince MP, the Minister for Health and Secondary Care, replied.
Behind the scenes of organising the debate was Hannah Deacon, one of the UK’s most high-profile medical cannabis experts and advocates and mother to Alfie Dingley, the first person in the UK to receive a medical cannabis prescription. Regarding the debate, Hannah said:
“It was welcomed to see the debate recently on the economic importance of the medical cannabis sector, whilst my passion lies in patient access, I am also keenly aware that the Government is focused on our economy and the value of innovative sectors such as this.”
However, it was clear that MPs still lacked knowledge about the sector:
“It was sad to see a health minister had been sent to comment on this debate, and even some incorrect information such as all NHS prescriptions are licensed when over 4.5 million is spent every month on unlicensed prescribing in the NHS. Even with this in mind, this debate was the first of its kind and a great move forward, and specifically grateful to David Mundell MP for hosting this debate. We have a long way to go but the economic value of this sector in the UK, the jobs it can create and the health benefits, I hope means the Government can only ignore it for so long.”
Although these economic arguments still need building on and consolidating, there appears to be some hope that they may be the key to unlocking further medical cannabis reform and broadening access for both patients and clinicians. Therefore, it’s my opinion that we should harness them in the hopes of increased progress in the future.
This piece was written by Volteface Content and Media Officer Megan Townsend. She is particularly interested in the reform of drug legislation, subcultural drug use and harm reduction initiatives. She also has an MA in Criminology from Birmingham City University. Tweets @megant2799.