 The final item of business is a member's business debate on motion 3233, in the name of Collette Stevenson, on access to cannabis-based products for medicinal use. The debate will be concluded without any questions being put, and I would ask those members who wish to speak in the debate to please press the request to speak buttons now. I call on Collette Stevenson to open the debate up to seven minutes, please, Ms Stevenson. Thank you, Presiding Officer. I am grateful to members who supported my motion, and I will try to cover as much as I can in seven minutes. First, I thank Rona Mackay and Pauline McNeill, the co-conveners of the Parliament's cross-party group on medicinal cannabis. This area is complex and wide-ranging, so the work that they and the CPG are doing is a very welcome contribution. When the Home Office rescheduled certain cannabis-based products for medicinal use or CBPMs in 2018, many people were relieved. Under the current set-up, doctors can prescribe a medicinal product that has a valid marketing authorisation, but for unlicensed products there is a restriction in place where only a subset of doctors, generally consultants, can prescribe. The only other access routes for patients are as participants in a clinical trial or through private prescriptions. Medicinal cannabis has been proposed as a treatment for a range of conditions, including multiple cirrhosis—I would like to move on, thank you very much—and epilepsy. In the latter case, one product, Epidiolex, is now available on the NHS for some patients. The MS Society provided a useful briefing for today's debate on another product, Satyvex, which might be rolled out on the NHS, and that would be good to see. The Society also carried out a survey and found that 22 per cent of people with MS in the UK had accessed illegal forms of cannabis to treat their symptoms. There is a common theme there, and it is public knowledge that parents of young children with epilepsy from right across the UK had to resort to illegal access of products too, and that is what forced the legislative change. As I said in my motion, a constituent who currently receives a medicinal cannabis product, Cole-Thomson, aged nine, has a drug-resistant focal epilepsy. He used to have daily seizures and has spent a lot of time in hospital over the years. Since he started taking better light three years ago, however, he has been doing well. His mum, Lisa Quarrow, is in the gallery today. I want to acknowledge the work that she has done in campaigning for access to medicinal cannabis and her efforts to fund raise for Cole's medicine. Lisa shared a video on Facebook the other day with Cole Doon, Tai Kwan Do and Plain the Dums. I can only imagine how proud of Cole and how relieved she is given the prognosis just a couple of years ago. You could argue that Cole and the few other children in a similar situation are a success story, but that would probably downplay the trials and tribulations facing parents like Lisa. For a start, Cole's better light is sourced through a private prescription costing over £1,200 per month. Lisa has found it impossible so far to meet an NHS consultant who would prescribe better light. I understand that many doctors are hesitant to prescribe cannabis-based products that do not have a marketing authorisation because those products often do not have a rigorous evidence base behind them, as licensed products are required to have. Furthermore, medical societies develop specific guidance for their members, some of which have raised concerns around the lack of clinical trials to demonstrate safety, quality and effectiveness. Patients, policy makers and clinicians are entitled to expect manufacturers to provide evidence. I appreciate that point, but I would also challenge scientists, medics, pharmaceutical companies and any other relevant parties to consider the different ways evidence can be gathered. For example, the last meeting of the CPG focused on the role of evidence in widening the use of medicinal cannabis. We heard about the potential for observational trials of patients already on a product. I welcome the Scottish Government's commitment to collaborate with NHS England and the National Institute for Health Research to support research trials so that we can give NHS consultants the reassurances that they need to consider prescribing more cannabis-based medicines. I understand NHS England is involved in discussions on two clinical trials for adults and children with epilepsy and that Scottish patients will be eligible. That is very welcome. However, when it comes to something like treatment-resistant epilepsy and a patient-like goal that has been doing well on a cannabis-based product, we have to be aware that certain research methods would not be acceptable to all patients. The go-to randomised-control trial option that could see participants end up on a placebo or a different medication. Clearly, some patients and their loved ones would be reluctant to take part on that basis. There are a few other things that I would be interested to know about CBPM use, and perhaps the minister could touch on in closing such as how the CMO has worked with doctors since the rescheduling to get feedback and develop protocols or guidelines, what role the CMO and the CSO can play in supporting, encouraging or facilitating relevant research, whether shared care guidelines are under development and whether sign could develop general or condition-specific guidelines. Lastly, we should consider the role of GPs, too. I understand that some GPs have indicated that they would prescribe unlicensed cannabis-based medicinal products if they could, particularly where treatment has been initiated by a relevant consultant or they have seen first-hand the benefits to an individual patient. I would call on the Home Office and relevant stakeholders to consider options like that and consultation with patient groups, GPs and others. To conclude, I am delighted to have kicked off this debate, the first in Scotland on access to medicinal cannabis products. It is such a wide-ranging topic and, of course, I wanted to spend some time talking about Cole Thomson from East Kilbride. More evidence is key to widening the use of those products, and I want to see movement on that as soon as possible. I hope that I have given a flavour to some of the opportunities and challenges in this area, and I am looking forward to hearing other members' contributions. I now call Rona Mackay to be followed by Craig Hoy. As I have heard, the debate on access to medicinal cannabis is a first for this Parliament, a very important first. I thank my colleague Collette Stevenson for bringing it to the chamber. As a co-convener of the cross-party group on medicinal cannabis, the issue is long overdue to be debated. We have heard Collette Stevenson's heart-rending account of her constituent, Lisa Quarrell, and her son Cole. As a mother, I cannot imagine the stress and heartache of having to fight every day to keep your child alive and have the constant worry of how to pay for private prescriptions of the drug that he depends on. Around 40 other mothers in Scotland have children who have severe epilepsy and, like Lisa, they have to do this every day, not to mention the thousands of chronic pain sufferers and those with conditions for which cannabis can relieve the worst symptoms. Cannabis is the oldest medicine in recorded history. There is evidence of medicinal and religious use for over 4,000 years, so this is not a new drug. There is clearly stigma around the use of cannabis. The psychoactive aspect of cannabis is what scares people, but medicinal cannabis has very low levels of THC, that is the psychoactive component, which far outweigh the risk elements of side effects. Let us be clear. Cannabis for medicinal use is not about people looking to chill out and have a good time. It is about giving people quality of life and pain relief when other drugs have failed to do that. Why should sufferers be denied that because of ill-informed prejudice? The misuse of drugs regulations in 2018 allowed for cannabis-based medicines to be legally prescribed for any condition. Thomas Mulvey of the multiple sclerosis society has been calling on the Scottish Medicines Consortium to approve Savitex for some time. Cannabis-based Savitex has been shown to be hugely beneficial to treat symptoms associated with MS and will be considered by the SMC later this year. As my colleague Collette Stevenson said, the society's UK-wide report into Savitex found that 22 per cent of people living with MS had accessed illegal forms of cannabis. On the subject of Savitex, Savitex, as has been pointed out by Ms Mackay and Ms Stevenson, has a licence for the treatment of moderate to severe cases in terms of multiple sclerosis. The manufacturer has not yet made a submission to the SMC and, as a result, it is not recommended for routine use on the NHS in Scotland. The SMC remains in discussions with the manufacturer of Savitex around their plans for submission, but the decision and timing of their submission is up to them. Members may want to encourage the company, but there is nothing that we can do until they make that submission. I want to let the chamber know that that was the case on this very important issue. I thank the minister for that clarification. That is interesting, because the report found that 22 per cent of people living with MS had accessed illegal forms of cannabis to treat their symptoms, and that is outrageous. I understand that Savitex gained MHRA approval 10 years ago, and MS sufferers have been forced to break the law to gain access to it. I hope that that does change quickly. Why are we not prescribing such a demonstrably effective drug? There are currently no NHS patients in Scotland receiving CBM and only three in the UK. International data tells a different story, but I do not have time to outline that. The barriers to prescribing appear to be nice guidance, which, as I understand it, is not legally enforceable in Scotland and not legally challengeable by Scottish patients. That is typical of the legal confusion that surrounds the prescribing of cannabis-based drugs. However, it is nice to clarify that healthcare professionals in England should not feel prevented from considering the use of unlicensed products if appropriate for individual patients. Although the regulation of medicines and medicinal products is a reserved power, funding for cannabis-based products through NHS prescriptions is a devolved issue. Only specialist doctors on the general medical council's special register can prescribe unlicensed cannabis-based products for medicinal use. GPs cannot or will not prescribe them. Prescribing around the world is mostly through primary care, and for some reason the UK has gone down the route of allowing only specialists to prescribe. Weak clinical evidence is cited as a barrier, but I would argue that the thousands of patients whose lives have been improved immeasurably are evidence that they should be prescribed. Then there is the fear factor with clinicians, lack of awareness, lack of training. The general medical council, who is responsible for overseeing medical practitioners in good prescribing practice, is working with private clinicians in the prescribing of CBM. However, it would appear that many NHS clinicians fear being struck off if they are to prescribe. I believe that it is possible for Scotland to lead the way in cannabis research. My time in the cross-party group has been a huge learning curve for me. The issues around prescription are embedded in a legal mindfield, but I am optimistic that that will change soon. The cabinet secretary is lazing with the UK Government to discuss the need to build the evidence base for CBPMs, and he believes that the UK and Scottish Government could work together to achieve that. In conclusion, I urge this issue to be taken forward and clarified in Scotland without further delay. Look at international evidence, get the trials under way, and sort out the legal complexities. The lives of thousands of patients, old and young, depend on it. I call on Craig Hoyd, followed by Pauline McNeill, up to four minutes please, Mr Hoyd. Thank you, Deputy Presiding Officer. May I take this opportunity to thank Collette Stevenson for bringing forward this timely members' debate in exploring access to cannabis-based products for medicinal use? As we heard, this is a complex situation and one where we are looking at a lot of emerging evidence. However, what I do hope is that having this first debate in this chamber will focus the mind of members so that we can track this debate more closely. As Collette Stevenson said, this takes us into some new territory involving access, trials and new approaches to treating some complex medical needs such as MS. I recognise and I think that my party recognises the important role that medicinal cannabis plays and that it can be a critical lifeline for patients. Take, for example, the case of Alfie Dingley, a 10-year-old boy from Warwickshire who suffered up to 150 seizures a week. His mother launched a high-profile campaign that was recognised by the UK Government and helped medical cannabis become legalised in the UK in 2018. Following that, Alfie has been able to grow up without a seizure for over two years since receiving support through the NHS. Unfortunately, Alfie's family is currently forced to seek private treatment to access the drug, which costs up to £2,000 a month. This is clearly a serious financial burden that many patients and parents seeking to use medicinal cannabis simply cannot afford. That will undoubtedly be a source of great frustration that those drugs are not easily accessible for parents whose children are clearly suffering or are in pain. I do not think that any parent should be forced to go down the route of illegally accessing drugs in order to relieve the suffering of their children when there is a responsible and legal alternative. UK Government ministers are well aware of those issues. I encourage that ministers are working to reduce the import and export costs for medicinal cannabis. It is important that we explore every option to ensure greater access to the drug for medicinal use. The National Institute for Health and Social Care Excellence believes that more evidence is needed to justify the prescription of unlicensed cannabis products. To this end, we must ensure that patients are treated effectively with medicinal cannabis and that they are not adversely affected by any negative sides of the drug. Again, it is important that we look to trials. It is also important that each case is judged individually by a clinician. I believe that the decision should remain solely with them, but I think that there is a case for looking at greater understanding of the role of different clinicians, including GPs, in relation to this. I warmly welcome the work of the UK Government in this area, which has seen 13 on-going trials in the UK and six other trials already completed. I look forward to further clinical trials and the greater use of an evidence-based approach and observation-based trials, which I think will be critical in the future development. Additionally, presently, there are two new clinical trials into treating refractory epilepsy that are being developed by the National Institute for Health Research and NHS England. I think that again, we would warmly welcome those and look forward to the result of those. I think that it is important that we have an evidence-based approach. I think that it is important that we take this issue and discuss it in this Parliament and elsewhere. I look forward to following that debate, both in this Parliament and in the wider UK context. Firstly, I thank Collette Stevenson for hosting the first-ever debate on medicinal cannabis. She should be proud of that. I also thank Rona Mackay, my co-convener, for the first-ever group on cross-party group on medicinal cannabis. I also thank Anna Ross, who is in the gallery, who is the secretary to the group and Kate Spence and Rona Staff, who have supported the setting up of this group. It really is making a huge difference to cannabis patients having a forum to bring the big issues. The question now is whether we are making enough progress, and I want to talk about that. Cannabis is the oldest recorded medicine in history. It is not a new medicine. Lots of people get relief from it, but yet there are so many barriers to what should be a basic and fundamental right to access treatment that gives you relief from pain and able to do more things than your life you previously could not do. Some people get incredible relief from that. Even though the UK legalised access to cannabis in late 2018, it is only prescribed as a last-line treatment when all other treatment options have failed, and we need to work to change that. We have heard already from some people, especially children like Cole-Thompson, that it has changed their lives and that it is frustrating to see parents such as Lisa Thompson in financial peril trying month after month to access beds like for Cole's epilepsy, when if you were a Dutch patient you would access it at a not-for-profit cost at a Dutch pharmacy. The seizures that accompany those types of drug-resistant epilepsy can be life-threatening. There are many young children in this situation. It is important to note that. Rona Mackayla, myself, is due to meet Police Scotland to get clarity on the number of cases where patients have legally prescribed cannabis prescriptions that are still facing court action because of a lack of understanding on the front line. I am sure that we can get that resolved, but it is really, really important that that is. Similar to Lisa and Cole-Thompson to 9, Montgomery's six-year-old daughter, Indu Rose, has a similar drug-resistant epilepsy. She says that the family flew to the Netherlands to obtain it from a Dutch doctor using a private UK prescription because the NHS refused to pay for it. Tonine said that she has spent 34,000 and broken the law to keep her daughter alive. So we certainly cannot expect families to continue to take these kinds of risks to keep their children alive. It is frankly immoral. There is evidence, as others have said, that medicinal cannabis helped us to relieve MS-related specificity. Muscle spasms or stiffness-known as specificity affects up to 80 per cent of people with the MS. The Sativex is the main product available in England and Wales for this. Rona Mackayla said this earlier that the Nice Guidelines recommend offering a four-week trial of Sativex to two adults with the MS, but in Scotland the issue has been that the manufacturer did not make a submission to the Medicines Consortium. The Sativex is not routinely available, however it is due to being considered later this year. The MS Society produced a report into this and found that 22 per cent of those living with MS had accessed illegal forms of cannabis to treat the symptoms. That seems to be very wrong to me. In fact, one of the reasons I spoke in this Parliament why I set up the cross-party group is my own father, who had acute pain from arthritis, said that if it ever became legalised then he would use it and it is a testimony to him that I have championed this cause. Like many other cannabis-based medicines, although it can be accessed by private prescriptions, doctors are often hesitant to prescribe it without SMC approval. There is a big issue about confidence in doctors and there is some confusion about who can prescribe and who can't. Medicines can be legally prescribed by specialist doctors on the GMC specialist register if there is a special clinical need, but GQPs cannot prescribe unlicensed cannabis-based products for medicinal use under the current rules. I believe that there needs to be some changes to that. It is time for serious change to the policy and the delivery of access to medicinal cannabis. We need to make sure that trials are the appropriate trials for this kind of use. We raised this three years ago with the chief pharmaceutical officer and we have made very little progress. I believe that we should empower doctors and we should empower patients who will need this because it is changing their lives and I look forward to the minister's reply. I welcome the opportunity to speak in this debate and congratulate my friend and colleague, Collette Stevenson, on securing this debate. I thank my office manager, Scott McElven, for his assistance and research to help me to prepare for this. It is really interesting to hear directly what the impact that this has had on Colle's life and Lisa's experience. It is really important that this debate is here in chamber today. For me, just as synthetic drugs can help some conditions and not others, it is important to note that cannabis is not a one-size-fits-all line of treatment. It is also important that we make the distinction between legalising cannabis for recreational purposes and for medical treatment. When discussing legalised forms of medicinal cannabis, it is chemical elements from within the plant that we are seeing the benefits from. I absolutely recognise and agree with Rona Mackay about the stigma associated around this because it is really important that we are highlighting the medicinal effects and not the THC effects that other people might be seeking. The benefits are becoming more evident through proper clinical trials and research and global research, as well as at Glasgow University. The research suggests that the benefits of cannabis come from some of its compounds, cannabinoids like cannabidiol CBD. Interestingly, hilltop leaf limited, which is a private medicinal cannabis cultivation and extraction business, aims to provide an alternative plant-based clinical treatment to synthetic pharmaceuticals. It is open to sight in Dumfries and Galloway with South Scot Enterprise funding, and it is growing cannabis for medicinal research and use. Those compounds can translate to multiple physical benefits. When I worked as a post-anesthesia care nurse, pain management and pain relief was critical as part of my job. Whether I was given IV morphine, IV diamorphine or intravenous paracetamol, that was acute pain management, but a lot of those drugs are also used in chronic pain management, too. I was really interested in the evidence from the various clinical trials that have generally agreed that medical cannabis does reduce pain by altering pain pathways in the brain. The evidence from those studies shows the benefits of cannabis-based drugs for patients with arthritis, fibromyalgia, endometriosis and migraine. In some instances, those drugs are reported to help to replace the long-term use of non-steroid anti-inflammatory drugs, NSAIDs, such as ibupropyrn, which also have negative side effects. CBD can help to reduce inflammation, and clinical trials have been carried out for patients living with Crohn's disease, irritable bowel syndrome and rheumatoid arthritis. In every one of those studies, cannabis-based medication decreased inflammation and led to increased independence and greater wellbeing for patients, and wellbeing is something that we should absolutely support and pursue. Due to the effects on the limbic system, research is being carried out, including here in Scotland, by Glasgow University, on the ability of cannabis-based medication to treat anxiety, epilepsy, multiple sclerosis, Parkinson's, post-traumatic stress disorder, Tourette syndrome and insomnia, there is clearly a body of international evidence into the benefits of medicinal forms of cannabis, and we should be further exploring regulated forms of medicinal cannabis for prescription here in Scotland. Following the changes to the misuse of drugs legislation in 2018, cannabis-based products can be prescribed in cases of special need, so we have heard already that there are three products that I am aware of, Epidaedalex, Satyvex and Nabilone. Epidaedalex is recommended for prescription here in Scotland, but we have seen difficulties from our general practitioners about the way that the drugs can be prescribed or not be prescribed, and some of the Royal College of GPs have said that they have been pressurised to prescribe unlicensed medical cannabis products. The reason being is that patients with life-limiting conditions read social media posts about the benefits of medicinal cannabis products, so the RCGP has shared the concerns of the lack of medical cannabis products available and I would encourage what we can do to ask the minister for supporting the GPs in their practice to take any clinical guidance forward and see what education is available for patients and clinicians about the products. In closing, I am conscious of time, I agree that there are many benefits for medicinal cannabis compounds and products, and I encourage the Scottish Government to continue to support clinical research into those products to improve the outcomes for people and health conditions for those folk that are totally life-limiting. I am pleased to rise from my party to speak in this important debate, and I congratulate Gillette Stevenson for bringing this to Parliament and for an excellent speech. I think that some of the barriers that a number of MSPs have faced trying to help constituents will come on to that. Many of us as Deputy Presiding Officer in this chamber write a weekly newspaper column, and I vividly remember writing one to celebrate the Home Office decision to issue the first long-term licence for personal use of medical cannabis. That was four years ago, and yet today most patients, as we have heard, who could benefit from cannabis therapies, just are not getting access to them through the NHS. My own constituent, Murray Gray, who I have mentioned many times in this chamber, is now nine years old and has a profound and complex form of epilepsy that regular medications just cannot touch. In early 2019, Murray's epilepsy took a dramatic turn. He entered what is known as status. That is a condition where the seizures just won't end. It is like a rolling thunderstorm in Murray's brain, and he would not come round. Murray was having literally hundreds of life-threatening seizures every single day, and it is highly likely that he would have died had his mum Karen Gray not moved heaven and earth to obtain private prescription for bedrolite, a cannabis oil that she gets from the Netherlands. Karen administered the medicine to Murray herself, and in a short space of time Murray's seizures dropped away altogether. Karen knows that were she to stop giving him his daily dose of cannabis oils, Murray would return to a state of near-constant seizure. She has had to find £1,300 every single month for the cost of her prescription, and at times it has brought her family to the edge of financial ruin. The problem is that even though Murray's GP is willing to prescribe the oils, he is not on the approved list that we had described of those clinicians who can, and none of those, none of those who are on it, are willing to. It's the point I would have actually made to Collette Stevenson when she was making her speech. I think this is a problem we can encounter time and time again. There's a catch 22 of the people who know their patients unable to prescribe yet the people, the consultants on that, very short lists unable to. It's not because they think it's bad for him, they're just not entirely sure of the drug because of the lack of UK trial data. They also probably still have a residual anxiety around cannabis therapies and how that jars up against the misuse of drugs out, and it's not just Murray who's struggling to get the help that he needs. Only three NHS prescriptions have been issued in the whole of the UK for some of these therapies. Murray's older brother Dean hand delivered a letter into Bute House asking the First Minister to help his mum cover the cost. The reply came back with not enough evidence that Murray's treatment is safe and that the Government were powerless to out. Presiding Officer, this treatment is literally keeping Murray alive. It's hard to see how stopping it would be safer than taking it. Three children in the UK already have an NHS prescription. It's safe in those circumstances. It's surely safe for Murray. Government can't compel clinicians to write scripts. I understand that, but it can support Karen and others who find themselves in a similar position. The Government must also do all it can to make sure that clinical trials on medical cannabis are conducted to give clinicians the confidence they need. Presiding Officer, there are also cases of police being behind the curve on that. Recently, a man in Shetland who uses medical cannabis for chronic migraines had it confiscated. When the police claimed he hadn't provided satisfactory evidence, it was being legally prescribed. It wasn't until my colleague Beatrice Wishart intervened that it was returned to him, but he had already been issued with a police caution which he would have to go through the process of appealing. Presiding Officer, there is clearly a need for liberalisation across the board when it comes to medical cannabis. Outdated views and unnecessary reviews are too often getting in the way of the immense benefits that these treatments can provide. For the sake of Murray and others like him, we all need to catch up with the science. I'm grateful to Collette Stevenson for securing the time for this debate. At the outset, it's important to acknowledge that those people seeking to access cannabis-based medicine are often in significant pain and have had and have a diminished quality of life. It's very difficult to ignore the desperation they feel, especially when the health and well-being of children is involved. Collette Stevenson mentioned Cole Thomson, who at not even 10 years old suffered up to 20 epileptic seizures a day before being privately prescribed cannabis oil. This must have been unimaginably distressing for him and his mum Lisa, who has been a tireless advocate for her son. In particular, patients feel a deep frustration that, while the scheduling of cannabis-based products changed in 2018, clinical use remains low and only for specific conditions in exceptional circumstances. Many have sought private treatment, which has significant cost implications. Sometimes, as we've heard today, amounting to hundreds and even thousands of pounds a month. That's simply not a sustainable financial outlay. Others have accessed illegal forms of cannabis to treat symptoms. Research by the MS Society has shown that almost a quarter of MS sufferers have obtained cannabis-based products that are illegal to possess. Often the strength of THC and the quality of the ingredients in those products are not known, with the potential to cause harm to the user. It's also important to note that there's a different prescribing regime in England and Scotland for medicinal cannabis. That geographic disparity is felt acutely by sufferers of MS north of the border, where Satyvex has not been approved by the Scottish Medicines Consortium. I understand from Spice and also confirmed today by the Minister that this is because the holder of the NHS marketing authorisation has not made a submission for this product. I do hope that there will be some action following this debate today. I would also add that, while the therapeutic benefits of cannabis-based products for certain conditions have been conclusively demonstrated, there is a risk that such products could be seen as a panacea by people in acute pain and discomfort. As these individuals seek to effectively manage their conditions, clinicians and healthcare professionals are trying to manage patient expectations. Doctors are also professionally responsible for any medicine as they are weighing up an individual's suffering as well as their safety. We don't want, however, people to turn to the illicit market and the harms that could involve. Deputy Presiding Officer, it's for clinicians to determine the risks and the benefits of medicinal cannabis, not politicians. I do, however, agree with Collette Stevenson's call for further research in this area with high quality and robust clinical trials to contribute to the evidence base. I understand that there are more than a dozen on-going trials in the UK, which is welcome. I will conclude by echoing calls for collaboration and co-operation between the Scottish and UK Governments on this issue. The UK has a thriving life sciences sector that is at the forefront of scientific research, and we must capitalise on this expertise across the four nations. Monica Lennon, who will be the last speaker before I ask the minister to respond to the debate. Up to four minutes, please, Ms Lennon. Thank you, Presiding Officer, and congratulations to Collette Stevenson on securing this debate, but also bringing together members from across the chamber who clearly are very passionate and very concerned and want to make progress. It's always good when we have member's debates to find out what members really care about. It's also really good that we have the cross-party group now. That's a real forum for change to happen, and hopefully one of the ministers will be able to come along and do course as a member of that group. I'm pleased to be working with people across the Parliament and outside, so it's good to see Anna Ross in the gallery, along with Lisa Quirell. I can see councillor Monique Macadam, who's also been a real ally and support to Lisa, but it can't be left to individual parents and individual families to fight this battle. It's a battle for all of us. I think that there's a lot that's been said already about the barriers and about the challenges, but I think that the job that we have now in this Parliament is to focus on what we can do in Holyrood, in the Scottish Parliament, rather than the things that we can't do. I was speaking to Lisa Quirell about Cole's situation. I know that Lisa is very anxious that we make progress, not just for Cole, but for anybody who needs this medication. Lisa pointed out to me that the sign guidance that we have in Scotland is quite old now, I think that it's 2013, so that's perhaps due an update, and it would be good to hear from the minister in his response what the situation is there. I will focus my time on Cole Thomson. I have mentioned Cole in the chamber before, so he's not a stranger to this chamber or indeed the First Minister and Jean Freeman when she was Cabinet Secretary. When a parent also has to become a carer for their child, it's absolutely exhausting, but when they also have to battle against systems and institutions and fight for everything, it's just really heartbreaking to watch. I think that it's good in East Kilbride and Central Scotland that we have a number of MSPs willing to support Lisa, but it does need change to come at government level. Cole is an exceptional wee boy. I've had the privilege of meeting Cole, and what's really encouraging about his journey and the fact that he's now on this medication and keeping him alive in stage 3, is that it's also given him back his education, it's given him back his hopes and his dreams. I was asking Lisa what would Cole say if he was here today, and his mum said that Cole, who is nine, who's in P5, said that I just don't want to go back to being sick again and to go back to being in a wheelchair. I want to be a black belt. How wonderful is that? It's our duty in this place not just to offer sympathy and warm words, but to show Cole and other children like Murray what we're actually going to do to help them realise their hopes and their dreams. I think that Cole will achieve that black belt in a whole lot more, but he will need our help to get there. I think that it's really important to mention as well the people who are willing to speak up and put their heads above the parapet. Here is Mrs Graham, who is principal teacher in Cole's school. She talks about the difference that the medication has made to Cole's life. She's really proud of Cole because of that, but she's written to the NHS and to the cabinet secretary, Humza Yousaf, to say that she has a duty of care towards Cole in terms of meeting his educational needs, but she also has a duty of care—not you, Presiding Officer, but the NHS and the cabinet secretary. She also has a duty of care—a duty to ensure that Cole gets the correct medication and treatment to give him the best quality of life. I think that looking at comments from Tracy, and I forgot. Tracy is from Unison who works closely with Lisa. She reminds us all that, in the NHS, we have the right to get treatment free at the point of need. Surely Cole has the right to grow up in Scotland with the right support and the right resources. I know that that is a time-up, Presiding Officer, but I think that it's been a really good debate, not just to highlight individuals who need the support now, but we have to get that right for the people who don't have a voice to people whose mums are not quite as vocal as Cole's mum, and I'm keen to hear what the minister has to say, because, in this chamber, we're all on the same page. We all want to go in the same direction, and we want to give little boys like Cole Thomson the hope and the route map to get to that black belt. I now call on Kevin Stewart to respond to the debate up to seven minutes. Thank you, Presiding Officer, and I want to thank Collette Stevenson for tabling that important comprehensive and, I think, very fairly balanced motion and on securing this first-ever debate on this issue. So, plaudits to Ms Stevenson for that. Members today have related the experiences of families who find themselves in such painful and distressing circumstances trying to do their best for their children. We've also heard from many members how families have access cannabis-based products using their own money through private prescriptions and the further pressure that this has placed on already stretched family finances. I'd really like to thank all the members for the tone of today's debate, because I think that that is very important as we move forward on this issue. I'm quite sure, Presiding Officer, that all of us can only have enormous sympathy for any family or any patient who finds themselves in this extremely difficult position. I'm quite sure that we will all understand their desire to explore any avenue to help them or their loved one. In my contribution today, therefore, I want to reflect briefly on what the Scottish Government has the powers over in this area, the situation now and what we are seeking to do to try to help. Presiding Officer, the regulation of medicines is at the moment a UK Government responsibility undertaken by the Medicines and Healthcare Products Regulatory Agency. Before a medicine is marketed, the manufacturer must demonstrate its safety, quality and efficacy. Applications for a marketing authorization, also known as a licence, must include data demonstrating its quality, safety and efficacy, and the MHRA will consider that data before a licence is granted. I should also note that, when the law changed in 2018, it did not relate directly to providing those products within the national health service. In the rescheduling of products under the Misuse of Drugs Act 2018, it did not alter the role of clinicians in deciding what treatments to prescribe to patients. Clinicians make those decisions on a case-by-case basis, taking account of the specific needs of the individual. Government ministers cannot—I'm quite sure that everybody agrees—should not intervene in these clinical decisions. I'm very grateful to the Minister for Giving Way. I understand the limitations in front of his Government in terms of helping these families, but the one power that his Government does have is to create bespoke benefits. He could work with other ministerial colleagues to create a benefit to reimburse the very small number of families who are having to privately fund the prescriptions. Do you agree to look at that? Again, that is a very difficult area, because the Government is, of course, very well aware that families have spent substantial sums on private prescriptions for cannabis-based products. I hope that the Parliament will understand that the cost of treatment sought privately must be met privately and not consume funding that would otherwise be made available to the NHS. However, what I would say is that what we should be striving to do here is getting this move forward and underlying the importance of new products being developed and fully assessed so that they can then be licensed and considered for general availability on the NHS here in Scotland. I think that that is what we would all want to strive for, and that is what we should do. I am very grateful to the minister for giving way. I wonder whether he can respond now or later in terms of whether the Government has any policy about how we can move this on. For example, there are barriers in clinical trials. I, myself and Alex Cole-Hamilton, said that we raised this many years ago. We do not seem to be making any progress on that. Doctors need confidence. I understand that it is Government policy to be in favour of it, but can you be specific at any point as to how you are going to unblock some of the ways in which people are being prevented from getting it on the NHS? I am going to try and explain in their speech how we plan to move forward in all of this. I do not have very much time left, so I hope that you may be a little lenient with time. What I do not cover in today's speech I will write to individual members about the issues that they have raised. Since the changes in UK regulations, doctors on the specialist register of the general medical kind have been able to prescribe an unlicensed cannabis-based product for medicinal use if clinically appropriate for their patients. A lot of people have covered GPs today, and GPs may prescribe licensed cannabis-based medicines subject to any restrictions under the product's licence, but the law also allows GPs to prescribe unlicensed products under the direction of a specialist as part of a shared care arrangement. In Scotland, as has been highlighted earlier, the only licensed cannabis-based product for medicinal use at the moment is Epidiolox, which is licensed for severe epilepsy. That drug has been through randomised control trials and has been assessed by the MHRA and the Scottish Medicines Consortium. That means that, unlike other cannabis-derived products, it has been assessed for quality, safety and efficacy, and clinical use and effectiveness. I will give a bit of time back to the minister, because it is white. Will the minister recognise that there is a different prescribing regime in England and Scotland and that there is a disparity? Can we do some work to bridge that? I do not think that that is quite right, and I will get back to Ms White with some of the specifics. There is a huge amount in front of me around about what GPs can or cannot do. I am not going to have time to read through all that today with the chamber, but I will write to all members who have taken part in today's debate outlining how all that works if that is suitable for members. Are clinicians professionally and clinically responsible for any medicine that they prescribe? The responsibility when prescribing an unlicensed product is greater than when prescribing a licensed medicine. That is why, before prescribing an unlicensed product, a clinician must be satisfied that there is sufficient evidence or experience on its safety and efficacy. Where they feel that it is not appropriate to prescribe a particular product, then they do not have to. Where the evidence base remains limited and there is not full clarity of the risk or harms, it is right that doctors are cautious to prescribe such products. If I can move on a little bit to some recent clinical guidelines, which demonstrate a clear need for more evidence on the safety, quality and effectiveness of unlicensed medicines to support that routine prescribing on the NHS. That, as members know, is why access on the NHS remains limited and prescribing is almost entirely within the private sector, and it is also why the Scottish Government continues to support the development of new clinical trials. Current evidence for the medicinal use of unlicensed cannabis-based products is from small, low-quality observational studies and patient-reported outcomes. I hope that members will understand that it would not be safe to allow for general access on the basis of such limited data. We have learned in the UK in the past, unfortunately, about the dangers of allowing new medicines to be given to patients without their first being through a testing of safety and efficacy. That is why we are supporting the establishment of clinical trials led by NHS England and the National Institute for Health and Care Research. I think that somebody asked, I think that it might have been a harper, around about the CSO involved, chief scientific officer's involvement. He has been in discussions around about these issues too. The minister really needs to conclude, I'm sorry. These randomized controlled trials will involve two groups of patients, adults and children with epilepsy, and for each there will be three arms. One arm with a cannabidiol known as CBD, one with a tetrahydrocannabinol, commonly referred to as a THC, which is the principle psychoactive constituent of cannabis, and one arm with a placebo. I understand that the study team will announce the plans for the trials as soon as possible, Presiding Officer, including when patient recruitment is expected to commence and the trials complete. It is essential, absolutely essential, and we've touched upon that earlier on in the debate in my response to Rona Mackay, that manufacturers need to come with us, to conduct their research. Despite repeated calls, some in the cannabis industry have largely failed to invest in clinical trials, although GW Pharmaceuticals stands as a noteworthy exception to all of that. Presiding Officer, as I conclude, I want to assure the Parliament that the Government has been clear and unambiguous on its support for exploring solutions in this very difficult situation. We are more than willing to work on a cross-party basis to ensure that we move forward on that front. We are committed to working with clinicians, with the UK Government and with regulators. Crucially, we need manufacturers to take the steps that are needed in clinical trials, so that patients and families can get the help and support that they need as quickly as possible. If we can build an alliance across this chamber, it may well be that we can work well together to persuade those manufacturers to do exactly that. I would ask the minister when he is writing in the terms that he referred to each member who participated in the debate this evening that he also ensures that Spice receives a copy of that just so that the information is widely in the public domain.