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Estimates questions on Medicinal Cannabis

6 June 2017
Ms  DAWKINS  - Once the controlled access scheme comes in September, where do Tasmanians, who are successfully treating conditions with home-grown cannabis now, stand?
 
Mr FERGUSON - I will get the Chief Pharmacist to add to my answer in a moment. 
 
First, we do not encourage people to do that.  We want to encourage people to only be taking medicines that are prescribed by a doctor of good standing and dispensed through licit means.  I will not attempt to canvass what the Police Commissioner or the minister would have to say about this.  The controlled-access scheme is what people in the community, members of our parliament, have been calling for.  We are establishing the licit and recognised means by which a patient who is potentially able to benefit from a prescription of a non-registered cannabis product might have the opportunity to use that product and also have ongoing care and close monitoring under the controlled-access scheme.
 
Ms  DAWKINS  - A number of people in our community, of whom I am sure you are aware, have been treating their own children who suffer from epilepsy with home-grown cannabis.  They have gone through a process over the past five, 10, 15 years where they have honed the product to be able to suit the needs of their child.  They are very concerned, as I am sure you could imagine, that a controlled-access scheme will not be able to understand all the information they have about their child.  That is not the way a system like that would work.  Have you had any discussions at all with the Police minister about how those people could be protected?  Would they be funnelled into that scheme with no other options?
 
Mr FERGUSON - Doctors are highly educated and well-read individuals.  To be a paediatric neurologist is a massive undertaking.  We have committed in our $3.75 million to take out part time - the individual concerned is not a part-time doctor, but for his paediatric neurology specialty he is part time.  We have committed in these funds for that individual to be full-time, as a paediatric neurologist.  That is about expanding the medical workforce capability to be able to assess a patient, to listen to their experience and case history, which would include illicit use of other products that have been sourced by whatever means.  It would also include using known evidence and recognised science to establish, first, whether prescribing a cannabis product is clinically appropriate at all and, second, under what conditions, regime, monitoring. 
 
Doctors are instinctively conservative because of the errors we know that have happened over hundreds of years with experimental approaches and the impacts that has had on people, or by providing medicines to a patient where the research was not robust.  Doctors, for that reason, are very cautious about prescribing and my understanding is that people would be encouraged to use the controlled access scheme.
 
The Government is seeking to resource the work force.  The compelling argument has been made that children with drug-resistant epilepsy are a compelling case but I am not able to give a promise that everybody who applies to visit will be given a prescription.  I trust the specialist doctor and I encourage you too, to trust them that they will use their best judgment and also, from a compassionate point of view, would always be trying to give that young child the very best in health care, which will potentially in the future include an unregistered product.
 
Ms  DAWKINS  - Can you talk me through how long that might take?  If somebody was to call today and say, 'We understand this is coming in September, and my child I believe would benefit from using this system', when would they be seen?
 
Mr FERGUSON - We are encouraging people to look to the 1 September start date as the time, and the chief pharmacist can add to my answer here.  We would encourage people to, first and foremost, speak to there GP.  Part of the communication strategy is sharing with GPs what the process will look like and how they are involved, understanding, of course, that by far most GPs want nothing to do with cannabis and have made it very clear to us through their colleges and professional organisations that they do not wish to be involved.
 
We actually want them to be involved from the point of view of at least listening to their patient as a family doctor and knowing now about the means by which the controlled access scheme would work to write an appropriate referral to the paediatric neurologist, in this case, and for that patient then to be seen through our expanded workforce.  We want to encourage people to be talking to their GP, they can be doing that now but officially we have targeted the 1 September start date for the scheme for people to be thinking of.