Sativex---------A Glimmer of Hope??

In my previous blog I mentioned that this week the States was to debate 3 cannabis related propositions. The outcome was predicable but it was the quality of the debate that was disappointing.

States Members have the ability of lodging propositions seeking States approval on a variety of issues. There are many Members who never do but fortunately there are a handful like Deputy Monty Tadier who do and he is to be complimented for lodging the 3 propositions which sought to improve the lives of those who through no fault of their own suffer pain and discomfort.

One of the propositions (P127) which can also be read below requested the Health Minister to take steps to make Sativex Spray available without cost to MS patients. The other 2 propositions were much more contentious because Deputy Tadier was seeking support to allow for cannabis to be prescribed for medicinal purposes.

Deputy Tadier decided to debate the Sativex Spray proposition first as it was relatively straight forward and I shall devote this blog to that matter. I will declare an interest because my wife has MS and when asked if she would be the petitioner to represent other MS sufferers she readily agreed.

Before Backbencher’s propositions are debated the relevant Minister normally lodges “Comments” indicating whether the proposition is supported, if it is not, reasons are given. Deputy Tadier lodged his proposition on 16^th July. The Comments which are below were published on 8^th September however the debate was deferred due to the impending elections. It should be noted that after the elections there was a change of Minister. However the new Minister Senator Green did not lodge his Comments until the 8th of December which was the day before the debate but his comments differed from the previous Ministers. 

Both Ministers opposed the proposition but it worth noting their reasons. The previous Minister Deputy Anne Pryke’s Comments could be summarised as follows.

Sativex can be supplied by any pharmacy, in accordance with the doctor’s prescription. It is, however, only available as a private prescription and costs have to be met by the patient.

Previous application from a consultant to make Sativex available via the Hospital pharmacy – in that case specifically for patients suffering with MS (Multiple Sclerosis) – has been rejected by the Hospital Drugs and Therapeutics Committee, based on assessment of clinical evidence and cost-effectiveness.

This decision has recently been corroborated by NICE in its draft revised guidance which does not recommend the use of Sativex for MS patients.

Current Health and Social Services Policy directs that the Department will not provide treatments at public expense where NICE has rejected that treatment. Final NICE guidance on recommended treatments is expected later this year and, should the advice on the use of Sativex for MS patients be amended, this position will be reviewed.

The issue within this proposition, therefore, is whether funding for a NICE non -recommended treatment should be met by taxpayers, at the expense of other treatments that are approved by professional, clinical expertise. The cost to the taxpayer of providing Sativex to any one individual patient would be in the region of £4–£5,000 per year.

There is no way to predict how many patients may subsequently be prescribed this treatment and, therefore, the potential overall impact on the Department’s already stretched annual drugs budget.

While it is available for prescription, Sativex remains a non-NICE approved treatment, and I cannot support a proposition for its supply to be funded by the taxpayer.

It is evident that the previous Minister could not support the proposition, because Sativex is not recommended by NICE, it is expensive even though Health does know how many people might need it but the Hospital Drugs and Therapeutics Committee, has already rejected the one application from a consultant based on assessment of clinical evidence and cost-effectiveness.

One is left to wonder whether the officer briefing Senator Green was the same who briefed the former Minister because it was not the information conveyed by Senator Green to States Members on Tuesday and confirmed by email to me.

Three weeks before the debate I wrote to Senator Green with a number of queries, unfortunately his answer below which was the information he gave to States Members was not sent to me until a couple of minutes after the vote had been taken. The following is an extract.

I am mindful that, ordinarily, Sativex is only available on private prescription. However, there is an existing mechanism in place for a recognised Consultant in an appropriate specialism, to make a request for public funding of such a treatment on behalf of a specific individual.

The treatment of patients must always be based on clinical assessment and professional expertise. But where clinical judgement can demonstrate that there are exceptional circumstances in an individual case, which would support the prescribing of this licensed product, a special request can be made for the cost of treatment to be met through public funding. To date, no application has been for exceptional consideration in such circumstances has been received. For these reasons, Monty’s petition is, to all intents and purposes, redundant and that’s why I do not intend support it.

Although the former Minister said there had been an unsuccessful application Senator Green says there have been none. If there have been none it would not be surprising because I doubt whether GP’s or their patients are aware of what appears to be a policy change introduced by Senator Green. I can confirm that my wife and her MS circle of friends are not aware of the policy change but know full well that if recommendations have to go via a consultant the whole process could take many frustrating months.

I mentioned above that the quality of the debate was disappointing and that was because apart from Deputy Tadier who proposed the proposition and the Minister responding the only other Member to speak was the newly elected Senator Dr Zoe Cameron who had made it known that she had been elected to try to get the health service fit for the future.

She had featured in the Jersey Evening Post that day in which she had expressed her dissatisfaction with politics mainly because she had not been given the Health Minister or even the Assistant Minister’s post. However on Tuesday she had the ideal platform to speak about the plight of MS patients, the merits of Sativex and informing Members whether she was aware that it was available albeit via the Consultant route. Also had she contacted Chemists she could have informed Members that the cost of Sativex in Jersey would be around £3000 and not the 4/5k as quoted in the Comments.

It is estimated that possibly one person in a thousand may have Multiple Sclerosis (MS). As there are around 100,000 residents in Jersey there could be around 100 people with MS who have various stages of the disease. Sativex is primarily to relieve spasticity which can be a problem for some people with MS. Although the number of people who would benefit from Sativex is unknown it is likely to be only a small percentage of 100. The reason why not exact figure can be given is because Sativex has only been available to those who can afford to purchase it.

Sadly it is evident that Senator Cameron did not pick up on the contradictions in the former Ministers Comments and the current Ministers speech. She had an opportunity of informing Members of how the current system is not working but failed to do so. Her short uninspiring speech added nothing to the debate, it was hardly the stuff of a potential Minister and she was one of the 29 Members who voted against the proposition.

The debate lasted less than 20 minutes and Deputy Tadier’s proposition received 16 votes which were around the same number he received for his other propositions. He might not have won the vote but he shook some branches in relation to the issue of Sativex because not withstanding the previous Minister’s Comments the current Minister says that Sativex can be freely prescribed if supported by a GP and Consultant. 

I have written to Senator Green asking what steps he is taking to ensure that MS patients and their GP’s are informed of his policy.

Readers might find this blog posted by Tony the Prof to be of interest---Please click here

Sativex Proposition P127/2014

Details of the Vote for P127

Bedrocan Proposition P126/2014

Cannabis; Possession of cannabis for treatment purposes P128/2014

Curtis Warren---- "Love In"-- Defending the Indefensible

At the last States Sitting the Home Affairs Minister, Senator Ian Le Marquand refused to accept that former Drugs Councillor Teresa Rodrigues had a 2 year love in with Curtis Waren whilst he was held on remand at La Moye Prison. As such he saw no reason to inquire into the allegation which had been reported in the Mail on Sunday on 16th February. It was also reported that Connetable Steve Pallet the Chairman of the relevant scrutiny panel had also declined to review the matter.

Both the Senator and Connetable are mature men and it is disappointing that they should have dismissed the matter in such a bravado manner.  Surely the simplest way of dealing with the matter would have been by calling for a report from the Prison Governor and the Jurats who form the Prison Board of Visitors. As it is they both lay themselves open to ridicule should it transpire that there is some substance to the allegation.

Given the abrupt dismissal it is not surprising that some States Members, Bloggers and the mainstream media are asking further questions. At the last States Sitting, Senator Le Marquand was unable to give the number of allegations of inappropriate relationship which had been reported during the last five years but said he would happily find out.

Ministers have a habit of failing to give answers but saying they will enquire and will inform the Member asking the question at some later time, but often fail to do so. Fortunately Deputy Tadier is not letting the Minister off the hook and has wisely lodged a number of written questions which should receive answers at the next States Sitting on 4^th March.

Deputy Tadier wants to know how many disciplinary cases there have been in the past 10 years at La Moye Prison for employees, and in how many of those cases the employee was either dismissed or resigned pending, or after, the action. He wants the Minister to provide a summary of any alleged misconduct, in terms of its nature (i.e. sexual, drug dealing, etc.)?  He also wants to know whether Teresa Rodrigues was the subject of a disciplinary investigation and, if so what was the basis for, and result of, that investigation? Finally he wants the Minister make the case notes available.

Deputy Tadier is doing his job as a Back Bencher and is to be commended for doing so, but should it not have been Scrutiny’s job or better still for the Minister to come clean in the first place.

This morning Radio Jersey invited Deputy Tadier and Senator Le Marquand to its studio to answer a number of questions in relation to the allegation. Unfortunately Senator Le Marquand was not available so his Assistant Minister, Senator Farnham stood in for him, unfortunately he was poorly briefed and Matthew Price had little difficulty in exposing his short comings. I am grateful to Radio Jersey for providing the link to the interview. Please click here.

Senator Farnham struggled from the outset because it is very difficult defending the indefensible. There is no way that he is as adept as Senators Bailhache, Ozouf or Le Marquand  in sidestepping questions and his replies soon led Matthew Price calling them “weasel words.” It is a poor tradesman who blames his tools and it is pointless claiming that the logistics of the prison may have led to the possibility of an affair taking place. However was Senator Farnham trying to say that there is a possibility that Ms Rodrigues might be telling the truth because apart from Curtis Warren there is no one who can say she was not.

Or is it that there is evidence of the affair but it has been suppressed.What is so frustrating and unseemly is that Senator Farnham believes that everything is just conjecture, with no hard facts and wants Deputy Tadier to produce the evidence. I am sure that if Deputy Tadier asked the Prison Governor to open his books and allow for inmates both current and former to be interviewed in confidence and without prejudice his request would be instantly rejected.

I know that Senator Farnham took objection to the “Weasel words” but listening to the answers he gave this morning one could hardly say that he convinced anyone and probably not even himself. He is on record as wanting a Department of Justice but justice for whom? He knows the difference between right and wrong and by defending his Minister’s obstinacy he is not only failing himself but also the electorate who in few months’ time will be looking to vote for candidates with backbone and the courage of their convictions.  

For the Radio Jersey interview  Please click here

Jersey's Dean---Another Meaningless Apology??

On 17th June I published a Blog titled Jersey’ Dean –Meaningless apologies. In that Blog I made reference to public apologies given to HG. In my view they were clearly meaningless because they were not given personally, there was no intention of doing so and when carefully looking into the wording of the apology it was unclear as to what the apology was for, if indeed there was one.

Yesterday in the States Chamber Senator Philip Bailhache a knight of the realm, former Bailiff, Chief Judge, former Attorney and Solicitor General and would be Foreign Minister made a Personal Statement. Interestingly he made it as a backbencher whereby according to the rules he could not be questioned on the contents/accuracy of his statement. This might not have been the case had he done so in his capacity as Assistant Chief Minister.

For readers who may not be acquainted with the background I will cover the relevant points and state that Senator Bailhache, as is his right, has been offering assistance to the Island’s Dean who is the subject of a complaint over his handling of an abuse complaint from a lady known as HG.

It was claimed by two business men that Senator Bailhache whilst on a flight between Jersey and London was reading documents appertaining to the case which revealed the names of the victim and the accused. Most of us have read documents or other material whilst on flights so what has made a mountain out of a mole hole?

It is evident that the business men contacted Deputy Trevor Pitman and expressed concerns about Senator Bailhache reading what they thought was sensitive documents which could be read by them and possibly other members of the public. It is unclear what research was carried out by Deputy Pitman before asking questions in the States but it would be helpful to know whether Senator Bailhache was travelling on States business and in what capacity. Was he travelling as a backbencher or as an Assistant Minister, as one can see above, there is a difference but none of us is the wiser?

The exchanges that ensued could be akin to a playground spat whereby the bully whilst denying any wrongdoing called his accusers nasty names and impugned their integrity. The bully and the accusers were then questioned by the Head master who believed that everyone was telling the truth. However to his credit Deputy Pitman stuck to his guns and pursued the matter to a stage where Senator Bailhache has been boxed into a corner and has now made a skilfully drafted statement which includes an apology. However it is open to interpretation and appears to be very much a damage limitation exercise.

Senator Bailhache is strongly denying not telling the truth however it does appear that he has been very economical with it. He claims that had he been made aware of what was being alleged a misunderstanding could have been avoided? To those who have been following the matter it seems to have been a simple one. It was claimed that he was reading sensitive documents on a plane which he had not only denied reading but in rebuttal used language which he now accepts was stronger than was necessary or appropriate. He would like to make it clear that he did not impute dishonesty or malice to Deputy Pitman or his constituents. There are some people who may not be convinced with that claim.

I believe that most people when being accused of something ensure they know exactly what they are being accused of before shooting from the hip and casting aspersions on the accusers. However this does not seem to be the case with Senator Bailhache who appears to be of the belief that his actions are above reproach.

The matter could and should have been resolved the first time the matter was raised in the States on 30th April. The reason why it was not is not down to Deputy Pitman but rests squarely on the shoulders Senator Bailhache and Chief Minister Gorst who failed to investigate the matter in a thorough and expedient manner.

What the Personal statement reveals is that Senator Bailhache has problems with his memory; he is not sure what he reads and even today could be mistaken in what he thinks he was reading. Given that he is aspiring to be the Island’s first Foreign Minister it does not bode well for Jersey.

The Statement is published in full below and it will be for readers to draw their own conclusions.
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PERSONAL STATEMENT TO BE MADE BY SENATOR SIR PHILIP BAILHACHE


ON MONDAY 15th JULY 2013

On 18th June Deputy Trevor Pitman claimed that I was not telling the truth to the Assembly in relation to a complaint by one of his constituents and this is my first opportunity to respond to that claim. That claim is strongly denied.
I should like to begin by stating that I have at no time been approached by Deputy Pitman seeking an explanation as to what happened on a London flight; the only exchanges that have taken place have happened on the floor of this Chamber in response to questions. If I had been made aware of exactly what was being alleged, a misunderstanding could have been avoided. It was not until Deputy Pitman made available to the Chief Minister a copy of the email from his constituent shortly before questions were put on 14th May, and the Chief Minister passed that copy to me, that I was able to understand the precise nature of the allegations.

When questions were put to the Chief Minister on 30th April I had assumed that the flight in question was a flight that I made to London on the evening of 20th March not long after the suspension of the Dean’s Commission had taken place. On that flight to London I have a clear recollection of reading the Korris report, as stated by the Chief Minister to the Assembly on 30th April. It was only on 14th May that it became clear to me for the first time that the flight referred to by Deputy Pitman’s constituent was on the afternoon of 21st March when I was returning to Jersey from London. On that flight I do not believe that I would have been reading documents relating to this matter because I had read them in London, but I may be mistaken.

In answering questions on 14th May I said that the content of the email from Deputy Pitman’s constituent “taken in the round [gave] a fictitious and malicious account of my reading habits on aeroplanes”. Having had time to reflect, I am sorry that I used language that was stronger than was necessary or appropriate. I withdraw the phrase “fictitious and malicious” and would like to make it clear that I do not impute dishonesty or malice to Deputy Pitman’s constituent or, for the avoidance of any doubt, to the Deputy himself. Having said that, the recollection of Deputy Pitman’s constituent is, at least in part, mistaken. That is perhaps not surprising because the constituent has stated in his email that he was sitting in a seat on the opposite aisle and reading papers in someone else’s possession from that position cannot be easy. That email alleged that the constituent had seen me reading “various police statements…” and it was later clarified to the Chief Minister that this meant “police witness statements”. That recollection is mistaken because I did not have in my possession on the aeroplane any copies of such police statements. I do not believe that it would have been possible for the other information referred to in the email to have been seen on that occasion, but in that respect I may be mistaken. If it was possible for any third party to have identified EY or HG from the papers in my possession, I would obviously regret that very much.

I should like to clarify two other points. First, I have never had in my possession any papers that I was not entitled to have in my possession, nor that involved a breach of the Data Protection Law or any other statute. Specifically, I have never seen any police statements relating to the investigation into allegations made by HG against EY. Secondly, my interest in these issues is not one that relates to my duties as an Assistant Minister. My interest stems from my position as an elected representative of Grouville Church on the Deanery Synod, and my strong feelings about the manner in which the Dean has been treated. Any backbench member has a perfect right to interest himself in matters of this kind.