Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2)

I move, That the Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2) be now read a first time. I nominate the Health Committee to consider the bill.

It’s a pleasure to speak to this bill in my name, the Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2). Two years ago, this Labour Government said at the first reading of their medicinal cannabis bill, this bill will “make medicinal cannabis more readily available”. Unfortunately, this has failed. I do not see one single new medicinal cannabis product enabled by their bill on the shelves for New Zealanders over these past two years. Other failures of incomplete policy are a failure to educate GPs. Patients and industry experts tell me that they are at the mercy of expensive cannabis doctors, who are now selling low-quality cannabis gummies online in New Zealand, and cannabidiol, CBD, still needs to find an affordable and accessible pathway. What we have got is not at all what New Zealanders wanted or expect from a medicinal cannabis framework, or what I believe this House envisaged.

So how can this member’s bill help? Let me set the objective for this bill. I bring this member’s bill in my name to the House tonight in full knowledge that legislation and regulations have already been passed, but in the belief that they can be made better. In this knowledge, we are asking that this bill be sent to select committee for whatever the best parts are to be considered.

Here is a one-sentence summary of what brought us to this place. In July 2018, Labour and National presented their medicinal cannabis bills, which went head to head. Labour passed all the details to regulations that were still to be determined, and we drafted the detail into this bill for public and parliamentary scrutiny, and we committed to retail products on the shelves in one year. Two years on, and there are no new medicinal cannabis products on the shelves from this legislation. Two years lost, one in forming the regulations and one in complying with them, and no hope in sight for immediate relief. The promise has fallen far short.

I will draw three features from my member’s bill around how the existing framework can be made better. Here are six proposals from the bill for how retail accessibility and affordability can be accelerated. The first is positioning of low-dose medicinal cannabis products on the over-the-counter framework. Secondly, provisional consenting from Medsafe. Thirdly, follow-up clinical trials—phase zero, phase one, and phase two only. Fourthly, controlled importing of approved quality, low-dose product. Five, GP prescribing without specialist co-signing. And six, pharmacy dispensing, as is done in the US.

We also need to tighten up regulations around licence eligibility and locations. It is wrong that an inmate who is currently in prison for a serious offence such as murder is eligible for a medicinal cannabis licence and that active gang members can be employed in the industry. It is also wrong that medicinal cannabis can be grown beside a wāhi tapu and a school.

Here are suggestions, then, from this bill, tightening up the regulations to make this framework more enduring. For licence holders, there must be no history of a serious offence, no history of controlled drug habituation, and no associations adverse to the intent of the bill. This is very similar to what Australia does. For employees, they should not be currently addicted or habituated and not currently an active gang member. There is a very clear and overwhelming association between gangs and the drug trade. The Attorney-General has formed an interpretation on this point that while there is a clear connection between gangs and drugs, the prohibition on their employment is not a proportional response to the rights of freedom of association. I disagree, and I suggest we put this to the court of public opinion—if they think active gang members should be employed in the medicinal cannabis industry. Finally, locations where medicinal cannabis can be currently grown are wrong. It should not be allowed to be grown alongside a wāhi tapu, school, or residential area.

In summary, it’s disappointing that after two years, there is still not affordable and accessible access to medicinal cannabis products in New Zealand. As the sponsor of this bill, I have the privilege of selecting the speakers amongst a caucus completely, unanimously behind this bill. I’ve asked the Hon Simon Bridges and Chris Bishop to offer contributions as key people in getting this bill here tonight, and I thank them and my caucus colleagues.

To conclude, in progressing this body of work, I believe we have contributed usefully to the debate on medicinal cannabis, and I commend this bill to the House.

When I was Leader of the Opposition I was faced with a situation where the Government was doing nothing on medicinal cannabis, and many New Zealanders were contacting me—it was a huge issue on the television, on the radio, all the time there were worthy cases of people in pain who couldn’t get the pain relief that they wanted. I was, I’ve got to be honest, somewhat sceptical. I wondered if this was a Trojan Chlöe Swarbrick horse for decriminalisation, and that’s what was really going on here. But I did accept that there was a need for a regime of medicinal cannabis.

It was—and is—of course, no different than the many other ways that we medicate, whether morphine—a class A drug, of course—or others in our medical and health system. But I knew that what I also wanted was a regime that was robust, that was serious, that wasn’t—as so many bills, member’s bills that come before this House are—just a slogan with nothing really behind it. So what was I to do in this situation? Well, I asked Dr Shane Reti if he could go away and do this, and can I say to the member who’s brought this fine bill and done this piece of work forward—he was at that stage in somewhat obscurity, not too far in front of Jami-Lee Ross in this Parliament in the pecking order, but I asked him if he would go away and do the work on this. A bill to devise the scheme that makes up this bill, a legal one, but, more than a slogan, something that was truly robust, taking best practice from around the world.

Dr Reti came back with what I think is, and I don’t say this simply to flatter him in the House, but one of the best pieces of work I’ve seen in politics, can I say, at least from a politician. He did an incredible job on this, he looked globally, he went to the United States where he had a number of significant medical and political contacts, and he put together this brilliant piece of work. We presented it, the media, they could not find fault, and the stakeholders accepted the worth. I don’t think there was a criticism there, frankly, out in the public, and David Clark laughs. That’s because I’m coming to what he did, which was three-fifths of not very much.

💬 Hon Dr David Clark: This is absolute nonsense.

And that is that, well, the member has got to speak if he’s going to say that, we look forward to it. It was better than what a thousand officials in the Ministry of Health under Dr David Clark came up from. Because, in the end, a long time after, actually, Dr Reti had shamed the Government into doing something, this Parliament passed a Government law that was a skeleton, at best, with no bones on it; unlike Dr Shane Reti’s bill, that had the substance, that had the robustness here, and did the job, and he presents that bill to the House.

I’m not going to go through the detail of the bill. It’s there, people can read it, Dr Reti has referred to the seven pieces—

Chlöe Swarbrick: Have you?

Well, the member over there, Chlöe Swarbrick says “Have you?” and she probably thinks she’s funny, but the reality is she’s boring when it comes to drugs. She only has one agenda, and that’s to free it up and get more on the streets. That’s her view, it’s not my view, actually.

And I say I’m not going to go through the detail, but this is incredibly well thought through, the detail is there that isn’t in any of the Government’s work. I say to the members opposite, there’s only one Minister in the House, one member of the executive, or two if I count Mr Tirikatene over there, I urge them to take this on actually, to support this. Because if they did that, they wouldn’t just have a slogan. They just wouldn’t have a skeleton without the flesh on it. They would have something of substance, that’s robust, and that would give New Zealand a world-class medicinal cannabis regime we could be proud of.

Thank you, Madam Speaker. I’d just like to start by acknowledging Dr Shane Reti and the work he’s put into developing this comprehensive bill. I think access to medicinal cannabis was an incredibly important debate that dominated my first year in Parliament, as well as many of us here in this House. Unfortunately, I can’t support this bill, and I’d like to spend a little bit of time explaining why. As I’ve said, it is a comprehensive bill. There is a lot of work that has gone into it. It runs for 29 pages, with a lot of description around how the scheme should be set out.

But there are two parts in the first couple of pages, which, I think, for me, highlight why I can’t support the bill. The first, I guess, is the title; not so much the Misuse of Drugs (Medicinal Cannabis) Amendment Bill, but the (No 2) bit that follows on, because I think that (No 2) bit—I’m not a lawyer but my understanding is it is because you’ve had a bill with exactly the same name occurring before you’ve had this bill. I think the issue that we’ve got is that this same bill was introduced back in 2017, and there was a big focus back then on access to medicinal cannabis.

We had a huge number of submitters come and speak to us as the Health Committee. I think, looking at it, we had 1,786 written submissions on this bill and we heard 158 oral submissions. For me, the thing I remember the most was some of the submitters that came and talked to us about their wanting to access medicinal cannabis—particularly, older people, some who had really, really severe arthritis, and they were in pain day to day and they wanted to be able to access something that would potentially transform their lives. I remember parents coming and talking to us, they had children who had intractable seizures, and access to medicinal cannabis products had the potential to actually transform their child’s life and their life. The message they gave us is: you need to go faster; don’t dilly-dally around—you need to get on with the job. That’s one of the messages that remains with me and, I think, it is one of the reasons why I would have significant concerns on starting again from scratch.

So just a brief recap about where we got to. Just to start with, as I said, the bill was introduced in December 2017. As the select committee, we received it after its first reading in January 2018. We considered this bill for quite some time, reporting it back in July 2018, and then debated in the House and then the bill was passed in December of that year. One of the main modifications there was in recognition of the fact that it would be a little while, while we developed up these regulations, and so there was a defence included in there. Part of that debate was: rather than having somebody with a terminal illness, changing that to people eligible to receive palliative care would then have a defence if they were using cannabis that wasn’t approved under the scheme because the scheme wasn’t yet in place.

So then, once the bill was passed, the ministry started to develop up those regulations and put that time into that. So then in July 2019, there were four weeks’ public consultation around the regulations and also the standards so that the public got to have a say, and then that was considered, and the final regulations were released in December 2019 and then due to take effect on 1 April last year—which they did. We’ve now had the medicinal cannabis scheme in place, and in that time we’ve also established the Medicinal Cannabis Agency so that they are the ones administering this scheme. So there is a lot of work that has already gone into where we are today.

So, basically, under the scheme, you can only get medicinal cannabis products on prescription from a medical practitioner. If you are a manufacturer or an importer, you have to provide evidence to the Medicinal Cannabis Agency that you meet those minimum standards, which is incredibly important. And people who work in the industry have to hold a licence or they have to work for somebody who has a licence, and that licence is quite particular about the things you can do—whether you are commercially cultivating cannabis, manufacturing, or supplying the products.

I think this is where one of my concerns about the current bill is. A lot of people would have made significant investment in what they’re thinking about: setting up a business. They’ll be looking at what the current regulations are. They’ll be buying their land. They’ll be investing in R & D. They’ll be working towards manufacture of a product.

The problem we’ve got is the regulations of medicinal cannabis are very, very comprehensive, but so is Dr Shane Reti’s bill. So the question is: what happens if there are differences between the two and does that introduce uncertainty for people who have probably invested significant amounts of money in developing something out to match the current regulations?

So just some of the examples just looking at who can hold a licence under the current regulations. There is a range of things: you’ve got to be under 18, you can’t have had any prior offences under the Act, and you can’t have had a licence revoked for various reasons. So, basically, there is a range of things that prescribe who can hold a licence. When we come across to Dr Reti’s bill, there is quite a significant overlap between some of those criteria, but there are some other criteria. So in determining whether a person is suitable to hold a licence, the director-general may consider the connections and associations that person has with other persons who may have the ability to influence the conduct of the person. Now, if I was the Director-General of Health, I’d be struggling a bit with quite how to enact that. Some of the other criteria: it can take into account a person’s previous business experience or any other matters that the director-general considers relevant. Now, if I were a manufacturer who was investing a lot of money in working out how I can develop up my products in line with the regulations, if it came down to any other matters that the director-general considers relevant, that would introduce quite a significant amount of uncertainty into my application and my business planning.

So I think the issue we’ve got is that if we’re going to have a comprehensive new bill coming in and trying to weave one part in with the other, we’re going to end up with uncertainty in the sector, which will be a considerable issue for people that are quite far down the pathway already.

I think the other issue around the bill is just looking at the enactment. This is where I got a little bit confused, because in the explanatory note, clause 2, the commencement clause “provides that the Bill comes into force 12 months after the Bill receives the Royal assent.” But then if you go across in the bill to the commencement, it says the Act comes into force six months after the date in which it receives Royal assent. I’m not quite sure, again, what one does if you’ve got different dates. But for me the issue is thinking back to those submitters who were saying to us, “Look, we’ve just to get on with this. We need some products that we can use that are safe and that are effective. Please get on and hurry up because, you know, we’re in need of a product that can relieve our pain and our children’s distress. We want to get on with it.” I think the problem is that if we’ve now got this bill coming through the House, and on average it probably will take six to nine, up to 12, months before it gets passed, and then we’ve got a further period where the bill may come into effect 12 months after the date—or six, I’m not quite sure which. That just adds, again, further delay and it pushes things further and further out in terms of when people may get products.

So I think that the argument has been made here: could we not weave the best parts of one bill in with the regulations from the other and see where we get to? But I just think that that process—I’m not even sure how one could quite do that. It would be quite a complex thing to try and work out at the select committee process which parts you would include and which parts you wouldn’t, but then how would you actually then amend what was already in place?

So I think the issue we’ve got is that we need to consider one scheme or the other. Part of the reason why I went through the time frame and gave you a bit of a history of the previous journey we’ve been on is just to reflect that to do it properly, it does take time. We needed to have that time for the select committee to hear all of those submitters, to listen to what they had to say, but we needed then for the ministry to go away and develop up those regulations, then we needed that time to consult, we needed that time for them to be refined, and then for the regulations to be put in place. We then needed that time for the scheme to be put in place and we needed that time for manufacturers to look at what was in front of them and then, basically, make their business cases accordingly. So I think where we’ve got to now, after all of that time, is we’ve got a comprehensive framework as laid out in the regulations, and I look forward to seeing some of those new products coming across the line. So, unfortunately, I can’t support this bill. Thank you, Madam Speaker.

The question is that the motion be agreed to.

E te Māngai, tēnā koe, tēnā koutou e te Whare. In starting this contribution tonight, I need to address the fact that with some of the points made by previous speakers, most notably perhaps the Hon Simon Bridges, my blood is boiling, particularly because of the way that there has been a complete asphalting over the history that has got us to this point.

First and foremost, the Hon Simon Bridges alleged that the National Party put this on the agenda last term, completely neglecting the reality that in the term prior the Hon Julie Anne Genter had a bill pulled out that I then inherited in the subsequent term which I was having conversations at the time with Dr Shane Reti about in rooms which then led to this place. And he is aware of that, he knows that, and so too does Chris Bishop.

The other thing that I would say is that to try and—and that also neglects the reality that Metiria Turei had a bill that came before this House in 2009; 10 years ago. It also neglects—and I’m gutted to hear Dr Shane Reti talk about how there was somehow this competition of ideas between National and Labour, neglecting the fact that his bill has the literal title of No 2 because my bill came first. On top of that, there is the point that was made by Simon Bridges about how I am boring on this subject. And I’m not sure if that’s because I’d really like to engage in the nuance and the complexity and the evidence, but I’m happy to have that dialogue with the National Party any time.

So it will come as no surprise to Dr Shane Reti that the Greens are not supporting this bill tonight, and he knows that because he didn’t approach us to talk to us about it, which means that he’d probably done the numbers and realised the way that the chips were going to fall. But just for anybody who is listening tonight to the debate that’s occurring in the Chamber: that’s not what the process looks like in this place when bills are known to be going through the process to be passed and the numbers are being done to accumulate their passage through the Chamber.

But on top of that, the major reasons that the Greens are not supporting this is because, in substance, it represents a highly pharmaceuticalised, commercial model, which will not increase access, nor improve affordability for patients. But also actually, perhaps worse than that is perhaps a point of difference for the Greens in this debate tonight, and is actually something that I want to acknowledge the Hon Dr David Clark for really listening to me on and engaging with me on when he was the Minister of Health in the development of what is now the medicinal cannabis regulations, which was to explicitly focus on the injustices caused by cannabis prohibition, particularly noting that a majority of New Zealanders will have used cannabis—80 percent of New Zealanders by the time they’re 21 will have used cannabis, but there’s only a small proportion of New Zealanders who carry a criminal liability for having done so.

So what we want to do in creating a legal framework is not set up a system that perpetuates those injustices, particularly when marginalised demographics are those that are targeted under prohibition. So we explicitly made it so that those who had former convictions would be able to work inside of the industry, not necessarily hold the licences but to work inside of that industry. And here I can’t give a better example of the slow progress when you wait for expungement of criminal convictions than the 1986 homosexual law reform, which finally decriminalised homosexual acts between men in consensual relationships, but it took more than 30 years for us to expunge those convictions, by which point many of those who held those convictions had passed on. Waiting to do the justice bit until after you’ve dealt with the politics of today simply isn’t good enough.

The other thing that I think needs to be noted and that I will applaud Dr Shane Reti on is the fact that there is in here a really good thing in greater education for prescribers and for GPs. That is something that absolutely needs to be picked up. But fundamentally, and this was exposed in a parliamentary written question that I put to the Minister of Health Andrew Little, under section 35E of the Misuse of Drugs Act 1975, which was put in place by virtue of the medicinal cannabis laws that we passed in the last term of Parliament, there is a requirement to review the efficacy of medicinal cannabis regulations within two years of their passage. I have it on record that that is to be reviewed and completed by 18 December at the end of this year.

Obviously there seems to be, by virtue of the comments that some parliamentarians have made in the media, appetite to continue discussing this issue, and I hope collaborative effort can continue.

Thank you, Madam Speaker. I rise on behalf of the ACT Party in support of the first reading of the Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2). This bill seeks to amend the Misuse of Drugs Act to provide for a medicinal cannabis scheme that is more robust than what we have under our laws. Currently in New Zealand, we do allow for the use of medicinal cannabis. We don’t prosecute if somebody grows their own cannabis for medicinal use, but what we don’t have is a robust framework to allow access to the medicinal products beyond growing your own plant, those that are cultivated to a high quality and regulated standard in a controlled environment and are approved as medicines that can be sold and dispensed in pharmacies. What this bill seeks to achieve is a safe market for medicinal cannabis products. It would create an environment where those who manufacture medicinal cannabis products will not be able to be located within 5 kilometres of residential areas or 1 kilometre of schools, and products would not be able to be advertised to the public.

Medicinal cannabis has high levels of support in New Zealand. It’s because so many people have a personal story. They know somebody who has suffered, and they know that if they developed a condition or the condition deteriorated and the medication that they were on was not enough, they’d want another option, something else to help them cope. There are many New Zealanders who live with chronic pain and suffer from seizures that could lead more fulfilling lives by being able to access medicinal cannabis products. These New Zealanders want to do the right thing. They don’t want to grow their own cannabis plant or get it online. It’s not something they do. ACT believes in the inherent dignity of every individual New Zealander. We need to provide more choice for New Zealanders who want another option.

This bill would create a safe environment where a person’s health problem can be alleviated, even if only a little, in a safe, controlled, and familiar way, like other medicines that they may take for a medical condition from the local pharmacy. ACT will support this bill at first reading so the public could have their say at select committee. Thank you, Madam Speaker.

Thank you, te Mana Whakawā. It’s an honour to again speak, for the third time tonight. I know that people love hearing my voice. It’s the Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2). I want to take this opportunity to acknowledge the sponsor of the bill, Dr Shane Reti. The first select committee that I was part of was the Health Committee, and I had the privilege of experiencing how Dr Shane Reti is very diligent and is passionate about his area of health. I want to acknowledge him for that.

However, I am speaking opposing this bill. I feel that I did leave the select committee halfway through the shepherding of the Government’s bill in the last term, so I didn’t really quite get to the end. But, just listening to all the contributions tonight, I get a feeling that this bill seeks to establish a medicinal cannabis scheme that already exists. That’s why I’m a bit confused. The member can correct me later on in reply, but, again, I think the medicinal cannabis scheme is now up and running, and a range of further medicinal cannabis products will be available over time.

I acknowledge one of the last speakers, Chlöe Swarbrick, who gave us a history of the conversation about cannabis and how we arrived here today. What did concern me—because I am respectful of the member—was the way he talked about how active gang members will be able to be suppliers of medicinal cannabis. I just want to know: how do you identify an active gang member? How do you identify them? I know that there is some register that people refer to—how do you identify? Anybody could be a gang member, who goes to work full time or whatever. I’m concerned about the general swiping of gang members who could be—yeah. So I was a bit concerned about that.

Then, one of their speakers spoke about how it was a huge issue for them in the last term. In 2017, it became a huge issue. I know from memory that National supported the Government’s bill, up to the point where the conversation was about loose-leaf cannabis. From memory, I think National did support the Government’s bill at first reading and through conversations at select committee, but through that conversation something changed. Something changed, and I think that was confirmed by one of their speakers, who said that it was a huge issue—it became a huge issue to them at the time.

You might correct me, Madam Speaker, but I’m a bit confused. I think that there is—

💬 Chris Bishop: Yeah—well, that’s pretty obvious.

The reason why I say that is I believe that we already have an established medicinal cannabis scheme.

I want to acknowledge Dr Liz Craig, who was also confused with the commencement of the bill. It talks about six months, and then it talks about 12 months. It’s still confused about that. But that doesn’t take in the fact that thousands of New Zealanders have had this conversation. We’ve all had the conversation in the last term, and up to now. We’ve got a scheme already established.

I want to acknowledge this bill. Shane Reti did talk about the bit where there’s card holding. Cards will be issued to medicinal cannabis users, and their carer would also be provided with a card. I want to acknowledge him for that, because that provides some accountability. Even active gang members might be able to hold a card as a carer to one of their children—so there goes the point where active gang members may be defunct.

Anyway, I stand in opposition to this bill, but I have due respect to the member. I continue to hold respect for the member, but, unfortunately, I cannot support this bill. I therefore speak in opposition to this bill to the House. Mālō.

💬 Hon Member: Labour call?

💬 Hon Member: Take it Chris.

💬 Hon Member: Sarah.

💬 Sarah Pallett: Madam Speaker.

Chris Bishop.

OK. Madam Speaker, thank you very much. The interesting thing about the last two years—fair to say a pretty vexed issue before the Parliament of the last two years—of medicinal cannabis and personal use of cannabis and possible legalisation is this Government has trumpeted their own scheme, and one of the reasons why we’re told that we can’t vote for this bill in the Parliament that Dr Reti went away and worked on is that the Labour Government has their own scheme. We just heard it from the previous speaker, Anahila Kanongata’a-Suisuiki, that “The regime’s in place. We’ve passed the regulations.” Well, here’s a question for the House and for the Labour Government: where are the products? Where are they? Because four years in to this tawdry administration there are no medicinal cannabis products available. So where are they?

There was a great hullabaloo in the last Parliament about this progressive step forward. David Clark, in his ill-fated time as Minister of Health, talked about how we were going to get medicinal cannabis, and people in pain who had arthritis were going to get access to it, and it was going to be fantastic—widespread availability. And we said, “Well, that sounds good, but you produced a shoddy piece of legislation that just leaves all the work to the officials—all the work subcontracted out to the Ministry of Health officials to do the detail, to do the actual grunt work that’s required when you’re passing legislation.”

We said it would be a failure, and Dr Reti, under instruction from Mr Bridges, went away and in four weeks did more work and more substantive policy to advance the cause of medicinal cannabis in New Zealand than the Government has done in four years, and the result is this bill that we’re debating. He went to the United States. He went and consulted with the experts, and by himself he drew up a more substantive and comprehensive piece of policy that met with more approval from medical experts and medicinal cannabis lobbyists and people who know what they’re talking about in this field than David Clark was able to produce in three hopeless years as the Minister of Health.

And now we find, six months into this useless Government’s regime, that the regulations have been passed, they’ve set up the administration, but where are the products? They’re not there. So a Government that trumpeted and sang from the rooftops about how we were going to get wider access to medicinal cannabis, and easier access, and went up and down the country and talked to all the stakeholders and talked to all the people who are desperate for access—the Government has failed them. They’re in Government till the next election; they’ve got another 2½ years. But I’ll make a prediction now: the roll-out of medicinal cannabis in New Zealand will be slow and it will be bad.

What the Government should do, if they knew what they were doing and they actually had some expertise on the subject, is they should vote for this bill. This bill fills in the gaps of the legislative lacuna that the Government has put in place. We heard, from the speaker before, all these trivial objections. She clearly hadn’t read the bill—basically reading out some poor Labour Party research unit’s attempt at rebutting the bill—and said, “Oh, I don’t know who’s a gang member, so we don’t know how to vote for it.” Well, the reason that’s in the bill is because Dr Reti says if you hold a medicinal cannabis licence, you shouldn’t be a gang member. That wasn’t in the Government’s legislative regime. And the previous speaker says, “Oh, well, how do I know?” Well, here’s a clue: it’s the gang lists that Poto Williams, the Minister of Police, administers. It’s the gang lists that Simeon Brown’s been banging on about in the House for the last six weeks. There is a gang list; that’s how you find it out.

So the purpose of this bill is to increase access to medicinal cannabis and accelerate it, and if we’d passed it two years ago when it was lodged by Dr Reti we would have medicinal cannabis on the shelves right now. It is to the Labour Government’s eternal shame that this tawdry Government did not adopt it at the time. We advanced it in good faith. We said to the Parliament, “There’s actually a widespread consensus around access to medicinal cannabis; let’s get it over and done with. Let’s pass it, and let’s increase access.” Instead, four years into this hopeless Government’s regime, we’ve got no products on the shelf. Shame on you.

I rise today to take a call on the Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2). I want to start by first acknowledging Dr Shane Reti, who is my colleague not only in Parliament but also as our previous careers—both being general practitioners. I also want to acknowledge Chris Bishop, part of the Health Committee, which I am on now, as well.

💬 Chris Bishop: He’s a good member—a very good member!

Thank you. The bill seeks to establish a medicinal cannabis scheme that already exists. The Government has already established a medicinal cannabis scheme, which was the No. 1 bill, hence why we’re talking about the No. 2 bill. In December 2017, we introduced the Misuse of Drugs (Medicinal Cannabis) Amendment Bill, which, first of all, sought to introduce a medicinal scheme to enable access to quality products; secondly, to introduce a statutory defence for terminally ill people to possess and use illicit cannabis; and, thirdly, to remove cannabidiol from the schedule of controlled drugs. In December 2018, after careful consideration by the Health Committee we passed this bill, including a statutory defence inserted specifically for people eligible to receive palliative care.

In July 2019, the Ministry of Health began a four-week public consultation on the proposed regulation and standards for medicinal cannabis. People have had their input into this. In December 2019, the final regulations were released to take effect in April last year. As planned, the medicinal cannabis scheme came into force last April with its purpose to improve access to quality medicinal cannabis products for patients.

By this time, the medicinal cannabis agency had been established to administer the medicinal cannabis scheme. Under this scheme, the medicinal cannabis products are only available to patients on prescription from a doctor. Manufacturers and importers are required to provide evidence to the medicinal cannabis agency that they consistently meet minimum requirements standards of quality before they can be supplied.

People who want to work in the industry need to hold the medicinal cannabis licence, as Dr Liz Craig just talked about, or they need to work for a person or company that holds a licence. The licence will specify the types of activities that a licence holder may carry out, such as a commercial cultivation of cannabis, manufacturing or supply of medicinal cannabis products.

The Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2) as proposed by Dr Shane Reti was intended to provide a medicinal cannabis scheme, but it already exists. The scheme already exists and went through due diligence, after two years of going through a process in this House. The No 2 bill would cement the primary legislation features of the medicinal cannabis scheme that already exists, which must remain flexible because we want the experts to keep pace with the emerging industry techniques that are coming out and to respond to these. The Government remains committed to increasing the availability of quality medicinal products and thus making these products more affordable for people.

In contrast, the National Party, however, appear stubbornly attached to a bill that would take us backwards rather than helping to ease people’s suffering. National is unfortunately behind with this, as it is with other bills in the House.

Under this scheme, medicinal cannabis schemes are only available to patients on prescription from a doctor at the moment. Manufacturers and importers are required to provide evidence of the medicinal cannabis agency, that they consistently meet the standards I just talked about.

National supported the Government for the bill in the first reading, but then pulled out from the bill and proposed its own version of the bill. As a member of the Health Committee this year, I want to acknowledge that the bill has already gone through a Health Committee process. It’s already gone through a public consultation process.

I want to acknowledge the former Minister of Health, David Clark, who was just here a few minutes ago, because he was talking about how 25,000 people would benefit from this under palliative care who could be using these medicinal cannabis products under the already existing legislation that went through the House last year.

The No. 1 bill by the Government is compassionate legislation that is making a real difference to people living with pain and nearing the end of their lives. People nearing the end of their lives should not have to worry about being arrested or imprisoned in trying to manage their pain at the same time. So in conclusion, I would just like to say that the bill already exists; that is the No 1 bill, and it went through a comprehensive consultation process before the National Party decided to introduce another bill with the same name, just putting a No 2 at the end but not much significant change. Thank you.

Thank you, Mr Speaker. It is a privilege again to speak to this amendment bill No 2. But like my colleagues, Dr Gaurav Sharma, Dr Liz Craig, I just want to acknowledge Dr Shane Reti—I think it’s the whole collegiality of being in the medical field as well, so ngā mihi to Dr Shane Reti for the work he’s put into this bill.

Just up off the Zoom session with my Pacific peer group, which is a group of medical doctors that discuss such matters specifically to our Pasifika and our community in South Auckland, and this is one of the topics that was discussed, briefly discussed, and is such an important thing. Because, I guess, an experience that we have in South Auckland, and I guess just in the whole medical community that we see, we see a lot of our multiple comorbidities, chronic-care patients, and those who are on palliative care as well. And we see the struggle that we have to manage with our dear patients in regards to pain relief, and the pain team that are involved, the palliative team that are involved, and a number of specialists that have to juggle a number of medicines to help with our patients. So that’s why, when it came to late 2017, when the principal bill was introduced, there was the delight from my colleagues, including myself, that there was another form of medicine that we can use in our tool kit to help families and those patients in the suffering of loved ones.

The principal bill, that again we look at, again with my colleagues that have expressed—currently, like the notion goes, the medicinal cannabis scheme does exist at the moment, and it enables access to quality products. And I know that Mr Bishop has mentioned, “Where are the products?”, but I do, you know—these sort of products do take time. And there are two products that have been verified not too long ago, 5 March, and there is a couple of the Tilray products that are going to be going through the process, but they’ve been verified by the ministry. There is also the Sativex spray as well that is currently available under prescription.

So with the current bill, thirdly, it removes cannabidiol from the schedule of controlled drugs. And again, I say this, this bill that tries to amend the principal bill, the scheme that currently exists, and I see that it is fit for purpose at this time.

With the new technology we see, with new research, the evolvement of medicines. I believe the proposed new amendment will be too restrictive. This, the principal bill, needs to be allowed to be flexible so that we have expert regulators that can keep up with these evolving medicines, technology, and research. And I feel like this new proposal would restrict that.

It is already available for patients via prescription. Yes, I acknowledge that there is still education to be done for those who do prescribe. In my clinic in Māngere, we do assign one person who has that special interest, and I know that other clinics have done so, so that there is at least one clinician who keeps up with all the changes in research as well, and provides for the clinic. So I acknowledge that there are other clinics that are trying to do the same in order for patients to access these products.

Thirdly, I will talk to the loose-leaf cannabis, as this amendment would restrict that. And again, if my electorate of Takanini would know that when it came to the referendum, you know, in terms of speaking to the other cannabis referendum, I was opposing that referendum. But when it comes to medicinal cannabis and our discussions with our community, the vast majority supported this bill when it was first introduced, and, on our talks about what the provision is like with the current scheme, they still support that as well.

So, when I see this bill and the amendments, I acknowledge what Dr Reti is trying to propose, but I still think that the current bill, as it stands, is still fit for purpose at this time, and that’s why I oppose this bill. Thank you, Mr Speaker.

Thank you, Mr Speaker. I rise to speak to the Misuse of Drugs (Medicinal Cannabis) Amendment Bill (No 2), and I’d like to begin, also, by acknowledging my Health Committee colleague Dr Shane Reti. Thank you for your work on this, and I’m sorry, but I can’t support this bill. It’s a really interesting one for me, because this bill seeks to establish a medicinal cannabis scheme that I feel already exists, but the proposed new scheme isn’t a better scheme. It does appear to be a worse scheme and a backwards step. This new scheme would, sadly, remove the flexibility that we need to keep pace with an emerging industry, the flexibility that we need to enable new businesses making medicinal cannabis to succeed. Obviously, enabling new businesses to succeed, especially in a new field such as this and in Aotearoa New Zealand, is really important, as we know.

More important, though, in my opinion, is that I feel that this bill—and I’m most concerned—would increase suffering. What we currently have in place enables people to access cannabis for pain, but, as has been described earlier, it can be extremely hard to access. We recognise that, but, unfortunately, what I see before me is a bill that would make it harder. Now, we know that there is extremely strong evidence that medicinal cannabis provides substantial benefit to some people experiencing pain, people for whom opioids like morphine and codeine just don’t work—people like my late mother. My mother passed from metastatic breast cancer that had spread through her bones, and she was in an enormous amount of pain for the last few years of her life, but the pain that she experienced towards the very end, the last few months of her life, was intolerable and unrelievable. Most clinicians standing here today will be aware of quite how painful some of the conditions that your patients will experience can be, and you’ll also be aware that, sometimes, no amount of morphine or opioids can touch the sides of the pain that they’re experiencing. Ironically, a drug such as cannabis, even though we would consider it to be lighter in its effect, and certainly has fewer side effects, can be much more effective.

So people like my mum, at the end stages of her life, need access to the best, most effective, safest pain relief, without the fear of being arrested or charged with an offence, because that fear does inhibit access. I can say that with confidence because my mum, while she was experiencing the pain that I can only describe as intolerable, both for her and for us watching, did not accept the cannabis that was offered to her unlawfully, because at the time it was illegal for her to use it and she would’ve faced prosecution and become a criminal, in her own mind and in the eyes of the law as it stood at the time.

The legislation currently in place introduces a statutory defence for people eligible to receive palliation so that they can use illicit cannabis without fear of prosecution. In short, the purpose of the scheme currently in place is to improve access to quality medicinal cannabis products for patients on prescription from a doctor, and manufacturers and importers are required by the Medicinal Cannabis Agency to consistently meet minimum standards of quality before they can be supplied. Whilst we get our domestic manufacturers to get production of the quality and quantity we require, we have people that can’t wait, and they won’t be criminalised.

Dr Reti’s bill represents in my mind a backwards move in a House that I feel needs to keep moving forwards, and, therefore, I am sorry but I can’t commend this bill.

Tēnā koe e te Māngai o te Whare. It is a pleasure to do a bit of a retrospective, as the chair of the previous Health Committee in the 52nd Parliament, with Dr Reti as my chair; this was our first bill, the Misuse of Drugs (Medicinal Cannabis) Amendment Bill. It was a pretty intense process, a lot of people who came to talk to us shared stories about their vulnerabilities and the fact that they wanted access to medicinal cannabis, as opposed to other pharmaceuticals, to relieve their pain.

So I want to take the opportunity, actually, to commend Dr Reti. I mean, what we did was create a mechanism to develop the regulations and then to develop, through the Medicinal Cannabis Agency, a process where we could have New Zealand made medicinal products made available to New Zealanders. That was the purpose, and that remains the purpose. I detect the frustration about the process, but the reality is we have the Medicinal Cannabis Agency, and as Dr Reti and I discussed today, they are currently assessing 33 New Zealand-based applications, but they may still be six to 12 months away. But within that context, having Dr Reti’s bill go through doesn’t actually make sense. But there are aspects of this bill that I think have merit, particularly his focus on looking at the process for GPs to prescribe medicinal cannabis.

Who knew that the Ministry of Health and hospital specialists actually had to approve a GPs prescription or prescribing for their patients to be able to have access to medicinal cannabis. I found it really interesting, I looked at a woman called Karen Oldfield who works for the Medical Research Institute of New Zealand, who had published a report in 2020. So she surveyed 76 GPs, and of those, 42 of those GPs’ patients wanted access to medicinal cannabis, so 55 percent. But, in fact, only 14, or 33 percent, of that 42 got the medicinal cannabis prescription. When they asked the GPs why, they said because it was too expensive, because of that special approval I noted, and also because of a lack of strong evidence. But what evidence did they need to be able to prescribe? For 84 percent of those GPs, they said they needed a Pharmac-approved and funded cannabis product.

So we have a system—some people are frustrated, but I actually do think, in commending Dr Reti for the amazing work that he did, there continues to be an opportunity, as a member of the Health Committee, to engage with the Medicinal Cannabis Agency about providing our doctors, our GPs, and our pharmacists, with the education and tools that they need to listen to the patient voice. Because it’s pretty clear patients want medicinal cannabis, we want New Zealanders to develop those medicinal cannabis products for our people, and then ultimately to export them to others around the world who think that medicinal cannabis is a better option for them. Kia ora.

Thank you, Mr Speaker. I’ve listened to the discussion and I’d like to thank all members very much for their contributions. I’d like to respond to some of the statements that have been made.

Dr Liz Craig had concerns around the eligibility for licence holders, and offered the comment that taking into account the associations of people that may influence the licence holder may not be reasonable. Well, that’s straight from the Australian regulations. They figured it out that you can have an undue and unhealthy influence on a licence holder and that that needs to be managed. She talked about the open-endedness of saying the eligibility of licence holders could be at the discretion of the director-general. Much health legislation has that. Look at pretty much all of the COVID legislation at the moment. She talked about frustrating delays. We committed to have product within 12 months of enabling our bill.

Chlöe Swarbrick wanted to talk about the title of the bill—said that No 2 was just a reproduction of her bill No 1. That’s incorrect. Her bill also was titled the “Other Matters Bill”; this is titled the No 2 bill because the Government of the day had the No 1 bill and so this was in contrast to what was being offered, so she has that wrong. She’s also rewriting history with her review of the discussions and negotiations we had. We can put those discussions on the table if you really want. We can talk about who came with a mandate to negotiate and who didn’t, but I’d suggest we don’t.

She talked about what the bill has as maybe being a pharmaceutical model. Look, we view medicinal cannabis as being a drug like any other drug. You’ve heard me say that we believe that it can be placed on the over-the-counter framework. Some people believe it’s a food, for goodness’ sake, so we need to be reasonable here. However, it is a drug like any other drug. It has a dose response curve. It goes through Medsafe, and we were facilitating advanced procedures through Medsafe.

Brooke van Velden got it. She got the key points and actually identified some of the detail around locations. Anahila, thank you for your contribution.

💬 SPEAKER: Order!

She struggled—member Anahila; MP Anahila—

💬 SPEAKER: Kanongata’a-Suisuiki.

Thank you. I want to thank her for her contribution, but she struggled with identifying a gang member. That’s not hard at all. Look at all the firearms legislation. Furthermore, the bill itself says: “is not a member of a gang as defined in section 4 of the Prohibition of Gang Insignia in the Government Premises Act 2013.” So it’s all there, how to do that. Dr Sharma said the scheme already existed. No, it doesn’t. Where is the product? Further speakers and colleagues in the select committee, thank you for your contributions, but if this is working so well, again, where is the product?

This bill puts in a range of provisions that strengthens the medicinal cannabis framework. We’re proposing tightening the regulations for licence holders and employees. We’re proposing tightening regulations for where medicinal cannabis can be grown. Is there anyone in this House tonight who really thinks it’s OK to grow cannabis beside a wāhi tapu? I’m sorry, I do not. Many of the unintended consequences and overlooked issues could also be addressed in select committee. We’ve talked about GP education. We’ve talked about low-dose CBD and the hurdles and difficult pathway it has to come to New Zealanders. Clinical research is another area that hasn’t been discussed.

Before I make my final summation, I want to acknowledge the wide range of experts who contributed intellectual and industry knowledge to the formation of this bill. I want to acknowledge the Massachusetts health commissioner, Kay Doyle; the Massachusetts health director of Government affairs, David Lakeman; New Hampshire Senator, Jeff Woodburn; New Hampshire health commissioner, Nick Toumpas; Colorado director for marijuana, Andrew Freedman; the New York commissioner of health, Dr Howard Zucker, and his team, Esti Alonso, Erin Hammond, Josh Figuera; the Pharmacy Guild of New Zealand—they contributed a lot in how we figured out how we could actually dispense this. I’d like to thank the Royal New Zealand College of General Practitioners; MCANZ, the Medicinal Cannabis Awareness New Zealand, and Shane Le Brun have all been very helpful. I would also like to finally acknowledge Sarah Gwynn, who was the drafting agent with PCO, who did an awful lot of work—you can see this is 29 pages—and she really helped finesse the detail, and it wouldn’t look like this tonight without her help. So I want to thank all of those people.

In summary, we’re seeking for this bill to be referred to select committee. We believe there are parts of it that can make the current framework that we have more robust and better. New Zealanders urgently need access to affordable medicinal cannabis, and this bill would build on the work that has already been done. Let’s give New Zealanders who are suffering pain and harm another tool in their tool box to relieve their suffering. I commend this bill to the House.

Just while the Clerk’s adding up the votes—and I’m going to look straight ahead so I’m not being seen to look at anyone—I want to remind people about the rules for eating and chewing in the House. People are allowed to sort of have the occasional lolly, but they’re not allowed to eat their dinner, and they’re certainly not allowed to chew gum in the House.