Johnny Green: High Noon

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From top: At the signing last week in the Department of Health HQ of legislation to allow for the operation of the Medical Cannabis Access Programme, were from left: John Lynch, Director of Compliance HPRA; Dr Mairin Ryan, Deputy Chief Executive HIQA  and, front  from left: Minister of State for Health Promotion and the National Drugs Strategy Catherine Byrne & Minister for Health Simon Harris; Johnny Green

It’s 4.20.

Here’s Johnny Green!

With his weekly ‘roll-up’ of all things ‘erb.

Johnny writes:

Pivoting back to last week’s Roll Up  let’s travel on one of the spurs off the timeline; day two of Vera Twomey’s historic walk, November 2016, and the Minister’s announcement to commission a policy review.  Remember November 2016.

An tÚdarás Rialála Táirgí Sláinte (HPRA for short,) were tasked and promptly produced a set of recommendations to the Minister by January 2017. Remember January 2017.

On  June 26, 2019, exactly one day after my last Roll Up, another entry into our timeline was established; “MISUSE OF DRUGS (PERSCRIPTION AND CONTROL OF SUPPLY OF CANNABIS FOR MEDICAL USE) REGULATIONS 2019

The significance and the scale of the opportunity that legalising cannabis promises Ireland is no longer a matter for the backrooms and smoke-filled lanes of political skulduggery, patronage and party henchmen;.

Yet your Government and your media did not prompt or wonder why 30 months were allowed pass before this photo-op.

An interesting observation came, not from any opposition member or from the establishment media that Ireland continues to salute, it was from that bastion of industry periodicals, The Irish Medical Times;

“The Minister for Health is to have no liability for the use of cannabis- based products under the newly launched Medical Cannabis Access Programme (MCAP)”

In all likelihood this may well have been prompted by their own obligation to put their readers and members on notice of potential professional practice liabilities that they found snuck into the amendments;

 “(7) A practitioner issuing a prescription for a specified controlled drug for use by his or her individual patient does so under his or her direct responsibility in order to fulfil the special needs of that patient.

(8) The fact that a product is a specified controlled drug is not an endorsement of the safety, quality or efficacy of the specified controlled drug and the Minister shall have no liability in respect of the use of a specified controlled drug by a person issued with a prescription under this Regulation.”

For the record, there is not one single recorded death as a result of taking cannabis in THC form.

A Senior Minister, his advisors, and indeed his legislative draftsmen must know that THC is just not toxic enough at any consumable level to cause an overdose. One would be more ill from consuming equal levels of marmalade.

What this should now be telling you is that the Minister took thirty months just to implement contents of that very same HPRA report.

Earlier, above, you might have supposed that the HPRA were efficient and diligent in completing the Minister’s ask within the two months that included Christmas and New Year’s; however hold back on your compliments, if there were any for this Quango of a whole range of interests.

The extracts from the Bill, quoted above, are all I need to know to inform Broadsheet readers that the HPRA took from the UK Barnes Report.

There is nothing wrong with that of course, why not make use of available, verified and trusted research. I am introducing the source only to widen the background into a legal cannabis environment and to provide the debates with actual facts.

is this the current intended legislation as put forward, not letting patients grow their own medication under the Irish programme, whereas it is permitted in the US and in Canada, and since Ireland introduced research and facts from other jurisdictions to form their own reports and base their own legislation on, I think the Irish should be told why?

Why should chronic pain be excluded? Pain Clinics and Pain Management Consultants need to be called upon and brought to the table, along with Health Sector Bean Counters and Pharmacists, and confirm who is the end beneficiary of this legislation? The Patient? The HSE, Or the Suppliers?

Do you need to ask why the study and consultation period for the HPRA report was too short? Is everyone satisfied to rely on the UK Group outcomes and session notes?  I would certainly expect some oversite confirming the credentials and independence of the contributors.

Why is the HPRA opposed to the establishing of a regulatory authority for Irish Cannabis; i.e. Irish Weed. (Germany, the US and again, Canada have.)

Are the HPRA themselves actually qualified to be allowed that assertion?

Is that not a matter for the Department of Finance?

This is where, in my view, there is evidence to suggest that the authors responsible for the HPRA Report attempted to sabotage Gino Kelly’s Bill, in favour of one crafted for their Minister.

In Gino Kenny’s bill, a separate cannabis control commission was presented, yet the HPRA took it upon themselves to diss this component, even in the absence of a mandate or instructions by Minister Harris.

Why would they do that, everyone knows Ireland loves a good Quango.

This is a good authority on the very subject of a regulatory authority, Sir Norman Lamb a former Health Secretary in the UK –

“It is going to defeat our regulatory system if we try and drive it through the system as it is now. My instinct is that we will need a specialist cannabis authority as they have in Germany.”

The HPRA, who were not shy about handpicking some sections of the UK’s recommendations for their own report, took it upon themselves to decide a separate regulatory entity was not required. Now whose interest would that be in?

Which leads us now to the most important question to be answered before any further advances; who are the HPRA ?

A cautionary scan of their 2017 Annual Report, Very quickly advises that they had a 1.2 million loss in the year, and of their 27million takings, 3 million is a top up from the taxpayer.

They do appear to have got burned by some ill-advised and badly timed real estate activities, another drift well outside their remit perhaps, prompting another question, do they really need Dublin 2 offices and a mortgage?

You will note that their accounts are qualified and I see that there is some mess with Superannuation issues.

Celebrity accountant Vanessa Foran tells me this is very common in the Health Sector as SuperAnn Liabilitiy in any one year cannot be valued with any accuracy, the comfort for the Auditors is that it future pension liabilities are underwritten by the Department, so she is confident it is merely a Technical Qualification caused by FRS102.

Early days for me with this mess and it is 4th of July week, so you can expect us to circle back to this again. Particularly the HPRA and what who they think they are or should be.

In summary, the new legislation is a something of a step forward, but you can see by the questions surrounding its creation there are also a good few bigger steps behind.

At the very minimum Ireland should have established a self-funding “Cannabis Control Commission” or at least set about one.

An echo of week one’s Roll Up; but entrusting the HPRA and Minister for Health Simon Harris, who himself has zero industry background, of any sort, with this billion euro industry remains a strategic mistake, that one day may be discovered to be a mistake on purpose; that may come back to haunt him and everyone else too.

But then, Ireland loves a Tribunal just as much as any Quango.

Johnny Green will attempt to keep Broadsheet readers up-to-date on the growing cannabis industry worldwide. His weekly Roll-Ups appear here every Tuesday at 4.20. Follow Johnny here on twitter for updates.

Johnny Green illustration by Alan O’Regan

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32 thoughts on “Johnny Green: High Noon

  1. curmudgeon

    Mr. Green is a very welcome recent addition to the Broadsheet roster. Every article is meticulous in its efforts to get the point across with references aplenty and some very sound logic.

    1. eoin

      + 1

      Traditional media are grappling with this and there was a half-decent attempt at analysis in the SBP last weekend, but it’s very welcome to get regular reportage, and particularly in the context of the rarefied world of Irish politics and medical practice to get challenging views.

      1. V

        heem
        I probably wouldn’t use the word decent Eoin
        half or otherwise

        It was a feature, albeit subtle, nonetheless it had many of the same hallmarks of a promotional feature

    2. Paul Revered

      Agreed

      One point I want to raise is whether other medicines have this caveat in relation to ministerial liability?

  2. eoin

    Is that unusual for approved medicine, to pass liability for prescribing the medicine and the effect it can have on the patient to the doctor?

    Also, can we please have legislation which passes the liability for the premium of a prescribed medicine over its generic counterpart onto the prescribing doctor. That’ll learn them rapid not to accept lavish gifts and junkets in return for them prescribing off-patent medicine which costs the taxpayer hundred of millions each year.

    1. Johnny Green

      Hi Eoin,they want it both ways-subject the medicine to rigorous tests/studies/approval process but then deny its a medicine and avoid any liability,naturally while collecting lots fees.
      All more reason to establish a self funding,competent and conflict free independent Cannabis Commission,as proposed in Gino’s bill that was rubbished by HPRA,despite having no remit to assess proposed legislation by ejected representatives.

  3. Dr.Fart MD

    it’s fine gael remember .. whatever theyre doing, it will be to benefit the wealthy in private sectors.

  4. A Person

    Can you please clarify, are you recommending the legalisation of all cannabis or medicinal cannabis.?

    1. Johnny Green

      Seriously man how much you smoking:)

      ‘Today is a significant milestone. For years, families have fought for this programme to be established and for years, we have faced many challenges, obstacles and hurdles. I am so pleased to be here today to advance this Programme and help the lives of many families across the country.
      The purpose of this Programme is to facilitate compassionate access to cannabis for medical reasons, where conventional treatment has failed. It follows the clear pathway laid out by the Health Products Regulatory Authority in their expert report ‘Cannabis for Medical Use – A Scientific Review’.
      Ultimately it will be the decision of the medical consultant, in consultation with their patient, to prescribe a particular treatment, including a cannabis-based treatment, for a patient under their care. It is important to state that there are no plans to legalise cannabis in this country.‘

      https://merrionstreet.ie/en/News-Room/Releases/Medical_Cannabis_Access_Programme_launch_enables_compassionate_access_to_cannabis_for_medical_reasons.html

  5. SOQ

    Slightly off topic but congratulations to Kama Hemp in Clones, Co. Monaghan on their nomination to the World CBD awards- impressive.

  6. V

    Why were HIQA witness to the signing?

    They hardly have a function within any Cannabis Regime
    would they?

  7. Cian

    Johnny, you’re not being fair. While there have been no deaths due to cannibals that isn’t the extent of liability.

    If you say that can cannibals, or THC, has medicinal benefit then it has an active ingredient that reacts with our brain/ body. And this could have either a beneficial or adverse effect. If it has an adverse affect then the minister could be held liable. So that clause is sensible.

    1. Reverend Pall

      What’s fair?

      What’s fair about the fact an industrial plant that people can use and have done for 100s of years for cooking, making ropes etc is regulated the same as if it was a Class A drug?

        1. Reverend Pall

          Who’s talking about Cannabis?
          I’m talking about industrial hemp.
          Maybe you don’t know what you’re talking about.

  8. Johnny Green

    Hi Cian,who said I have play fair:)
    I was merely trying illustrate an important point that may have been overlooked, with Ireland’s war on drugs still ongoing.Just a little irish to absolve yourself of any liability,but tax and regulate the hell out the medicine as if it omg it is medicine,while via your own negligence and absence of any coherent policy,the HSPA engages in further mission creep and grabs this 1 Billion euro market for themselves.
    Why are the losing millions every year,what’s with the 20 million mortgage on headquarters in D2.

    1. Cian

      You don’t have to play fair. But if you do play fair more people will trust what you write and be brought along to your way of thinking. I like your articles- but feel they lack some credibility.

      Personally I would like to see cannibas legalised. I would like to see more research into the medicinal properties of thc and anything else that can help us. I would like doctors on board and willing to prescribe (where appropriate). But I don’t think it is a panacea for all ills.

      But pretending that it is a miracle drug with zero side effects is as bad as the scaremongering the anti- side are capable of doing.

      I’m not offering an opinion on whether HSPA should be the responsible agency or not – I’m not knowledgeable enough. But, for me, if a writer can’t distinguish between death and liability (or chooses not to) then their deductive reasoning is unsound and I won’t trust their ‘alleged’ greater knowledge and understanding of HSPA.

      1. Johnny Green

        Well that escalated quickly Cian-the snake oil claims/medicine will be discussed as we move along.
        The post is really about this ever expanding money pit and is it fit for purpose, they were tasked with producing a report.The report they produced had them in a starring role!

        “Formerly known as Irish Medicines Board (IMB), we became the HPRA in July 2014. Our new name better reflects our broader remit and regulatory functions which have expanded over a number of years to include:
        Human medicines
        Veterinary medicines
        Clinical trials
        Medical devices
        Controlled drugs
        Blood and blood components
        Tissues and cells
        Cosmetic products
        The protection of animals used for scientific purposes
        Organs intended for transplantation”

        Now includes cannabis,based on their expertise in…..

        As you started throwing shade,I have serious issue/problem with a active stockbroker/money manager sitting on this board with a ringside seat,while his company is working this space, conflicts ah stop its Ireland.

        “Mr. David Holohan is Chief Investment Officer at Merrion Capital and was appointed to the Board of the HPRA by the Minister for Health in January 2016. Before joining Merrion in 2010, he was a Partner at a Dublin based investment firm and previously worked for a multi-billion dollar European hedge fund situated in London”

        http://www.hpra.ie/homepage/about-us/our-structure/board

        wow-quite a timely appointment by the minister, of a stockbroker/hedge fun chap to a health regulatory authority, with no experience at all in this area……

        1. Cian

          Great. When you mention facts I can get behind what you’re saying.

          I’m not sure if a separate quango would help – as the board would be appointed by the minister.

          You also have a negative attitude toward people. If they have relevant experience (e.g. a TD pharmacist) you say they are biased and have conflict of interest. If they have no biases you say they’re inexperienced. ¯\_(ツ)_/¯ can’t win.

  9. Joe Small

    Honestly, it looks like a bunch of people who like getting stoned a lot are trying to hijack a very small number of individuals who may require cannabis derived products for medical reasons.
    I was all in favour of decriminalization but after living in a country where drugs were decriminalized I realized that the most vulnerable in our society are also the most vulnerable to drug addiction.
    Being stoned all the time isn’t an addiction but its certainly not healthy either.

  10. Johnny Green

    Ireland simply can’t bury its head in the sand and pretend this is not happening,what does this even mean,this is the minister in charge talking about ‘stocking’
    He’s absolutely totally and completely lying,only one import license has been issued,where’s the supply coming from to ‘stock’ the medicine,it’s a ridiculous thing say,how about setting up decent supply chains or wow allowing patients grow their own,like most other jurisdictions do….
    ‘With the changes I made to the law last Wednesday, it may be possible to now start stocking some of those products in pharmacies for patients who are authorised, which might reduce the need to travel. We have made some progress on the reimbursement, but I think we can do more‘
    https://www.thejournal.ie/medicinal-cannabis-scheme-4707198-Jul2019/?utm_source=shortlink

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