Misuse of Drugs (Medicinal Cannabis and Other Matters) Amendment Bill — First Reading

A personal vote was called for on the question, That the Misuse of Drugs (Medicinal Cannabis and Other Matters) Amendment Bill be now read a first time.

Ayes 47

Motion not agreed to.

• MISUSE OF DRUGS (MEDICINAL CANNABIS AND OTHER MATTERS) AMENDMENT BILL

First Reading

CHLÖE SWARBRICK (Green): I move, That the Misuse of Drugs (Medicinal Cannabis and Other Matters) Amendment Bill be now read a first time. I nominate the Health Committee to consider the bill.

Surely, the point of our laws is to keep people safe and prevent them from suffering. Where people are already suffering, it is to ensure that they get access to help or relief. So what happens when the law itself is responsible for suffering and prevents people's access to that help or relief? I believe it is Parliament's moral obligation to change that law or, at the very least, be brave enough to listen to those who it is hurting, to open our hearts and our minds. This bill is about how we treat our sick. It is about what happens to all of us when we find ourselves sick. It is about the help that we as a society can give and the help that we deny.

This bill will provide affordable, sustainable access to medicinal cannabis for people like Grace Yeats, who I met earlier today on the Parliament lawn. At 10 years old, Grace was diagnosed with a rare brain illness that left her unable to walk, to eat, to sit, or to speak, until she was prescribed a medicinal cannabis product, Sativex. This treatment costs her mum Tracy a prohibitive $1,100 a month. They currently rely on the generous charity of their community to afford it. Their family is asking the ability to produce their own medicinal cannabis spray by extracting it from cannabis plants, which would guarantee consistent, affordable access and dignity. They are asking for your support on this bill.

I'm sure all MPs have received similar stories this past week. I hope that they have read them. I hope that they've understood that there are thousands of Kiwis, those who are out of work, for example, due to pain, meaning that they are often receiving Work and Income New Zealand benefits; meaning that even if they are lucky to be able to jump through the Ministry of Health hoops, they are faced with a cost that they are unable to meet; meaning they either remain in pain or out of work, or turn to the black market and become, effectively, criminals.

I ask all in this House to put themselves in the position of the late Helen Kelly and her son Dylan Kelly, who had to watch the pain and hurt his mother experienced in the last few months of her life. She found relief in medicinal cannabis, which, under current law and, indeed, under the Government's proposed law that was voted through yesterday, would have made her a criminal. I know that there is support across this House and in each and every party for this bill, and I know that each and every one of us voted for the Government's bill just yesterday, which, in the immediate term, serves only to create a criminal defence for those with a terminal illness.

As many in their speeches pointed out yesterday, that is not enough. It does not provide legal access, let alone those with chronic pain, with muscle spasticity symptoms, with epilepsy, and with other illnesses and ailments that could benefit from the prescription of medicinal cannabis. This bill does that, and all of us in this House know that.

I acknowledge there's a few who have concerns about the potential ramifications of this bill. There's been murmurings that people will pretend to be ill, about people wandering into their doctor's, faking a toothache, and, supposedly, walking out with a prescription for medicinal cannabis. To address this point head-on: quite frankly, it's ludicrous. New Zealand's health profession does not hand out pain medication willy-nilly. Anybody who has this concern should seek to place this bill before select committee so that technical aspects and definitions can be borne out, so that they can hear the evidence, learn about how similar frameworks have worked in other jurisdictions, and listen to the experiences of those suffering at the hands of an outdated law that makes them criminals for using the only medicine that works for them.

The past few months have seen a handful of prosecutions for otherwise regular people who produce and supply cannabis products to the terminally ill or those in chronic pain. One of those people was Rose Renton, who, in recent times, brought an 18,000-strong petition to Parliament calling for safe, affordable, medicinal access to cannabis, in the legacy of her son Alex Renton, for whom she fought tirelessly to secure access to medicinal cannabis, to stop his suffering and seizures near the end of his life. You do not find a solution to a problem by beating it with a blunt and broken instrument. The law here is broken, and good, kind, otherwise law-abiding people are risking jail to help their neighbours and those in their community currently experiencing unnecessary suffering.

A Curia Market Research poll commissioned by the New Zealand Drug Foundation in mid-2017 demonstrated that 78 percent of New Zealanders were in support of growing and/or using medicinal cannabis for any medical reasons, such as to alleviate pain. That is an unequivocal majority of New Zealanders ready and willing to have that debate, including a majority of voters from every single party in this House. Seventy-eight percent of National Party voters believe New Zealanders should have access to medicinal cannabis when they need it. That is in sharp contrast, unfortunately, to the publicly stated National Party caucus support. I would like to invite any National Party MPs who support this to stick their neck out and to be on the right side of history tonight. It will not pass without your votes. This is also a plea to those on this side of the House. This bill and the people it affects need your support as well.

We have seen substantial legal development in comparable jurisdictions. The law in Australia has been liberalised to allow for greater access by way of doctor's consultation, which is not dissimilar from the threshold of this bill. In Canada and certain United States, they for a very long time had the ability to grow their own plants for medicinal use, and studies have quelled the moral panic by demonstrating no greater uptake in recreation or amongst young people, as is often the catchcry of opposition to this bill.

An incredibly thorough and reputable meta-analysis in 2017 titled The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research, which I have circulated to members of this House via email, found that there was conclusive and substantive evidence that cannabis and cannabinoids are effective for the treatment of chronic pain, for example, in adults; as an effective treatment for chemotherapy-induced nausea and vomiting; and for improving patient-reported multiple sclerosis spasticity symptoms.

None of this, of course, is to ignore the reality that there is a risk of harm that comes with cannabis—the abuse of it. Notably, however, the risk of that harm is currently far higher with the class A narcotics that are currently prescribed to patients that may otherwise receive medicinal cannabis. A user cannot overdose on cannabis, as is possible with morphine, tramadol, and other prescription drugs. Medicinal cannabis too does not come with the same host of side effects and nausea and decreased quality of life that sometimes accompanies these drugs.

Friends of the late cricketer Martin Crowe noted that he self-medicated with liquid cannabis during his final days of aggressive lymphoma. Lady Deborah Holmes, widow of Sir Paul Holmes, has opened up about he turned to cannabis for pain relief in his final weeks, dealing with prostate cancer. I wage, without a shadow of a doubt, that the stories I have told tonight are the tip of the iceberg. If we in this House are bold and brave enough to take this to select committee and open our arms, our hearts, and our minds to New Zealanders, we will hear many more stories like this.

We cannot pretend that this is not a problem. It is a problem because people are suffering. It is a problem because people presently risk going to jail for helping their friends and whānau. The status quo is not working and we, as a House of Representatives, have an opportunity—nay, I would say—a moral obligation to forge a better path forward. I ask my colleagues in this House across all party lines to vote with their conscience and to allow the voices of the people of Aotearoa New Zealand to be heard at select committee.

• Mr SPEAKER: Order! [Interruption] Order! I want to warn persons in the gallery that I have some personal experience of being removed from the gallery for interfering in a debate. I know what the rules are and I know what the court says. It is very important that members have the ability to express themselves in this House, on one side or the other of this issue, and that people in the gallery listen but do not get involved.

• Hon Dr JONATHAN COLEMAN (National—Northcote): Thank you, Mr Speaker. This is the second of two bills that Parliament is debating this week, both of which relate to medicinal cannabis, and I want to congratulated Chlöe Swarbrick, the Green member, for bringing this bill to the House and for having it drawn from the ballot prior to that and for the chance to debate what is a very important issue to thousands of New Zealanders. I also acknowledge Julie Anne Genter, who is now a Minister but was the person who originally put the bill into the ballot.

Now, I know, of course, that this is something that is being hotly debated around the country. As the member said in her speech, there have been many high profile figures who've gone public with their views on medicinal cannabis and their personal experiences of resorting to medicinal cannabis—in the most high-profile cases relating to terminal illness. I also want to acknowledge that there are very many New Zealanders with a range of chronic conditions and debilitating pain who are seeking relief from that state and very naturally have an interest in obtaining access to medicinal cannabis. Of course, as we've heard over the course of these debates, that access is currently fairly limited. But there is no question that, internationally, the views on medicinal cannabis are liberalising, and that is happening at a fairly rapid rate.

However, let's be clear. Cannabis is not a drug to be taken lightly. I think everyone in this House would agree with that. Most people here would have had experience of people in their social circle, wider life, or indeed in their professional life who have abused cannabis, and we have seen some of the consequences of that. In a certain group of individuals it can greatly exacerbate a predilection or an underlying disposition towards mental disorder. So I think no one would disagree with the proposition that cannabis is actually a drug that society should not take lightly.

The member who has brought this bill to the House gave a very fluent, quite emotive speech, citing many examples of patients seeking access and benefiting from medicinal cannabis, and, indeed, those are quite compelling stories when you listen to them. But I think what's really important is to focus on the bill itself and compare that to the Government bill, which we debated yesterday. And while I am no supporter of this Government, I have to say there were some things to commend in that bill, which was discussed yesterday.

So I think there's a general mood in this House to allow controlled access to medicinal marijuana, but that has to be done in a regulated fashion. It has to be done in a way where we are sure that there are controls in place, where we know what preparations patients are receiving, and where we can understand the evidence base. This is an area where there is an emerging evidence base, but it's still pretty early on.

Medicinal cannabis encompasses a wide range of preparations, right from those that have undergone rigorous clinical testing—in this instance, in New Zealand, Sativex, which is used for the relief of spasticity in multiple sclerosis—right through to people wanting to access loose-leaf marijuana to smoke cannabis in order to relieve their symptoms. So there's often quite a bit of confusion, actually, about what medicinal cannabis encompasses.

But if we look at this bill, it's very important to see what this bill will actually do. Unfortunately, this bill is deeply flawed, because what it allows is for anyone who has what is called a qualifying condition to access cannabis, to grow their own cannabis, or to nominate a relative or any other person to grow cannabis on their behalf. That is where I have a problem with this bill. There's no mention there of controls. There's no mention of regulation. There are just some coverall provisions, which talk about qualifying health conditions including chronic back or other pain. Now, I can tell you, as a doctor, I've dealt with many, many patients who have come to see me with chronic pain. Pain is one of the most difficult areas of medicine to get to the bottom of, to manage, and to treat. But also it's something that's pretty hard to disprove. If someone comes and tells you they've got pain, how can you really assess the true extent and degree of that pain?

But it also says, even more broadly—and you could drive a truck right through the middle of this—that a qualifying health condition is also "any other medical condition that a medical practitioner certifies may benefit from supplementary plant cannabinoids." "[A]ny other medical condition"—so it's up to the doctor to make a call. Of course, we've got great confidence in our health professionals in New Zealand. I mean, we've got a strict process of registration. There are continuing medical education requirements. So, by and large, we trust the health profession. But the problem is that is placing a huge onus on any doctor. Most doctors are good; a few are bad and end up maybe being expelled from the profession. But what I can tell you is that doctors are going to hate this bill, because what they will have is enormous pressure placed on them by patients to prescribe cannabis. You see that in terms of other painkilling medications. So what you'll get is you'll get a group of doctors who absolutely refuse to have anything to do with medicinal cannabis, and that, actually, at a certain level, would be unfortunate. Then you'd get a very small group, hopefully, who would be known as the prescribers, the person to go and see if you want cannabis. And then you'd get the middle group, who, with all best intentions, have enormous pressure placed on them to prescribe medicinal cannabis. This will be a doctor's nightmare.

But, also, what's really concerning about this bill—and I know it's not the member's intent—is this is going to be de facto decriminalisation. Basically, it is going to mean that anyone can grow as much cannabis as they want for the treatment of one of these qualifying conditions, and it just needs a doctor's say-so. Miss Swarbrick says there are similar schemes in Canada and Australia. Well, when you look at the detail of those schemes, they are tightly regulated. This bill is silent on the supply. In Canada, you actually have to go and get your seeds from a regulated supplier. There's nothing in here about a regulated supplier. This does not create a regulated market for medicinal cannabis based on a body of evidence. This is just carte blanche for patients and their nominated people to grow cannabis for what is a very vague qualifying condition.

The other thing that the bill does is it confirms that cannabidiol will no longer be a controlled substance. Well, the National Government actually had already done that through regulation, and, indeed, it is in the Government bill.

Much as I'm critical of this current Government, and much as they also left a lot out of the bill that was before the House yesterday, what that bill yesterday had was a regulation-making power, and that regulation-making power in the Government bill sets the groundwork for a regulatory scheme to create a market place that will increase the access for people who need medicinal cannabis products, and it will mean that they can get products that have been approved on the basis of the available evidence to help relieve their debilitating conditions. That is the way to go.

The other thing about the Government bill is the select committee process will allow all those who have an interest in this particular bill to submit to the select committee and have their case heard. So I think—much as I'm no fan of this Government—that the bill that the Government brought to the House yesterday will enable that public discussion that thousands of New Zealanders wish to have. This member's bill currently before the House is deeply flawed. It will create carte blanche for people to grow whatever cannabis they want and to use it. It will be decriminalisation by stealth, and on that basis National does not support this bill.

• GREG O'CONNOR (Labour—Ōhāriu): Thank you, Mr Speaker. I stand opposed to this bill, and I want to start by saying that I don't oppose it from any philosophical basis around the liberalisation of cannabis laws, but from a strong belief that passing a bill that permits unregulated cultivation of cannabis—with the medical profession as gatekeepers, as the previous speaker, Jonathan Coleman, pointed out—represents an absolute wasted opportunity to learn the lessons from those other jurisdictions. I congratulate my colleagues on bringing this to the House, and for what they are trying to achieve, it may not be a bad piece of legislation. But, again, I agree with the previous speaker that this will lead to a situation where through the legal ability to grow cannabis, the State will lose absolute control over any ability to regulate it.

Any change we make to cannabis laws liberalisation must achieve two things: one, at best, it makes it less available to those teenagers—our people under 20—which all the evidence shows are damaged by cannabis and by use of same, and, secondly, what must be achieved is we must get it out of the hands of the criminal gangs. This will not achieve that.

One of the problems is that many overseas jurisdictions are quoted in these arguments. I've been fortunate enough to go to the Netherlands and spend time with regulators and with growers and suppliers and with police—and the same in Portugal and the same in Colorado. One important factor around oft-quoted Netherlands is that cannabis is not legal there. It is permitted. There is no legal supply of the drug. As they say, "Illegal in the back door. Legal out the front." There is a proposal now that the local bodies be allowed to grow the cannabis legally, but that is still subject to some debate. So, importantly, it is not legal; it is permitted. I don't think we have a mature enough system to allow that to happen.

In Portugal—again, oft-quoted—it is not legal. You're still arrested; you just don't got through the criminal justice system. You end up, in Portugal, going into the health regime—again, well documented.

Colorado is the jurisdiction that we most look at, and they started their journey to full legalisation exactly where we are, where they permitted people with a medical certificate to grow six plants. That very quickly morphed into the ability of others to grow those six plants for those people. The biggest commodity very quickly became the list that you could grow cannabis for, and by then, they'd lost control.

What I fear with this bill is that I is going to deny the opportunity to get it right. We are going to have a referendum before or at the next election, and that's the time when the public of New Zealand will decide which way we will go on this. That referendum is already going to be redundant by the time we get there, because we'll end up trying to build a regime on the basis of what will be a very liberal, highly available amount of cannabis there, and we will be trying to fix it. If we're going to do this—if we're going to achieve what the architects of the bill want to achieve, and if we want to achieve what I'm sure many here want to achieve, which is a very sensible, world-leading cannabis regime—we are denying ourselves the opportunity to do just that by doing this piecemeal, like we're doing here.

What the Government bill that went to select committee yesterday has done is it has bought us time, which will allow us to address many of the issues that have been brought up here today. But it will mean that when we move forward, we get it right. We don't have to recreate. We don't have to reinvent the wheel. It's been done. We pride ourselves on being world leaders on this, and we can. If this goes to select committee, I fear it will come out, it will go ahead, and it will come back, but it will be a poor example of legislation, and it will be a missed opportunity to get this absolutely right.

What I implore the House and my fellow members to do is don't send this to select committee. Let's get it right, let's start with a blank bit of paper, and let New Zealand end up with a highly workable cannabis regime that makes it safe for our children and for all those in the future, and, most importantly, that gets it out of the hands of criminals. Thank you.

• Dr LIZ CRAIG (Labour): Thank you, Mr Speaker. It's an absolute pleasure to be taking a call on the first reading of this bill. As we've already heard, what it tries to do is it will make it legal for people who are suffering from terminal illness or other medical conditions to use cannabis with the support of a registered medical practitioner. The thing is, though, that unlike the bill that passed its first reading yesterday, it's not about getting medical cannabis on prescription. It's actually about allowing people to grow their own, or allowing their support person to grow their own on their behalf. For me, I'm supporting this bill to first reading so that it can go to select committee, for a couple of reasons, which I'll go into, but beyond that, unless there are some significant changes made, I'm unlikely to support it further.

So why am I supporting it to select committee? I think the first thing is that so many people around the country have been in touch. There's a real sense out there that people want their voices heard, and I think select committee will allow us to do that.

The other thing is that we saw that the Government's own bill passed its first reading yesterday and will go to select committee. I think that bill will address a lot of the issues that people in the community are raising, but what I would like to see is some formal discussion about whether and how much further we can go beyond people that have got a terminal illness. So that's why I'd like that looked at in that select committee process.

The problem, though, is that I also have some real concerns about this bill, and that's why, unless they're changed, I wouldn't support it further. There's two parts to that, and I think the first one is really about the expectation of people growing their own cannabis. In medicine, there's no other area that I've ever seen where you've got somebody who's terminally ill or in severe pain and we're asking them to grow their own medication, and the problem there is that there's a whole lot of inherent challenges within that.

Apart from the obvious things like crop security, there are some other things that have been raised with me, not by people opposing the bill, but actually by people who have managed to access some of these products. What they're saying is that the issue for them is not about wanting to grow their own—they don't—but they want access to high-quality product. Some of them have been talking about—you know, with cannabis, and particularly growing your own, it's not one entity. It's not one agent. It's a whole lot of different chemicals with different activant agents. And so, with the cannabinoid (CBD), you know, for pain relief—but then the THC's got psychoactive properties. And one of the people that was in touch with me was saying, "You know, I want to purchase it from a registered supplier who knows how to separate out the CBD from the THB." You know, they want to be able to know that what they're getting is what they need.

The other thing is that a lot of people don't want to smoke cannabis; they actually want to use the oils and balms. And so for them, being able to actually process that and get it done by a proper manufacturer—that's actually what they're needing, not being able to just relieve it with smoking and some of the issues that's inherent in that.

And the other thing, I think, is about a, you know, steady, year-round supply. Because, you know—sort of listening to some of the stories of frequent users talking about what happens when there's a shortage of cannabis and the challenges that this particular person was sharing about having to smoke mouldy cannabis when the supplier was down to their last bits. And, also, if you run out completely, what are the alternatives? And so there are a real lot of issues around quality of supply.

The other thing I've got concerns about is the broad definition of what's a qualifying condition because, under the current bill, as proposed, anything that a medical practitioner feels somebody would benefit from cannabis for would be able to be prescribed. And we're actually acting in a bit of an evidence vacuum here because we haven't got a lot of, you know, randomised, controlled trials like other drugs about what this could be effective for and what it's not good for. We've got a sense it's good for cancer and chronic pain, but here the extension would be to people with, maybe, immune disorders and with other nervous system conditions where we don't have an evidence base to back us up, and we've also got known adverse effects.

Particularly for me the one is young people and psychosis, where there have been, in susceptible individuals, some queries about whether you can bring on psychosis. So it's not a completely safe product, so we've got to be quite careful.

So for me I think we need to have that debate. We need to have people to be able to put forward their views, and we need to think about the broader extension, but I think a lot of those other issues need to be sorted out at select committee so that we've got a safe, high quality product and we know who's going to get the benefit from it, but we've got to step back from causing further harm. So for me personally, I'll commit it to first reading, and I commend this bill to the House. Thank you.

• Hon NIKKI KAYE (National—Auckland Central): I am very pleased to take a call on this piece of legislation, but I do take a call on this legislation and say that I am the most deeply conflicted that I have ever been in nine years as a member of Parliament. Can I acknowledge Chle Swarbrick, and can I acknowledge Julie Anne Genter. You've done amazing work; you're intelligent, passionate, and strong women; and thank you for the work that you've done on this legislation.

Can I also acknowledge the National caucus. One of the reasons that I am a National member of Parliament is I deeply believe in freedom. And, as many people within the public gallery will know, while this is not a conscience vote for us, we have been given the ability to vote for this legislation if we want to. So let me put that on the record this evening.

I want to mention that as well, because I do want to make reference to the "waka jumping" legislation. I say it not to be political, but to say that one of the most beautiful aspects of this House is to see conscience votes entrain, or to see the freedom of MPs to healthily debate issues. And one of the reasons I'm a member of my party is because we have, through conscience votes, issues on local issues—whether it's been standing up on Great Barrier mining or issues like this, we have the freedom to be accountable for our actions and to speak freely as to what we believe.

With that privilege comes huge responsibility. The reason I am deeply conflicted is that, on the one hand, I have been in severe pain—I've had breast cancer—and the thought that I could possibly deny people who have chronic pain and debilitating illnesses' access to, potentially, medicinal cannabis that could help them is abhorrent to me. However, on the other side, I have had family members, as I mentioned in my maiden speech, deeply affected by drugs—and, as a former Minister of Education and Minister for Youth, the number of young people who came up to me and said that their journey in the criminal justice system started as a result of being addicted to drugs.

So I'm faced with two bills that have come before this Parliament. Both of them are flawed. One goes too far and one does too little. So that is the dilemma that I have, and I actually believe there are many members of Parliament in this House that have the same dilemma. And this is why I am conflicted. I want to acknowledge the work that you have done.

I will not be voting for the legislation this evening, but what I am committed to doing, with other members of Parliament—and I know from the conversations that I've had in the last 24 hours. I'm not going to cross the floor on a bill that I know, even with my vote from the National Party, we don't have the numbers for. But what I will do is I will work with Chle Swarbrick, I will work with the Prime Minister, I will work with those other members in New Zealand First that want change around those people who have chronic pain or debilitating conditions to provide greater access for either cannabis products or loose leaf.

And I think we can do that with the existing Government bill, and that is what I will be campaigning for, and I commit to working with you, Chle, and other members of the House—to try and deliver that. It has been one of the toughest political decisions that I have ever had to make. But I want to then finally speak to the people in the gallery but also the people that are watching tonight. It's very easy to look at parliamentarians and think they don't care. That is not my experience of this place. People do care. And there is a pathway through, and I'll be fighting for that.

• KIRITAPU ALLAN (Assistant Whip—Labour): I'm still a green member in this House, no pun intended, but I may just have a little more faith, hope, aspiration in our political system that if we were to indeed support this bill, which may have some flaws—in fact I think there are a few—through to the select committee that members of the public that have been engaging every single member of this House for the past few months will in fact have their chance to have their say.

I rise to speak in support of this bill to its first reading. Those that know me personally know that I have found the position that I'm taking this evening a very hard one to take. Within my communities and, indeed, like my colleague over the opposite side of the aisle, drug use, its impacts, its harm within my own family and my own life have indeed shaped my outlook. But when I took my oath and when I took my seat within this House, I took an oath that I would keep my eyes open regardless of my own personal convictions, that I'd keep my ears open, and be open to engage with the debate. I put up a forceful argument in opposition to this bill for a number of months, as many members of this House will know. I put up opposition because I was afraid of many of the comments that have come throughout this room, the deregulation, the increase in harm, so on and so forth. And the challenge always put back to me from every single person who was an expert within this field was "Kiri, go and read the research. Go and look at the work that is being done across the world in jurisdictions where medicinal cannabis has been legalised." Indeed I did, and what I must say, and I look particularly to the example over in Canada.

Canada has done extensive work looking into the implications of marijuana for personal use and, indeed, medicinal cannabis. But there was one particular report that looked into the implications of cultivation for personal production, which was an area that I had particular concerns with. The arguments, effectively, were two part: one, and I think we have heard a bit of the scaremongering from both sides of the House tonight, that it's going to increase harm, it'll create further access by gangs, and so on and so forth. The more nuanced research presents a different case, and that is that some jurisdictions who have indeed engaged with these deeply morally challenging issues, but where they have been brave enough to go in to an area and legalise, decriminalise, or make accessible cannabis for medicinal use there has been a decrease in harm, there has been a decrease in criminal justice statistics.

I particularly want to just make a comment because this has been a point of some debate amongst Māori communities in particular. There is not a universal agreement on this issue, and indeed, in fact, it's one that we grapple with intimately around kitchen tables.

Sitting suspended from 6 p.m. to 7.30 p.m.

KIRITAPU ALLAN: This bill that we've been asked to consider tonight extends the parameters for medicinal cannabis use from those with a terminal illness to those that are suffering in chronic pain. There are real fears, as I illuminated prior to the break, that a Pandora's box may somehow erupt and open and that we might not be able to contain the harms of drugs.

But from a pragmatic perspective, my community up there on the East Coast—my communities, Māori communities, small communities—right now is suffering at the hands of so many different types of harm. Right now, 40 percent of young Māori incarcerated in prison are there because of drug-related offences. I have to confront my fears when I engage with the subject matter of this bill. The community have asked us to engage with these matters, and engage with them thoroughly.

I implore members of this House, when we are casting our conscience vote tonight, to trust in the parliamentary process, to send this bill to select committee, so that we can indeed hear from our communities.

• Dr SHANE RETI (National—Whangarei): Thank you, Mr Speaker. It's a pleasure to speak on this bill tonight. I congratulate the originator of the bill Julie Anne Genter, and the member who currently has it in her hands, Chlöe Swarbrick.

Over the past recess I had the opportunity to explore and spend some time in US jurisdictions that have a large history, a long history, of medicinal cannabis. On Christmas Day I found myself in Eugene, Oregon, a liberal state that has medicinal cannabis and also has recreational cannabis. On New Year's Day I was in Camarillo, California—medicinal cannabis for quite a while, and on that day Proposition 64 came in, which made it recreational. In between then, I was in Nevada and other liberal states, with recreational and medicinal cannabis.

My contribution tonight, then, will be a reflection of several things: first of all, 20 years of clinical practice and then my observations when speaking to colleagues and communities in these environments.

I want to make some opening remarks. I said yesterday, and I want to reinforce, that I am very pleased that medicinal cannabis is part of our conversation. It is timely. There's nothing to be afraid of. It's a good conversation to have. It sits it alongside other medicines. Let's look at these other medicines. Other medicines have a known source, a known production line, a known manufacturing programme. Other medicines have a known dose response. They have known drug to drug interactions. They have known side effects. Other medicines are dispensed in known places, at known times, by known people. Other medicines are in their final form. They're not in a midway sort of form. Leaf could be a midway sort of form because you could infuse it, you could smoke it, you could bake it. It's not the final form that you may take it in.

But many of these medicines, if they are available, are expensive. I understand that, and so I think part of this bill—certainly the area of self-cultivation—says, "Look, how can we get past the expense of these products?" If we look at the pharmaceutical spectrum, if you like, for regulation we would have the pharmaceutical-grade products at one end and what this bill proposes, self-cultivation, at the other.

In the middle is something interesting—the high standard pharmaceuticals, high standard grade pharmaceuticals, or you might also call them "near pharmaceuticals". I'm really hoping that Mr Clark's bill, the medicinal scheme, will talk to these, because the bill's intent talked about setting high standards. This near-medicinal group, which is about 25 percent cheaper than standard high-grade pharmaceuticals, could well be very suitable for the purposes that this member is looking for.

There are four main parts to this bill, and I'll talk to some of them. First of all, the qualifying conditions: briefly, what's in and what's out. What's in doesn't make sense to me—chronic immune order conditions. If you look through all the 52 states, those that have THC containing medicinal cannabis, not one of them has chronic immune conditions as their qualifying criteria—not one. Too broad. There are occasional immune conditions, but not immune system disorders. It's too big. What's not in—every state, except Maryland, has cancer on that list. This bill does not. So I've got some issues about what's in and what's not.

The second part of this bill talks to a medical recommendation. I commented yesterday that that's part of the weakness of the Minister's bill, that there is no clear indication from a medical practitioner that it's useful.

The third part to this is the cultivation, possession, and use of cannabis. I've talked of that, and talked to some of the self-challenges that I have around self-cultivation, around quality, around control standardisation, and the alternative I'm proposing is to look at "near pharmaceuticals". I also have issues with the fourth part, which is around immediate relatives or nominated persons.

I support this discussion. I will not be supporting this bill, on the basis of too broad a qualifying criteria in one area, not inclusive of cancer in another; a lack of quality, consistency, and monitoring around self-cultivation; and a cultivation net that includes immediate relatives and nominated persons. That is just too big.

But I do support this discussion. I believe the Government bill is the forum to have this discussion, and I think we can expand it a bit to cover some of these things. It was part of the discussion we had in the select committee this morning. Can we pick up parts of the bill in the select committee, under the Government's current legislation? We're exploring that. I hope we can. It's a good and timely discussion. Thank you.

• Hon NICKY WAGNER (National): Thank you very much, Mr Speaker. Yesterday, National voted for the Government's Misuse of Drugs (Medicinal Cannabis) Amendment Bill. We voted for it because, like most New Zealanders, we support the use of therapeutic cannabis products for people who are terminally ill but also for people with severe and debilitating illnesses.

I discussed yesterday that the bill doesn't deliver on Labour's electioneering promises to legalise medicinal cannabis, because all it actually does right now is provide a statutory defence for people for the possession and the use of cannabis if they're terminally ill, and only if their doctor thinks they're going to die in 12 months.

The bill is flawed in other aspects too, particularly because it doesn't include a wider definition of people who may like to use it in terms of those debilitating and severe illnesses. But we voted for it as a stopgap measure. We voted for it out of compassion for the terminally ill, but also, and very importantly, because it provides a regulatory power to create a medicinal cannabis scheme. That, I think, is where the opportunity is that we can get something of value to the people of New Zealand, where we can perhaps create the reasonable, rational, sensible, and practical middle ground.

What, really, New Zealand needs in terms of medicinal cannabis is an evidence-based approach. It needs to be able to provide secure access for patients. We need to be able to have ensured quality control of the product. It needs to be affordable, and it needs to have a safe and clearly managed supply chain. Unfortunately, the bill that we are debating tonight doesn't deliver any of these things. In fact, we believe that the bill is so loose that it's almost unworkable.

It's unworkable particularly around the definitions. The definitions are too broad—too broad in terms of which disorders qualify, although I have to admit my colleague talks about leaving out cancer. Also too broad as to who and how the product can be supplied. Essentially, if you take it at face value, almost anyone can grow and process cannabis for almost anybody, and we all know the risks of that.

National's view is that cannabis-based products used for medicinal purposes must be treated like any other medicine, and just like any other medicine, they must be subjected to the same sorts of trials and testing processes. They must be able to be of maximum effectiveness and they must be safe. But there's also a significant opportunity for non – pharmaceutical grade products to be prescribed in certain conditions, and this is what my colleague also has just mentioned. The key, of course, is how we separate and utilise the cannabinoid, which has the potential for the therapeutic effects, from the THC, which is the psychoactive component of the plant. That needs much more research and much more work.

The National Government has already delegated decision-making powers to prescribe cannabis-based products to the Ministry of Health, and specialists can now prescribe unregulated products, which could include pharmaceutical grade or non – pharmaceutical grade products derived from cannabis for patients, as long as it's signed off by the Ministry of Health. National's advice to all people, or patients who feel that they may get some benefit from cannabis-based products, is to talk to their doctors, in the first instance.

So, in summary, National certainly supports the use of therapeutic cannabis-based products for their patients, but we cannot support this bill. Yesterday, we voted for the Government's bill as a stopgap, but with the clear expectation that the Government will work efficiently, well, and urgently to set up the medicinal cannabis scheme as promised—a scheme that can deliver secure access for patients, that can deliver consistent and assured quality control for the product, affordability, and a safe, well-managed supply chain. Thank you, Mr Speaker.

• ANAHILA KANONGATA'A-SUISUIKI (Labour): Happy New Year, Mr Speaker. It's a privilege for me to stand today to speak for the first time in 2018. I would like to acknowledge this opportunity to speak on the Misuse of Drugs (Medicinal Cannabis and Other Matters) Amendment Bill, which was in the name of Julie Anne Genter and is now in the name of Chlöe Swarbrick.

I would like to honour the memory of those New Zealanders who have passed away, that had the belief that the Government could have intervened in the pain relief, using the healing properties of cannabis. I would also like to acknowledge those who are currently terminally ill or are suffering, who are in pain—who are in pain and who are looking for alternative medication to relieve the pain. My empathy with the family and friends of those New Zealanders who hour by hour, minute by minute think and love their friend who is currently suffering in their time.

I want to acknowledge the Labour-led coalition. Yesterday, after nine years of a National Government who had known the conversations that New Zealanders have about the healing or the pain relief properties of cannabis, and had appealed on many occasions by—we've heard today from the member who's bringing this bill to the House about leaders who are actually supporting the healing properties of cannabis. So I want to acknowledge the leadership of the Hon David Clark for his bravery in bringing the Government's bill yesterday.

I'm going to read the reason why I am acknowledging this bill—the Misuse of Drugs (Medicinal Cannabis) Amendment Bill. The reason why I loved what the Government had put forward is that it reads—and I want to read this because I want people who are laypeople like myself, I'm a first-term member of Parliament, so before then I didn't know many words. I want to acknowledge the learned colleagues, the two doctors who were sharing their knowledge of medicine and giving us an insight that some doctors are bad, in the words of Dr Coleman, and may use this bill, if it comes into law, in other, negative manners.

But the Government bill yesterday seeks to amend the Misuse of Drugs Act 1975: "The Bill will—introduce an exception and a statutory defence for terminally ill people to possess and use illicit cannabis and to possess a cannabis utensil; and provide a regulation-making power to enable the setting of standards that products [are] manufactured…" We had a medicines bill in 1981 that sets out many standards—pages after pages of standards—and I agree with the Government's bill that there need to be standards.

The bill that we are talking about, Ms Swarbrick's bill—what concerns me is that, yes, it acknowledges changes and acknowledges terminal illness, but what concerns me is to cultivate and possess cannabis products, or having a family member or named person cultivate and supply this for the named person. I am a descendent of medical healers. My brother currently mixes herbal medicines and he provides that freely to people who believe in his medicine. My father is a traditional healer who, through compassion and love—it will be three o'clock in the morning or four o'clock in the morning, people are knocking at his door asking for his healing thoughts to prescribe to their illness.

I unfortunately haven't inherited any of those healing powers or knowledge, but what I can share is an insight I heard from the member today about Grey Power supporting this bill. I had an experience with a few elderly ladies in the organisation that I belong to, and they talked about how good their medication is—it's doing really great for them. Through their compassion and their love, they share their medication—"OK, you take a couple of pills and I'll take this, and it's going to do you wonders." So they self-prescribe and share the pills.

I'm concerned about human behaviour—human behaviour in terms of sharing your home-grown cultivation of cannabis and its healing powers. As a person, if I've got someone who is in pain that I love, and it comes to a point that I can share this medicine with them, if it's about love—I can honestly say that I may not follow the rule of law, if it's about love.

But to end this, if you allow me to make another call, Mr Speaker, so I can finish my story—

Mr SPEAKER: You're not having a whole new call, but wind it up.

ANAHILA KANONGATA'A-SUISUIKI: Wind it up—OK. It is human behaviour to share something that is going to benefit another human being who is suffering. If I am the person who's been approved to cultivate and supply to person A this healing power of the medicine, for them to make them feel better—I put this question to you, all the members of this House. We've had an opportunity yesterday to discuss the healing powers of cannabis. I put this to you: would you deny your loved one that healing power of cannabis if they're not the named person? So I—

Mr SPEAKER: Order!

• JENNY MARCROFT (NZ First): Kia ora and thank you, Mr Speaker. Thank you for the opportunity to stand and speak on this member's bill in the name of Chlöe Swarbrick. I've really grappled—[Interruption]

Mr SPEAKER: Order! Thank you, Dr Coleman. The member will start again, please.

JENNY MARCROFT: Thank you, Mr Speaker, and thank you for the opportunity to stand and speak on this bill, this member's bill in the name of Chlöe Swarbrick. I've really grappled to understand and work on the decision—the way I will vote—because, as I spoke in the House yesterday about my own personal experience of watching my mother with breast cancer die in a very terribly painful way. On the one hand, we must be compassionate, but on the other hand, the wide range of inclusions and the lack of regulations in this bill are a real concern for me.

There is widespread cannabis use in our community and that presents significant harm. The casual exposure to cannabis that this member's bill will enable will be especially harmful to our youth and their perceptions of what drug use is. A just and caring society needs to balance the potential harm to one section of our population against denying the needs and the real concerns of another section of our population. The Misuse of Drugs (Medicinal Cannabis and Other Matters) Amendment Bill will legalise the psychoactive substance component THC with unlimited use of any form of cannabis. It will, literally, enable the use of any form of cannabis without limitation.

Now, this is important to note, because science creates a distinction between a medicine and an uncontrolled substance. What are the dosage labels on a plant? Where are the published articles on experiments showing the linkages to side effects and safety of mixing more than one prescription drug with any other drug? How, for example, will someone's heart medications interact or react with cannabis—with THC—and what about someone who's taking a range of medications for a variety of illnesses—for a variety of conditions. What safeguards will be in place for them if they are self-medicating?

I wonder about this on a personal level too. I struggle to reconcile a decade of "Drugs are bad." These are the discussions I've had with my teenager. Casual exposure to cannabis is harmful to our youth and their perceptions of harms of drug use.

Our moral compass is skewed when we treat a medicinal product as something unscientifically grown in our backyard or under a grow lamp in a rented suburban House. Is it really a medicine when there are no controls; no recommended doses; no daily limits? We should not be enabling the growth of unregulated and unmonitored drugs. The science just isn't there yet. However, the research completed already paints a bit of a grim picture.

Dr Kate Baddock, chair of the New Zealand Medical Association board writes about the social impacts of cannabis use in her commentary on cannabis, written for the digest on 1 October 2017. It reads, "The use of cannabis in adolescents and young adults is associated with reduced academic achievement in a dose related fashion. The pooled results from a large Australasian study suggest that the use of cannabis before the age of 15 may contribute as much as 17 percent toward failure to complete school, go to university, and attain a degree."

I also note a point of concern that the member's bill allows a nominated support person. What will happen if that nominated support person is sent off to purchase some weed and they end up in a queue with a whole bunch of other people with medical exemptions lining up outside the local tinny house? What about the lady who's living on her own who grows a few plants and people find out that she's got a stash? Is her property in danger? Is she in danger? There need to be controls carefully thought through.

The public interests in terms of medical marijuana are already being considered by the Government bill, and thereby the public will still have an opportunity to submit in a select committee, and that's really important—just on a more refined and focused bill than this one. I am compassionate to the needs of those who are suffering a terminal illness or who have a debilitating condition, but this bill is too far removed from the use of marijuana as a medicine, and therefore I cannot support it.

Mr SPEAKER: Before I put the vote, I have noticed that there are only two members who have been seeking the call and who have not got it. This is an unusual situation, but because it is a conscience vote I am going to seek the leave of the House for there to be two further speeches. Is there any objection to that? There appears to be none.

• DAVID SEYMOUR (Leader—ACT): Thank you, Mr Speaker. I rise in support of this bill. I want to just address what it's about and what it's not, because, ironically, this bill is not about marijuana or cannabis.

I don't particularly like cannabis—I don't like marijuana. I tried it once, I got very hungry, and I never did it again. I don't understand why people smoke it, but a lot of people—and some of the members we've heard—say that it is beneficial. My personal experiences and preferences are hardly the point, because if this bill is not about cannabis then it is about prohibition. There is no policy called "cannabis", but we are lawmakers. Our job in this House is to deal with policies, and the policy in question is the prohibition on people who have serious, painful illnesses on using cannabis.

We have to ask ourselves as lawmakers, has the prohibition on cannabis been effective? I'll give you the answer that I gave on the Government bill last night. You can analyse any policy by asking three simple questions: what's the intent; is it effective; and what are the side effects? Well, the intent of banning people with illnesses from accessing medical cannabis is, pretty clearly, to stop them accessing medical cannabis.

What of the effectiveness? We know from the number of people who are doing it from police, including former police officers in this chamber, that it is a highly ineffective prohibition because so many people are doing it. The objective is to stop people smoking cannabis; the effectiveness is almost zero. The people that want to do it are doing it.

The unintended consequences are that people put themselves in danger dealing with criminal elements whose criminal sphere they fund by acquiring elicit cannabis, and they receive a product that is made all the more dangerous by being underground than it need otherwise be. I can tell you—or at least I've heard—that most of the current suppliers don't follow the Consumer Guarantees Act, and they don't often issue refunds. That is the circumstance in which so many people find themselves.

The politics of this is very simple. This bill will pass tonight if we can find about half a dozen brave and thoughtful souls on the National Party benches. I'd put it to my colleagues in the National Party—let me put it this way—I listened to Nikki Kaye's speech, and I thought of something Richard Prebble once said to me: "If you can't ride two horses at once, you shouldn't be in the political circus." Well, Nikki Kaye was riding those horses so far apart she just about hung, drew, and quartered herself.

The National Party members need to think long and hard about this question: had the Labour Party—the evil Labour Party—not put up their piss-weak watered-down bill that will go halfway to where they'd like to get, would they be voting for this bill tonight? I'd point out to members—

Mr SPEAKER: Order! People remonstrated with me yesterday for the use of language that might be common where I come from but is probably not appropriate here. I think the member just better be careful how he expresses himself.

DAVID SEYMOUR: In fairness, it's not common where I come from.

If the Labour Party had not put up a weaker bill, many more people on this side would be voting for it. That's the only difference. I'd put it to members in the National Party benches that you don't want to be found trying to ride two horses at once, because sometimes you tear yourself apart.

What you want to be doing is asking the simple question: is the policy of prohibition a successful policy; if not, would New Zealand be a better country if we ended that policy for people with chronic illnesses, and would it be a better policy if people could acquire what they are acquiring already through much safer, much more legitimate means that did not lead to children in this country growing up in households funded by the proceeds of crime that only exists because of prohibition? That is the question: could you make New Zealand a better place by taking a small step to ending that prohibition tonight?

If members in the National Party benches agree with me, it only takes half a dozen to bravely and thoughtfully cross the floor. Try it, fellas. It's exhilarating. I've done it—you feel like Julie Andrews, skipping across the floor. You can make a difference for New Zealand and have a great time doing it. That's the best appeal I can make to my colleagues in the National Party. I hope to see half a dozen of you in the Ayes lobby tonight. Thank you, Mr Speaker.

• CHRIS BISHOP (National—Hutt South): Thank you, Mr Speaker. Thank you very much. You could almost think Richard Prebble had reincarnated into the Chamber—not reincarnated, but at least reappeared into the Chamber.

I have spent a lot of time with this bill, and gone back and forth on whether or not I should support it. Let me make it clear that I think the status quo with medicinal cannabis is manifestly inadequate when it comes to cannabis for medicinal use. Over the last three years, I have met countless sick people whose lives are improved by the use of cannabis. Some of these people have been in the media; most of them have not. Access to medicinal marijuana at the moment is difficult, expensive, and time-consuming. I think we can and must do better.

It's also clear to me, from some of the work I've done on my own accord, that the direction of travel internationally is towards a legal, regulated market for medicinal cannabis products. Other jurisdictions have grappled with the same problems we are, and the various models overseas vary, but they all have probably three key things in common. Number one, there's clear authority given to doctors to prescribe medicinal cannabis, alongside guidance as to how and when it can be appropriate; secondly, there's a robust regime that allows domestic producers of medicinal cannabis to register and be licensed; and thirdly, there are strict regulations on manufacturing and imports to control quality, to make sure patients have trust in the products they use. Schemes like this exist in Canada and in Colorado, and my colleague Greg O'Connor made reference to a couple in his speech, in his very excellent contribution to this debate, and ultimately I think that's where we need to head in New Zealand.

So when we come to the two bills that have come to the House on successive days, we talk about David Clark's bill. That does one very worthy thing and one thing the previous Government had already done, and is utterly silent on the very worthy thing it purports to do. Let me explain. The worthy thing is it provides people with a terminal illness a statutory defence to the charge of possessing and using cannabis. It could go further, but it does one thing that's a step forward, I think. It also changes the classification of cannabidiol. It would be fair to say the previous Government's already done this, and we've heard from my colleagues tonight about how that is essentially a tidying-up exercise, and puts into legislation what's already been done through regulation. If you were being uncharitable—and I'm not an uncharitable person, but if you were—you could say it's an attempt to fill out a bill that lacks a bit of substance. What the bill doesn't do is establish a regulatory scheme to actually establish medicinal cannabis in New Zealand. It says it does, but it doesn't. We have to wait at least two years for that to happen.

So then we come to this bill. Now, it, too, is inadequate. Members have canvassed, on this side and the other side as well, a lot of deficiencies. It does not set up any sort of regulated market for medicinal marijuana. There are no controls on production and supply. It will not give doctors any confidence—and this is a very important point—about prescribing medicinal marijuana. The qualifying criteria, as my colleague Shane Reti pointed out, are too broad. So it was a difficult decision, but I have decided to vote against the bill.

Ultimately, I want a conversation about wider access to medicinal marijuana and how we can design a world's best practice regulatory regime for New Zealand. The appropriate place for that is at the select committee, the Health Committee, that considers the Government bill that purports to establish that scheme. I also, and this is very important, want the voices of those with chronic pain to be heard and listened to. Again, the right place for this is at select committee, and as part of designing a good regulatory regime we must listen to the thousands of New Zealanders out there who get therapeutic value from medicinal cannabis. I thought Greg O'Connor made a very important point in his contribution to the debate. Let's get this right, through the Government bill that sets up at least the starting point to, over the next couple of years, and I suspect beyond as well, through Government consultation and through engagement with this side of the House—because I think there is good-hearted support, as you've heard from members on the National side tonight, for a robust regulatory regime that allows people who gain therapeutic value from medicinal marijuana products to use them. But let's get this right.

Because this bill is so flawed, so deficient, and because we already have a vehicle in the Parliament as it exists right now, I cannot bring myself support this bill, worthy as it is. Thank you.

Mr SPEAKER: Chlöe Swarbrick in reply.

• CHLÖE SWARBRICK (Green): Thank you, Mr Speaker. I have only five minutes to address all of the concerns that have been raised throughout this debate, so I will keep this brief, but I would again implore any of the MPs who have risen to voice their conflict, and/or potential lack of understanding of the purpose or how this bill would actually work in operation, to vote for it, to hear the voices of those New Zealanders who will benefit from it.

I have heard tonight a point raised by many speakers—Chris Bishop the most recent, but they included the likes of Dr Jonathan Coleman—stating that there is no mention of regulation. Greg O'Connor mentioned that this is a wasted opportunity, the State will lose any control to regulate it—Nicky Wagner, as well. And I would state that any member who has said that should refer to clause 6 of this bill, which outlines, "prohibiting, limiting, restricting, and imposing conditions on, either generally or in relation to particular cases or classes of case or particular classes of person, the cultivation, administration, supply, use, or possession of medicinal cannabis pursuant to any provision of section 9A:". That is a provision for a set of regulations to be determined at select committee and during that process by which we will open the door to that conversation with patients, many of whom are currently having accessing their medicine making them criminals.

A few people have mentioned that this is outside what other countries and other jurisdictions are doing. I'd note that Canada does have a nominated supplier mentioned in their legislation, and 29 US states, Hawaii included, allow people to nominate someone to grow on their behalf for medicinal purposes. I'd very much like to touch on the point that was raised by my colleague Kiritapu Allan about faith in this system. This here, this vote tonight, is about opening the door to a conversation with patients who would benefit from the use of medicinal cannabis, who, under the Government's bill, will still be criminalised. It will take at least two years to open up that regulatory scheme that the Government's bill proposes.

For those concerned about doctors prescribing something that may potentially get people high, I am sorry to tell you that that presently happens, with the likes of tramadol and morphine, and for those who are concerned about people smoking, for recreational use or otherwise, I'd refer them to the Ministry of Health study on the issue of cannabis, the most recent of which was, unfortunately, undertaken in 2012-13. It found that of nearly 400,000 users of cannabis in New Zealand—400,000—42 percent of people used it for medicinal purposes, including alleviation of pain and nausea. The cat is out of the bags, folks! We are not putting it back in there. As was mentioned by my colleague David Seymour, prohibition here simply is not working.

As was mentioned by both Chris Bishop and Greg O'Connor, we do have an opportunity to get it right, and I think the best way to get that right is to ensure that we have the broadest scope, we have the broadest potential for change, going before select committee, which will only happen if we can vote this through its first reading tonight and send it through to the select committee stage. Prohibition, as I mentioned, is not working, and in many cases we find that good drug law is somewhat counterintuitive. So, again, my final plea tonight is to not stop this conversation before it is started. I know that many of you have received emails, messages, calls, people dropping into your office who have shared their stories with you. Bear that in mind as you vote with your conscience tonight. You have an opportunity to make history. As all of you will know, voting this through its first reading does not guarantee a vote at second reading. It simply opens that door. So don't shut down this conversation. I implore you to vote for this bill. [Interruption]

Mr SPEAKER: Order! Members will be aware that this is a conscience vote, and I should just remind people of the processes. I will put a voice vote, I will declare a result, and if any person wants to have a personal vote, a personal vote will be held.

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