Thank you, Presiding Officer, and I'd like to thank Members for their contributions today, and the consideration that they've given to the concept of providing herbal cannabis to patients for medicinal use. I recognise the very genuine and cross-party interest in this subject, and a very sensible debate, I think, it's been, about—. But, before I go into the heart of the Government response, I want to recognise that there's more than one purpose to having these Member debates. There's something about saying you definitely want the Government to do something in the here and the now, and some people may want that to happen absolutely, and others may want to make sure there continues to be a public debate about the use of cannabis for medicinal purposes and how that can be advanced. But, for myself and from a Government point of view, the motion provides not just food for thought, but, in practical terms, for me it raises more questions than answers. And I do, of course, accept that there is some evidence that cannabis or its derivatives can have a role to play in managing chronic pain, anxiety, spasticity, and nausea and vomiting in the context of chemotherapy. And historically, of course, a tincture of cannabis was used for pain relief alongside laudanum and opium. However, we are now far more aware of the damaging side effects of poorly understood, poor-quality drugs, and prefer to use safe and regulated medicines. And we want people to have access to licensed, effective medicines to alleviate these conditions rather than people resorting to what are currently illegal drugs of unknown provenance, potency or purity.

I think it's fair to comment on some of the confusion about the purpose in what we're being asked today, because, in different contributions by proponents and supporters of the motion, we've heard the difference between, say, herbal cannabis and making that available for medicinal use, or the use of cannabis derivatives, or, as has been regularly referred to, cannabinoid drugs. I want to clarify: I don't think, from a Government point of view, this is really a debate about decriminalisation. There are different issues about decriminalising cannabis. I think this is really about should you make it available for a specific purpose, and, if so, in what form. So, it isn't about a prohibition on cannabis derivatives in licensed medicine.

But I'm pleased that, in the course of the motion, Members did recognise that this Government is the only administration in the UK that has recommended using Sativex to treat the spasticity symptoms of multiple sclerosis, such as spasms and cramps. It maybe helpful to remind Members how and why we did so: because the manufacturer took considerable time, money and effort to develop Sativex, the first cannabis-derived medicine in the world. The company had to produce a safe, effective medicine that met modern standards, and therefore followed exactly the same rigorous procedure required for the development of every new medicine for use in the UK. That included identifying which of the 60 cannabinoids and other chemicals present in cannabis could act to reduce pain. At that point, it's worth mentioning that the pharmacological effects of many of these are still unknown. Having identified them, the development stages then involved establishing the most effective combination of these chemicals and early testing for toxicity before proceeding to a clinical trial stage. The clinical trial phases are, of necessity, tightly regulated to protect the volunteer test subjects and the subsequent potential patient population. It's worth noting that it's been estimated that only four out of every 100 medicines developed by pharmaceutical companies ever make it to market.

In the UK, the Medicines and Healthcare products Regulatory Agency, the MHRA, they licensed Sativex for use in the UK in July 2010. That is only one part of making it available on the NHS, because they only authorise a licence or a marketing authorisation when satisfied that the medicine is safe and treats the targeted condition. Then the National Institute for Health and Care Excellence or the All Wales Medicines Strategy Group appraise new medicines by comparing their clinical and cost-effectiveness with existing treatments already on the market. Now, NICE does not recommend Sativex for treating spasticity in MS on cost-effectiveness grounds—so, not efficacy, but on cost-effectiveness. As a result, it's not available routinely for NHS patients in England, but the Welsh Government asked the AWMSG to undertake an appraisal of Sativex, and they recommended it to us in August 2014. My predecessor then made sure that it was available in Wales from that point, where clinically appropriate. I know there have been challenges about getting Sativex properly available to all people who could and should benefit, but that in itself has nothing to do with the fact that it is a cannabis derivative. There's a broader challenge there that we're trying to address within Government about making sure that the new medicines that are recommended and are available are then made properly available to all people as clinically appropriate.

This underpins our approach, not just here today in this one instance, but together with the appraisal process, and indeed the review we had on the individual patient funding request process as well, that we want to have and we will continue to take an evidence-based approach to determining which medicines could and should be made available on the NHS here in Wales.