Dear Ministry of Social Development,

For the purposes of this information request when I mention 'MSD' I mean MSD, it's Staff, it's Case Managers, it's Regional Health Advisors or anyone involved in the decision making process to grant or decline Medicinal Cannabis Products as an allowable cost in a clients Disability Allowance.

When I mention 'Medicinal Cannabis Products', I mean any and all things related to or derivative of Medicinal Cannabis, or any titles, classifications and headings MSD would place Medicinal Cannabis Products under for the purposes of an allowable cost for Disability Allowance. I have sighted in a previous OIA that it is/was still being listed under 'Alternative Medical Treatment' which is the wrong classification as it is now a prescription medication. That must change.

My questions are as follows:

1) What criteria does a Client have to meet to get assistance via the Disability Allowance for Medicinal Cannabis Products as an allowable cost in their Disability Allowance?

2) Why does MSD decline Medicinal Cannabis Products as an allowable cost in a client's Disability Allowance? If the answer is anything related to science and evidence please give a thorough explanation with sources in response to Q6.

3) How many clients are currently in receipt of Disability Allowance assistance that covers Medicinal Cannabis Products as an allowable cost?

4) What percentage of applicants applying/applied for Medicinal Cannabis Products as an allowable cost covered under the Disability Allowance are declined or lapsed, and what is the most common reason for declining this assistance? If you could, please separate the data between lapsed and declined.

5) When declining Medicinal Cannabis Products as an allowable cost under the Disability Allowance is MSD responsible for explaining the reason of the decline? If not, why not?

6) Does MSD base their decision when granting/declining Clients who've applied to have Medicinal Cannabis Products included in their Disability Allowance on any evidence-based research? If so, please cite specific examples? If not, why not? And how are decisions then made if not based on evidence-based research?

7) Does MSD have any written or digital resource(s) or guidelines and process' (that are not already readily available to the public, such as internal memos, bulletins, reminders etc) regarding decision making when granting/declining Medicinal Cannabis Products as an Allowable cost under Disability Allowance?
If so, could you please provide it without it impacting the business? If there is no process/resource or guide, why not and how is the decision then made?

8) Since the passing of the Misuse of Drugs (Medicinal Cannabis) Regulations Act 2019, has MSD delivered any education to it's Staff, Case Managers and/or Regional Health Advisors (or anyone involved in the decision making process) to make them aware of the changes and what that means for clients/patients? If so, how and what was involved? If not, why and will this change?

9) Since the passing of the Misuse of Drugs (Medicinal Cannabis) Regulations Act 2019, has MSD updated any of it's systems to align with current legislation? Example: Cannabis is now classed as a Medicinal Product that can be prescribed and therefore being updated as such on all of MSD's software/resources/processes/tools. If not, why?

10) Has MSD updated any of its processes and/or understanding around Medicinal Cannabis Products, the prescription process and it's challenges, in order to better service whanau across New Zealand who are now legally prescribed it? If not, why, will this change, when? If so, how?

11) Have staff at MSD who ultimately decide grant/decline for Medicinal Cannabis Products received any training or extra education relating to Medicinal Cannabis Products? If not, why?

12) What are MSD's policies or actions to ensure that Regional Health Advisors have adequate medical knowledge and understanding to make medical decisions? How often is their competency and knowledge tested, and how? If not, why?

13) Under 'Pharmaceutical Charges' in the MSD Deskfile I have found this statement:

"Costs not included
Disability Allowance cannot be paid for:

- pharmaceutical items not related to the client's disability (for example a cough suppressant for the flu) or
- illegal drugs used for medical purposes (for example marijuana for pain relief)."

Why has this remained as such, declaring Cannabis/Marijuana as an ILLEGAL drug when it is not, based on the Misuse of Drugs (Medicinal Cannabis) Regulations Act 2019?

14) This speak to the above question, is it MSD's understanding that MSD may have influenced the decision making process by not adequately updating its resources? If not, how has MSD made this clear for staff who have the right to grant/decline?

15) When declining assistance for Medicinal Cannabis Products under Disability Allowance, what work is being done to ensure that the needs of the client/patient are fully understood, heard and they have a mana enhancing experience?

16) Is MSD aware that declining Medicinal Cannabis Products as an allowable cost is forcing clients/patients to go down a more harmful path that WILL increase in cost to Government over the time the longer the patient/client is prescribed? Dispensings for Morphine and Oxycodone increased between 2017 and 2021 and will continue to climb. There is already a large and growing amount of people on these types of pain medications which will eat away at your quality of life resulting in more prescriptions and treatments. The warnings on the labels carry risks.

17) When a Regional Health Advisor consults a Client's doctor regarding their Medicinal Cannabis Products, what questions are being asked to formulate the decision to grant or decline? Why is the client/patient not consulted with during this process? Why does it appear that the client/patient is placed last in the factors for decision making? They are left scrambling trying to figure out how they will manage.

18) Te Pae Tawhiti talks about Mana Manaaki, Kotahitanga and Kia takatu tatou, can you answer how MSD can meet these values if clients/patients are being turned away from support and being put on drugs that actively take away quality of life from them?

Being sick isn't a choice, and you shouldn't be dictated to when it comes to your medication. You should be able to choose a medication that works for you. The world has a dystopian hue when you tell the citizens what to consume.

MSD has an opportunity to be proactive as they claim, to be in service to the New Zealand People, to listen, learn and understand the needs of people. This plant WAS illegal, stop treating it like it still is. If MSD could rid themselves of their judgement on Medicinal Cannabis Products, there might be a someone who, because they can now afford their CBD oil, can get some respite from their earth shattering migraines and can return to work, imagine...

Yours faithfully,

Mr de Brouwer