Dear Ministry of Health,

I am writing to request information under the Official Information Act 1982 concerning the policies and regulations that govern the treatment and administration of prescribed medications, including medical cannabis, within hospital settings. My recent experiences during medical treatment at both Hawke's Bay Hospital and Wellington Hospital have highlighted several issues regarding these policies, specifically relating to the use of medical cannabis.

1. Requirement to Administer Medicine Outdoors and Smoke-Free Regulations:
Although I am not a smoker and understand that hospitals adhere to smoke-free regulations without designated smoking areas, I was required to administer my prescribed medical cannabis outdoors during my recovery in Wellington. This requirement, seemingly in contradiction to smoke-free regulations that explicitly exclude medical cannabis, forced me to leave the hospital premises, exposing me to low temperatures and nearby security risks during a police incident involving a machete and firearm (https://www.stuff.co.nz/nz-news/35026439...). I seek clarification on the legal basis for this policy, which appears to breach patient rights.

2. Confiscation and Differential Treatment of Controlled Drugs:
Upon my arrival at Wellington, my prescribed medical cannabis was confiscated, cited as standard procedure for controlled substances. Yet, fentanyl, another controlled substance, was administered to another patient within hospital premises without the need for them to go outside. This discrepancy raises significant concerns about potential double standards in the handling of controlled drugs.

I seek clarification on the legality of this confiscation. Please provide a copy of this policy in full for my review so I can better understand how my medication was handled when outside of my possession.

3. Fire Safety Claims and Evacuation Policies:
At Hawke's Bay Hospital, the head of security warned that using my medical cannabis vaporiser inside could trigger smoke alarms and necessitate an evacuation, thus I was compelled to use it outside of hospital grounds. I request detailed information on the fire safety regulations and specific evacuation policies that support this claim.

4. Breach of Duty of Care:
As a patient officially admitted to the hospital, it is concerning that the hospital's policies required me to leave the premises to use my legally prescribed medication, potentially compromising my safety and recovery. This practice seems to neglect the hospital's duty of care to its patients, especially those recently out of surgery and in a vulnerable state. I seek explanations on how these policies align with the hospital's responsibilities towards patient safety and care.

Given these points, I respectfully request the following information:

The specific Ministry of Health regulations or policies that require patients to administer certain medications, such as medical cannabis, outside hospital premises, especially considering the exemptions in smoke-free regulations.

Details on the standard procedures for the confiscation and administration of controlled drugs, with specific emphasis on the distinctions between medications such as medical cannabis and fentanyl.

Clarifications regarding fire safety regulations and evacuation policies related to the use of vaporisers and other similar devices within hospital settings.

All training material provided to healthcare staff in regards to Medical Cannabis.

Clarity on these matters is crucial for my understanding and to ensure that all patients receive equitable and safe treatment while under hospital care. I appreciate your attention to this matter and look forward to your prompt response within the statutory 20 working days as provided under the Official Information Act.

Thank you for your assistance.

Yours faithfully,

Anthony-John van Duuren

Dear Miranda,

Thank you for your response dated 30 May 2024. I appreciate your efforts to address my queries concerning the administration of medical cannabis within hospital premises. However, there seems to be a significant misunderstanding in your response regarding the forms of medicinal cannabis that can be utilised for patient treatment, particularly in relation to inhalation methods, which are critical for my condition.

Clarification on Inhalation Forms of Medicinal Cannabis:
Your statement that "there are no medicinal cannabis products under the medicinal cannabis products minimum quality standard that can be smoked or vaped" contradicts the availability of prescribed medicinal products specifically for inhalation. These are vital for rapid onset of pain relief and other therapeutic effects. Inhalation is a recognised method for the administration of medicinal cannabis, and it is crucial that hospital policies reflect this. The distinction between smoking and vaping is crucial, as confirmed by legislation, which specifies that vaporizing does not fall under the same restrictions as smoking. This is an essential consideration for patient treatment options and compliance with smoke-free regulations.

These are the legislated definitions of what defines smoking, vaping, or medical product as per the Smoke-free Environments and Regulated Products Act 1990: legislation.govt.nz/act/public/1990/0108/latest/DLM223196.html

Furthermore, as these products are not prescribed for "smoking" — rest assured, I am not suggesting that patients be allowed to "smoke one up" in their wards. However, legislatively, it appears that patients are allowed to vape their medical cannabis, and it's up to the hospital to accommodate that: legislation.govt.nz/regulation/public/2019/0321/latest/LMS285305.html

Smoke Alarms and Misinformation:
I have consulted directly with Fire and Emergency New Zealand (FENZ) regarding the sensitivity and specifications of smoke alarms to vapour. According to FENZ, the vapour produced by medicinal cannabis vaporisers does not have the particulate size or heat to trigger the smoke alarms installed in hospital settings. Therefore, the risk of triggering an evacuation due to the use of a medical cannabis vaporiser is highly unlikely.

Duty of Care and Patient Safety:
The requirement to leave the hospital premises to administer a legally prescribed medication not only compromises my safety but also contradicts the hospital's duty of care. This practice is especially concerning for patients who are in a vulnerable state post-surgery.

Given these points, I respectfully request a re-evaluation of the current policies regarding the use of medical cannabis vaporisers within hospital settings. It is vital that these policies accurately reflect the realities of medicinal cannabis administration forms and the safety measures already in place.

Additionally, I would appreciate it if you could provide:

- Any specific research or evidence that the hospital's current policies are based on regarding the use of vaporisers and their impact on hospital smoke alarms.
- A review of the training materials provided to healthcare staff concerning the administration of medicinal cannabis, particularly regarding inhalation methods.

Sincerely,

Anthony-John Van Duuren