Jersey Let Medicinal Cannabis Scripts Triple Before Inspecting Clinics

Jersey pharmacists dispensed 72,065 medicinal cannabis items in 2025, a 35% jump from the year ministers first called the island’s rate a problem. Clinic inspection was still sitting in the last phase of a staged care-law rewrite when that count landed.

The 2023 dispensing audit had already given ministers the comparison they used in public: a private, GP-written market stacked against England’s tightly shut NHS door. The inspection law they promised after that paper did not arrive before the item count more than tripled.

The Audit Found 6.08% of Working-Age Islanders

The Government of Jersey ran the exercise in late summer and early autumn 2023, reading monthly returns that pharmacists send the Chief Pharmacist. It covered 2022 and January to June 2023, and it counted only private prescriptions of unlicensed cannabis-based products for medicinal use. Licensed hospital products such as Sativex were left out.

For the 2022 calendar year the auditors logged 23,639 items and 4,361 estimated patients. A nine-month slice, January to September, was lined up against Care Quality Commission figures for England because that was the England window on hand. Jersey’s working-age share in that window was 6.08% of the working-age population. England’s was 0.05%.

JERSEY AND ENGLAND, JANUARY TO SEPTEMBER 2022

Eighteen doctors wrote the 2022 scripts. Twenty wrote them in the first half of 2023. The States Assembly had opened the route in 2018; GPs have been able to prescribe since 2019. The paper also logged 529 personal import licences in 2022 and 201 in the first half of 2023, on top of local dispensing.

England’s 0.05% Measured a Different Kind of Market

The ratio is more than 120 times. It is also a comparison of two systems that do not admit patients the same way. Unlicensed cannabis in England is not a GP product. NHS guidance still expects those products to be started by a clinician on the specialist register for unlicensed cannabis products, and the health service does not routinely fund them.

A House of Commons Library briefing put NHS community dispensing of the licensed cannabis medicines at about 5,000 NHS community prescriptions in 2023. That tally is Sativex, Epidyolex and nabilone in the community, not the private unlicensed flower and oil that dominate Jersey’s returns. Jersey’s audit used England’s 2022 controlled-drug snapshot as if it were a peer clinic market. It was a bottleneck.

Private unlicensed dispensing in England has grown hard since that snapshot, which only makes the 2022 baseline staler. The island still used it in Assembly questions into 2025. Ministers were not comparing two GP systems. They were comparing an open private list with a service that barely writes these products at all.

Clinic Inspection Was Parked Behind Hospitals and Ambulances

Environment Minister Steve Luce, who held the regulatory brief, called the gap significant when the findings went public in late March 2024. He pledged the law needed to regulate and inspect cannabis clinics. Health Minister Tom Binet published the paper and asked for faster sharing of patient information between clinics and GPs.

The audit also suggests that some people are receiving multiple prescriptions at levels which may be harmful to their health, this is of significant concern. I am, therefore, committed to developing the legislation necessary to regulate and inspect cannabis clinics in Jersey.

Steve Luce, Minister for the Environment, March 2024

A week later, answering Deputy Karen Wilson, Luce put the work behind another project. Hospital and ambulance regulation had to finish by the end of 2024 before drafting began. Officers then expected to write through 2025 and bring a debate in the Assembly in early 2026. He also said the full audit was already public, and that reports of a second hidden paper were wrong.

THE CLINIC-LAW QUEUE

1. 28 March 2024: Luce commits to legislation to regulate and inspect cannabis clinics.
2. 9 April 2024: He tells the Assembly that drafting waits until hospital and ambulance regulation finishes, with a debate aimed at early 2026.
3. 8 November 2024: Binet writes to States Members that Jersey Care Commission powers over the clinics are a longer-term 2025 project, after an EMIS records link and a review of advertising rules.
4. July 2025: Government places cannabis clinics in the final phase of Regulation of Care Law reforms, after hospitals, ambulance and adult mental health, so the watchdog is not overwhelmed.
5. 18 February 2026: Binet says Jersey still has no legal controls on cannabis-based prescribing practice and no independent inspection regime.

A scrutiny panel asked in November 2025 for a timetable before the government’s term ended. The clinics stayed in that last phase. Digitised pharmacist returns, which Binet told the Assembly in November 2025 now reach back to the previous quarter, gave Health and Care Jersey a faster view of the same market the 2023 paper had described by hand.

How the Prescription Count Moved After 2023

The first-half 2023 run already sat above a flat 2022 pace: 16,714 items and 2,880 estimated patients in six months. The years after the public warning did not cool. A written answer in 2025 put 2024 at 53,477 items for about 4,000 people, written by 20 prescribers. Deputy David Warr noted that this was 13.4 items a patient.

The unique-patient count did not explode with the item count. 2022’s 4,361 estimated patients and 2024’s figure of about 4,000 sit in the same band. What moved was how often those people were filled. A mid-year written question then put January to June 2025 at 33,296 items, a run-rate that already pointed past 2024 before the full-year disclosure.

JERSEY UNLICENSED ITEMS AFTER THE AUDIT

That 2025 total is more than three times the 2022 audit year. A 72,065 medicinal cannabis items in 2025 disclosure, circulated on 19 August 2026, also recorded the 35% rise on 53,477. Police said the legal product made it harder to tell lawful possession from street cannabis. A separate July disclosure found export licences rising and import licences falling.

January 2023’s 30 Double-Prescriber Patients

The audit’s sharpest operational finding was not the England ratio. In January 2023, 30 people collected prescriptions from two or more prescribers in the same month. Some of those fills came from the same clinic. Others came from different clinics. The amounts, the auditors wrote, could reasonably be read as more than one month’s supply.

NICE guidance on controlled drugs tells prescribers to write no more than 30 days for clinical need. NHS advice on Schedule 2, 3 and 4 drugs makes the same 30-day request. Jersey’s private unlicensed market had no clinic inspector and no shared record that would stop a second monthly fill. Binet later described that hole in the Assembly: a person could visit different prescribers and leave with a month’s supply from each. He called it a very unhealthy situation.

Clinic-side argument on the island still leans on round monthly flower caps, 60g is the number that gets posted, as if a ceiling on one script solves a patient who can open a second file down the road. A cap on a single clinic card does not catch the 30 people who already showed up in one January. Until records join up, the second script is a paperwork problem, not a clinical one.

The Mental Health Warning That Followed the Audit

Andy Weir, director of mental health, told scrutiny in 2025 that inpatient admissions had risen among people prescribed large volumes, and that quite a lot of medicinal cannabis was being sold on. Binet backed the worry and said the Assembly had legalised cannabis before doing the correct amount of background work. He hoped for very real progress over the 12 months from that November sitting.

This Assembly has legalised cannabis before doing the correct amount of background work.

Tom Binet, Minister for Health and Social Services, States Assembly, 11 November 2025

Clinic operators rejected the picture of unsafe practice and a wide black market in prescription flower. Medicann chief executive Gary Whipp said the products help islanders live a better quality of life. Prescribers asked for a Jersey rulebook aligned with NICE and General Medical Council standards rather than a freeze. The split is not over whether the 2022 rate exceeded England’s NHS sliver. It is over whether high-volume private scripts are treatment, leakage, or both.

WHERE EXPERTS DISAGREE

• Weir and Binet: High-volume prescribing is showing up in psychiatric admissions and in diverted product on the island.
• Clinic operators: Most patients are using a legal medicine, and the fix is shared records plus a local standard, not a story about abuse.
• The open point: The 2023 paper never published a full harm series, and the 2025 item count still has no public unique-patient figure beside it.

Binet told Members in November 2025 that officers were working with the primary care body to connect cannabis-clinic records to GP files, so a prescriber would not have to ring each surgery by hand. He also said medical-cannabis prescribing should be further controlled in law, with that drafting then underway. The Care Commission still did not hold the clinics.

Binet Pushed Tighter Scripts and a Softer Street Law

The same ministry that wanted tighter clinic rules also opened a second front on possession. Binet told States Members in November 2024 that options on criminalising, decriminalising, or licensing non-medical cannabis would come to the Assembly. In early 2026 he brought a proposition to treat small-amount possession as a public-health matter rather than a crime. Deputy Tom Coles, who had tried a similar move in 2024, called the new paper well balanced.

That pairing looks odd only if clinic inspection and street law are treated as one switch. They were never sequenced that way. Cultivation licences already sat under the Misuse of Drugs (General Provisions) (Jersey) Order 2009, issued by the health ministry with Home Office input, while the clinics that write the flower had no Care Commission inspector.

THE PARALLEL TRACKS MINISTERS RAN

• Pharmacist returns: Paper monthly sheets gave way to digitised dispensing data that can be read to the previous quarter.
• GP records: Private clinics were promised EMIS access so a second prescriber could see the first script.
• Advertising: Orders under the Medicines Law were listed for a 2025 review, including cannabis product promotion.
• Care law: Clinic inspection was parked in the final phase, after hospitals, ambulance and adult mental health.
• Street possession: Binet’s public-health proposition moved on a separate Assembly track from the clinic rules.

In February 2026, answering Warr on whether the item count was open to abuse, Binet said most of these products are private unlicensed medicines but not unregulated, because registered doctors remain professionally liable. He also said the thing Jersey lacked, unlike some other places, was legal controls on prescribing practice and an independent inspection regime. Officers, he said, were actively developing those controls, with a view to consulting prescribers and patients that spring.

The August 2026 disclosure still put the last full year at 72,065 items. The Care Commission’s clinic visits remained where Binet had left them in the reform queue, in the last phase, after the hospitals.

Disclaimer: This article is news reporting on Jersey’s medicinal cannabis audit, later dispensing figures and the unfinished clinic-inspection law. It is for information only and is not medical, legal or prescribing advice, and it is not a judgement on any patient’s treatment. Anyone considering, using or stopping a cannabis-based medicine should speak to a qualified doctor or pharmacist who can see their full record, and anyone facing a possession or licensing question should speak to a Jersey lawyer. Item counts, patient estimates and the status of the Regulation of Care reforms reflect the government audit, States answers and freedom of information disclosures cited here and may change as later returns are published.