NHS Incompetence Exposed: The Four-Year, Taxpayer-Funded Failure of the UK Medical Cannabis Registry
The National Health Service, a leviathan of state-run bureaucracy, has been forced to confess to a spectacular, four-year failure in its handling of the UK Medical Cannabis Registry. After years of silence, obfuscation, and the squandering of public funds, an inquiry by Business of Cannabis, culminating in a Freedom of Information request, has ripped the veil off a project so dysfunctional it borders on parody. The NHS has grudgingly admitted that some form of data will be released by the end of 2025, a tacit admission that for over four years, a critical tool for patient safety and medical research has existed as little more than a ghost in the machine, a testament to the institutional paralysis that grips the British state healthcare system when faced with innovation it fundamentally despises.
This is not a simple story of administrative delay. It is a chronicle of profound incompetence, of a system more interested in deflecting responsibility than serving the sick. It is a story of how the promise of medical cannabis, legalised in 2018 to great fanfare, has been systematically undermined by the very organisation entrusted with its stewardship. For the tens of thousands of British patients who rely on these treatments, and for the taxpayers who unknowingly funded this debacle, the so-called registry stands as a monument to government failure, a data black hole that has actively harmed medical progress and abandoned patients to a two-tier system where the state pretends they do not exist. The facts are clear, the timeline is damning, and the expert consensus is universal: the UK Medical Cannabis Registry, as conceived and managed by the NHS, is an abject and useless farce.
At the heart of this fiasco lies a fundamental, almost unbelievable, design flaw. The registry, when it was grandly announced, was intended to be the central repository of knowledge on the use of cannabis-based products for medicinal use (CBPMs) in the United Kingdom. Its stated purpose was to build a robust evidence base, monitor patient outcomes, and guide clinicians in making safe and effective prescribing decisions. This is a laudable, common-sense goal. Yet, the NHS, in an act of what can only be described as deliberate institutional sabotage, designed the registry to ignore 99% of the relevant data.
The registry exclusively tracks the tiny number of patients who manage to navigate the labyrinthine NHS system to receive one of three licensed medicines, Sativex, Epidyolex, or Nabilone, plus a handful of “specials” prescriptions. This amounts to roughly 1,000 patients in total. Meanwhile, an estimated 60,000 patients, shut out from the NHS by institutional hostility and impossible barriers to access, are legally and safely receiving prescriptions through the private sector. These 60,000 people, who form the vast, overwhelming majority of medical cannabis users in the UK, are completely invisible to the state’s official data-gathering efforts.
Imagine a transport authority claiming to study national traffic patterns by only monitoring a single, rarely used country lane while ignoring the M25. The absurdity is self-evident. This is precisely what the NHS has done. Pierre van Weperen, the Managing Director of Grow Group UK, a key supplier in the sector, pinpointed this fatal error with clinical precision. “The registry only includes NHS patients, mainly those with epilepsy or Multiple Sclerosis using Epidyolex or Sativex,” he stated. “It should encompass all patients using prescription medical cannabis to generate meaningful national insights. Clinics and patients would likely support this for the greater good.”
His point exposes the intellectual bankruptcy of the project. A dataset that excludes 99% of its potential subjects is not a dataset; it is an anecdote. It is scientifically worthless, incapable of generating the “meaningful national insights” it was supposed to produce. It cannot inform policy, guide research, or improve patient care on a national scale. It is, by its very design, a useless exercise in bureaucratic box-ticking.
This catastrophic failure of scope is not an accident. It is a reflection of the NHS’s deep-seated institutional disdain for medical cannabis. The 2018 legalisation was a political decision forced upon a reluctant medical establishment. The subsequent actions of NHS England suggest a strategy of malicious compliance. By creating a registry that is structurally incapable of demonstrating the widespread and effective use of medical cannabis, the institution ensures that the official “evidence base” remains conveniently small and manageable, perpetuating the narrative that these are niche treatments for a handful of people, rather than a lifeline for tens ofthousands.
The human cost of this bureaucratic gamesmanship is real and significant. Clark French, the founder of the patient-led advocacy group United Patients Alliance, did not mince his words when describing the NHS’s betrayal. “Cannabis significantly enhances quality of life for many, as seen in our members’ experiences,” he asserted. “Limiting the registry to NHS prescriptions while ignoring legal private prescriptions undermines its purpose.” For patients with conditions like intractable epilepsy, chronic pain, PTSD, and anxiety, this is not an abstract policy debate. It is about their quality of life. The failure to collect comprehensive data means that the potential of these treatments remains officially unquantified, stalling wider acceptance and keeping access relegated to those who can afford to pay privately.
The timeline of this debacle reveals a pattern of consistent ineptitude. The recommendation to establish a national registry was first made in a 2019 NHS England report titled Barriers to Accessing Cannabis-Based Products for Medicinal Use on NHS Prescription. The irony is staggering; the NHS identified the barriers and then proceeded to erect another one in the form of a dysfunctional registry.
The project was officially launched in March 2021, with management handed to the NHS Arden and Greater East Midlands Commissioning Support Unit (CSU), one of the many opaque administrative bodies that populate the NHS ecosystem. At the time, Muhammed Vohra, the project lead at Arden & GEM, issued the kind of empty corporate platitudes one expects from such an entity, claiming the registry aimed to “improve patient care through standardized data collection and robust monitoring.” This statement has aged like milk. For years, the project vanished into a bureaucratic void.
By late 2022, it was so apparent that nothing was happening that the NHS Chief Medical Director, Professor Stephen Powis, and the Chief Pharmaceutical Officer, David Webb, were compelled to write a letter to all NHS trusts. They urged clinicians to actually contribute to the registry after prescribing, a clear sign that the system was dormant and that clinicians were either unaware of it or ignoring it.
This brings us to one of the most damning indictments of the entire affair, delivered by Professor Mike Barnes, Chairman of the Medical Cannabis Clinicians Society and arguably the UK’s leading expert in the field. His assessment is devastating. “I know most of the 170 prescribing clinicians, and the registry is rarely mentioned,” he revealed. This single sentence confirms that the registry is not a tool used by the medical community. It is a phantom, a bureaucratic fiction that has no relevance to the daily practice of the very doctors it was meant to support. He expressed a faint hope that “by year’s end, the NHS will provide transparency on patient numbers, treatments, and plans to make the registry more useful.”
But his concluding sentiment captures the entire scandal perfectly: “A registry including the private sector, which accounts for 99% of prescriptions, would have yielded valuable data. As it stands, the registry is nearly useless and reflects NHS England’s persistent disinterest in this valuable medicine.”
The notion of “persistent disinterest” is a generous one. The evidence points to something more akin to active obstruction. When Business of Cannabis began making inquiries in May 2025 about the registry’s performance, it was met with a classic bureaucratic shuffle. NHS England and Arden & GEM, the two organisations paid by the taxpayer to deliver the project, reportedly focused their efforts on deflecting responsibility and pointing fingers at each other rather than providing a straight answer.
It was only the legal weight of a Freedom of Information request that forced the state’s hand. Even then, the response from NHS England was a masterclass in evasion. It confirmed it would publish something by the end of 2025 but refused to provide any current data on patient numbers or trust participation. It shielded its incompetence behind Section 22 of the Freedom of Information Act, which allows public authorities to withhold information that is intended for future publication.
Let us be clear about what this means. The NHS is using a legal clause designed to ensure the orderly release of finished reports as a shield to hide its own multi-year failure to produce anything of substance. The authority’s “public interest test” for withholding the information is particularly galling. It claimed that releasing the data now, in its current state, could cause errors and confusion and would disrupt its “communication plans.” This is the argument of an organisation that knows its work is a mess and is terrified of public scrutiny. The real “public interest” lies in exposing this colossal waste of time and money, not in allowing the NHS to curate a sanitised version of its failure at a later date.
The internal ignorance within the NHS itself is just as alarming. Sal Aziz of PatientsCann UK, a medical cannabis patient network advocate who also works within the NHS, highlighted a shocking level of unawareness at the trust level. “I’ve spoken to senior trust directors who claim the NHS doesn’t prescribe cannabis due to reputational risks,” Aziz said. This reveals a culture of fear and ignorance that pervades the system. His greatest concern is what the eventual data release will show: “My concern is the registry will reveal limited usage and poor record-keeping by trusts.” It seems the registry’s only useful function may be to officially document the NHS’s own dereliction of duty.
Even the cautious welcome from industry bodies is tinged with deep frustration. Mike Morgan-Giles, CEO of the UK Cannabis Industry Council, urged that the registry be expanded to include the unlicensed CBPMs prescribed privately. His call to “strengthen the evidence base” and “improve access” is a polite way of saying that the current system does the exact opposite.
What could have been achieved with a competent, functional registry? Four years of high-quality data from over 60,000 patients would have been a goldmine for medical science. Researchers could have analysed long-term treatment efficacy across dozens of conditions. They could have built detailed profiles of side effects, identified optimal dosing strategies, and performed cost-benefit analyses comparing these treatments to older, often more dangerous, pharmaceuticals. The UK could have become a world leader in medical cannabis research.
Instead, that opportunity was squandered. Four years of data were lost forever down a bureaucratic sinkhole. This is not just a missed opportunity; it is a form of active negligence. The NHS had a mandate from the government and a clear public health duty to collect this information. It failed on every conceivable level. It failed the patients it is supposed to serve. It failed the clinicians who need guidance. It failed the researchers who need data. And it failed the taxpayers who funded its incompetence.
The impending data release, forced by journalistic inquiry, should not be viewed as a positive development. It is the bare minimum, an act of reluctant compliance from an organisation caught red-handed. The information, when it finally arrives, will be a ghost of what it should have been: a partial, statistically insignificant snapshot that primarily documents the NHS’s own failure to engage with a legal and vital class of medicine.
The fundamental questions remain. Who will be held accountable for this four-year, taxpayer-funded debacle? What will be done to rectify the registry’s fatally flawed design? Will the NHS finally end its cold war against medical cannabis and embrace a system that includes all legal patients, both private and public? Until these questions are answered with concrete action, the UK Medical Cannabis Registry will stand as a shameful symbol of everything wrong with unaccountable, state-run monopoly healthcare: its inertia, its arrogance, and its profound, damaging disconnect from the needs of the people it exists to serve.