High street pharmacists are able to buy life-saving drugs at discounted rates negotiated by the NHS. Photo: AFP
A growing number of pharmacies as well as wholesalers, dispensing doctors and some NHS hospitals are profiting from the multi-million pound export trade, the research claimed.
The practice, which the government says is unethical, has lead to a shortage of about 40 drugs including treatment for cancer, high blood pressure, Parkinson"s and high cholesterol.
"A bar is like a pharmacy" Medicines shortage: ministers hold summit High street chemists to take over range of GP services Pride of secret police man Medicines shortage prompts Government summit Health officials to spend £30 million on Twitter and Facebook marketing campaign
The latest figures come after The Daily Telegraph disclosed last month that patients lives were being put at risk because pharmacies were illicitly selling NHS drugs to the Continent, leading to shortages in this country.
The trade, estimated to be worth about £30 million a month, has been made worse by favourable exchange rates which make British medicines cheaper for customers paying in euros.
Among some of the high-profile drugs that are experiencing a shortage include Arimidex and Femara, which are both used for breast cancer, Actonel tablets, for osteoporosis and cholesterol-lowering statins.
High street pharmacies are able to buy life-saving drugs at discounted rates negotiated by the NHS.
However, supplies are limited and stocks are being sold on the black market in European countries including Germany.
European trade legislation means that selling medicines is not technically against the law, but because drug manufacturers carefully ration the level of supplies they sell to individual chemists, the result is a growing shortage of drug
New research by IMS, a consultancy firm, suggests that as many as 11 per cent of the 12,600 UK pharmacies could be exporting drugs, along with a small proportion of dispensing doctors and some wholesalers.
Figures from the Medicines and Healthcare products Regulatory Agency, the body which grants EU export licences, show almost twice as many were granted this year.
More than 200 new licences were issued last year, bringing the total to almost 1400, 1,357, double what were approved the previous year.
This year, more than 100 applications have been approved for the licence, which costs £1,737.
Government guidance says the trade is unethical but ministers are powerless to stop it because it is legal for drugs to be traded into Britain from within the EU.
Mike O"Brien, the Minister of State for Health, has previously told The Daily Telegraph that ministers were becoming increasingly concerned that patients may die unless pharmacies stop this "unscrupulous" practise.
He has called a summit of those involved in the supply chain early next month.
Sandy Craine, founder of the CML Support Group UK, said: "This is a big problem and it needs to be sorted urgently."
John Turk, chief executive of the National Pharmacy Association, denied pharmacists were "cashing in".
"The vast majority of community pharmacists have nothing to do with exporting medicines," he said.
"In the face of shortages, they are putting in hours of extra work each day sourcing medicines to ensure timely supply to patients."
Neil Paton of the Royal Pharmaceutical Society said he "did not recognise" the figure of one in ten pharmacies trading abroad.
A spokesman for the Department of Health told the Daily Mail that the legal and ethical duties of ensuring a "smooth supply" of NHS medicines had been made clear to the industry.
Midweek wines: Old Man Creek Shiraz 2008; Sainsbury?s Californian Chardonnay NV; Casillero Del Diablo Shiraz Rose 2008
Three cheers for the home-made, midweek supper. How would we get through the dank weeks of late winter without chops, bangers or steamy stir-fries?
This year, thanks to a new bit of kit, Ive majored on slow-cooker classics such as beef braises and lamb tajines; other times its been toad-in-the-hole or roast root veg. Hearty, warming, no-nonsense meals eaten by the fire, and sometimes (whisper it) in front of the telly…
Restaurants: Culinary paradise found...in East Kent Sauce: light red wines for summer Sauce: wines to go with steak Sauce: lighter wines Sauce: Argentine wines
For a proper soothing supper, you must, of course, have a delicious wine to hand.
A comforting style, by which I mean ripe and rounded, not light and summery; head back to fragile wines when theres blossom on the trees. Midweek wine must be good value, of course, this being Tuesday, say, not Saturday. None of us is out to impress on a Tuesday, surely? We just want cheering up.
The best wines for the job come, unsurprisingly, from hot climates the South of France, Spain, Australia and California can offer especially keen prices on everyday wines. Pick a red grape with a smoky, peppery edge for extra "winter warmer points: shiraz/syrah, red zinfandel, tempranillo, grenache. Whites to be paired off with robustly flavoured fish or poultry dishes should be rich and creamy, possibly aged in oak for extra clout chardonnay, viognier and the riper chenin blancs, then.
Are pinks out of the question? Not at all, but I find gutsy New World ros is heaps better than wimpier Euro-pink for matching with, say, spicy prawns or a tomato pasta bake. No wimps are welcome at the midweek winter feast.
TRY THESE...
Old Man Creek Shiraz 2008, South-Eastern Australia (Marks & Spencer, £4.99)
Spice, leather and plain chocolate ooze out of this aromatic, rounded red. A true winter warmer for pairing with beef or lamb stews
(Or try Ashwell Valley Shiraz, from Telegraph Wine Shop)
Sainsburys Californian Chardonnay NV (£4.08)
For the price, this is a decent midweek white, with buttery depths and a fresh finish. Spot on for pan-fried salmon, garlic chicken or cream-based pasta sauce
(Or try Santa Isabel Torrontes Chardonnay 2009, from Telegraph Wine Shop)
Casillero Del Diablo Shiraz Rose 2008, Chile (widely available, £6.99)
Succulent, modern ros with plenty of red-berry juice and a peppery note. Drink with spicy prawns, vegetarian curries or a ginger and pork stir-fry
(Or try Arroyo de la Vega 2008 Tempranillo Rose, from Telegraph Wine Shop)
TIPPLE TIP light relief
"Tesco has launched what it claims is "the lightest ever wine bottle" in an attempt to reduce its glass use by 560 tons a year. The first of the new 300g bottles (most wine comes in 500g bottles) are being used for the chains own-label Australian non-vintage red. Can you feel the difference?
By Ben Harrington, Markets Reporter Published: 6:30PM GMT 19 Feb 2010
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On Friday, Anders Nielsen, equity strategist at Goldman Sachs, noted that since he published his 2010 forecasts in December "some investors have raised concerns that these numbers are too optimistic".
So, Mr Nielsen felt obliged to "reiterate" his belief that the European market will see 38pc corporate earnings growth in 2010 and 28pc in 2011. This is because companies" "exposure to growth abroad will drive a recovery in earnings in line with that experienced coming out of past recessions".
Shares and Markets: News, charts, data Talk of Harbinger stake in African Minerals Talk of Aviva selling its back book business Water companies cant wash away FTSEs rise Miners lift FTSE for a bullish end to the week Barclays earnings power helps dodge sell-off
The blue-chip index gained 33.08 points to 5358.17 during Friday"s session. Elsewhere, the FTSE 250 put on 46.09 points to 9431.36.
Shire leapt to the top of the leaderboard after its full-year results beat market expectations. Dealers were surprised the company reported a rise in fourth-quarter profit, helped by higher sales of Vyvanse, its drug treating attention deficit and hyperactivity disorder (ADHD). Meanwhile, Shire"s division that produces drugs for rare genetic diseases benefited from problems at rival Genzyme. Shire"s shares hit a nine-year high, rising 60p to £13.70.
Banks continued to be in demand on renewed talk investors are switching out of European rivals and into British banks. Royal Bank of Scotland edged 0.7 higher to 34p and Barclays rose 3.9 to 312p as Evolution raised its price target to 482p from 448p.
BT Group, which was heavily sold off on Thursday, rallied 2.8 to 118.6p following positive comments from Fitch, the ratings agency. Although Fitch said BT"s £9bn pension deficit is "undoubtedly a negative factor for group deleveraging", the pension deficit payments can be absorbed by the group"s operational cashflow in the short to medium term.
Traders, though, took defensive positions after a strong week for the riskier stocks. Imperial Tobacco perked up 45p to £20.80 and National Grid rose 13 to 650p.
Mining companies were the laggards as the dollar strengthened following the Federal Reserve"s decision to increase the discount rate for banks. Precious metal producers fared the worst. For example, Mexican silver miner Fresnillo lost 11 to 774p and gold specialist Randgold Resources shed 66p to £46.99.
However, Cluff Gold, the Aim-listed gold mining company, bucked the trend after it confirmed it had received an approach from a potential bidder. Randgold is rumoured to be the purchaser. Cluff surged 9 to 71p.
Among the base metal produders, Vedanta Resources slipped 6p to £25.54 despite an upgrade to "overweight" from HSBC. "Vedanta offers the highest growth potential in our universe, which in our view is not yet reflected in valuation," said Thorsten Zimmermann, analyst at HSBC.
On the mid-tier, Morgan Crucible bounced 16.8 to 186.3p on the back of a "buy" note from Goldman Sachs. "We believe the company is well positioned to benefit from a cyclical recovery in its end markets and that concerns over the outlook for [its subsidiary] NP Aerospace are more than discounted in the current share price," said Tim Rothery, analyst at Goldman Sachs.
In the leisure sector, Millenium & Copthorne Hotels jumped 41.2 10.9pc to 417p after its fourth-quarter profits beat expectations.
On a more speculative tack, bid talk lifted Connaught, the property services company, 8.2 to 326.1p.
However, VT Group slipped 11 to 648p as analysts began to rule out the possibility of the prospect of a counter-bid.
The man who invented a whole new cookery book of golf shots, little sautees and hot tumblers, appears to have thrown golf out with the leftovers. It now seems highly unlikely that he will play in this year"s Masters.
The news is as shocking as Roger Federer zipping up his racket bag for a year or Wayne Rooney throwing his football boots into the back of the cupboard. The greats of sport are obsessed with what they do.
Tiger Woods said nothing, but with great sincerity Woods was clearly petrified Fellow players supportive of Woods Tiger Woods scandal Tiger Woods "deeply sorry" for affairs Tiger Woods can be a "wonderful playboy"
Jack Nicklaus did not win 18 majors without having golf balls for brains, thousands of them spinning around inside his head, every second of every day. Sport might leave men such as Andre Agassi sobbing on the floor of the changing room, but they cannot cut the addiction. It is who they are.
But almost 10 minutes had elapsed before Woods even cast a sideways look at his return to the game. He said: "I do plan to return to golf one day, I just don"t know when that day will be. I don"t rule out that it will be this year. When I do return, I need to make my behaviour more respectful of the game."
Those words might have been a nod to the likes of Tom Watson, who had asked Woods to show more respect for golf"s traditions, but they will also send a cold shiver down the spines of the TV networks who are desperate for the viewing figures that Woods brings to the game.
In the lead-up to the address it had been speculated that Arnold Palmer would introduce Woods and that he would announce a return at next month"s Tavistock Cup. Instead Woods seems to have scratched his name from the starter"s sheet. Where Palmer was supposed to stand there was just a void.
The Masters without Tiger will be like Manchester United without Fergie. The place echoes with his deeds the chip that hovered on the edge of the hole and dropped like a sign from God in 2005 or the tearful embrace with "pops" eight years earlier when Woods won his first green jacket by a record 12 shots.
Woods also reacted angrily to what has been written about his association with Dr Tony Galea. The old Woods briefly flared when he said: "Some people have made things up. They said I used performance-enhancing drugs. This is completely and utterly false."
Sir Nick Faldo cannot believe that Woods is walking away. Faldo said: "Tiger said actions speak louder the words and I would have thought the most obvious action would be to scoop up the whole family, you"ve got a private plane, plenty of wealth to have tutors and nannies and come back on tour.
"His whole world has been golf. His whole world is created by golf and if he doesn"t get back to golf then you would assume he doesn"t have a world. He"s chasing Jack"s records and that"s what"s created his wealth."
But Woods no longer lives in Faldo"s world. The Englishman had no trouble hitting one more straight drive as another marriage crumbled around him. The problem for Woods is that the two main wires in his body have come into contact and blown the system.
He cannot play golf and save his family. Yet these were the two mantras of his life: golf and family, family and golf. When Woods came through those plush blue curtains something had to give and it is golf.
We saw a different Woods to the smart alec who has put people down these past few years. Now Tiger is down. There was no room for his glib one-liners. He had to come across as a changed man who was fighting for his family.
There were moments of excruciating stage management that we could have done without. The look straight to camera whenever he said sorry and the hand on the heart when talking of family belonged in an episode of an afternoon soap opera.
But it has certainly played with parts of America. When he said: "For all that I"ve done, [stage direction: swallow, look to camera, dissolve] I"m sorry," two women ran weeping from the press centre. Another came over with tears in her eyes and asked if we were crying.
We were. We were crying tears of helpless laughter. Even the most stone-hearted man could not have failed to have been moved. And yet having watched Woods perform for so many years, I believe that a lot of the acting was to help him get through his speech. And I believe he was sincere.
What he has done is unprecedented. What other sportsman has walked away from the game at the peak of their career to try to save their family? It is a rare, rare thing that borders on the heroic. It may make Woods a fool in the long run, we shall find out, but it makes him a heroic fool.
He looked into the future and saw an endless golf course without any kids. He could choose golf and Nicklaus"s record and lose his kids, or he could try to save his family. Yesterday Woods put on a penitent performance in an effort to save his family.
He will never be the same man on the golf course again. Men he used to look down on have now seen Woods grovel. They will no longer fear the red shirt on the final day. They will feel better about themselves.
Woods has lost the intimidation factor for ever, but yesterday may just have made his will and self belief even stronger. He talked about the "need to regain my balance and be centred", of rediscovering his Buddhist path. When he eventually comes back he may just be better than ever, but the others will no longer fear him.
----------------------
What has been said
"For an apology to be successful it has to be believed. Tiger Woods said sorry in such a controlled environment that many people are bound to ask, "does he really mean it?" He would have been better to face a hostile press conference and take it all on the chin, even if it meant having to answer - or refuse to answer - some very difficult and embarrassing questions.
"He admitted that he did what he did because he thought he could live life on his own terms. But now he apologises on his own terms too. It doesn"t quite ring true. And it was stupid to alienate others in the sport by allowing his statement to clash with an important tournament."
Lance Price - former special advisor to Tony Blair and author of "Where Power Lies"
-----------------
"Hes not a gifted public speaker. It was over-rehearsed and wooden, I thought Gordon Brown was better in his interview last week, which tells you how lamentable Tiger was. Youve got to remember that hes a pretty gauche fellow, all hes ever done is chase these ludicrous white balls across the greensward.
"Im glad of one thing, he didnt play the Im a sex addiction card. Theres no such thing as sex addiction. This is just compulsive behaviour. Were all potentially greedy, wed love to have our hands in the cookie jar regardless of the consequences. But now, after all those apologies, hell have nowhere to turn if he strays again. The more severely high you set the bar, the more temptation you expose yourself to."
Phillip Hodson, fellow of the BACP and Britains first agony uncle
---------------------
"I think he did really well. This was the first good move in a disastrous PR campaign. I expect that he will be attacked by journalists, but in terms of the public, most people will feel that he came across as someone who was sincere, who regretted what hed done, and who took the blame on himself.
"As a PR exercise, it doesnt bear comparison with John Terrys Dubai fiasco. That one was excruciatingly embarrassing, but this one was the right tone, the right presentation, and I think it will help to move things forward. Of course, he shouldnt have been here in the first place.
"A good PR would have made sure it never came out. Theres a lot of stars that have been far more active than he is and no-one dreams of it."
Max Clifford, public relations expert
------------------
"It was an amazing performance. If he had been a professional actor he couldnt have done it much better, he seemed very contrite and very serious. Some of the people who are criticising him are divorced Tom Watson, for instance. Some of our greatest stars, like Warren Beatty, make Tiger look like a celibate priest.
"The old saying that an erection has no conscience is very true. You have to be a very remarkable person, if youre chatted up by an attractive woman in the right circumstances, to say no.
"You know, the furore over the abdication in 1936 couldnt have been any greater than this. I wouldnt have thought a sportsman could have created such a great deal of publicity for his misdemeanours. Sometimes Im glad I live in a timewarp."
Previous of Images Next Tell us the location of this photograph for the chance to win a luxury suitcase Photo: CORBIS The winner will receive a Briggs & Riley carry-on suitcase worth £299. To purchase Briggs & Riley products visit www.johnlewis.com
These limestone formations, known as The Pinnacles, are found north of a state capital city that sits on the Swan River. Fremantle lies to the south. Name the city.
Quiz: test your travel knowledge Where in the world: terms and conditions
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To enter, send the answer (with your name, address and telephone number) to: whereintheworld@telegraph.co.uk
The winner will receive a 20in Briggs & Riley (01491 642333; www.briggs-riley.com) carry-on upright suitcase in olive, worth £299. The case carries an unconditional lifetime warranty that includes airline damage. The first correct entry drawn at random will be the winner. Entries close at 4pm on Wednesday, Feb 24.
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The answer to the last quiz is Riga. S Castle of Strood, Kent, wins the suitcase.
Attempts by Avigdor Lieberman, Israel"s foreign minister, to distance his country from the affair have hardly been convincing Photo: AFP
It is difficult to summon much sympathy for Mahmoud al-Mabhouh, the Hamas military commander who was smothered to death in his Dubai hotel room by a mysterious team of tennis-playing assassins.
Before he met his end, the 50-year-old topped the list of Israel"s most-wanted terrorists. As one of the founder members of the Izzedine al-Qassem brigades, the military wing of Hamas, he had a well-documented track record of involvement in terrorist activities, from the abduction and murder of two Israeli soldiers in 1989 (which explains why he fled to Syria soon afterwards) to smuggling arms from Iran to Gaza. It is as a result of al-Mabhouh"s activities that Hamas today is in possession of a stockpile of Iranian-made missiles that could inflict devastation on Israel.
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As the saying goes in the Middle East, he who lives by terrorism ultimately becomes its victim. And the praise heaped on Mossad, Israel"s foreign intelligence service, by the country"s jubilant media tells you all you need to know about who was ultimately responsible for al-Mabhouh"s death. "Impressive and crowned with success," proclaimed the Israeli daily Yediot Ahronot, while the Jerusalem Post confidently predicted that Meir Dagan, the hawkish head of Mossad, would not lose his job over the affair.
If there was any doubt about Israel"s involvement, the country"s media would be the first to proclaim its innocence. Indeed, details of the Mossad connection were first published in Britain by an Israeli journalist three weeks ago, but no one thought any more of it until the Dubai authorities made their revelations about the possible involvement of British passport holders. Subsequent attempts by Avigdor Lieberman, Israel"s foreign minister, to distance his country from the affair have hardly been convincing: given the operation"s sophistication, with a team of 11 highly trained agents fulfilling a range of roles, it is difficult to imagine any of the region"s other intelligence services having the nous or the resources to carry out such a daring mission.
Most Israelis, of course, would argue that al-Mabhouh"s murder was not an act of terrorism, but an act of war, and that he was a legitimate target for a programme of assassination that has liquidated scores of Hamas activists, from the wheelchair-bound cleric Sheikh Ahmed Yassin to Hamas"s legendary bomb-maker Yihyeh Ayash, aka "The Engineer". I doubt there are any Israelis who will mourn the passing of a commander of an organisation that is committed to their nation"s destruction.
There will, though, be some who will question the methods used, and in particular whether it was wise to forge the passports of British citizens to protect the identities of the hit squad. Mr Dagan who I think we can safely assume organised al-Mabhouh"s murder has something of a reputation as an adventurer. During his seven years at the helm of Mossad, he has unleashed Israel"s assassination squads in Gaza, Lebanon and, most spectacularly, Syria, where they succeeded two years ago in killing Imad Mugniyeh, the terrorist mastermind responsible for blowing up the American embassy and Marine barracks in Beirut in the early 1980s.
As in the al-Mabhouh killing, Mossad and the rest of the Israeli security establishment refrained from claiming any credit for Mugniyeh"s death, even though, as Hizbollah"s chief military planner in southern Lebanon, he posed a tangible threat to the security of Israel"s borders.
Al-Mabhouh"s activities constituted a similar threat but the crucial difference between the two operations is that the only people outraged by the car bomb that killed Mugniyeh were his Syrian and Iranian protectors, while Mossad"s modus operandi for al-Mabhouh is threatening a major rift with one of Israel"s key European allies.
The attitude of most Israelis towards Britain is coloured by their memories of the mandate period immediately after the Second World War, when the perfidious British were accused of trying to prevent impoverished Jewish immigrants many of them survivors of the Holocaust from establishing a state of their own. For that reason Israeli officials in Jerusalem are always happy to point out that British criticism of their policy is largely irrelevant, as the power to dictate the destiny of the Middle East today lies in Washington, not London.
Relations between the two countries have been soured more recently by the British Government"s decision to insist that Israeli produce from the occupied West Bank be clearly identified as such, a move denounced as tantamount to a boycott.
But despite these difficulties, Britain and Israel have established close intelligence co-operation. Apart from working together to prevent Islamist-inspired terrorist attacks, intelligence officials have set up a partnership to deal with the threat posed by Iran"s nuclear programme. And it is this that is now in jeopardy as a result of Mossad"s cavalier disregard for British sensibilities. At the very least, Mossad could have had the decency to use fake passports, as it did with its Irish documents, rather than stealing the identities of those British citizens currently resident in Israel.
Perhaps Mr Dagan was trying to make a point that Britain needs Israel"s co-operation on intelligence matters more than Israel needs Britain"s. If so, he is likely to find he has made a grave miscalculation. Britain has cut its ties with Mossad in the past after its London station chief carelessly mislaid a sackful of forged British passports and will do so again unless Israel can provide a credible defence of its actions.
Who said the art of letter writing was dying? The week began with a letter from 20 economists and it ended with a pair of missives from 67 practitioners of the dismal science. For good measure, we even had a midweek note from the Governor of the Bank of England to the Chancellor explaining why the consumer prices index has spiked. Are we any the wiser for this flurry of epistolary activity? Leaving aside the Governor"s letter (as ever, it was refreshingly analytical rather than political), probably not.
For this slightly unedifying spectacle the "my list of signatories is longer than yours" boasts are already being bandied about is party warfare by proxy. The original 20 broadly supported the Conservative view that deficit reduction must start now, while yesterday"s double-barrelled riposte favours the government stance that the recovery is too fragile to contemplate spending cuts yet. It would take a Jonathan Swift to milk the full satirical potential of massed ranks of economists taking potshots at each across the letters columns of newspapers. Entertaining though it is, it does not signify a great deal. We are witnessing not so much the clash of big ideas as angels dancing on the head of a pin.
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As Jeremy Warner argues on this page, the reality is that neither party has a great deal of scope for doing much about the deficit in 2010, even if it wanted to. Serious budget cuts cannot be effected at the flick of a switch. What is needed are credible plans for future years. That is what the markets are looking for and so are business leaders. They want some clarity about the likely trajectory of debt reduction in the medium to long term. The Government says it will halve the deficit in the lifetime of a parliament, in our view a disappointingly unambitious target. The Tories, in contrast, say they will pay down the "bulk" of the deficit in that timescale a position backed, incidentally, by the Governor of the Bank of England, Mervyn King. What they have been unwilling to say is how they will achieve this. Paradoxically, each camp can use January"s shocking borrowing figures to justify their positions.
The imminence of a general election is imposing a baleful influence. The Government is determined not to offend its public-sector clientele before polling day and will therefore keep the spending spigot open. The Tories, meanwhile, have been sounding a worryingly uncertain note. In his party conference speech last October David Cameron talked candidly about the tough choices that lay ahead. Yet within weeks the party was rowing back from that position, no doubt alarmed at the negative feedback from the focus groups.
In other words, it is the politics of the deficit, rather than its reduction, that has been dominant. It was no coincidence that within hours of yesterday"s letters appearing, the Prime Minister rounded on the "well-financed Right-wing" that is trying to "scare people into accepting a bleak and austere picture of the future". This is clearly not going to be an election campaign for the fastidious. Mr Brown"s attempt to depict himself as the only man who can secure the recovery will, however, ring hollow among those who largely blame him for getting us into this mess in the first place.
Even so, dealing with the deficit continues to present a formidable challenge to the Conservatives. We believe they are being more honest in stressing the scale of the threat and the need to start tackling it now. Yet they remain too tentative. The higher rate of tax is going up in a few weeks, the very last thing the economy needs just now. But, of course, that increase is not designed to raise revenue, rather to put the Tories on the spot and it is working. In refusing to commit itself to scrapping the tax rise, the Opposition is displaying a lack of conviction that it may come to rue in the election campaign.
High street pharmacists are able to buy life-saving drugs at discounted rates negotiated by the NHS. Photo: AFP 
Midweek wines: Old Man Creek Shiraz 2008; Sainsbury?s Californian Chardonnay NV; Casillero Del Diablo Shiraz Rose 2008 
Tell us the location of this photograph for the chance to win a luxury suitcase Photo: CORBIS 
The winner will receive a Briggs & Riley carry-on suitcase worth £299. To purchase Briggs & Riley products visit www.johnlewis.com 
Attempts by Avigdor Lieberman, Israel"s foreign minister, to distance his country from the affair have hardly been convincing Photo: AFP