Combatting doping in sport Contents

2British Cycling and Team Sky


59.In September 2016, the Russian-based cyber espionage group, Fancy Bear, published documents obtained by hacking into the WADA computer systems, which showed how a number of athletes had been granted Therapeutic Use Exemptions (TUEs), which permitted them to take medicines to treat long-term conditions like asthma or pollen allergies. These exemptions were required because the drugs that were requested to be administered were banned within periods of competition in the absence of TUEs.

60.Whilst permission was given by WADA for their use to meet a stated medical need, some people have questioned the ethics of the TUE system, as these drugs can also have performance enhancing properties. As a result of the Fancy Bear hack, there was particular scrutiny of the three TUEs granted to the British cyclist, Sir Bradley Wiggins, before the 2011 and 2012 Tour de France, and the 2013 Giro d’Italia, for the use of the powerful corticosteroid, triamcinolone, to treat his asthma. Each of these applications was approved under the WADA rules at the time, by a single doctor at WADA, Mario Zorzoli.

61.Following the Committee’s earlier work looking at how the anti-doping rules are administered and policed in athletics, we decided to investigate how some of the same issues are addressed in cycling. In particular, we wanted to know how British Cycling, as a national governing body, and Team Sky, as the then team of Sir Bradley Wiggins, ensured that the proper anti-doping procedures were being followed. We consider it important that, regardless of the nationality of athletes and teams, anti-doping rules are enforced consistently and fairly.

Therapeutic Use Exemptions (TUEs)

62.Therapeutic Use Exemptions (TUEs) enable athletes to obtain authorisation to use a prescribed prohibited substance or method for the treatment of a legitimate medical condition.74 The list of prohibited medications is decided by the World Anti-Doping Agency (WADA).75 For a national governing body to approve a TUE, there are strict rules: that the athlete would suffer significant health problems without taking the substance; that it would not be significantly performance-enhancing; that there is no reasonable therapeutic alternative; and the need to use it is not due to prior use without a TUE. Some substances are prohibited at all times, while others are prohibited only during competition periods. There has been a marked rise in the number of TUEs across all sports generally, according to WADA’s Annual Reports. In 2013, there were 636 approved TUEs, in 2014 there were 897, in 2015 there were 1330 and in 2016 there were 2,175.76 The rise, according to WADA officials, is the direct result of an increase of TUEs being entered into WADA’s Anti-doping Administration and Management System (ADAMS), and not an increase in TUE applications.77

63.Richard McLaren, who carried out one of the WADA investigations into doping in Russia, spoke about how the system of granting TUEs is open to abuse and that a review ought to be conducted.78 Lord Coe, President of the International Association of Athletics Federations, has defended TUEs in athletics but admitted that they could be exploited.79 David Millar, the former British pro-cyclist, who served a two-year ban from cycling between 2004 and 2006 for doping, also believes that the TUE system, “is open to abuse. Some of the medical conditions used to justify a TUE can be difficult to validate; and as I discovered, an unscrupulous rider and doctor could exaggerate or simply make up symptoms that would merit a prescription and exemption.”80

64.The former President of the Union Cycliste Internationale (UCI), Pat McQuaid, recalled discussing the potential abuse of the TUE system with Dr Zorzoli, the medic who approved Bradley Wiggins’ certificates. He said, “I do remember having a discussion with Zorzoli and he told me that at the Classics [like the Tour de France] there were riders who were looking to win or do well and were taking corticosteroids during that period on a TUE. He felt that it wasn’t a genuine TUE but that it was just to help them.”81

65.The stated purpose of some of the use of corticosteroids used under TUEs was to treat long-term conditions such as asthma. Our predecessors received briefings from several doctors, who wished not to be named, about the validity of this approach. They were told that, on average, 20% of British Olympians have asthma, higher than the UK population average of about 8%. Some sports are ‘respiratory-heavy’, such as: swimming, where 70% suffer from asthma, probably exacerbated by breathing in chemicals used in swimming pools; cycling, where between 30-40% of elite cyclists are affected; and about 25-30% of footballers and rugby players. On the other hand, athletes competing in sports like shooting and archery have rates of asthma at around 5-10%.

66.Some medical experts were of the view that having to resort to the use of drugs such as triamcinolone to treat asthma was a sign that the athletes and their medical advisers were not managing their condition effectively. They were of the view that corticosteroids are such an aggressive form of treatment that they should be reserved for emergencies, and used only for a brief period of time. One noted of the British Olympic swimming team (of whom 70% suffered from asthma and most had lung capacity of only 50%), with the effective management of their asthma, none of them required any banned treatments and therefore none needed a TUE. Professor Brian Lipworth of the Scottish Centre for Respiratory Research said that it would be “utterly bonkers” to prescribe drugs like triamcinolone to treat asthma, adding “there are so many alternatives which are just as effective but with less severe adverse effects.”82

67.David Millar believes, though, that drugs like triamcinolone are used by riders because of their performance-enhancing properties. He states that the drug is a “very powerful synthetic corticosteroid. I know this because I’ve used it, three times: the first for a medical reason [...] the other times, for performance enhancement.” According to Millar, the drug is a “catabolic agent” and added that on the occasions he used it he was “the lightest I’d been in my career, yet I didn’t lose power—often the penalty when a rider sheds weight. Physically, I looked like a machine, muscle fibres were visible and a road map of veins crisscrossed my entire body. It made me better all around.”83 This improvement in the power-to-weight ratio for a professional cyclist is particularly important before major road races like the Tour de France, which involve a lot of cycling up hill.

68.Bradley Wiggins’ own race preparation is a good example of the need of riders to control their weight. Wiggins’ road racing weight is around 70kg, compared with a weight of around 83kg when he competed for Great Britain in the velodrome during the 2016 Rio Olympic games.84 Michael Rasmussen, like David Millar, a professional cyclist convicted of doping offences, has also spoken out about his abuse of drugs like triamcinolone, stating, “There is no doubt in my mind that corticosteroids [are] very, very strong and performance enhancing. It would postpone this sensation fatigue, increase your recovery speed and most importantly and quite easily I would drop one or two kg which is very important when you want to climb mountains. It will drain the body from all excess fat in a quite short period of time. It’s a very fast and very effective drug in that sense.”85

69.The Cycling Independent Reform Commission (CIRC), established by the Union Cycliste Internationale (UCI) following the Lance Armstrong doping scandal, noted in its final report published in 2015 that: “Corticoids are widely used today both to reduce pain and therefore improve endurance capability and to achieve weight loss to improve power to weight ratio. On the WADA Prohibited List all corticoids are prohibited when administered by oral, intravenous, intramuscular or rectal routes, but Therapeutic Use Exemptions (“TUEs”) can be requested for such administration”.86

70.One doctor stated that it was impossible to lose the weight that some riders achieve without assistance, and that TUEs are used to enable this practice. He stated that riders use corticoids to “lean out” i.e. to lose weight quickly, and keep it off, without losing power. By way of example he explained that to lose 4kg in 4 weeks by using corticoids would provide a 7% power/weight improvement.87 He added that when used in large quantities and in conjunction with other substances, they supported performance gains.88 Another doctor stated that some quite recent big wins on the UCI World Tour were as a result, in part, of some members of the team all using corticoids to get their weight down to support the individual who won (who also used the same weight-loss technique). It was reported that this had been a planned approach by that group’s management.89

71.Evidence given to the CIRC was done so anonymously, and witnesses included former Team Sky Doctor, Roger Palfreeman. Dr Palfreeman was certainly aware of the performance-enhancing properties of corticosteroids. Writing on ‘Doping in Sport’ in the academic journal ABC of Sports and Exercise Medicine published in the same year as the CIRC report, Dr Palfreeman stated, “Systemic corticosteroids are widely abused in some endurance sports, where they are used for a number of reasons. Anecdotally, they are thought to result in the breakdown of adipose tissue [fat], particularly when combined with high volumes of endurance training. This effect is used primarily in endurance sports where the power-to-weight ratio is an important determinant of performance”.90

72.Triamcinolone continues to have a positive effect for people who have taken the drug for two to four weeks after it is administered. Dr John Dickinson of the University of Kent, who is one of the foremost experts on the treatment of asthma in sport, has stated that, “some of this stronger medication can potentially improve endurance performance which is where this use becomes controversial. Rules may have to be adjusted so that athletes with a TUE taking stronger asthma medication cannot compete during the time they are using it. This rule change would protect the athlete’s health and the integrity of sport.”91

73.Organisations such as the Mouvement Pour un Cyclisme Credible [MPCC], whose purpose is to “defend the idea of a clean cycling based on notions of transparency, responsibility and mobilization of its members,” have also called for a minimum eight-day rest period for riders who are given intra-articular corticosteroid injections, of the kind prescribed for Bradley Wiggins.92 This would help restrict the use of the drug to treating severe medical need, rather than as a performance enhancer. Membership of the MPCC includes 38% of world tour teams, and 86% of professional European continental teams are also members; Team Sky, however, is not. This policy of an eight-day rest period following treatment with corticosteroids is also supported by WADA and the UCI. It is clear that when drugs are used which may have performance-enhancing effects, their use must be fully documented and controlled. It is incumbent upon any organisation or individual who uses such drugs to ensure that proper procedures are followed.

74.Bradley Wiggins has defended his use of triamcinolone to treat his asthma and allergies in 2011, 2012 and 2013. In an interview on The Andrew Marr Show, he argued that his use of TUEs simply put himself “back on a level playing field” with his rivals.93 Shane Sutton, Bradley Wiggins’ coach at Team Sky at the time, has explained that it was then common for athletes to use TUEs to “find gains” if they were allowed to. “If you have an athlete who is 95% ready and that little 5% niggle or injury that is troubling him, if you can get that TUE to get him to 100%, yeah of course you would in them days.”94 The rules at that time permitted the use of triamcinolone subject to the granting of a TUE exemption. In such circumstances, however, it was imperative that procedures relating to the granting of a TUE are applied and enforced rigorously.

The 2011 Criterium du Dauphiné cycling road race

75.The 2011 race, the 63rd running of the Criterium du Dauphine, started on 5 June 2011 in Saint Jean-de-Maurienne, Southeast France, and ended on 12 June in La Toussuire. It was won by Bradley Wiggins, and was a significant part of his preparation for the Tour de France, which started on 2 July. A few days before the end of the race, the Team Sky Doctor, Dr Richard Freeman, asked Shane Sutton if he could arrange for a medical package to be collected from the drugs store shared by Team Sky and British Cycling at the velodrome in Manchester, and brought out to La Toussuire for the end of the race.

76.Sutton confirmed that Simon Cope, then the women’s road racing coach at British Cycling, would be coming out to join him in La Toussuire that day, so could bring the package with him. Dr Freeman then spoke to Phil Burt, a physio at British Cycling in Manchester, and gave him instructions about what to include in the package. Phil Burt has stated in writing to the Committee that he has no recollection whatsoever of what he put in the package. There are also no records at British Cycling to confirm what drugs were supplied. When the package was prepared, Phil Burt left it on the desk of Shane Sutton’s assistant for Simon Cope to collect.

77.Simon Cope confirmed in his evidence to the Committee that he had been previously asked to go out to La Toussuire on 12 June “to help in a logistical role”.95 He described picking up the package: “It was left on a desk in the British Cycling office. From what I can remember, I think it was a jiffy bag […] with a little post-it note just saying, “For Simon, for Richard Freeman”. That was it”.96 Even though Simon Cope would be required to carry that package through an airport and onto an international flight, he had no documentation to confirm what was in the package, nor had he been told by British Cycling what was in it.97 Equally, when we asked Mr Cope if he had misled airline staff when asked if he had packed his own bag, he replied “if they asked that question, yes”.98 He also confirmed that the package was sealed and that when he arrived in La Toussuire, he gave it directly to Dr Freeman.99

78.When Shane Sutton gave evidence to the Committee, he stated that Dr Freeman had told him after the end of the race in La Toussuire that he had treated Bradley Wiggins with the medication that was in package.100 He said that Freeman had told him “Brad’s been sorted”.101 Sutton was clear that he did not see what was in the package, and was not there when it was administered. The Committee asked Sir Bradley Wiggins if he could confirm to us in writing his recollection of the treatment he received on 12 June 2011. In his statement he makes clear in response to our question to him that he has “no knowledge that ‘any laws were broken or any anti-doping trafficking regulations were breached’ in relation to myself either before, during or after the race. As a rider I was not involved in the logistics of running the team whether in competition or otherwise.” With regards to the treatment he did receive, Sir Bradley Wiggins told us that, “as far as I can recall, I did not receive any treatment after the race other than the usual recovery packs. By the evening of 12 June 2011 I had travelled to a high altitude training camp in Sestrière where I was given Fluimucil through a nebulizer.”102

79.On 23rd September 2016, UK Anti-Doping (UKAD) started an investigation based on information received about a possible anti-doping rule violation, concerning the contents of a package delivered to Dr. Freeman in France. The allegation was that the package contained triamcinolone, which, if administered to Bradley Wiggins after the race had finished in La Toussuire, would have counted as an anti-doping rule violation, as it was banned in competition which includes up until midnight on the last day of the race. There was also no TUE in place for Bradley Wiggins to permit its use at that time; however, an application for a TUE, dated 30 May 2011, to allow Bradley Wiggins to use triamcinolone had been submitted to WADA. Bradley Wiggins’ TUE for triamcinolone was not granted until 26 June 2011. This fact is evidence that Bradley Wiggins, or a member of his team, wished him to take triamcinolone around that time. Bradley Wiggins’ coach Shane Sutton has confirmed to the Committee that he was aware of the TUE application for triamcinolone that had been made by Dr Freeman to treat Wiggins, and that he believed this was in place when the team was in La Toussuire on 12 June. Therefore, if triamcinolone had been administered during a competition period it would not have given him any cause for concern. Shane Sutton told us that “[Dr Freeman] told me virtually the minute he got the TUE and I think it was end of May [2011] [but I] can’t be 100%. That’s why I thought everything was above board.”103

80.On 19th December 2016, the Committee took evidence from the manager of Team Sky, Sir David Brailsford. He said that he had conducted his own inquiry within the team to try and determine what was in the package. He told the Committee that according to Dr Freeman, the package contained the drug Fluimucil (Acetylcysteine), which is not a prohibited substance and is used for the treatment of a build-up of mucus or catarrh.104 However, Dr Freeman also explained that Fluimucil can have “unwanted immediate side effects on airway reactivity (asthma)”.105

81.However, there are no records held by either British Cycling or Team Sky. UKAD told the Committee that its investigation had discovered that Dr Freeman kept Bradley Wiggins’ medical records on a laptop that was stolen in Greece in 2014, and no back-up copy was ever made.106 Despite the fact that it was Team Sky policy for medical records of riders to be uploaded to a shared Dropbox cloud computing storage site, this was never done. Nor, in the three years from 2011 to 2014, did anyone at Team Sky check this, and insist that the records were uploaded. This is even more lacking in credibility given that these were not just the records for a junior rider, but those of the lead cyclist in the team.

82.Team Sky told the committee in written evidence submitted in March 2017 that, “One of Dr Steve Peters’ responsibilities, as Team Sky’s Clinical Director, was to review whether rider medical notes were being uploaded properly to Dropbox. While Dr Peters did take steps to improve compliance in respect of Team Sky policies going forward, Sir Bradley’s records from the Critérium du Dauphiné were not retroactively uploaded to Dropbox. To address compliance issues more rigorously, Team Sky appointed a full-time Compliance Officer in 2013, whose role was to ensure compliance with all Team Sky policies.”107

83.The failure to keep proper medical records was not just a breach of Team Sky policy, but also that of the General Medical Council (GMC), and the Medicine and Healthcare Products Regulatory Agency (MHPRA). The GMC guidance for doctors states that, “Documents you make (including clinical records) to formally record your work must be clear, accurate and legible. You should make records at the same time as the events you are recording or as soon as possible afterwards. You must keep records that contain personal information about patients, colleagues or others securely, and in line with any data protection requirements.”108 The MHPRA gave written evidence to the Committee on 1st March 2017, addressing the failure of both Team Sky and British Cycling to store proper records relating to the supply of the medical package to Dr Freeman. In this they stated that, “If British Cycling supplied the medicines to Dr Freeman, they would have needed to hold a wholesale dealer’s license and keep a record of the supply to Dr Freeman, including the name and quantity of the product supplied and the date of dispatch.”109 We know, therefore, the following: (i) there is no verifiable evidence of what was in the package, and (ii) there are no medical records to establish what was in the package.

84.To many people, the whole story of the package seems implausible, to say the least. If the package was needed urgently, why, according to travel records given to the Committee by British Cycling, did Simon Cope collect it from Manchester on 8th June, but not fly out with it until 12th June. If the package did indeed contain Fluimucil, why was someone asked to bring it out from Manchester, when one of the pharmacies where Team Sky had previously sourced this same drug was just a few hours’ drive away in Switzerland, at the Pharmacie De La Plaine, in Yverdon.

85.Team Sky’s accounts of what happened in La Toussuire have also been inconsistent. It was initially claimed that the package Simon Cope brought out to La Toussuire was for the British women’s team cyclist, Emma Pooley, and not for Bradley Wiggins. However, it was later confirmed that, at that time, Emma Pooley was 700 miles away in Spain. Team Sky also claimed that the team bus, containing both Dr Freeman and the package, had left La Toussuire before Bradley Wiggins had completed his post-race media commitments, until video evidence proved that this was not the case. Matt Lawton, the Daily Mail journalist who first reported about the package that was sent for Bradley Wiggins, also reported on 20th December 2016, that David Brailsford had said to him, “If you didn’t write the story, is there anything else that could be done?”110 Further information shown to the Committee claimed that the product that was requested to be sent out to the event was triamcinolone. We recently asked Dr Freeman to comment on the contents of the package. In response, rather than confirm what David Brailsford told the Committee that the package contained, “only Fluimucil”, he wrote that he had taken legal advice, and said:

where I have not had disclosed to me the nature of the “new evidence”, its format, source and any other relevant details, including why the evidence should only be available now, it would not be appropriate for me to respond presently. Given the potential seriousness of the matters you have now raised, I am advised that mindful of the background of various investigations which are ongoing, I should not be expected to provide any further comment to you presently.111

86.When UK Anti-Doping (UKAD) reported on its investigation into the package, it concluded that it “remains unable to confirm or refute the account that the package delivered to Team Sky contained Fluimucil.”112 In her statement, the Chief Executive of UKAD, Nicole Sapstead, commented that, “Our investigation was hampered by a lack of accurate medical records being available at British Cycling.113 This is a serious concern. As part of their conditions to receive public funding from UK Sport and other Home Country Sports Councils, all sports governing bodies must comply with the UK National Anti-Doping Policy. In this case the matter was further complicated by the crossover between personnel at British Cycling and Team Sky.” Furthermore, in a private letter to British Cycling on 14 November 2017, which was published by the BBC in January, UKAD went further and stated that the lack of records for the package sent to Team Sky in 2011 was not an isolated example, but was a consequence of the failure of British Cycling’s systems.114

87.UKAD commented that:

There was no process to record what pharmaceutical products and medical supplies were stored by British Cycling at the Manchester Velodrome or elsewhere, and what was checked in and out of the medical room on site […] The medical room […] was chaotic and disorganised—there was no apparent filing system and papers were just piled up in cupboards and filing cabinets.”115

UKAD also noted that they “found little, if any evidence of supervision or executive oversight of the Team Doctors (Dr Freeman and Dr Steve Peters) by British Cycling.”116 Even more seriously, UKAD stated in their letter that British Cycling’s actions could have compromised their investigation. They wrote, “Despite being aware of the allegations in relation to the 2011 ‘package’ British Cycling was slow to inform UKAD of these, in fact, contact on this matter was made at UKAD’s instigation. Contact by British Cycling with some members of staff at British Cycling, prior to informing UKAD could have potentially compromised our investigation with the possible loss of data evidence”.117

88.This letter also seems to discredit the evidence given to the Committee by British Cycling in the oral evidence hearing in December 2016. When the then Chairman of British Cycling, Bob Howden, was asked whether they kept detailed records of packages being moved in and out of their stores he said, “If it is a pharmaceutical product, then yes.”118

89.Like UKAD, the Committee is not in a position to state what was in the package, because of the absence of any records of the medication that was sent, notwithstanding the evidence seen by the Committee. The lack of these records is a serious failure both for Team Sky and British Cycling. It is also a failure of management at Team Sky, led by David Brailsford, as how can the managers and coaches assert with confidence that they are following the highest ethical standards in cycling, if they don’t have access to records to show what treatments the doctors are prescribing to the riders? We have no verifiable evidence that the package contained Fluimicil. We cannot say that the package contained triamcinolone. We do know that Bradley Wiggins applied for a TUE to take triamcinolone and that he was, some time later, granted TUEs to take that medication. Responsibility for the continued doubt on this matter rests on British Cycling, Team Sky and the individuals concerned, all of whom have failed to keep simple records. Such failure was unprofessional and inexcusable, and that failure is responsible for the damaging cloud of doubt which continues to hang over this matter.

90.In his evidence to the Committee, David Brailsford stated that Team Sky, “have a very good compliance and governance structure within the team; I would say world leading. We don’t have a single doctor operating in isolation.”119 If that was the case, then the situation would not have arisen that Bradley Wiggins’ medical records could have been lost. The system at Team Sky was either not as robust at David Brailsford states, or certain information was deliberately not recorded in line with the stated policy of the team. Both David Brailsford and Dr Peters must share some of the responsibility for the failure of Dr Freeman to ensure that Bradley Wiggins’ medical records were properly stored.

Medicines policy at Team Sky

91.When giving oral evidence to the Committee, David Brailsford, stated: “I don’t think there is any justification for taking medication without a medical need.”120 In a lengthy interview with The Telegraph’s ‘Cycling Podcast’, broadcast on 16th October 2016, he also described the importance of not crossing the ethical line where treatments are “medically prescribed without medically being required.”121 In his evidence, Shane Sutton described Team Sky as “Immaculately clean […] it is absolutely 100% a clean team.”122

92.The definition of the term ‘clean’ in cycling is not as straightforward as it might seem. The CIRC report noted that, “There is no ‘one size fits all’ definition from within the sport of what clean means. The generally accepted understanding of being clean is that an athlete does not take products that are on the WADA Prohibited List. Some riders will take substances on the List but, having not been caught, consider themselves clean. Some will take substances that are on the List but are not yet detectable, and therefore believe that they are clean. Some riders stop doping before a big event and therefore consider themselves to be riding clean. All definitions have been described by riders and other stakeholders. The Commission heard that some riders also experiment with performance-enhancing substances and practices that are not yet on a banned list. There is a considerable amount of spin around what being clean means to riders and teams.”123

93.During the course of our investigation, the Committee was keen to understand more about how Team Sky policed the ethical line that it had drawn for itself, to make sure that drugs such as triamcinolone were used to treat genuine medical needs only. In written evidence to the Committee published in March 2017, Team Sky stated that, “Our records indicate that 55 ampoules [pre-measured doses ready for injection] of triamcinolone were ordered by Team Sky over a 4-year period between 2010 and 2013. Only a small proportion of this was administered to Team Sky riders. According to Dr Freeman, the majority was used in his private practice and to treat Team Sky and British Cycling staff.”124 The Committee asked Team Sky to confirm how ampoules were given to riders, and how many riders were treated with it. They responded stating that, “For reasons of medical confidentiality, you will appreciate that Team Sky cannot divulge specific information which might reveal the identity of any rider’s medical treatment. However, we can say that, based on Team Sky’s shared medical records, less than 10 ampoules of triamcinolone were administered to Team Sky riders in the four years between 2010 to 2013.”125

94.We already know from Bradley Wiggins’ TUE certificates that he was treated on three occasions with triamcinolone during this period.126 It would only be a breach of a rider’s medical confidentiality if Team Sky were to state that he was the only rider to be treated using this drug in the four years between 2010 to 2013. If Team Sky had said that two or three riders had received the treatment, we would not have been able to identify the others from this evidence.

95.The Committee asked Dr Freeman, who worked with Team Sky throughout this period and whose knowledge of the use of the drug was cited by the Team in its evidence, to how many riders he had administered triamcinolone. He replied, “I can only recall one rider.”127 We also asked Shane Sutton whether he was aware at this time of any Team Sky riders other than Bradley Wiggins who were being treated with corticosteroids such as triamcinolone, to which he replied, “None whatsoever.”128 The Committee asked David Brailsford whether Bradley Wiggins had used corticosteroids like triamcinolone, out of competition and therefore without the need for a TUE. He replied, “Not to my knowledge”, but also stated that he “would not ask the medical department” about this, as “That was up to them.”129 He did confirm though that there were occasions during his time with British Cycling and Team Sky where corticosteroids would have been administered to riders outside of competition, on medical advice. Bradley Wiggins has though stated in writing to the Committee that he was treated with triamcinolone on other occasions outside of competition and without the need for a TUE.130

96.The Committee also received a written statement from a whistleblower, who wishes to remain anonymous, from Team Sky, which we published in April 2017.131 The identity of this person is known to us; they are well respected within the cycling community and held a senior position at Team Sky at the time of the events under investigation. The whistleblower also raised the issue of the use of triamcinolone at Team Sky, stating that they “believe that TUE’s were used tactically by the team to support the health of a rider with an ultimate aim of supporting performance. At that time there were regular rider review meetings and all details of the rider were discussed, medical confidentiality was waived (this is common practice in sport) and the seriousness of Brad’s allergies were not discussed. The use of the triamcinolone acetonide was never discussed in these meetings however it had been discussed outside of the rider review meetings as a general discussion, because it had been used for years in cycling and the consensus was it would be inappropriate to use.”132 The whistleblower also challenged the consistent assertion by David Brailsford and Shane Sutton in their evidence to the committee that the coaching staff were led by the medical team when it came to treatments, stating

In 2012 the team was under extreme pressure to perform. Dave B and Shane Sutton put a great deal of pressure on the medical team in particular Richard Freeman to provide more proactive medical support. Using TUEs was openly discussed in hushed voices as a means of supporting health and wellbeing […] At the [DCMS Select] committee interview Shane hid behind trusting the medical team, this is utter nonsense, he directed the medical team, he constantly bullied Richard Freeman.133

97.The former pro-cyclist David Millar explained from his experience of using and abusing triamcinolone to enhance his performance, that it was “a once-a-year drug; the stress it put on your body required time to recover. You’d be mad to take it more often or in bigger doses, although, sadly, there were enough madmen around at the time in professional cycling who surely did just that.”134 However, from the evidence presented to the committee it might appear that Bradley Wiggins may have been treated with triamcinolone on up to nine occasions, in and out of competition, during a four-year period. It would be hard to know what possible medical need could have required such a seemingly excessive use of this drug. While the use of triamcinolone out of competition is within the WADA rules, such frequent use of the drug, given its potential performance enhancing properties, seriously calls into question David Brailsford’s assertion that Team Sky only use medicines to treat medical need.

98.Members of the Committee have also received confidential material from a well-placed and respected source regarding medicines policy at Team Sky during the period covered by Bradley Wiggins’ TUE certificates, for the use of triamcinolone within competition periods. This states, with particular reference to Team Sky’s preparations for the 2012 season, that Bradley Wiggins and a smaller group of riders trained separately from the rest of the team. The source said they were all using corticosteroids out of competition to lean down in preparation for the major races that season. This same source also states that Bradley Wiggins was using these drugs beyond the requirement for any TUE. Shane Sutton has also stated in writing to the Committee, with regards to Bradley Wiggins’ use of triamcinolone that, “what Brad was doing was unethical but not against the rules”.135

99.There have also been repeated allegations about the unethical use by Team Sky of the opiate painkiller Tramadol. Tramadol is a prescription drug, and, whilst not banned, has been under review by WADA due to concerns about its abuse in professional sport. This powerful painkiller helps riders to push themselves harder physically, during races, but can have the side effects of drowsiness and dizziness, which some have linked to serious accidents. A recently published academic paper from the University of Granada and the University of Kent has also found that Tramadol can improve a cyclist’s power by an average of five per cent in a 20-minute time trial.136

100.In written evidence to the Committee, Team Sky stated that: “If required, Team Sky doctors are able to use Tramadol for pain management of certain injuries (e.g. fractures or severe skin loss) in accordance with the team’s analgesics ladder policy.”137 David Brailsford told the Committee in his oral evidence:

We try to avoid the use of Tramadol. Certainly, when there is no medical need there is no appropriate, legitimate reason to use Tramadol. I think that is very, very clear. What I would say, however, is that if somebody has had a crash and they have lost a lot of skin [...] There is a pain scale, analgesic ladder, and depending on the assessment of pain, then there is an appropriate level of analgesic that could be prescribed. I do think that where there is a genuine medical need, for example, if somebody has lost a lot of skin, they could be prescribed a painkiller, let us say at 7.00pm or 8.00pm, so they could sleep, and the effects of that painkiller have worn off by the time they start racing the next day. I don’t think that is in any way the wrong thing to do. In fact, if it helps somebody sleep, it is probably better for them to do that than it is for them to be sleep-deprived and start racing the next day.138

101.This policy is a change from Team Sky’s ‘no Tramadol’ policy of previous years. In 2014, a former Team Sky rider, Michael Barry, said he had used the drug before his retirement from cycling in 2012. He said “ethically, I really started questioning the use of the Tramadol, and the sleeping pills, especially when you see the younger riders using this stuff heavily. If we went into a medical clinic and just asked their GP, they probably wouldn’t give these out.” He added that, “I never saw it used in training, only in races, where I saw some Sky riders using it frequently.”139

102.In response, Team Sky said, ‘None of our riders should ride whilst using Tramadolthat’s the policy of this team. Team Sky do not give it to riders whilst racing or training, either as a pre-emptive measure or to manage existing pain. We believe that its side-effects, such as dizziness and drowsiness, could cause issues for the safety of all riders. We also feel that if a rider has the level of severe pain for its appropriate use, they should not be riding. Tramadol is not prohibited by WADA, but this has been our firm position for the last two seasons and all medical staff and riders are aware of this.’140

103.A former Team Sky rider, Jonathan Tiernan-Locke, claimed that he was offered Tramadol by Dr Richard Freeman whilst riding for Great Britain in the 2012 World Championships. He recalled that, “At the time it was quite prevalent. In this particular episode I just remember being offered it on the bus.”141 Another former rider, Josh Edmondson, has also spoken out about using Tramadol whilst at Team Sky, and how over time it brought on feelings of depression, saying, “It was a serious problem for me especially towards the end of 2014. I didn’t leave the house for two months.”142

104.It is clear that former Team Sky riders have questioned the use of Tramadol by Team Sky and cited the negative effects it had upon them. In these cases, the use of Tramadol would not appear to be only in rare cases where extreme pain has been caused by injury, but rather as part of the pre-race preparation for certain riders.

105.It is clear from the evidence the Committee has considered that the Therapeutic Use Exemption (TUE) system is open to abuse. The assessment of medical need has been based too closely on trying to achieve a peak level of physical condition in the athlete, rather than returning them to a normal state of health. In the period up to 2014, when TUEs could be granted based on the assessment of the team doctor, and a single doctor at the World Anti-Doping Agency (WADA), the potential for abuse in the system was even greater.

106.We welcome the reforms made by WADA since this time, to create clearer guidelines and requirements before a TUE can be issued. The TUE system needs to be kept under permanent review, but the question inevitably remains, that if an athlete is so ill that they can only compete using a drug that is otherwise banned during competition, then why are they competing at all? From the expert evidence received by the Committee, a case can be made that better management of an athlete’s long term health conditions, and particularly asthma, should remove the need to apply for a TUE.

107.The investigation by UK Anti-Doping (UKAD) into the alleged anti-doping rule violation by Team Sky in 2011 was made much harder by the failure of both the team managers, and British Cycling to ensure proper records were kept relating to the supply of medicines and the treatment of athletes. It is not acceptable that Dr Freeman should have been able to act during the period under investigation without proper supervision. It should have been ensured that the medical records for Bradley Wiggins were uploaded to the shared cloud storage system, as then required by Team Sky. The General Medical Council (GMC) should investigate Dr Freeman for his failings, and, if he is found to have breached their rules, take appropriate action against him.

108.We welcome the recent changes in policy at British Cycling to ensure greater oversight of medical professionals working within their sport. However, we believe that UK Sport should determine an amount of compensation that should be due to UKAD from British Cycling and Team Sky, to cover the costs of an investigation that was made longer and harder by their failure to keep proper records. UK Sport and Sport England should also include a requirement in the Governance Code for national governing bodies, that they have policies in place to ensure that best practice in being followed in respect of drugs use, and the keeping of medical records, within their sport.

109.The Committee is not in a position to state what was in the package delivered to Team Sky by Simon Cope at La Toussuire on 12 June 2011. Dr Freeman has stated that it was Fluimucil, and an allegation was made to UKAD, and has been seen by the Committee, that says it was triamcinolone. We do not believe there is reliable evidence that it was Fluimucil as Dr Freeman will not now confirm it was and, previously, he was the only reported source of this information. The mystery surrounding the delivery of the package, and the extraordinary lengths to which Team Sky went to obtain an easily available drug delivered to them, have also fuelled speculation as to what the package might have contained. There remains no documented evidence as to what was in the package. If the package contained triamcinolone, which we know Bradley Wiggins, or his team, wanted him to take around 30 May 2011, and it was indeed taken, then the impacts and consequences on all concerned would have been profound. Team Sky’s statements that coaches and team managers are largely unaware of the methods used by the medical staff to prepare pro-cyclists for major races seem incredible, and inconsistent with their original aim of “winning clean”, and maintaining the highest ethical standards within their sport. How can David Brailsford ensure that his team is performing to his requirements, if he does not know and cannot tell, what drugs the doctors are giving the riders? David Brailsford must take responsibility for these failures, the regime under which Team Sky riders trained and competed and the damaging scepticism about the legitimacy of his team’s performance and accomplishments.

110.From the evidence that has been received by the Committee regarding the use of triamcinolone at Team Sky during the period under investigation, and particularly in 2012, we believe that this powerful corticosteroid was being used to prepare Bradley Wiggins, and possibly other riders supporting him, for the Tour de France. The purpose of this was not to treat medical need, but to improve his power to weight ratio ahead of the race. The application for the TUE for the triamcinolone for Bradley Wiggins, ahead of the 2012 Tour de France, also meant that he benefited from the performance enhancing properties of this drug during the race. This does not constitute a violation of the WADA code, but it does cross the ethical line that David Brailsford says he himself drew for Team Sky. In this case, and contrary to the testimony of David Brailsford in front of the Committee, we believe that drugs were being used by Team Sky, within the WADA rules, to enhance the performance of riders, and not just to treat medical need.

111.The Committee has considered evidence about the performance-enhancing properties of corticosteroids, and how their use can be avoided in the treatment of long-term conditions such as asthma. We believe that WADA should introduce a complete ban on their use. We were also concerned to hear evidence about the negative health impacts for riders resulting from the abuse of the painkiller Tramadol. Again, we believe that WADA should consider introducing a ban on the use of Tramadol.

76 WADA, ‘Annual Report 2014’ and WADA, ‘Annual Report 2015

77 WADA, “FAQs: Therapeutic Use Exemptions”, published November 2017, pg. 6

80 New York Times, “How to Get Away with Doping”, 14 October 2016

81 Cycling News, 23 September 2016

82 Daily Telegraph, “Sir Bradley Wiggins last-resort drug”, 21 September 2016

83 New York Times, “How to Get Away with Doping”, 14 October 2016

85 BBC Newsnight, 23 September 2016

86 Cycling Independent Reform Commission, “Report to the President of the Union Cycliste Internationale”, pg 59

87 Cycling Independent Reform Commission, “Report to the President of the Union Cycliste Internationale”, pg 60

88 Cycling Independent Reform Commission, “Report to the President of the Union Cycliste Internationale”, pg 60

89 Cycling Independent Reform Commission, “Report to the President of the Union Cycliste Internationale”, pg 60

90 Roger Palfreeman, “Doping in Sport”, in Greg P. Whyte, Mike Loosemore, Clyde Williams (eds.), ABC of Sport and Exercise Medicine (London, 2015)

91 Sandy Fleming, “Expert comment: Dr John Dickinson on the truth about cycling and asthma”, University of Kent, 13 December 2017

92 MPCC, “What’s the MPCC?”, accessed December 2017

94 BBC Panorama, “Britain’s Cycling Superheroes: The Price of Success?”, 19 November 2017

102 Responses by Bradley Wiggins to written questions.

103 Correspondence between Shane Sutton and the Committee

105 Dr Richard Freeman (BDA0018)

107 Team Sky (BDA0017), para 3

108 GMC, “Good medical practice”, 25 March 2013

109 MHPRA (BDA0014), para 8

110 The Daily Mail, “Sir David Brailsford’s bid to hide the truth”, 19 December 2016

111 Letter from Dr Freeman to the Committee, published on the Committee’s website.

121 The Cycling Podcast, 16 October 2016

123 Cycling Independent Reform Commission, “Report to the President of the Union Cycliste Internationale”, pg 21

124 Team Sky (BDA0015), para 29

125 Team Sky (BDA0017) para 3

127 Dr Richard Freeman (BDA0019), para 1

130 Responses by Bradley Wiggins to written questions

131 Whistleblower (BDA0021)

132 Whistleblower (BDA0021)

133 Whistleblower (BDA0021)

134 New York Times, “How to Get Away with Doping”, 14 October 2016

135 Correspondence between Shane Sutton and the Committee

137 Team Sky (BDA0017), para 18

2 March 2018