Sports can no longer be left to “mark their own homework” on concussion, a parliamentary inquiry has concluded.
The report from the Digital, Culture, Media and Sport (DCMS) committee of MPs called for the Government to oversee the introduction of a coherent UK-wide minimum concussion protocol within the next year, mirroring the approach taken in Scotland.
It also called for the Health and Safety Executive (HSE) to be more closely involved in sport, with committee chair Julian Knight accusing it of a “dereliction of duty” in leaving it to sports to manage risks themselves.
The report recommended HSE works with sports organisations to establish a national framework for the reporting of sports injuries by July 2022.
Within a year of that, all sports should be required to report any event that might lead to an acquired brain injury, the report said.
“The protections afforded by the state to workers apply as much to footballers and jockeys as they do to miners and construction workers,” the report said.
“We are astounded that sport should be left by the Health and Safety Executive to mark its own homework.”
The report accepted no definitive causal link had been established between playing sport and dementia but said it was “undeniable that a significant minority of people would face long-term neurological issues as a result of their participation in sport”.
Knight told the PA news agency: “Frankly to date we have just seen buck-passing and it’s complete nonsense.
“We know there is a link between dementia and acquired brain injury and sometimes that happens in sport. It’s more likely to happen in sporting environments, therefore what we need to do is mitigate those risks through proper advice. We still want people to enjoy the sport they love but be aware of the risk and have as many safety protocols in place as are sensible.
“We need to stop being worried about being sued. It isn’t about accepting responsibility for the past, it’s about setting a pathway to good governance in the future.”
The report also accused the football authorities of taking too long to engage with the issue. It stated that the coroner’s verdict on former West Brom and England striker Jeff Astle almost 20 years ago should have led to the Football Association taking a “stronger, sustained interest” in the issue.
Astle’s death was ascribed to industrial disease linked to the repeated heading of a ball.
The players’ union, the Professional Footballers’ Association, should also have “publicly hounded” the FA over the issue, the report said.
“Over the past 20 years neither the Football Association nor the Professional Footballers’ Association have fought hard enough, or publicly enough, to address this issue within the broader football community,” the report stated.
“They are, however, only part of a broader failure to address the issue of acquired brain injury in sport.”
On how concussion is handled in professional sports like football and rugby, the report added: “One of the biggest problems is the apparent lack of clarity on who is responsible for driving change. Change has not happened quickly enough and while the science currently available to us describes the problem it does not provide solutions.”
The report also called on the Government to mandate elite sports funding body UK Sport to ensure the sports it funds raise awareness of concussion effectively, have good protocols and implement those protocols.
It said preventable brain injuries had been suffered because funded sports had protocols that “looked good on paper” but were not implemented, and that the low frequency of head injuries meant there had been little effort to drive numbers down even further in the elite sport community.
It also recommended that UK Sport deploy a medical officer at major sporting events such as the Olympics to ensure protocols were applied and to have the power to prevent athletes competing if deemed at risk.
The report found athletes often possess “a determination to succeed and to downplay the consequences of personal injury in the pursuit of success”, and that therefore the governing bodies had a duty of care to protect them from those instincts.
It added: “The drive that distinguishes world champions and gold medallists also disincentivises prioritising personal safety. Sport has a responsibility to ensure that our elite athletes are not allowed to trade their long-term health for short-term sporting success.”
The report said the Government would be central to the drawing up of an over-arching concussion protocol across the UK, and to ensuring it was properly communicated.
“We find it difficult to see any downside of a coherent UK-wide protocol for concussion and recommend that the Government look to the Scottish model and then work with the devolved governments in Scotland, Wales and Northern Ireland to develop, in the next 12 months, a UK protocol for concussion across all sport,” it said.
Do you know how to recognise concussion? Do you know how to manage concussion in your athletes? Do you know when it's safe for them to return to sport?
— sportscotland (@sportscotland) November 24, 2020
“This should be used by national governing bodies as the minimum standard in creating the rules for their sport and should take account of, and be consistent with, the national framework for the reporting of sporting injuries we recommended earlier in this report.
“This protocol should be refreshed every two years. Once this protocol is in place we recommend the Government deliver a comprehensive communications campaign to ensure that everyone involved in sport, from the athletes to coaches and doctors, is aware of best practice.”
The Government is also called upon to help set up a central research fund – where research is “seen to be independent” – and to incentivise sports to contribute by offering a degree of matched funding.
The report said the Government had been guilty of a “failure to follow through with practical interventions” in the past, on the back of previous reports.
“We urge the Government to grasp the nettle this time, move past the concerns about how regulation may change sports, and take real and effective action,” the report said.
The report also called for better record-keeping by NHS England when grassroots sports players report to hospital with concussion, and for new learning modules to be drawn up for GPs and accident and emergency staff.