Two more named in Players' dementia action

The legal action against rugby union’s authorities took a decisive step forward on Thursday when the firm representing nine players diagnosed with long-term brain injuries sent pre-action letters of claim to World Rugby, the Rugby Football Union and the Welsh Rugby Union. Rylands Law also revealed the identities of two more of the nine players involved in the test cases alongside Steve Thompson, Alix Popham and Michael Lipman. They are the former Wales under-20 centre Adam Hughes and the former England under-21 back-row Neil Spence.

The development comes as the former England captain Dylan Hartley spoke out about the lack of teaching in rugby around the risk of dementia. “From when I started until last week, I didn’t know dementia was a potential outcome for any rugby player,” Hartley said on RugbyPass’ Offload podcast. “That wasn’t educated or taught to us.” Hartley admitted he is having his “own problems” with concussion in retirement, but said he does not want to reveal more about them.

Neil Spence during his playing career at Rotherham.
‘A side of me is lost for ever’: two more rugby players on their brain injuries

Hughes, 30, is the youngest player involved in the action so far. He has been diagnosed with “having brain injuries and post-concussion symptoms”, and has been told he is on a “similar medical trajectory” to Popham, Lipman, Thompson and Spence, who have all been diagnosed with early-onset dementia and probable chronic traumatic encephalopathy. Hughes played for the Dragons, Bristol and Exeter between 2010-18, and his experience throws doubt on the argument that the game has become significantly safer in the past decade.

Hughes was forced to retire at the age of 28 after a particularly severe concussion and is now working as a financial adviser. “It was just one head knock too many. I was finding it more and more difficult to recover from each and every bang to the head,” he said. He reports being knocked out eight times in his career. “At first it was the bigger concussions where I was completely knocked out that took me ages to recover from then over the time even the smaller ones started to have an impact. For the sake of my health, I had to bring it to a halt.”

One of Hughes’s former coaches, Rob Baxter at Exeter, said last week the game’s approach to head injuries has improved so much in the years since Thompson, Lipman and Popham retired that “there’s almost very little value in trying to compare the two”. Hughes, who played for the Chiefs in 2014-15, told a different story. “For me, I think the biggest issue around concussions was attitude. It was often treated like a weakness if you don’t dust yourself down and carry on.”

He added that “the game still has a very long way to go in terms of education about concussion”.

Adam Hughes (left), pictured in action for Dragons in 2016, retired age 28 after a severe concussion.
Adam Hughes (left), pictured in action for Dragons in 2016, retired age 28 after a severe concussion. Photograph: Huw Evans/Shutterstock

Four more players involved in the test cases have decided to remain anonymous. Rylands Law is already representing around 100 former rugby players and said 30 more have been in contact since the involvement of Thompson, Popham and Lipman was revealed by the Guardian last week.

In a statement World Rugby, the RFU and the WRU said: “We have been deeply saddened to hear the brave personal accounts from former players. Rugby is a contact sport and while there is an element of risk to playing any sport, rugby takes player welfare extremely seriously and it continues to be our number one priority. As a result of scientific knowledge improving, rugby has developed its approach to concussion surveillance, education, management and prevention across the whole game.

“We have implemented coach, referee and player education and best-practice protocols across the game and rugby’s approach to head injury assessments and concussion protocols has been recognised and led to many other team sports accepting our guidance. We will continue to use medical evidence and research to keep evolving our approach.”

Sir Bill Beaumont, the chairman of World Rugby, added: “As a player who retired on medical advice in the early 1980s, I care deeply about the welfare of all players. As an administrator, I will do all I can to maintain the confidence and wellbeing of those who play the game.”

The pre-action letters of claim set out the broad allegations upon which the cases are based. They state the governing bodies had a duty “to take such steps and to devise and implement such rules and regulations as were required in order to remove, reduce or minimise the risks of permanent brain damage as a consequence of the known and foreseeable risk of concussive and sub-concussive injuries”.

They also allege the risks of concussions and sub-concussive injuries were “known and foreseeable”, listing 24 failures on the part of World Rugby, RFU and WRU. The governing bodies have a maximum of three months from the date of acknowledgment of the letters of claim to provide their initial responses.

Roles and Responsibilities

There are a number of different types of organisations in the sport sector that have a role to play in ensuring the safety of participants. National Governing Bodies are the organisations responsible for the running of their sport, including the rules and regulations that govern sporting activities. They are able to issue guidance to their affiliated leagues and clubs, and set requirements around training, medical provision and welfare, including the use of new equipment and technology to enhance safety and the treatment of injuries. They can also take action if these standards are not met. Governing Bodies are also the custodians of the rules of their sports, and can make adaptations to what happens on and around the field of play. Their role is to encourage participation in their sport across all age groups, levels of ability and genders, as well as to identify and support sporting excellence, and to do this in an inclusive and safe way. Player associations are involved with advocating for, and supporting the welfare of, elite and professional sportspeople, most often those actively playing sport but, in many cases, those retired as well. Player associations champion the needs of their members, commission research, provide education and training, as well as providing short and long-term support to those affected by sporting injuries. Sports councils are bodies established at arm’s length from Governments in each of the home nations. They are responsible for providing public funding to sports organisations in their countries, and are tasked with supporting the sector and creating an overall environment that will encourage both wider and greater participation in sporting activity. Individuals also have a role in helping to prevent and manage injuries. Those involved in running clubs, coaching or officials, whether as paid staff or as volunteers, have a responsibility to understand what is expected of them, implement approved protocols, undertake any relevant training and certification, set and implement standards, and act on any concerns. This means upholding standards around medical provision, ensuring equipment is safe to use, and that players receive the treatment they need if they suffer an injury. Most importantly, perhaps, the people taking part in sport are central to all considerations around safety. Individuals need to be made aware of the risks of taking part and be provided with clear advice about safety. They are also entitled to speak up if things are unclear or do not seem right. Players can be supported in this by their family, friends, fellow players, coaches, organisers, officials and spectators, who may be able to spot risks or issues that are not immediately obvious to those on the field of play. We agree with the Select Committee that the Government also has a role to play. The Government is able to step in and take action when and where it believes others are not able to, or where there is need to accelerate and coordinate action. The Government can use its convening power to bring organisations together to tackle complex, wide-ranging and long‑term issues. It can hold organisations to account, particularly where public funding is involved, and can raise the profile of issues, helping to draw attention to areas where more education, research and awareness is needed. It can also legislate if deemed essential. In the case of head injuries in sport, the risks to health and the potential negative impacts that this may have on participation in sport are such that the Government believes there is a need to ensure appropriate action is being taken, to raise the profile of the issue and to improve understanding, protocols and treatment. The Government intends to make use of its ability to bring sectors together to help improve awareness and practice around head injuries in sport. This is an area where the immediate impacts may be “passing” or perhaps not even be apparent to an observer or the person involved. However, there is increasing evidence to indicate that over the long-term, repeated head injuries can be associated with brain damage which may manifest itself in later life. Many sports organisations are already taking action to improve awareness and limit the risk of injury. However, much more must be done in a coordinated and consistent manner to improve national awareness, education and communication on this subject.

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