Safety in sport – is it even possible?

In April 2016, the government asked Baroness Tanni Grey-Thompson to lead a review into the Duty of Care sport has towards its participants.  The aim of this review was to develop a comprehensive plan for how government and the whole sporting system could more effectively look after people who take part in sport, at all levels.

In the week following the death of Mike Towell, a Scottish welterweight boxer, this review is even more crucial.  Mike Towell was knocked down twice during his match with Welsh fighter Dale Evans in Glasgow on Thursday 29 September.  He subsequently died in hospital the following day as a result of severe bleeding and swelling to his brain.

As a personal injury solicitor specialising in helping those who have suffered a brain injury following an accident, this tragic situation makes me ask if more could have been done to avoid his death.  I will examine below the reasons why I consider the issue of safety in sport remains challenging and what I hope the outcome of the Duty of Care review will be.

Duty of Care Review Focus Groups

Focus groups were held with experts to discuss specific issues to understand where the review could add the most value, what improvements could be made to safety in sport and what the likely challenges would be.  One particular focus group aimed to look at injuries and medical issues at all levels of sport.  This focus group was made up of a number of experts from a variety of different fields, including the Rugby Football Union, Football Association, Sport England and the Royal Society for the Prevention of Accidents, amongst others.

The focus group looked at the following issues:

• Culture
• Confidentiality
• Responsibility and cost
• Litigation
• Prevention
• Cardiac screening
• First aid
• Concussion
• Investigation
• Data

Whilst the focus group looked at each of the above topics in detail, I have considered below only the issues of culture and confidentiality.  This is because I feel that these issues play a huge part in the implementation of increased safety in sport.

Culture and Confidentiality

The group discussed the balance between maximising safety, the desire to succeed and achievable standards for clubs and sports with limited resources.  One argument was that there should be no compromise with safety – if standards at a particular club, event or sport weren’t sufficiently safe, people shouldn’t agree to or be allowed to take part.  The group acknowledged that the picture regarding safety in sport was complex and although safety in sport was improving, there were no universal safety standards across sports.  The group agreed that in principle the Duty of Care should apply to everyone working in sport and not just players or athletes.

I consider that culture plays a huge part in attitudes towards safety in sport and that these attitudes will vary from sport to sport.  For example, rugby has a reputation for being a rough contact sport and so some individuals may be put off playing the game, for fear of injury.  Furthermore, certain types of injuries may be taken less seriously by those involved in the sport (both players and organisers) than they should, as the environment dictates that they are not deemed to be as serious.  In another sport, that injury may be seen as very serious.  Despite me using rugby as an example, I note that they have made great advances in the area of concussion, in trying to alert their players to the risks of repeated concussion and to take steps to minimise those risks.

This issue is intrinsically linked with culture in my mind.  As above, the culture of a particular sport may mean that certain injuries are expected or taken less seriously because of the nature of the sport.  Similarly, a player or athlete may be reluctant to disclose details of an injury or illness for a feeling that they may be disadvantaged for doing so.  I believe that this reluctance is caused by both confidentiality and culture.

I understand that Mike Towell suffered from headaches and migraine in the weeks leading up to his last fight and that a previous training sessions was cut short due to ongoing headaches.  When considering this situation, one must look at what could have been done to avoid this.

1. Was Mr Towell well informed as to what such symptoms may mean?  Did he understand the risks and ramifications of continuing to fight despite suffering from such symptoms?
2. Did Mr Towell make his medical practitioner aware of these symptoms prior to his fight and, if so, did they deem him safe to fight?
3. Should his medical team have investigated his condition further, knowing that he had suffered headaches in the weeks preceding his fight?
4. Should an MRI scan be a pre-requisite to a fight?
5. Was the referee made aware of his condition and would this have resulted in him stopping the fight sooner?

The above questions are very difficult to answer.  Mr Towell as a professional athlete made a decision to pursue a career as a boxer, despite the inherent and obvious risks to his health.  Whilst it cannot be known if any of the above steps would have led to a different outcome for Mr Towell, I feel that it is important in general that:

1. All participants in sport are well informed as to the risks of their given sport and what steps they can take to minimise those risks.
2. Those working in sport should be well trained as to the risks involved and the ways of minimising those risks and should undergo continued professional development so that this knowledge may be shared with participants.
3. The rules of certain sports could be changed or adapted so as to improve safety.  This may not be suitable for all sports or levels, but may encourage participation at grassroots level where the risks to health and safety are then lower.

Ultimately, changing attitudes towards safety in sport, whether playing or working in sport, will always be difficult.  I consider however that this is the biggest challenge facing the Duty of Care review.

It may be possible to identify what steps can be taken to improve safety in sport:

• improved risk assessments as to the risks of certain activities
• improved awareness for participants and those working in sport
• increased medical/trained personnel to provide assistance in the instance of an injury
• greater screening for medical conditions (such as MRI scans or cardiac screening)

However, if people’s attitudes towards safety remain poor, then participants in sport will continue to feel pressurised to continue playing despite their injuries, certain injuries will be taken less seriously than they should and participants will feel reluctant to disclose details of their injury or ill health, for fear that it will put them at a disadvantage.

It is my hope that the Duty of Care review will lead to an improvement in attitudes towards safety, both from participants in sport and those working in sport, such that very sad situations such as that suffered by Mike Towell and his family can be avoided.