For Six Nations not to introduce PSCA protocal would be a dereliction of duty

Many of the great and good amongst the 600-plus international rugby fraternity are in Dublin this week as part of the International Rugby Board’s Conference and Exhibition. Included in the agenda was yesterday’s IRB Medical Commission Conference and one hopes the respective team doctors from the six competing teams in the Six Nations relayed very clear and strong messages back to their respective Unions on the issue of player welfare and specifically concussion.

At the recommendation of the fourth International Consensus Conference on Concussion in Sport in Zurich, in August, the IRB renewed its trialling of the Pitch-side Suspected Concussion Assessment (a five-minute equivalent of the temporary blood suspension to assess concussion). Virtually every elite competition in the world, be it the Rugby Championship and all the leading franchise or regional competitions in the southern hemisphere, along with the Top 14 and Aviva Premiership, have been trialling the PSCA.

Notable in their absence from trialling the PSCA are the Rabo Direct Pro12 and the Six Nations. Given the RFU and FFR backing for the PSCA in the contest of the Top 14 and the Premiership, this does not reflect well on the Celtic and Italian Unions given they are the common denominator in the Six Nations and the Rabo Direct Pro12.

Valid reason
Their only valid reason for not trialling the PSCA could be one of logistics, on the premise that they are cross border competitions involving four or six nations, and by extension whatever additional costs may be accrued. However, given the financial largesse generated by the cash cow that is the Six Nations especially, frankly this does not stack up. Besides which, what price player welfare?

The only other conceivable argument for not trialling the PSCA would be on the premise that they the tournament organisers do not believe in the PSCA, or that at any rate it is ill-sufficient in dealing with the problem of concussion in rugby. But frankly, this doesn’t stack up either. If they deem five minutes insufficient time to accurately assess whether a player is concussed or not, how can leaving the player on the field of play be preferable. Five minutes is eminently better than one.

What’s more, given the Six Nations especially is the most watched tournament in northern hemisphere rugby to not trial the PSCA and leave things as they were is grossly negligent.

Thinking back to the incident coming up to half-time in the Munster-Leinster game in early October, when Peter O’Mahony suffered suspected concussion, we had the sight of Romain Poite getting down on his haunches to assess the Munster flanker’s well-being before he returned to the field of play.

Poite is many things, but no referee should be placed in such a position.

This is not to say that the PSCA is a proven solution to the issue of concussion in rugby. But according to the IRB chief medical officer, Dr Martin Raftery, since off-field assessment in the form of the PSCA has been introduced the incidents of players remaining on the field of play with concussion has dropped from 56 per cent to 13 per cent.

Pilot study
At last Sunday's IRB working group meeting, it was agreed that the PSCA should be trialled for another 12 months. As an aside, according to Nichol, a pilot study of 173 PSCA cases showed that not one doctor complained he did not have enough time to complete his assessment.

The IRB, and the game of rugby generally, has also been guilty of dragging its feet on the issue of concussion. When the then IRB CEO Mike Miller was asked by this writer almost three years ago why a ‘brain bin’, or temporary removal of a player from the field of play so as he could be assessed for concussion away from the field of play, he said this ran the risk of it being abused, a la Bloodgate.

The fear that it could be abused in this manner was a contributory factor, but it never should have been, and it should have been left to the Board's medical experts. According to Dr Raftery, that has been the case since his appointment in June 2011, and all the evidence suggests that this has indeed been the case.

Enthusiastic suporter
For the time being Raftery, along with Rob Nicholl, CEO of the Rugby Players Association and an enthusiastic supporter of the IRB's initiatives, former Australian captain George Gregan and others, sought to utilise yesterday's medical commission conference to impress upon those present, including the relevant team doctors from the six nations, of the urgent need to trial the PSCA.

For the Six Nations not to introduce the protocol in time for this season’s competition would be a dereliction of duty toward player welfare from people involved in the governance of the game who can re-enforce the seriousness of this issue, especially toward under-age rugby.

Also pertinent to the issue of player welfare, it is believed that the IRFU are looking to introduce contracts with more of a pay-per-play aspect, in other words with higher percentages of payment related to appearances.

On foot of agreeing with the Irish Rugby Players Association (IRUPA) that they extend full pay for injured players to nine rather than six months, this appears to be a case of giving with one hand and taking away with the other.

It is also very dangerous ground which, if brought into practice, goes against the concept of player welfare.