The International Rugby Board (IRB) CEO Brett Gosper said yesterday that he could not think of one reason why the Six Nations has not adopted the IRB concussion protocol trials called Pitch Side Concussion Assessment (PSCA).
One of the principal protocols of PSCA involves a five-minute pitch-side assessment by team doctors to determine whether a suspected concussion may have taken place and if that player should be allowed to return to the field of play or not.
From an IRB perspective, the Six Nations, Rabo Direct PRO12 and Heineken Cup are all out of step with most of the other major world tournaments in that they do not observe the PSCA.
When Gosper was asked if he could think of one reason why those competitions in which Irish rugby players compete did not accept PSCA, his answer was unequivocal.
"No," he said. "(There is) not a complete understanding on the PSCA, so maybe we need to do a bit more education in that area and target those people and unions who do have a problem. PSCA can and has been criticised by some people . . .
'Better process'
"But certainly we can't think of a better process than the one we have and of course this is an evolving process and we will change over time. But this is the best process available given the knowledge that we have currently available."
It was put to the IRB at yesterday’s World Rugby Conference in Dublin that the Six Nations and other competitions have not adopted the protocols, not because they are disinterested in the issue but because they don’t believe a five-minute assessment of a player at the side of the pitch is adequate and does not go far enough in protecting their welfare.
This was highlighted recently when former Ireland fullback Barry O'Driscoll, who is an uncle of Irish centre Brian, resigned from the International Rugby Board (IRB) medical committee at the decision to trial the PSCA protocol.
Suspected of suffering
Under the previous IRB approach, any player suspected of suffering from concussion had to leave the pitch and take a week away from the game, a period already reduced from three weeks under an earlier rule.
The issue of player assessment has also been a bone of contention and the argument has been made for independent doctors to make the examination as team doctors, who are highly skilled and qualified, are not independent parties. “If they incorporate the ‘five-minute rule’ I think you’re putting people with brain damage back on the field, and the arena they’re going back into is brutal,” said Dr O’Driscoll recently.
“The players have said ‘well, we know we’re guinea pigs, but that’s the deal’. It’s our job not to make them guinea pigs in an experiment like this.”
O’Driscoll is not alone. Dr Robert Cantu, clinical professor of neurosurgery at the Boston University School of Medicine was yesterday also said to be a critic, although the IRB rejected the claim.
"He comes from the NFL," said Chief Medical Officer of the IRB Dr Martin Raftery. "He says I don't necessarily agree with five minutes but I see why you are doing it."
Possibility of change
The IRB's logic is that five minutes of examination is better than zero minutes and while the PSCA trials are continuing the governing body remain open to the possibility of change if hard scientific evidence becomes available.
They say their motivation for doing the trials is purely for player welfare and not for legal considerations further down the road.
But PSCA detractors say that the system isn’t working anyway and cite Australia’s George Smith as well as Brian O’Driscoll, who continued to play after being concussed in this year’s Six Nations match against France, as examples. They say team needs continue to trump player health.
Smith was helped from the field in June’s summer Test against the Lions as he couldn’t walk unaided. However, he returned to play in the game five minutes later.
“It’s unacceptable. It’s unacceptable,” said Rob Nichol chief executive of the Professional Rugby Player Association. “What it did do was tell us we’ve got to up the ante on this more and more and more. Even before the PSCA, 10 years ago, George Smith should not have gone back on the field.”
However, Nichol fully supports the PSCA as a way forward. The IRB now faces battles on two fronts over the issue, one to get all of their major competitions onside and another to sell the idea to experts like O’Driscoll that the PSCA is fit for purpose.
