Janet Rice (Victoria, Australian Greens) Share this | Link to this | Hansard source

I present the report of the Community Affairs References Committee on concussions and repeated head trauma in contact sports, together with accompanying documents, and I move:

That the Senate take note of the report.

This consensus report is a landmark report in understanding the impact and extent of concussion on Australian sports players. The committee heard tragic stories from athletes whose lives had been shattered because of concussion and from family members who have lost loved ones from the impact of chronic traumatic encephalopathy, CTE, a progressive degenerative neurological disease that results in the decline of memory and cognition, depression, suicidal behaviour, aggressiveness and, eventually, dementia. The people who shared their stories with the committee urged us to push for more action so that others would not suffer in the way that they had, and I thank these athletes and their families for sharing their stories with us.

The committee's view was that there is clear evidence of a causal link between repeated head trauma and concussions and CTE. Our report states:

While important research questions remain regarding the degree of causation and the nature of long-term impacts, these questions should not be used to undermine the fundamental nature of that link.

The stories we heard were heartbreaking. Former professional rugby league player Mr James Graham stated that, although rugby league gave him a great life and many opportunities, he believed that it's likely that it will come at a cost to his health and life span. He said:

Some of this is due to the nature of my sport, due to the environment that I was put into, the attitudes that existed around concussion and my own choices, at times, to carry on and take advantage of a system that allowed me to play six days after being knocked unconscious.

Ms Kirby Sefo, an Australian rugby player, told us that she had sustained in excess of 40 head knocks over her career and spoke about the debilitating symptoms she experiences:

I begin with dizziness and hypersensitivity to light. I lose parts of my vision. I experience a loss of balance and disorientation, followed by heavy fevers and sweats and then severe vomiting. Once the vomiting settles, I'll pass out into a deep, deep sleep that can vary anywhere from 45 minutes, with the longest I've experienced being around eight hours.

Lydia Pingel is a 30-year-old former AFLW player. She told us that she was medically retired from contact sports due to seven concussions she received over three years. Two years on she has a cognitive impairment and suffers from persistent post-concussion syndrome. She said:

Subsequently, my life has completely changed due to that. There is no rehab. There are no specific treatments. There is nothing specific, essentially, to what I'm going through or specific to concussion in general.

Ms Pingel also gave evidence about the pressure on her during her career to play on:

A concussion was never taken as serious as any other type of injury like a knee, hamstring, ankle etc. There was no mandatory rehab, no monitoring or follow up care once you had a few days off, did lighter training and said you felt 'ok' and 'fine' to train and play … it was easy to manipulate the club, coaches, physiotherapist, and vis versa especially if you were an 'important player' to be cleared to play and train because what also constituted the recovery period wasn't clear.

Renee Tuck told the committee the tragic story of her brother, former AFL player Shane Tuck:

Shane's CTE and brain disease had been a very slow burn for him up until the last four years of his life … We watched him decline over many years, but the last two years were probably the most tormenting and traumatising for him. Shane had a lot of auditory hallucinations … He slowly ended up on the verge of dementia. By the end, he'd lost motor skills and memory.

Enid Taylor, the wife of the late Barry Taylor, shared with the committee the impact that dementia had on their family. Mr Taylor had played rugby union from under-7s until he was almost in his mid-30s.

He showed signs of a change of personality at around about 60. But prior to that … he had become quite aggressive. Once he was diagnosed with dementia, from then on it was horrendous. … He was aggressive and irrational. It was a madness; it wasn't normal. He eventually became totally dependent, incontinent and the rest, so he went into care where he was for 3½ years until he passed away …

The committee has made some strong recommendations about how to reduce the impacts of concussion, better manage concussion, collect better data on concussion and to support more independent research. The committee recommends the establishment of the national sports injury database as a matter of urgency, noting that this will significantly help address the lack of sports injury data available in Australia.

Another key recommendation is that the Commonwealth government should play a bigger role in supporting and coordinating research into the effects of concussion and repeated head trauma and consider a coordinated and consolidated funding framework for ongoing research.

We heard evidence of legitimate concerns about the evidence of concussion research, financed by sporting organisations. Sports historian Dr Stephen Townsend told us:

The governing bodies of contact sports see the concussion crisis as an existential threat, and they [are] desperate for research which suggests that SRC [sport-related concussion] is less common or less dangerous than is currently believed, or that their efforts to reduce SRC are working.

Dr Reidar Lystad told the committee there have been 'several incidents' of interference from sports governing bodies in research projects that they finance.

The committee heard a lot of evidence about how concussion is managed differently across different sports, which is confusing and is seemingly based on what suits the sport and, arguably, their profits rather than medical evidence, so we recommended the Australian government, in collaboration with medical experts, should develop return-to-play protocols adaptable across all sports for both children and adults that have incurred a concussion or suffered a head trauma.

We heard considerable evidence that players should have longer periods away from playing after concussion. For example, neurologist Rowena Mobbs told us:

In terms of adults, I would generally advocate a conservative path of four weeks off from play, inclusive of that weekend's games.

  …   …   

For kids it should be longer, and there's talk of six weeks.

Other recommendations concern how best to improve community awareness and education, and that national sporting organisations in Australia should explore further rule modifications in order to prevent and reduce the impact of concussion and repeated head trauma. We also recommended that the Australian government, in partnership with state and territory governments, should consider how best to address calls for better health care, including concussion and head trauma guidelines for GPs, suitable general practice consultations for people with concussion and increased training for first aid responders.

Critically, the committee also recognised the need for a best-practice model to provide ongoing support, financial and otherwise, to current and former players affected by concussions and repeated head trauma. Acknowledging the current situation, where professional sportspeople in Australia are generally excluded from workers compensation schemes, the committee considered that professional sportspeople should be covered by adequate insurance arrangements. The situation regarding former players who have been impacted by concussion injuries was summed up by John Hennessy from the Community Concussion Research Foundation, who said:

There's little care for retired players, many of whom are falling through the cracks with no workers compensation, no income protection, and, in many cases, some heart-wrenching stories of personal anguish and of families being destroyed, domestic violence et cetera. There is no support for many of those players from the AFL or AFLW. The care is not there.

Anita Frawley, widow of the late AFL player Danny Frawley, said:

What could be of higher priority for the competition than looking after the individuals on whose shoulders the success of the game now stands?

The Young People in Nursing Homes National Alliance submitted that, for people sustaining catastrophic sporting injuries, Australia's existing insurance system offers little hope. They said:

… this hodgepodge of funding and insurance arrangements for catastrophic injury means that Australians who sustain catastrophic brain and spinal cord injuries from sporting activity have worse outcomes than those who sustain equivalent injuries at work or on the road.

I, personally, am disappointed that, despite recognising the need for adequate insurance arrangements, the committee fell short of making a recommendation in this area. I want to put on the record that the Greens support the development of a no-fault insurance scheme for sports injuries. I urge the government to take this report very seriously and quickly move to implement its recommendations. I do note, however, that many of the recommendations are couched in terms of recommending that the government 'consider' taking action. I urge the government to move beyond considering and actually act. It is time for the Commonwealth to step up.

In conclusion, as I said, I really want to thank all of the people who submitted to the committee and I want to thank my fellow committee members. I particularly want to thank Senator Lidia Thorpe, who initiated this inquiry when she was a member of the Greens. I know that she is disappointed that she's not able to be here to speak to this inquiry today. I really do commend this report to the Senate and to the government.

Dorinda Cox (WA, Australian Greens) Share this | Link to this | Hansard source

I rise to speak to the Concussions and repeated head trauma in contact sports report from the Community Affairs References Committee. I thank the committee for its work—in particular the chair, Senator Rice. I echo her comments in relation to the call for action in relation to those recommendations.

Sport is an integral part of Australian life and it has been for quite some time. For decades, Australians have rallied around our favourite teams, our players and our athletes, be it in football, soccer, netball, basketball, tennis, swimming, gymnastics—and the list goes on. We do this at all levels. Every Saturday I take my girls down to basketball and cheer them on. We have eagerly followed the FIFA Women's World Cup and the mighty Matildas, and I take every opportunity I can to attend an AFL match.

According to the Department of Health and Aged Care, 13 million Australian adults and three million children take part in sport each year. Additionally, 3.1 million Australians volunteer in some capacity. Playing sport has a number of social, physical and mental benefits. It is also great exercise and gives you a sense of community. For many, it is a significant part of our lives.

However, there are also a number of risks associated with playing sport, and there are a couple of issues that I want to highlight. Racism in sport is still a huge issue. So is accessibility, both for disabled people and in terms of the costs associated with playing sport. We're in a cost-of-living crisis, and, for many families, participating in community sport can be one of the first items of discretionary spending to be cut to save some money. Injury is another risk. Whether it's a calf injury such as you saw during the FIFA Women's World Cup, a broken collarbone from a tackle gone wrong, a rolled ankle or a concussion—the injury which has been the subject of this inquiry—injuries are very common and often seen as part of sport.

However, we've only just come to terms with the impact of concussions and how people who have suffered from them are treated in their recovery. There have been increased reports of the links of concussion and repeated head trauma to short- and long-term impacts on athletes' health. This includes a link to the neurodegenerative disease CTE, a condition that can only be diagnosed after someone has passed away. Other impacts include athletes suffering from anxiety, depression, psychosis, hallucinations, dizziness and brain fog.

This report details various definitions of concussions that exist, the lack of specific diagnostic tests and how concussions are underreported. The inquiry heard from families who watched their loved ones decline after repeated head injuries. There have been claims made—and, indeed, class actions have been undertaken both in Australia and internationally—that sporting codes have failed to recognise the seriousness of head injuries, despite the wealth of evidence and reporting about the risks, particularly about the long-term impacts. Various jurisdictions have put in place bans aimed at reducing hard tackles or using one's head in a game, such as during soccer.

We see far too often, at every level of competition, players suffering a knock to the head, leaving the field just for a couple of minutes and being eager to get back on, placing their health and wellbeing at risk to continue to play the game they love. Sometimes, they get straight back up and continue playing without even taking a break. For a very long time, we didn't know what the impacts were, but now we are seeing them. Unfortunately, it is too late for some. But there is still time to protect players at every level from the consequences of concussions and head trauma. We are seeing progress, but it's not coordinated, nor is it progressing fast enough. We absolutely can't let our love of sport place people at long-term risk of repeated head trauma. We need to make sure that we can protect our kids, and we need to protect, in particular, our athletes.

Louise Pratt (WA, Australian Labor Party) Share this | Link to this | Hansard source

I also rise tonight to speak on the serious issues raised in the Senate Community Affairs References Committee's Concussion and repeated head trauma in contact sports report. The recommendations and the actions put forward by the committee are indeed significantly important and do require consideration from the government. But I have to say that the issues put forward are more than a matter for government. If the government were to implement these recommendations in full, they wouldn't be enough. That is essentially because this is a cultural issue around how Australians play their sport and respond to it. There is a simple matter at hand. We do need significant cultural change in how codes, communities and players—children and adults—respond to concussion and its seriousness both on and off the field.

But it's not just in our contact sports. We have a lot of debate here about football and rugby, but some of you might be surprised to know that the largest number of concussions occurs in sports like cycling. That's of little surprise when you take into account roadside accidents. There are also falls from horses. Of course, that is not to underplay the focus on contact sports and the issues people experience as a legacy of concussions during their sporting careers. Some people have lived with the legacy of those impacts for a long time. That is in part what was highlighted to the parliament through our inquiry. But the impact of repeated concussion and traumatic brain injury belongs to a wide range of sports, and all sporting codes—and, indeed, the community more broadly—need to respond to this.

So what happens when a child gets a concussion on a Saturday, during their weekend game? Well, that child and their family could say, 'Come on, be tough and play on,' when in fact the child should be stood aside not just from that sport but also from bright lights or the risk of any other injury for at least a couple of weeks. The sporting code might say, 'You can't come back for a couple of weeks, Johnny; not until you've served the period set down.' But who lets the school sports teachers know or the basketball team know? This is much more than just an individual sporting code's responsibility. We really need to empower parent volunteers and get them to be serious about their obligations.

My next-door neighbour goes to her son's footy, and she was telling me about a recent concussion. Indeed, she is the first aider for her son's football team and was responsible for making sure that that child got appropriate medical attention. Has she been trained in that? No. Has she been briefed on her obligations in that regard? No. This is despite the fact that there is clear evidence that many sporting codes are trying to lift the standard, train their volunteers to respond at a community level.

The point I'm putting forward is that governments can have the best data in the world but none of that will help the very needy victims of concussion further down the track. The best cure is prevention. We need to have strong preventive approaches in our sporting codes. In our report we have recommended that sporting codes consider the extent to which rules of play could be affected by the need to respond to concussion. That could include putting into the rules of the sport the need to step aside from play after a concussive event, or it could include, as is already the case in children's sport, the need to further change sports rules so that fewer concussions occur.

That notwithstanding, we still need to enable a much more robust response to concussions when they occur. We must help Australians prevent repeated concussions and we must make sure they get the right diagnosis. When in doubt, sit them out. If you don't know whether or not it's a concussive event, you need to apply the rule that says a player must sit it out, and they must be supported to take precautions in all of the different aspects of their life.

There were a great many really significant issues canvassed in the course of this inquiry. I really want to underscore what we heard from the witnesses we spoke to about the terrible, debilitating impact of concussion on people who've experienced it, from people who, in some cases, had had a single head injury playing sport—and we've seen occasions where that has resulted in death—to people who had multiple concussions during their professional careers and people who became professional but whose professional careers were short, largely because they had sustained a significant number of concussions while they were playing sport recreationally.

Many of these incidents can be prevented. I know people are reluctant to change the rules of their sports et cetera, but we really need a serious dialogue about the integrity of sport to promote injury prevention. I've noticed that players are now starting to look to insurance for concussive injuries. If they insist, for example, that their codes support them to get insurance, and if that insurance becomes too expensive, then the codes are going to have to look seriously at how they go about preventing those concussions. If you can insure someone's legs, I don't see why you shouldn't be able to also insure them against head injuries. So I really want to use this opportunity of the tabling of this report to underscore our recommendations—to government but also very much to the broader community, to sporting codes, to state governments and to players and their families—about all the preventive actions that we need to take.

Andrew McLachlan (SA, Deputy-President) Share this | Link to this | Hansard source

Senator Colbeck, do you wish to make a contribution?

Richard Colbeck (Tasmania, Liberal Party) Share this | Link to this | Hansard source

Just a very quick one. Acknowledging that the mover of the motion that brought this report about is not available to be here, I seek leave to continue my remarks later so that the document may stay on the Notice Paper for further opportunity.

Leave granted; debate adjourned.