More than a game

Warren Gatland and Shaun Edwards have, over the past seven years or so, shaped a Wales team in their own image.  Hard, direct, uncompromising, ready to run through (or at least into) brick walls.

In their first game in charge at the start of the 2008 Six Nations Championship, Wales surprisingly beat then-recent World Cup finalists England.  Despite a first win at Twickenham in 20 years, changes were made for the next match.

Eddie Butler, writing in the Observer, may have had his tongue slightly – but only slightly – in cheek when he wrote that

‘Mark Jones was dropped for one game because, it seemed, he had stayed on the floor for a few seconds when he was not actually unconscious’.

That set the tone for a team which – in Northern Hemisphere contests, at least – has experienced a run of success which is almost unprecedented in Welsh rugby history.

This sort of fanatical dedication to the cause took a worrying turn, however, during last Friday’s defeat to England at the Arms Park.  This time, another Welsh wing took a serious blow to his head not once but twice.  During the first half, George North fell on a loose ball just as England second row Dave Attwood kicked at it.  He was taken from the field, checked, and passed fit to return after an absence of around eight minutes.  At the hour mark, North attempted to tackle Mike Brown just as hooker Richard Hibbard likewise tried to stop the England full-back.  On this occasion, North was hit on the side of the head by Hibbard and clearly briefly lost consciousness as he fell to the floor a couple of metres from the touch judge.  North’s opposite number, Anthony Watson, can be seen stopping to check that North is ok.

The decision to allow North to continue – let alone without a fuller concussion check – drew criticism from the rugby world.  Former players, journalists and even Uncle Barry O’Driscoll on behalf of World Rugby expressed concern that the correct concussion protocols had not been followed.

The WRU issued a statement on Sunday giving its version of events.  The subsequent BBC Online story noted that

“…North suffered heavy head blows in each half of Friday’s 21-16 loss to England, passing tests during and after match…Wales’ medics were treating another player when North suffered his second head blow.”.

A revised version of the BBC article appeared over 24 hours later. Reference to North testing negative for concussion in all tests, and to medical staff attending to another player at the time were removed.  Just as well in the case of the latter statement, as the BBC coverage clearly shows a member of the Wales medical staff already attending to North within ten seconds of the collision.

The story refused to go away, so the WRU last night published a video interview  with National Medical Manager Prav Mathema in which he explained the sequence of events and the treatment North received.  He stated that he and all other members of the on-field medical team were unsighted.  Mathema confirmed that he was the first to reach North and found him to be speaking lucidly and showing no clear signs of concussion.  However, he added that

“…regrettably, we didn’t get a chance to see the incident, and, had I been given that opportunity, there’s no doubt that he would have been removed from the field of play”.

Now that the whole medical team has had an opportunity to view the video footage, Mathema confirmed that North would be treated as having been concussed.

Brian Moore suggests that the match officials – including touch judges and the TMO – have a duty to intervene if they see a potentially significant injury.  He also believed that World Rugby should sanction the WRU over this.  As he summarises

“You cannot say that the Welsh medical team were negligent and/or that they did not follow the protocol without more evidence. You can say that there was a glaring deficiency in Wales’ game management team as a whole that allowed a serious incident, one seen by many others, to go unobserved and unremedied.”

However, World Rugby have today cleared the WRU of wrongdoing and have accepted their explanation

“World Rugby accepts the WRU’s explanation that neither the team medical staff nor the independent doctor had sight of the incident, and understands that the medics acted within the framework of information they had at the time, and would have taken a different course of action had they had direct pitch-side visibility or access to the same broadcast footage seen by those watching on television.”

The WRUs response has been to announce that it will reconsider its concussion protocols  – despite launching a ‘zero tolerance’ attitude to concussion only last September – and to ensure that medical staff in future have access to a live feed of play.  That sounds sensible, of course, but the incident was replayed a few minutes later on the screens within the stadium and on the BBC television coverage.   According to Gwladers who were there, it drew a voluble reaction from the crowd (although, given World Rugby’s statement today, who knows what they were watching..?).  The Wales coaching team have an army of analysts with them throughout game and a battery of screens and analytical equipment.  Footage of North’s first half treatment shows that Mathema and another member of the medical team were equipped with communication headsets – Mathema himself can be seen clearly talking into his headset as he helps lead North from the field.  Communication between the coaches, analysts, medical staff, waterboys, tee-carriers and the rest of the background staff shouldn’t be a problem.  It certainly shouldn’t be the case that people sitting on their sofas hundreds of miles way are apparently better informed about a player’s head injury than the Wales team’s coaching and support staff.

Whatever the fall-out, and whatever World Rugby’s judgement, North deserves to have his welfare put before the fortunes of the national team.  Ireland fly-half Jonathan Sexton announced in late 2014 that he would take 12 weeks away from the game – on medical advice – after receiving four concussions in the calendar year.   England lock Geoff Parling also took several months out of the game last autumn after suffering two concussions in a matter of weeks.   All Blacks number eight Kieran Reid took two months off last season after a series of concussions.  George North’s previous appearance for Wales – against the All Blacks in November – finished early thanks to a head injury which, confirmed as concussion, kept him out of the South Africa game the following week.  He should be monitored very closely this week, but he should not even be considered for selection for the Scotland game on Sunday.  His health – and the messages which senior figures in Welsh and World rugby send out to the rugby population about the health of all players at all levels – are more important.

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