Additional comments from Senator Lidia Thorpe

1.1We all love sports. We love playing sports, watching sports, and talking about sports. It connects us as communities, brings joy and in so many aspects is invaluable for our physical and mental health.

1.2Not all impacts of these sports on our health are positive though, as we have heard from the extensive accounts of head trauma and concussion in contact and other types of sports presented in this inquiry. These impacts have slipped under the public radar for way too long. It can affect everyone, no matter the level of sport, age or gender; and while we know they are strongly under‑reported, these head injuries are extremely prevalent in this country.

1.3The extent and effects of concussion have been ignored or down-played for decades, as we have developed a culture of ‘toughing it out’, to keep going and not let our teams down, and downplay this injury. As a result, Australia lags far behind the United States and Europe in its concussion prevention and management, to the detriment of players and their families and friends.

1.4I had initiated this inquiry due to the many stories I directly heard from players and concerns of stakeholders that there is a lack of acknowledgement of concussion and repeated head trauma and their long-term neurological impacts, including the possibility of CTE – and that we require urgent action in this field.

1.5I therefore wish to thank the Senate for its unanimous support in making this important inquiry a reality and the committee secretariat for your hard work and deep care throughout its conduct, resulting in a thorough report with many important recommendations.

1.6I thank all submitters and witnesses to this inquiry, including but not limited to stakeholders, experts and the sports for their deep engagement and insights.

1.7Most of all I wish to thank those players and families who came forward to courageously share their personal stories and losses. My heart broke at hearing your stories. It is for you this inquiry took place and I so hope that it will result in much needed action by governments, sporting codes, the healthcare sector and wider community.

1.8While I support the findings of the committee, I am disappointed in the lack of commitment and acceptance of responsibility visible in the recommendations put forward. What players and their loved ones need is firm commitment to change the way concussion is recognised, prevented and managed in this country. I therefore wish to outline some points insufficiently addressed by the committee, and to put forward a set of additional recommendations.

Concussion research

1.9Chapter 3 outlines concerns regarding research integrity and conflicts of interest in concussion research. It raises concerns about the independence of concussion research financed by sporting organisations, which might result in biased findings, omission of evidence and watered-down conclusions and recommendations.

1.10This situation is partially founded in a culture where certain concussion researchers, some of whom are highly criticised for their research methodology and maintain a close connection to the sporting codes, are the ones being engaged for research or winning tenders time and again, while other reputable researchers struggle to get any contracts.

1.11Acknowledging the challenge in influencing the research conduct directly instigated through the sporting codes, it is therefore all the more important that the Australian Government commits to funding further, independent research into concussion, and goes past the wording of ‘consider establishing independent research pathways’, as in committee recommendations 3, and actually commits to the establishment of a national sports research body.

1.12The same applies to recommendation 6, where the government should not just consider, but commit to a coordinated and consolidated funding framework for ongoing research regarding sport-related concussion and repeated head trauma.

1.13Given the sporting bodies’ responsibility to progress research, and in an attempt to steer away from them directly funding research with potential conflicts of interest, they should contribute to funding the national sports research body responsible for transparent and independent research. In addition to this, the federal government should boost its funding commitments.

1.14National sporting organisations to financially contribute to a national sports research body.

1.15That the Australian Government and sporting organisations increase funding for research into the effects of concussion and repeated head trauma on at‑risk cohorts who incur these injuries during their participation in sport.

1.16The Australian Research Council Act 2001 to be amended to include diversity targets and a declaration of conflicts of interest in the requirements funding rules prepared by the Australian Research Council for each funding scheme.

1.17To enable further research, the availability of concussion and other sports injury data is absolutely essential and I strongly support the creation of a National Sports Injury Database as per recommendation 1 of the committee’s report for this purpose. There is, however, a need to require national sporting organisations (NSOs) to submit inquiry data.

1.18That national sporting organisations have compulsive record-keeping of concussions and identified sub‑concussive events at all levels of competition, and share this data with the National Sports Injury Database.

1.19This system should ideally also apply to schools, hospitals, GP clinics, allied health clinics and places of work.

Concussion awareness

1.20The inquiry clearly demonstrated a lack of concussion awareness in the community and a down-playing of its seriousness by the sports. The final report, however, fails to present a recommendation to address this matter within the sports and ensure not only awareness of concussion’s possible long-term effects but also how to address and manage it immediately on and following impact.

1.21All national sporting organisations and their respective state and regional member associations must meet minimum competence on concussion and repetitive head trauma. Similar to CPR training, there should be compulsory education for all those involved with athlete preparation, coaching or management. Registered players should complete a concussion module annually to recognise the signs and symptoms of concussion and its basic management.

Return to play-protocols

1.22In the course of the inquiry, it became clear that different sports apply different return-to-play protocols, even when referring to the same research as the basis for it. This causes much confusion and risks players returning to play too early. We have heard a range of suggestions that current stand-down periods are inadequate and lengthier 21 or even 30-day stand-down periods should be considered.

1.23The committee’s recommendation 10 partly addresses this matter, but refers only to the government considering binding protocols and developing ‘adaptable’ return-to-play protocols, which lacks commitment in a space that requires national leadership due to a lack of a unified, binding approach.

1.24That the Australian Government, in collaboration with medical experts, develops consistent return-to-play protocols, nationally binding across all sports, for both children and adults that have incurred a concussion or suffered a head trauma.

1.25Ideally, these protocols would be endorsed by the Australian Medical Association, the Royal Australasian College of Physicians, the Royal Australasian College of Surgeons, and the Australian Institute of Sport to demonstrate a truly national approach that understands sport but remains independent of it.

Support for athletes and workers compensation

1.26The exclusion of athletes from workers compensation coverage and the lack of particularly long-term financial and other support for affected athletes was one of the key findings of this inquiry.

1.27Sporting codes are clearly failing in their duty of care for players, and as such, the committee’s recommendation 12, while a step in the right direction, does not go far enough in clarifying the expectation of professional sporting codes to look after their players. Such a recommendation is essential as it will also contribute to sporting codes taking head injuries and their short- and long-term consequences more seriously and ensuring athletes do not return to play too quickly.

1.28The committee recommends that professional sporting codes and players associations provide the necessary supports, financial and otherwise, both in the short- and long-term, to current and former players affected by concussions and repeated head trauma.

1.29The committee acknowledges that in the absence of workers compensation and adequate supports through the sporting codes, adequate insurance arrangements are needed for professional sportspeople and that ‘a no-fault accident injury insurance scheme may be the solution to providing adequate care and support for people who participate in sport and who suffer concussions, brain trauma, and any resulting long-term neurodegenerative conditions’. It further ‘notes that a similar scheme covering catastrophic injuries, the National Injury Insurance Scheme, was recommended by the Productivity Commission in 2011 and that this scheme’s implementation was also advocated for during the inquiry.’

1.30Yet the committee failed to include a recommendation to this extent. Governments are always hesitant to commit to radical action, yet it is often those actions that count most. A no-fault accident injury insurance lies at the heart of the support many athletes and their loved ones said would have made a real difference to them. Such a scheme would also extend beyond professional sports and could benefit so many people who have had their lives turned around by serious concussions and head injuries.

1.31That the Australian Government develop and implement a no-fault accident insurance scheme for those who participate in sports.

1.32We owe it to all those who have lost their lives, the lives of their loved ones, or the ability to live their lives to their fullest to no longer ignore the impacts concussion and repeated head trauma can have. The evidence has been emerging for decades and we can no longer look away or waste time in addressing it.

1.33I sincerely urge this and future governments to take concussions and repeated head trauma seriously and take immediate and committed action.

Senator Lidia Thorpe

Independent Senator for Victoria