Saturday 22 September 2018

Comment: Paris episode underlines need to establish panel of neutral medics

Antoine Dupont is treated on the pitch before being substituted against Ireland last week. Photo: Getty Images
Antoine Dupont is treated on the pitch before being substituted against Ireland last week. Photo: Getty Images
Brendan Fanning

Brendan Fanning

'They weren't the hardest of hits," Aaron Carpenter said of the hat-trick of concussions that made up his mind to stop playing rugby.

"I just thought if there is something going on, I need to stop playing this game and not put myself in any more risk for injury. I have a family. I just think the risk factor of continuing to play a tough game like rugby, putting my body on the line further just wasn't worth it for me."

Carpenter is Canada's record cap winner and was speaking last week to the Toronto Star on the announcement of his retirement. It was topical that we had another man go down this road just a matter of days after what happened in Stade de France last Saturday.

To recap on the events in Paris: In the first half France replaced star outhalf Matthieu Jalibert after a painful-looking collision with Bundee Aki that badly damaged the French player's knee. The contact also involved a clash between Jalibert's head and Aki's hip. In the circumstances, a HIA looked increasingly off-beam the longer the player was treated, but if it was a safety-first exercise then fair enough.

Then, as the temperature reached boiling point in the endgame, replacement scrumhalf Antoine Dupont was carted off with a serious knee injury. He too left via the door marked HIA which prompted immediate and animated queries from Johnny Sexton to Nigel Owens, who also seemed in some doubt, perhaps influenced by the Jalibert incident in the first half.

On the surface it stank. In last season's campaign there had been uproar after, again in the endgame, a timely HIA had allowed France to change props when they were engaged in a ferocious scrum battle with Wales.

So here were the French, at it again. Naturally enough, it didn't take long for the Six Nations HIA review processor to lob it over to a panel who have been busy last week talking to all concerned. Don't translate this into 'likely disciplinary action'. Indeed, brace yourself for a delivery of 'lessons learned'.

Cast your minds back to the tit-for-tat citings that plagued the early years of the Heineken Cup. You're going to cite our prop for stamping? Fine, we'll cite your hooker for gouging. And let's see who suffers the greatest inconvenience.

It took ERC a fair while to put the whole business into the hands of an independent citing commissioner, and when they did the pain eased significantly.

When that discomfort travelled towards the brain, and concussion became an issue that had to be dealt with, World Rugby introduced at Test level the position of match doctor: an independent medic who could make decisions without worrying about the influence of either side.

Simple enough, you would have thought. Just another name on the list of neutral match officials. Unlike the refereeing crew, however, these relatively new appointments are made not by the Six Nations, but by the host union. You can see why folks might ask questions about genuine independence. This is rugby's biggest annual Test extravaganza, a commercial powerhouse that plays mostly to packed houses, and it doesn't have a panel of neutral medics - like referees - so that there is no country-clash with either of the two teams?

There are nuts and bolts around the legalities and liabilities of having medics operating temporarily in a jurisdiction where they are not permanently registered. But in this country the Irish Medical Council recognises any practitioner registered in another EU country. So apply a month in advance for a temporary registration and away you go.

World Rugby understands this to be the case across Europe. Yet we have local lads filling the roles. Last Saturday, Gilles Garet was so local that he is vice- president of the FFR's medical staff. Before you fall off your seat laughing consider that normally Ireland's match doctor is Prof John Ryan, who is Leinster's team doctor. Ryan is well respected, with good reason, but if there was an issue with any of Leinster's contingent in an Ireland match-day squad, the good doctor could hardly claim independence, no more than Dr Garet in Paris.

As it turned out, the reappearance on the pitch last weekend of Maxime Machenaud was not what it could have been for France. Last year World Rugby changed the law precluding players who had replaced a colleague on a HIA from taking penalty shots or conversions. Brought in post-Bloodgate in 2009, its subsequent repeal was part of getting the whole HIA process over the line - the fear being that concussed goal-kickers wouldn't go off, or be taken off, if their replacements couldn't goal-kick. So Machenaud could have taken that late penalty - and not Anthony Belleau - and buried Ireland.

So what has all this to do with Canada's Aaron Carpenter?

"You got your bell rung and you went back out there and played," he said of his career. "From when I started playing rugby to where it is now, the injuries have gotten worse and worse. I don't know. The guys are getting bigger, stronger, faster. It takes its toll. It's a career of 13 years of getting beat up basically."

Hopefully the Six Nations review of last weekend will enhance the management of what is a very serious issue. Establishing a panel of neutral medics can only help.

Sunday Indo Sport

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