This week a group of more than 70 doctors, health and sports experts wrote an open letter to ministers calling for a ban on tacking in rugby in schools, with non-contact forms of rugby being played instead. They cite the increased risk of injuries “which include fractures, ligamentous tears, dislocated shoulders, spinal injuries and head injuries can have short-term, lifelong and life-ending consequences for children.”

Whilst the possible effects of fractures and ligament damage are well known, the understanding of the long terms effects of repeat concussions in contact sports is much more recent. This has been a hot topic in the US over the last few years in relation to rugby’s cousin American football, with many parents in the US refusing to let their children play the sport as a result.

A study of 91 former professional American football players, who donated their brains for research after death, found that 87 of them tested positive for the brain condition known as chronic traumatic encephalopathy (CTE). CTE is known to be the result of repeated head trauma and is a debilitating condition that can cause depression, aggression and loss of memory and motor skills. A lawsuit brought by former players against the National Football League was the subject of a $1 billion settlement last year and the story of the pathologist who first shed light on American football-related brain trauma has been made into a film starring Will Smith.

The health risks of concussions are also of concern within rugby’s governing body as World Rugby's chief medical officer has said rugby's rules may have to change to reduce concussions.

What does this mean for schools in the UK?

With no outright ban in place, responsibility for safety lies with each school. Schools have a duty to ensure, so far as reasonably practicable, that children are not exposed to risks to their health or safety whilst at school. This means that schools need to:

• Carry out a full assessment of the health risks of playing rugby, especially where this is compulsory, including reviewing the recent medical evidence on head trauma.
• Consider how the risks of playing rugby can be prevented or reduced (e.g. through supervision and coaching of proper technique as well as the wearing of protective gear).
• Consider whether the goals and benefits of playing rugby (e.g. the health benefits of exercise and learning fair play, leadership and teamwork) can be achieved through alternative forms of rugby or other sports.

Once these steps have been done, it will be down to the school to determine whether the risks of playing rugby are acceptable. A failure to do so could mean that the school is in breach of health and law.

Not only could a school or education authority face criminal penalties, but civil claims for damages could also be brought by individuals who later suffer from long term effects of head trauma where there was a foreseeable risk of injury. These claims could be many years down the line as the symptoms of CTE generally do not present until years or decades after the brain trauma occurred.

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