In a letter on April 5, NZR chief executive Mark Robinson told Christie the suggested improvements could not be spoken about publicly but were part of the sporting body’s internal work on head injuries.
Over the past few decades, NZR has produced a raft of material and recommendations around concussion management and contributed to research to try to establish the frequency and impact of head knocks on players.
But controversy over brain health and contact sport accelerated in recent years after links were drawn between repeated head knocks and chronic traumatic encephalopathy (CTE), a brain condition linked to repeated blows to the head that can only be diagnosed after death.
Symptoms associated with those with CTE include anxiety, depression and early-onset dementia, with a high rate of suicide among sportspeople with the condition. The NFL in the United States settled a 2015 class action that saw US$1.2 billion ($2b) in compensation offered to more than 1600 players.
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Billy Guyton, who was 33 when he died, was diagnosed with CTE posthumously.
Guyton’s father John Guyton has backed Christie’s call for NZR to talk about brain injury more openly.
Christie has also received support from the New Zealand Rugby Players’ Association, the Labour Party’s ACC spokeswoman Rachel Boyack, and Irene Gottlieb-Old, wife of former All Black Geoff Old, who has suffered progressive mental deterioration in recent years.
‘Let’s talk about brain injury’
Christie said he wanted the 2018 recommendations made public because they could benefit others and so the wider public could measure progress over the six years that have since passed.
Christie – who has donated his brain for research after his death – told the Herald that NZR telling him he could not speak showed the sporting body wasn’t having an open conversation about brain injury.
“It shows they don’t want to be exposed for not living up to their slogan of having the best interests of players and their wellbeing at heart. If they were confident, they would have released the recommendations straight away.”
The nature of the recommendations was unknown and Christie said he was unable to detail the steps he believed in 2018 would help make the game safer.
It had been agreed the review into Christie’s medical care would be confidential because it named medical professionals who might not otherwise co-operate with the senior lawyer who carried out the inquiry.
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But Christie said the safety recommendations were separate and bolted on to the review into his own case because he wanted to improve the detection, management and treatment of brain injuries across rugby.
“I did that because they needed change. I’d retired. I’d had an end-of-career injury payment. I could have walked away and nothing would be different.”
He said the recommendations did not include any personal information or names of medical professionals.
Christie said: “There are players all over this country who are dealing with concussion right now and they don’t know. The public don’t know how many players get concussion every week. It’s a lot worse than the public realises.
“Every single team has multiple concussions every year and we’re underestimating the effects of it. That’s why we have these older players with concussion [issues] – we weren’t managing it then and we’re not managing it now.”
Christie said it was important for NZR and others who were part of the issue to be as open as they could to encourage the best diagnosis and response to brain injury.
“There’s so much trust in people, trust in institutions. It’s not about trust – it’s making sure the system is efficient and operating properly. It should be based on outcomes. I would say there are thousands of people suffering with head injury and nothing being done.”
Christie (Ngāti Kurawhatia/Te Āti Haunui-a-Pāpārangi) played for Tasman, the Crusaders, the Highlanders and the Māori All Blacks between 2010 and 2017 when recurring symptoms associated with brain injury halted his career.
Those symptoms continued to this day with Christie suffering head pain, memory issues and fatigue.
The letter from New Zealand Rugby
The April 5 letter from NZR’s Robinson to Christie’s lawyer Craig Morice said the confidentiality required to protect medical professionals extended to the recommendations and “public statements by Shane about the recommendations, or any other part of the report, would be contrary to that”.
Robinson acknowledged that NZR’s lawyer Keith Binnie had referred to the recommendations as “in a different category” to the report.
He said that “does not, to my mind, mean that they can be discussed publicly by someone involved in the report, when that is likely to result in the identification of other involved parties”.
“Instead, I would interpret it to mean that the recommendations, without any information that could lead to identification of any of those involved, could (and should) be used by NZR to design and implement concussion-related initiatives.”
Robinson said Morice should tell Christie “public comments about the review or the report, including about the recommendations”, would breach confidentiality.
The Herald raised the letter with NZR, which said in a statement that it had agreed with Christie the report would be confidential.
“What NZR can say is that brain health and concussion is a key priority for the organisation and all concussion initiatives and programmes are publicly available.
“Player welfare is one of NZR’s major priorities and we are absolutely focused on doing everything we can to keep players as safe as possible from the risks of concussion, including supporting and facilitating research to understand the nature and frequency of head impacts to find ways that we can make the game safer for all.”
Morice said he couldn’t comment on “confidential matters”.
John Guyton said he wanted Christie to be able to speak about the recommendations and to have them made public so they could be assessed for progress.
He said NZR should be completely open about the issue and the links that existed between head injury and symptoms such as suicide.
“You need to talk about it so why aren’t we talking about it? It’s all hush-hush. They don’t want people talking about it. They are more worried about losing players and people losing interest in the game.”
He said he was seeking a full inquest into his son’s death so as to examine the actions of everyone he had engaged with as his condition deteriorated. That would include NZR, he said.
“I want awareness and change and I want help for these people.”
‘Always be open’
Rob Nichol of the player’s association said World Rugby and NZR needed to lead conversations on the issue.
“As part of that, openness, transparency and being prepared to discuss the issues, including recommendations or learnings, is fundamental. That’s what will engender trust and help create improvements – both in perception and reality.”
He said NZR should “always be open” to discussing recommendations and the difference they had made and how progress was measured.
“It’s a way of allowing people who have contributed to know they have been heard and had an impact. And … it’s a way to engender trust and make improvements.”
Labour’s Rachel Boyack said NZR needed to let Christie speak freely. She had met with Christie as an MP and discussed his frustrations with being unable to speak on the recommendations.
“This is an issue that has a direct impact on players’ lives and their lives past rugby. To keep the recommendations confidential and out of the public eye – I don’t think that’s good enough.
“I think the public deserves to see [the recommendations] so questions can be asked on a regular basis about how they are implementing these recommendations.”
Boyack said NZR should be subject to an external independent review that measured evidence against action.
Gotlieb-Old said she and Old moved to New Zealand from their home in the United States because it was believed being closer to where he played rugby would help him access treatment.
Instead, she said she found NZR to be “completely dismissive” and had since formed the opinion the sporting body avoided proactively engaging with former players on the issue.
“I really, really think they are trying to let this age out,” she said.
NZR said it was “concerned about the possibility that repeated head impacts during participation in rugby may impact on brain health later in life”. It said there was an “association” between repeated head impacts and CTE but a link showing one caused the other was “not currently well-established”.
It did acknowledge “emerging evidence” that rugby “carries a small increased risk” of neurodegenerative diseases such as Alzheimer’s and dementia later in life.
More research was needed, it said, while accepting “repeated head impacts are a safety risk in contact sports like rugby”.
NZR, the health-focused New Zealand Rugby Foundation and the New Zealand Rugby Players’ Association are currently working and preparing to release a “comprehensive and co-ordinated plan” on concussion and “head acceleration events”.
The issue is seen as an existential threat to the sport, with the mammoth 2015 NFL settlement followed by a class action in the United Kingdom by almost 300 former professional and amateur players. Injury compensation lawsuits are not possible in New Zealand as a trade-off for our accident compensation scheme administered by ACC.
David Fisher is based in Northland and has worked as a journalist for more than 30 years, winning multiple journalism awards including being twice named Reporter of the Year and being selected as one of a small number of Wolfson Press Fellows to Wolfson College, Cambridge. He joined the Herald in 2004.
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