A year on from the Senate inquiry into concussion, what’s changed and what comes next?

In September 2023, an Australian Senate committee released a landmark report on concussions^[1] and repeated head trauma in contact sports.

The committee made 13 recommendations to improve outcomes for past, present and future players.

The report emphasised shared responsibility and transparency in developing a national approach, with the government to lead nine of the recommendations.

As of October 2024, no official government update has been provided.

We’ve assessed the status of the recommendations – of the publicly available sources, we found evidence of action in some areas but no national strategy in directly addressing the focus of several key recommendations.

As part of this review, we searched the websites of the Australian government’s Department of Health and Aged Care^[2] and the Australian Sports Commission^[3]/Australian Institute of Sport (ASC/AIS).

We approached the Senate committee secretary and the Department of Health and Aged Care for more information but neither was able to comment.

We acknowledge there is likely more work going on behind the scenes, and these processes take time.

Here’s what we found.

Progress being made

In the past year, there has been progress made with several recommendations including those addressing community awareness, education and guidelines for amateur and youth sports.

The AIS continues to engage in health-led efforts with a suite of resources aimed at increasing community awareness and education.

In June this year, the institute published a new set of return-to-play guidelines^[4] specifically targeting community and youth athletes.

This represents a tangible response from a federally funded sporting body.

However, these guidelines must be easily implemented by clubs. To date, there is no indication the government plans to increase funding or resources to clubs to help do so.

The committee also called for national sporting organisations to “further explore rule modifications to prevent and reduce the impact of concussions and repeated head trauma, prioritising modifications for children and adolescents”.

Several major sporting codes have modified their rules^[5] and we expect them to remain focused on rule modifications to ensure the longevity of their sports.

General practitioners (GPs) are often the first port of call after a concussion, and the committee recommended the development of standardised guidelines for GPs and first aid responders.

This addresses concerns that GPs may require additional training in treating sport-related brain trauma.

In response, the AIS developed a free, online short course^[6] for registered GPs.

Work in progress, or lack of progress?

There appears to be work in progress or a lack of progress elsewhere, including key recommendations for a National Sports Injury Database (NSID) and professional sport data sharing.

The inquiry highlighted how patchy data collection had contributed to evidence gaps in understanding sports injury management and surveillance. The committee’s most urgent recommendation therefore was for the government to establish the NSID.

This would work closely with another recommendation that called for professional sport codes to collect and share de-identified concussion and sub-concussive^[7] event data with the NSID.

As of October 2024, the Australian Institute of Health and Welfare reports the NSID is still under development and is not yet ready to receive data.

Other recommendations related to research – establishing an independent research pathway, ongoing funding commitments and a co-ordinated and consolidated funding framework.

These recommendations called for the government’s existing agencies, or a newly created body, to coordinate research on the effects of concussion and repeated head trauma.

No new dedicated sports-related concussion research pathways have emerged since the inquiry.

In terms of funding commitments, in April this year – after former rugby league star Wally Lewis’s National Press Club appearance^[8] – Dementia Australia reported the government had^[9] pledged $A18 million for concussion and CTE support services and education.

Read more: Why a portrait of a former NRL great could spark greater concussion awareness in Australia^[10]

The May 2024 federal budget^[11] allocated $132.7 million to boost sports participation from grassroots to high performance. But this did not address concussion and repeated head trauma, and we haven’t been able to find evidence of a co-ordinated and consolidated funding framework.

Our view is concussion funding pools should be primarily focused on supporting independent research projects. However, sporting bodies clearly need to be involved – they provide access to athlete populations and most people in these organisations have a genuine care for athlete welfare.

Another recommendation called for a national concussion strategy. This should focus on binding return-to-play protocols and rules to protect participants from head injuries.

The recommendation included a role for government and whether any existing government bodies would be best placed to monitor, oversee and/or enforce concussion-related rules and protocols.

In our view, this recommendation involves much more than producing guidelines. It requires a more comprehensive national strategy, with consideration to monitoring compliance and enforcement.

We could not find any evidence indicating the current status of this recommendation.

Increased funding and support for affected athletes were also focus areas.

These recommendations called for a review to address barriers to workers’ compensation and ensure adequate insurance arrangements remain in place.

We could not find any evidence of whether state and territory governments are involved in the reviews of workers compensation to apply to professional athletes.

The committee recommenced the government consider measures to increase donations to brain banks^[12] for scientific research.

We couldn’t find any evidence of steps taken to implement this recommendation.

Moving forward

There has been progress in education and guidelines but a lack of the coordinated, transparent approach the committee envisioned.

A formal government response, as demonstrated in Canada^[13] and the United Kingdom^[14], is essential to establish trust and chart a clear path forward.

The Australian government, as guardian of the Australian public’s health, has an opportunity to do the same.

References

1. ^{^} landmark report on concussions (www.aph.gov.au)
2. ^{^} Department of Health and Aged Care (www.health.gov.au)
3. ^{^} Australian Sports Commission (www.ausport.gov.au)
4. ^{^} guidelines (www.concussioninsport.gov.au)
5. ^{^} modified their rules (www.theguardian.com)
6. ^{^} free, online short course (www.concussioninsport.gov.au)
7. ^{^} sub-concussive (www.sciencedirect.com)
8. ^{^} Wally Lewis’s National Press Club appearance (www.npc.org.au)
9. ^{^} government had (www.dementia.org.au)
10. ^{^} Why a portrait of a former NRL great could spark greater concussion awareness in Australia (theconversation.com)
11. ^{^} federal budget (www.health.gov.au)
12. ^{^} brain banks (www.brainbank.org.au)
13. ^{^} Canada (www.ourcommons.ca)
14. ^{^} United Kingdom (committees.parliament.uk)