Football and Dementia

Grahame Morris Excerpts

Thursday 14th September 2023 Commons Chamber

[Grahame Morris (Easington) (Lab)]

It is a pleasure to follow the hon. Member for Southend United West, and I wish her well in her efforts to secure the future of her team. I would like to express my gratitude to the Backbench Business Committee—to my dear friend the hon. Member for Gateshead (Ian Mearns) and his colleagues—for giving us the opportunity to participate in this crucial debate in the House of Commons. I also thank my good friend, the right hon. Member for Ross, Skye and Lochaber (Ian Blackford), as well as the hon. Member for Moray (Douglas Ross), for their support in securing Back-Bench time for the debate.

I also want to acknowledge the Professional Footballers’ Association and the invaluable contribution of Dr Judith Gates, who is one of my constituents. Dr Gates is a distinguished academic and educator, renowned for her expertise in chronic traumatic encephalopathy, the condition that has been linked to repetitive head impacts in sport. On Monday, in Ferryhill in County Durham, we will witness the launch of Head Safe Football, a new charity with a specific focus on brain-related issues in football. Dr Gates spearheaded that initiative at the request of the footballing community, aiming to provide emotional support, evidence-based knowledge and up-to-date research for footballers and their families.

Dr Gates’ dedication to this cause is deeply personal, because she is the spouse of the former England and Middlesborough footballer Bill Gates. Bill was diagnosed with dementia after a career that included a training programme involving hundreds of headers every day. Unfortunately, that led to headaches with migraines, and caused him to retire from football aged only 30. Bill was a renowned centre-half and is remembered for his prowess in the air, but his legacy is promoting Head Safe Football and raising awareness of the link between repetitive head impacts and CTE. I also commend the Scottish Football Association, as the right hon. Member for Ross, Skye and Lochaber did, on its proactive stance on addressing CTE and other brain diseases that are caused through football. Its efforts—including research initiatives, concussion protocols, restrictions on heading in youth football and limits on repetitive heading in training—have set a commendable example.

The evidence overwhelmingly supports the link between repetitive heading of a football and brain diseases. Several people have suggested to me that that link is theoretical, or that there is some doubt about it, but there is absolutely no doubt: there is a huge amount of evidence, both at home and from abroad, and I will mention some of those academic studies later in my speech. My late father was a coalminer, and sadly, miners were subjected to many industrial diseases including pneumoconiosis, chest diseases, and vibration white finger through the use of pneumatic power tools. Many of my constituents worked in the textile industry—in the rag trade—and many of those women machinists suffered Dupuytren’s contracture as a result of their work.

All those conditions are recognised as occupational diseases.

I am looking at the Minister; I do not know whether he has the power to direct—or he could ask—the Industrial Injuries Advisory Council to look at the issue. Until CTE is formally recognised as an industrial disease, the compensation that the people involved and their families so richly deserve will not be available to them. We often focus on the top-flight celebrity professional footballer, but many footballers who do not play at the highest level have been similarly exposed to repetitive brain injury. They are living in hardship and we have a duty of care to them.

I want to mention again the study that the University of Glasgow carried out quite recently, in October 2019. It revealed a clear connection between professional football players and neurodegenerative diseases. The research compared the mortality rates of more than 7,600 former Scottish footballers with a general population sample of more than 230,000 individuals—a very large sample. The findings indicated that the mortality rate due to neurodegenerative diseases among the former professional footballers was three and a half times higher, with notable increases in Alzheimer’s disease, motor neurone disease and Parkinson’s disease.

Another study, by the Karolinska Institute in Sweden, published in The Lancet here in the UK, showed that footballers are 50% more likely to develop dementia compared with the general population. The research involved comparative analysis of the health records of 6,000 top division Swedish players and over 56,000 non-footballers. The study also explored the contrast between outfield players and goalkeepers. Researchers discovered that, as we might expect, outfield players faced a much higher risk of Alzheimer’s and other types of dementia compared with the general population. In contrast, goalkeepers, who seldom head the ball, showed no increase in Alzheimer’s, dementia or similar conditions.

The World Health Organisation says that between 5% and 8% of the general population over the age of 60 have dementia. However, the figure is different for England’s greatest ever team, the 1966 World cup winning team—we are not being partisan in this debate, but that victory was achieved under Harold Wilson’s Labour Government; I think we also won the Eurovision song contest that year. Research carried out by “Sky Sports” news found that 46%—almost half—of that World cup winning team were suffering from some degenerative brain condition such as Alzheimer’s disease.

[Chris Stephens (Glasgow South West) (SNP)]

I thank my good friend for giving way. I had actually forgotten that England won the World cup in 1966; it is not something we hear often.

The hon. Gentleman has been dealing with the issue of scepticism. Does he agree that many former wingers actually worked the connection out? They were crossing the ball and worked out that the high-profile cases involved either centre halves heading the ball out or centre forwards heading the ball in.

[Grahame Morris]

That is a good point. Academic studies have identified that goalkeepers are not at any more risk than any other member of the population, but centre halves and centre forwards certainly have been. I am talking not just about the 90 minutes of football, but the many hours of training—consistently heading the ball. The general community and football authorities have a duty of care to the people who are suffering.

I want to mention another academic study, from Boston University in the United States. It identified CTE in young amateur athletes who played contact sports. After examining post mortem the brains of 152 participants who had died under the age of 30, it found that 41.4% had signs of CTE. More than 70% of those diagnosed were amateur athletes. The figures are shocking. It is imperative to pursue further research to determine not whether there is a link—there is; that is not in dispute—but whether there is a safe threshold for heading the ball. The ideal level is zero, but football authorities must undertake comprehensive research to fulfil their duty of care to players and establish a head-safe level.

I am not anti-football; I love our national sport, but I want it to be safe. I want us to recognise our responsibility to former players who are now suffering from these terrible conditions. Players themselves are rightly concerned about the risks associated with heading. A study by the Drake Foundation found that 66% of amateur footballers feared the impact of heading the ball on their health, with 70% advocating for guidelines to restrict heading in training and 48% desiring reduced heading in matches. There is also substantial support for extending rules in youth football, with 56% of parents endorsing restrictions on heading in training for children up to the age of 18.

The onus lies squarely on football authorities to ensure that their protocols and practices prioritise player safety. That includes ongoing research, immediate reductions in heading during training and matches, and a willingness to adapt the game to mitigate risks. There is no doubt that the game has changed. When I was first watching the game, it was much more physical. There were substitutions, but I think only one was allowed. The game has evolved and changed and it is right that it has. There will inevitably be a shift in the way football is played, but such evolution is inherent to the sport.

I hope SNP Members do not mind me mentioning the recent England-Scotland match on Tuesday night; I do not mean to be divisive—[Interruption.] I have forgotten the score already. I am not gloating.

[Chris Stephens]

I just want to put on the record that Scotland do not do too well in football against lesser nations.

[Grahame Morris]

I thank the hon. Gentleman for that.

The England-Scotland match was the 150th anniversary of international football, but I am sure it bore little resemblance to the inaugural England-Scotland international game in 1872 in how it was played; I do not just mean the longer shorts and so on. So the game does change and that is not a bad thing. It is critical to recognise that player safety should not be perceived as a threat to the game. Instead, it should be viewed as a new chapter in the ongoing development of a sport that we all cherish.

To safeguard football for generations to come, we must wholeheartedly support the concept of head-safe football. From a Government perspective, the implications are clear: we should adopt a public health approach. The Minister holds a crucial role in funding education and awareness efforts to future-proof football for today and tomorrow. That includes raising awareness about the risks associated with repetitive heading and its links to degenerative brain disease.

The right hon. Member for Ross, Skye and Lochaber mentioned the former West Brom striker, the legend Jeff Astle, who died in 2002 from a neurodegenerative disease associated with heading the ball. The coroner ruled he suffered death through an industrial disease, although it is not identified officially as an industrial disease. It is worth noting that my constituent Dr Judith Gates has diligently lobbied the Industrial Injuries Advisory Council over the past three years to recognise CTE as an industrial disease. Despite presenting extensive and authoritative information and research, the IIAC has unfortunately fallen short and failed in its duty to acknowledge this disease. I hope the Minister will be able to assist in his closing remarks in persuading the IIAC to look at that again. The evidence supporting that recognition is overwhelming and includes numerous peer-reviewed studies and coroner verdicts. It is high time to prompt the IIAC to step on to the pitch and fulfil its responsibilities by acknowledging the issue and taking the necessary actions.

Football holds a special place in our national psyche. It is a sport enjoyed by millions of people each week. It is evident that participation is on the rise. The professional football landscape is evolving, with National League North team South Shields transitioning to a full-time model, signalling growth even in the lower divisions, yet the most remarkable growth lies in the Women’s Super League and Women’s Championship.

The Lionesses have been a source of inspiration for the nation. We have had tremendous success and it is heartening to witness more young girls embracing football and getting involved in active sport. However, as the women’s game expands, it brings new challenges because medical studies indicate that female athletes are almost twice as likely to develop CTE as their male counterparts. I wholeheartedly support the surge in women’s football, but amidst the growth the safety of players remains paramount. Given the additional risks faced by female athletes, I hope the WSL will be a trailblazer in establishing head-safe football.

Football is a tight-knit community, and it must address this issue both now and in the future. Clubs that have prospered thanks to the skills and contributions of players such as Bill Gates, my constituent, have a responsibility to prioritise the wellbeing of their players. It is imperative that we take action to support a generation of players who are currently facing the challenges of degenerative brain diseases such as dementia and Alzheimer’s. With the clear connection between repetitive heading and CTE now established, it is high time we focus on increasing awareness and providing education at all levels of the game. Additionally, we should implement policies and procedures to restrict heading, whether during training sessions, or in actual games.

I ask the Minister to make it clear to the football authorities that this is their opportunity to deliver head-safe football, reducing the risk today and progressing the research to understand if there is a safe level of heading. If as an industry—a multi-billion-pound industry at the highest level—the football authorities do not accelerate their action on this matter, the Minister must be clear that the Government will have no option but to intervene to protect public health.

I would like to end with the words of my constituent Bill Gates, who on his diagnosis told his family, “It is too late for me, but I want to plant a tree, so others can benefit from its shade.” I thank Judith, Bill and the whole family. I will do everything I can to future-proof football for today’s and tomorrow’s players. I hope the Minister will commit to doing the same.

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[Jim Shannon]

The hon. Gentleman is absolutely right. The wage structure in Northern Ireland is nowhere near that level. There is some expectation of teams in the Irish league. There have been many buy-outs and clubs with lots of money-making financial investments, but let us be honest: in the years past many people probably played because they loved the sport. I thank the hon. Gentleman for his intervention.

Will the Minister undertake discussions with our American counterparts and share information so as to ensure that we have the most accurate information available on which to base our response to tackling this issue?

[Grahame Morris]

The hon. Gentleman makes some great points about international comparators and co-operation. Earlier he raised the issue of the old fashioned footballs—we used to call them caseys—that would be soaked with water. They were like heading a cannonball. It has been suggested to me in mitigation that in the modern game the footballs are much lighter, but that is not actually true. They may be of a different construction, but they are the same weight and they travel much faster—40, 50 or 60 mph. If I am not mistaken, Peter Lorimer, the Scottish footballer who played for Leeds—or perhaps it was a Manchester City player—had the record for the hardest shot, of more than 70 miles an hour. Imagine being hit on the head regularly—that must cause some damage. I do not think the new construction of the balls is any mitigation.

[Jim Shannon]

The right hon. Member for Ross, Skye and Lochaber (Ian Blackford) and I are of a certain vintage, and therefore probably remember those footballs better than most. The hon. Member for Easington (Grahame Morris) is absolutely right. It is about the force and the distance of the ball, how hard it is hit and the person on the receiving end.

There is no reason that the correlation and the evidential base that everyone has presented should not be considered for industrial payments for our retired footballers. There is much cross-party support, mostly from the Opposition Benches, though that does not take away from the Government side—those who have spoken are of the same mind. There is support from lobby groups and football clubs that have contacted us. The information that we have received over the years from interactions with retired footballers and ex-managers cannot be ignored. We must do our best to support them. This debate is so important to all constituents and footballers.

We have a love of football. We cherish the game of football on a Saturday afternoon. In my house, my wife supports Leeds, my second son Ian supports Chelsea, my third son supports Arsenal, my eldest son supports Ipswich, and I support Leicester. At 10 minutes to 5 on a Saturday it is interesting when the scorecard comes in.

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[Stuart Andrew]

I could not agree more with the right hon. Gentleman. I will come on to women’s football shortly, because some of the contributions have highlighted the fact that we have come such a long way, which is fantastic, although it is extraordinary that we have had to go on this journey.

The hon. Member for Strangford (Jim Shannon)—I am pleased to say that I will be visiting his constituency next week—clearly has a very wise wife. Not only did she marry him, but she is a Leeds United supporter. He worried me slightly as he built up the expectations for my response to this debate, but I will endeavour to do what I can.

The issue of dementia in football is clearly very important, and it touches the hearts of many people. Indeed, we have heard some extraordinary examples today, bringing testament to extremely emotional stories and accounts such as those of Jeff Astle and Gordon McQueen. I am grateful to Members for raising those important personal stories, because it is important to remember that we are talking about individuals and their families. The fact that the debate has drawn such cross-party support demonstrates the depth of feeling about this vital issue across the House, as well as in wider society.

The safety, wellbeing and welfare of everyone taking part in sport is absolutely paramount. On top of that, I know how important football clubs and players are to our local communities. Recent examples of dementia-related deaths of former footballers are of great concern to Members across the House, and certainly to me as the Minister for sport. The vast majority of people participate in sport safely, but we know that head injuries in sport do occur. Player safety must be a major focus for sport, as we highlighted in our recently published strategy, “Get Active”. Much more work is still needed to ensure that robust measures are in place to reduce risk, and to improve the diagnosis and management of sport-related head injury at all levels of sport. That should apply not just during matches, but during training. There should be provision for both professional and amateur players. That will be a key focus as we start to implement the strategy. I can assure the House that I will continue to make sure it is a high priority for me personally.

As we have heard, sports’ national governing bodies are rightly responsible for the regulation of their sport and for ensuring that appropriate measures are in place to protect participants from serious injuries. We look to individual sports to take responsibility for the safety of their participants. I am pleased to say that positive progress has been made in this area across different sports over recent years.

In football, for example, as others have mentioned, the football associations have changed their guidelines to prevent under 11s heading footballs during training in England, Scotland and Northern Ireland. However, it is not just national governing bodies that are contributing to improvements in player safety. Player associations play a valuable role in supporting professional players, providing short and long-term support to those affected by sporting injuries. In all the meetings that I have had with those player associations, I have taken every issue that they have raised with me up with the relevant agencies straightaway, because I recognise its importance.

The Government are also leading work on brain injuries in sport, specifically concussion. As part of that, my Department has worked with interested parties to develop the first ever single set of shared concussion guidelines for grassroots sport across the UK. It was published in April. The guidelines were developed by a panel of UK and international experts in the field of sport-related concussion. They build on the world-leading work that was first conducted in Scotland; I pay tribute to Professor Willie Stewart for the work that he did. We remain grateful to Scottish, Welsh and Northern Irish colleagues for their support in expanding the remit of the new guidelines to cover the whole of the UK. I also want to say thank you to Professor James Calder and Laurence Geller for helping us to get to this point.

[Grahame Morris]

On that point about concussion injury, I assume that that would happen from, say, a clash of heads in a football game, but that does not address the fundamental point of repetitive injury through many hours of heading the ball in football training. Is the Minister in a position to have discussions with his colleagues in the DWP about referral to the Industrial Injuries Advisory Council, because the evidence is clear?

[Stuart Andrew]

The hon. Gentleman is pre-empting later parts of my speech, but I think that it is important to highlight the concussion guidance. It is important that we give information to grassroots organisations that often will not have medical advisers on hand. Having that information available for grassroots volunteers is incredibly important and valuable, but that is the start of our work.

As I say, the guidelines are for the use of everyone involved in grassroots sports from school age upwards: participants, coaches, volunteers and parents, as well as those working in education settings and healthcare professions. The guidelines are especially helpful for grassroots players and being able to recognise and respond to concussion symptoms appropriately when no trained medical person is on hand; as we know, that is more likely to be the case than in a professional setting. Through the guidelines, we want to encourage more people to enjoy the benefits of being active and playing sport and we hope that they will prove to be a helpful tool in reducing the risks associated with concussion.

We have also established a research group on concussion in sport. My hon. Friend the Member for Southend West (Anna Firth) and the hon. Member for Easington mentioned international experts, and I am pleased to say that they will be represented so that we draw on the latest and best information. The group is working across the sport and academic sectors to identify the key research questions on sports concussion that need to be addressed. The aim is for the research efforts to become more co-ordinated across sport so that the sector can pool its understanding and expertise. Just a few months ago, I went to see some of the incredible work that Loughborough University is doing in this area and some of the equipment it uses to test what would make sport safer for all.

Alongside that work, DCMS has established an advisory concussion in sport innovation and technology panel to identify tech innovations to help with concussion in sport issues on an ongoing basis. The Department for Health and Social Care is formulating the Government’s new strategy on acquired brain injury, including dementia, and DCMS is feeding into the process to ensure that those who play sport are properly represented. We remain committed to working with the sector to help to make sport safe and enjoyable for everyone, including through technological solutions for the prevention of concussion.

To turn to more specific points, as the Chair of the Select Committee, my hon. Friend the Member for Gosport (Dame Caroline Dinenage), mentioned, there have been developments within football, too. The Professional Footballers’ Association and Premier League recently established a new care fund to provide financial support to former players who have been affected by dementia and their families. The initial amount of £1 million will be made available immediately to provide discretionary financial support to former players and their families to help to improve the quality of their life. I have discussed the great work of the Professional Footballers’ Association on player welfare with its chief executive.

As it is the first of its kind for English football, I welcome the creation of the fund and hope it will provide help to the former players who need it most. We will continue to liaise with the football authorities in support of funding for cross-game initiatives. The Professional Footballers’ Association also has a dedicated brain health team that provides a range of support to former players and their families, including assistance with claiming state support and benefits.

During the debate, there has been discussion about whether dementia in footballers should be treated as an industrial disease. The Department for Work and Pensions provides specific support to people with industrial injuries through industrial injuries disablement benefit. As many will know, DWP is advised by the Industrial Injuries Advisory Council, an independent specific body, on changes to the list of occupational diseases for which IIDB can be paid. I know that many Members feel strongly that professional footballers’ access to such benefits should be explored, as was mentioned by many members, including the hon. Member for Glasgow South West (Chris Stephens).

The hon. Member for Easington asked whether I could instruct the IIAC. If I had that power, I would love to use it, but I am pleased that the council is considering any connection between professional sportspeople and neurodegenerative diseases such as dementia. The council will publish its findings when its investigation is complete in due course, but given that the question has been raised a number of times, I will of course highlight the debate and the views raised in it to my colleagues in the DWP. It is important to remember that this is a complex area of work, and that going through the raft of published scientific literature that is available is significant work.

[Stuart Andrew]

The hon. Gentleman will appreciate that the IIAC is an independent body, but I would absolutely be more than happy to write to it or to my colleagues in DWP to say that colleagues in this House would welcome the opportunity to engage with the council.

[Grahame Morris]

I welcome the Minister’s response; that is real progress and we are very grateful for it. I do not want to pre-empt what he is going to say, but in terms of exerting his influence—particularly over the Premier League, for example, which is awash with huge sums of money to assist in this process—may I say that because I represent a coal mining area, I have had occasion to try to push the IIAC and to get it to make decisions on conditions affecting coal miners, and it notoriously takes an age. If there is anything he can do to expedite that, it would be much appreciated.

[Stuart Andrew]

Although I am flattered that Members think I have all this power to force people to do things, I am totally aware of my own limitations. I will do what I can and I will certainly highlight the issue. I do understand.

This is a complex area of work. There is a lot of information and research for the advisory council to consider, and it is right that it does so properly, so that it can come up with the right conclusion. Once the advisory council has reported, colleagues in the Department for Work and Pensions will carefully consider any recommendations.

It is also important to talk about dementia research, which is important to tackling the issue. I am delighted that the Department of Health and Social Care will double funding for dementia research to £160 million a year by 2024-25, spanning all areas of research, to deliver evidence to help us prevent, diagnose and treat dementia. The Government launched the Dame Barbara Windsor dementia mission in August 2022, and this will focus on accelerating the development of new treatments and boosting the number and speed of clinical trials for dementia. Departments are doing a raft of other things, recognising that this is an incredibly important area and that this disease has a big impact not only on sufferers but on the wider family network and carers.

I note that my hon. Friend the Member for Southend West has taken the opportunity to wear the colours of her beloved football club, and I pay tribute to her for the immense work she is doing to support that club through these difficult times. She is right about the support that many clubs offer. She referenced SUEPA and it is important to acknowledge that.

The hon. Members for Easington and for East Renfrewshire (Kirsten Oswald) both mentioned women’s football, where there is a lot for us to celebrate—it is amazing to see what has happened. The hon. Lady was told that she could not play football and, sadly, that was still the case after the Lionesses came home victorious from the Euros, with only 63% of girls finding they were able to access football at school. Thanks to their persuasive campaigning and our work with the Department for Education, I am pleased to say that we have made big strides in levelling that playing field. I look forward to seeing women’s football go from strength to strength. We commissioned an independent report; I am grateful to Karen Carney for all her work. We are considering many of her recommendations. Of course, players’ physical and mental health features in the report and it is important that we include it.

There is much good work going on in this area but, of course, there is always more to do. We recognise the strength of feeling on the issue of dementia in football and the effect it has on those who suffer from this terrible illness, as well as on their families. We will continue to work with the sport sector, including the football authorities, to ensure that player safety is prioritised so that everyone can take part in sport as safely as possible.