Football and Dementia

– in the House of Commons am 12:30 pm ar 14 Medi 2023.

Danfonwch hysbysiad imi am ddadleuon fel hyn

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber 12:30, 14 Medi 2023

I beg to move,

That this House
asks the Government to investigate the links between football and sport-related neurodegenerative disease.

I am grateful to the Backbench Business Committee for granting this debate, and to the number of Members across the House who support the motion, particularly my co-sponsors of the debate, the hon. Members for Moray (Douglas Ross) and for Easington (Grahame Morris). To use an old-fashioned footballing term, what a half-back line the three of us would make—although, if the hon. Member for Easington will forgive me, I will take up position on the left. I hope that we have an engaging debate and that, at the end of it, the Government will commit not just to examining the issue but to recognising our duty to support those suffering from football-related neurodegenerative diseases, and that the Industrial Injuries Advisory Council will conclude that classing those as industrial injuries is the right thing to do.

Many of us in this House are passionate about football and can celebrate just how much joy the beautiful game his given so many, but it is utterly tragic that so many of our heroes have suffered so much from diseases of the brain that academic research shows conclusively are a result of head impacts from careers in football. So many of those suffering, as well as their families, face challenging and distressing times, often without the professional and financial support that would make a difference.

Football holds a special place in the hearts of many people in Scotland and right across these islands. It is a sport that brings communities together, fosters camaraderie and showcases incredible talent. However, beneath the glory and the cheers lies a silent but devastating issue: dementia among football players. Dementia suffered by players should be classed as an industrial injury. That reclassification would provide much-needed financial and social support. As parliamentarians, it is up to us to demand that the UK Government and the devolved Administrations use their powers to support those who need early intervention and appropriate care and support.

Football has been an integral part of Scottish culture since the formation of the Scottish Football Association 150 years ago. Indeed, the oldest international game was Scotland versus England in Glasgow in 1872. Generations of players have graced our pitches, showcasing their skills and passion since the establishment of the game all those decades ago. However, the physical nature of the game, especially in the past, when head injuries were not adequately addressed, has left a legacy of suffering. Many former players are now facing the harsh reality of dementia, which robs them of their memories and quality of life. It is a tragic situation, and it is high time that we acknowledged that that is an industrial injury.

The connection between repeated head trauma and dementia is well documented in medical literature. Studies have shown that chronic traumatic encephalopathy, a degenerative brain disease, is prevalent among athletes, particularly in contact sports such as football. The repeated blows to the head during tackles, headers and collisions can result in long-term brain damage, leading to dementia in later life. According to a study by the University of Glasgow, professional footballers in the UK are three and a half times more likely than the general population to die of neurodegenerative diseases such dementia. That alarming statistic highlights the urgency of recognising the condition as an industrial injury.

In 2002, the passing of Jeff Astle at the age of 59 brought the issue of CTE into the public arena. Jeff, an ex-West Brom and England centre forward, was diagnosed post mortem with CTE. He had suffered from that terrible degenerative illness for five years. We should be grateful for the work done by Glasgow University, which conducted a field study of 7,676 former professional football players from Scotland. Although the headline rate is that footballers are 3.5 times more likely than the general population to die with a neurodegenerative disease, that risk increases to five times more likely for developing Alzheimer’s disease, four times for developing motor neurone disease, and double for developing Parkinson’s disease. The evidence is all there; these should be classified as industrial illnesses.

There is also a link to the length of a player’s career. If they played for less than five years, they are 2.26 times more likely to suffer from brain injuries, but if they played for more than 15 years, that figure rises to no less than 5.2 times. There is a demonstrable link between playing football, heading the ball and brain injuries, and we must recognise that now.

Photo of Caroline Dinenage Caroline Dinenage Chair, Culture, Media and Sport Committee, Chair, Culture, Media and Sport Sub-committee on Online Harms and Disinformation, Chair, Culture, Media and Sport Sub-committee on Online Harms and Disinformation, Chair, Culture, Media and Sport Committee

I hesitate to interrupt the right hon. Gentleman, because he is making an excellent speech and I do not want to disrupt his flow. He will have heard that the Premier League and the Professional Footballers’ Association have launched a £1 million brain health fund to assist former players and their families who are impacted by dementia. I have a foot in each camp, as a former Health Minister and with my Culture, Media and Sport Committee hat on, so I see the issue from a range of perspectives. A dementia diagnosis is a diagnosis not just for the individual concerned, but for their entire family and all their friends, as we know. September is World Alzheimer’s Month. That £1 million health fund is an important step forward, but there are 55,000 male and female former professional footballers in England alone. Does he agree that that fund must be merely a starting point in the work that the various football associations put in to tackle the issue?

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber

I am very grateful to the hon. Member, who makes valid points. We must recognise that the people we are talking about—the Jeff Astles and the thousands of people who are suffering, as she has identified—were often paid an average industrial wage; they were not well paid. They are in very serious ill health relatively early in life, and they do not have the financial circumstances to support themselves. They often have to rely on family members, and have to give up work early—let us remember that football players very often went into other careers. We are talking about people who are in many cases financially destitute, so that help from the PFA—with which I have worked closely in preparation for the debate—is welcome, but we cannot get away from our responsibility as a society to recognise football-related dementia as an industrial injury. Let us ensure that there is support for football players, as well as for those who suffer from these conditions in other sports. We cannot leave them, as we have been doing, to die on their own without support. That is the salient point.

The position a footballer played on the park also was a key determinant. Defenders were 4.98 times more likely than players in any other position to suffer from neurodegenerative diseases—perhaps that is not surprising given the propensity for defenders to head the ball. No tragedy better encapsulates the gravity of the risk to defenders than the case of Billy McNeill, the iconic Celtic and Scotland captain. Billy was a legendary figure in Scottish football, perhaps best known for leading Glasgow Celtic to their historic European cup triumph in 1967. Sadly, he became a victim of dementia in his later years. His family revealed how this once mighty figure gradually lost his memory and ability to recognise his loved ones. Billy’s case serves as a poignant reminder that dementia in football does not discriminate.

I recently had the opportunity to speak with Billy’s son Martyn, and as Martyn pointed out, it was not just about heading the ball; it was the multitude of head knocks that were endured in a player’s career. Of course, in those days, players tended to stay on the park regardless of their condition. There were no substitutes back then and little, if any, in the way of physio support.

In Scotland, we also pay tribute to Amanda Kopel, who has fought valiantly to highlight the case of her sadly departed husband, Frank. Frank passed away in 2014 aged 65, having been diagnosed with vascular dementia back in 2008. Frank started his career at Manchester United but is perhaps best known for his 10 years with Dundee United. Indeed, he was the first signing of the legendary manager Jim McLean. I see I have an Arab sitting beside me—my hon. Friend Kirsten Oswald. Amanda fought a long time to make sure that the Scottish Government put in place free personal care for those such as Frank, who at the time were excluded from such support, which was available only to those aged 65 or over when it was introduced in 2002.

Photo of Kirsten Oswald Kirsten Oswald Shadow SNP Spokesperson (Women), Shadow SNP Spokesperson (Equalities)

My right hon. Friend has correctly identified my football allegiance, not that that was any surprise to him. Frank Kopel was a hero of mine as a young girl. I used to go and watch him and many others running their socks off, and that was the golden era for my team, Dundee United. Amanda Kopel is also a hero for the work she has done. She has been instrumental in moving the dial, and all of us owe her a huge debt of gratitude.

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber

I was going to come on to say that. I had the opportunity to speak with Amanda last week, and my goodness, what a stoic figure and what a champion she has been in making sure that the support that was sadly not there for Frank is there for those who followed him. Amanda has rightly campaigned to make sure that those aged under 65 living with disabilities and degenerative conditions such as this can get support. I am glad to say that after a long campaign, fought on a cross-party basis, support was extended in Scotland to those under 65 through the 2019 free personal care Bill—actually, we do not refer to it as that; we rightly refer to it as Frank’s law.

We owe that debt of gratitude to Amanda, who, despite losing Frank in 2014, kept the fight going so that others facing the same harrowing circumstances could get that support. As Amanda said to me last week, this came too late for Frank, but we can help others. Up until the sad passing of Frank, the couple had been a team for a long time, having become childhood friends in Falkirk in 1958 aged eight and 10. She told me that their first kiss as sweethearts came over a game of postman’s knock —a game only too familiar to those of us of a certain age, if I may say so, Madam Deputy Speaker. [Interruption.] I was referring to myself!

Amanda has supported Frank all her life, but her efforts ultimately meant that so many others were able to get that support. There must be support through access to free personal care, but we still have to do more to make sure that we have early, effective intervention and that critical financial support is accessed through the recognition of these cases as industrial injuries.

I have talked about Billy McNeill and Frank Kopel, but we also recently witnessed the sad passing of Gordon McQueen—yet another legend of our game taken by vascular dementia, lost to his loved ones far too early. We all have our own first love. Mine was Hibernian football club. Dundee United used to be called Dundee Hibernian back in the day. The joy we all have in supporting our heroes leaves us with special memories. When we think of the likes of Peter Cormack and Alex Cropley—Hibernian legends we were blessed to go and watch—now suffering with this terrible disease, it has to act as a wake-up call to all of us. They gave such joy to those of us who went along to Easter Road, but every MP will be able to recount stories of their own heroes battling with this disease. All those players were from an age when, if they were lucky, they were on the same wage as the average worker. Many now face financial hardship while they battle a disease that will ultimately take their life.

Photo of Gavin Newlands Gavin Newlands Shadow SNP Spokesperson (Transport)

If I can take my right hon. Friend back to Gordon McQueen for one second, his first professional club was St Mirren in Paisley, Renfrewshire. I was contacted by many constituents at the time of Gordon’s passing who wanted to talk about and pass on their memories of Gordon. Another family blighted by this was the Ryden family from Dunbartonshire, with five brothers. John Ryden played for Spurs, among others; George Ryden played for St Johnstone and our deadly rivals, Dundee; Hugh Ryden played for Chester; and they had two other brothers. John, George and Hugh all contracted neurodegenerative diseases. The other two brothers did not. It is a very small sample size, but does my right hon. Friend agree that it is yet more damning evidence of the link between heading footballs and neurodegenerative disease?

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber

Yes, it is. I made the point that all of us who support football clubs can think of people we know. Sometimes they are in the public domain, but in many cases they are not. We are not just talking about those who played top-flight football; we are talking about those who played in the lower leagues and in the amateur game. This goes beyond the high-profile public cases we are talking about. The common link is a disease that we know is a direct consequence of heading a football in a game that we all love.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

Yes! I can recall well that the footballs in those days were much heavier. They were harder on the foot and on the head, so the dementia and Alzheimer’s that came off the back of heading the ball in those days was much more severe than it is today. I am not taking away from what happens today, but that illustrates the issue of the balls used in football at that time.

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber

I am grateful to the hon. Gentleman for making that point, because it is a really important one. The damage that could be done to a player by those heavy leather balls, which could be sodden with water, is very real and marked.

I will come to a conclusion, because I know that others want to speak. Let me thank the Professional Footballers’ Associations in both Scotland and England for shining a light and campaigning on this issue. In particular, we need to thank Tony Higgins of the Professional Footballers’ Association Scotland and Dr Adam White in England for their leadership.

When we talk of footballers who sadly are suffering from football-related brain injuries, it goes way beyond the public cases we know about. There are scores of cases ranging all the way from the Scottish Highland league right up to renowned figures in European football. Just as this ailment does not discriminate, neither should the support that we offer these individuals. By classifying dementia in footballers as an industrial injury, we can ensure that these players receive the support they so desperately need. Financial assistance can cover medical bills and provide for their families, who often shoulder the burden of care. Moreover, it is not just about the money; it is about recognising the sacrifices these players made for the sport and the nation, whatever level they performed at. These people went out on the pitch to do a job and to entertain. Now it is our turn to stand by them as they suffer the consequences of their employment.

Both the UK and the devolved Governments must step up and take responsibility for this issue. The health and wellbeing of former football players should not be relegated to the sidelines. The recognition of dementia as an industrial injury is not just a matter of justice; it is a moral imperative. Dementia among football players is a crisis that demands our attention and action. Reclassifying it as an industrial injury is a crucial step toward providing the necessary support to these players. Moreover, it serves as a reminder that the beautiful game should not come at the cost of players’ long-term health.

Let us honour the legacy of those who brought us joy on the pitch by ensuring that they receive the care and recognition they deserve. It is time to take responsibility and make a positive change in the lives of our footballing heroes.

Photo of Anna Firth Anna Firth Ceidwadwyr, Southend West 12:48, 14 Medi 2023

I thank Ian Blackford for securing this important debate. As the MP for the city of Southend, I am very aware that Southend is known for two things: the longest pleasure pier in the country, and Southend United, a historic 117-year-old club that is very much the beating heart of the city. I have spoken many times about the importance of football to our city, so it is obvious that we should have a keen interest in this important debate. I believe that understanding the correlation between football and dementia is vital, not just for the players, the clubs and the medical profession, but for the families and communities that are inevitably horrendously affected when these conditions develop.

The importance of the studies that have now been done cannot be overstated, particularly the research conducted by the University of Nottingham, which found that footballers are almost three and a half times more likely to be diagnosed with dementia than the general population. That study, which has already been referred to, is incredibly significant. Another study that should be noted was conducted by Swedish researchers, who compared the health records of 6,000 elite footballers with more than 56,000 non-footballers between 1924 and 2019—a huge longitudinal study. They found that 9% of male footballers playing in the Swedish top division were diagnosed with neurodegenerative disease, compared with just 6% in the controlled sample: in other words, footballers are 50% more likely than the rest of the population to develop dementia. However, the most interesting part of that study was that it found that goal- keepers, who rarely head the ball, had no observable added risk of dementia or Alzheimer’s whatsoever.

I am pleased that the increased level of research is now leading to positive action being taken, and like other Members, I very much welcome the introduction of the brain health fund by the Professional Footballers’ Association and the Premier League. Through that fund, we will see £1 million made available to support former players and their families who have been impacted by dementia and other neurodegenerative conditions. I am very proud to say that the Southend United Ex-Players Association is a great exemplar of work in this area. That is really what I want to talk about.

However, I cannot let this moment pass without mentioning that Southend United are facing terrible off-field issues that could tragically see the club being wound up in under three weeks’ time, yet they are continuing to play exceptionally well and defy all expectations. Were it not for the transfer embargo and the 10-point deduction due to the winding-up petition, Southend United would be fifth place in the national league. I take this opportunity to recognise the fantastic efforts being made by the Shrimpers Trust, its chairman Paul FitzGerald, and the entire working group—Liam, Sam, Mike, James and Robert—to keep this 117-year-old club alive. Negotiations are ongoing, but I urge everybody involved in those negotiations, including the chairman of the club, to put all personal interest aside before it is too late to save Southend United.

Coming back to the Southend United Ex-Players Association, that association—which does such great work in this area—is one of the largest in the country, with 465 members. It includes players going back as far as the 1950s, and at least a dozen members of SUEPA have some form of degenerative condition. SUEPA, which was founded and is led by Andy Leeder, provides fantastic support to former players. When they are invited to match days, as they often are, from time to time they feel the need to apologise for their memory failing, saying openly, “It was too much heading of the ball.” SUEPA has seen at first hand the impact of these degenerative conditions on the lives of former players and helps to support them in whatever way it can, from simple things—gestures like presenting ex-Southend United players with memorabilia of their achievements to remind them of the esteem in which they are still held—to completely renovating a garden for another ex-player to improve their quality of life, which has suffered so greatly due to these conditions.

Of course, SUEPA also makes the families aware of the help that is currently available from the Professional Footballers’ Association, and donates on a regular basis to the fantastic Jeff Astle Foundation. SUEPA would like to work more closely with the Professional Footballers’ Association in this area, and I call on the PFA to engage with SUEPA on this hugely important topic. It is my sincere hope that despite the current difficult circumstances that Southend United is facing—I thank the Minister very much indeed for his close engagement with the Shrimpers Trust and all the work he is doing to support the club—we will see SUEPA carry on for years to come, benefiting not just those players who currently play for Southend United but the many Southend United football stars of the future.

Photo of Grahame Morris Grahame Morris Llafur, Easington 12:55, 14 Medi 2023

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 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, Ian Blackford, as well as 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.

Photo of Chris Stephens Chris Stephens Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Immigration)

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.

Photo of Grahame Morris Grahame Morris Llafur, Easington

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.

Photo of Chris Stephens Chris Stephens Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Immigration)

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

Photo of Grahame Morris Grahame Morris Llafur, Easington

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.

Photo of Chris Stephens Chris Stephens Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Immigration) 1:14, 14 Medi 2023

I thank my good friends, my right hon. Friend Ian Blackford and Grahame Morris, and Anna Firth, who made an excellent speech; I know her predecessor, the great David Amess, would undoubtedly have been here taking part in this debate, pushing the case not only for Southend United, but for his beloved West Ham United. I am sure that when West Ham won the Europa conference league he was looking down with a smile.

I also commend Labour Member of the Scottish Parliament Michael Marra, who has been leading some debates on this in the Scottish Parliament. I commend, too, the Daily Record for its support for that campaign. I was very pleased that it published a story highlighting this debate. Michael Marra and the Daily Record have had the support of former footballers who have written to the authorities asking that the diagnosis of an industrial injury be put in place, including Alex McLeish, former Scotland manager, and the great Sir Alex Ferguson.

We have now heard evidence of industrial injury from Glasgow and Nottingham universities and Boston University in the United States, and it is clear that there is definitely a link and that football injuries such as head injuries or heading the ball are leading to dementia, Alzheimer’s and other conditions. Why is that? The Daily Record published a story about this debate and I made the mistake—a schoolboy error as it would be known in football—of reading the comments afterwards; a journalist once told me, “Never read the comments of a story you’re mentioned in.” There was a lot of scepticism in the comments. What frustrated me was people saying that there was no link.

As I said in my earlier exchange with my good friend the hon. Member for Easington, I am doing some work with Rangers football club former players association on this: they are very interested in this topic because they also think there is something in it. They have been providing support, thanks to donations from their supporters to former players. That includes paying for respite care for the families of those former players who have dementia and ensuring that family members can have a break for an hour or two a week to go off and do shopping and other things. The work the association is doing in this regard should also be commended.

There was initial scepticism even within the former players community when this link was first talked about, but the advocates of there being something in it and of the fact that the evidence is now clear includes former wingers. They have worked out that they were running down the wing and crossing the ball and it was then being headed by the centre-half or centre-forward, and it is they who are now the high-profile cases—many of the great players that have been mentioned in this debate.

I want to highlight the issue of wages, too, which has also been touched on. There are some sceptics who think we are advocating for rich people. Telephone number-type salaries flash up on Sky Sports News on transfer window final day, but that does not reflect the situation for many who are caught up in this. As has been said, those who played at the top level in the ’60s and ’70s probably earned twice the amount of an average tradesman and those in the lower leagues would have been getting about the same wage as an average tradesman. Some play, of course, for the love of the game, and they might only get £10; I remember some football clubs in Scotland even in the 1990s would just pay travel expenses and £10 for playing, and there were reasons for that, of course.

Gordon Smith, the former Rangers, Brighton and Hove Albion and Manchester City player, and former chief executive of the Scottish Football Association, had a chat with me about this issue, when he heard it was to be debated. He told me that when he signed for Rangers football club, Jock Wallace, the then manager, told him, “I have been trying to sign you, Gordon, for the last four seasons.” Gordon Smith did not know that because, at the time, the registration of a player was held by the club, and if the club chose to keep the player, they would not be told that another football club was interested in them. That was driving wages down.

We need to hear from the Minister today to ensure that this matter is recognised as an industrial injury in the work he is doing with his colleagues in the Department for Work and Pensions. As was touched on by Jim Shannon, the ball that was used in the ’50s, ’60s and ’70s was a lot heavier and harder, especially if people were playing in inclement weather. It might surprise you, Mr Deputy Speaker, but in Scotland we do get inclement weather during the football season. If there was rain or the ball was caught in mud, it would become even heavier, and that is almost certainly one of the reasons this situation has come about.

It is fairly clear that there is cross-party consensus on this matter, and I thank all the Members who signed up to have this debate today. I look forward to hearing from the Minister, because we now need a strategy with his Department and the Department for Work and Pensions so that our heroes can get the support they need.

Photo of Kirsten Oswald Kirsten Oswald Shadow SNP Spokesperson (Women), Shadow SNP Spokesperson (Equalities) 1:21, 14 Medi 2023

I am sure that anybody who is interested in football and the many people whose families have been affected by neuro- degenerative diseases, such as dementia, will be interested in what is being said today. I am sure they will want to support the calls that have been made for research, proper safety provisions and proper support.

There is no doubt that dementia is more prevalent among football players than in the general population. We have heard about the research that underlies that. The recent studies that I have been looking at have found that professional footballers are three and a half times more likely to die from neurodegenerative diseases than the general population. That is quite a statistic. We have also heard about the study in Sweden that concluded that male football players who had played in the Swedish top division had a significantly increased risk. That was among outfield players, but not goalkeepers. The evidence is all pointing in the same direction. It is not necessarily new evidence, either. We have known about this issue for some time, with studies from as early as 2017 showing a great risk of dementia among professional football players. I say this as a very big football fan, but I know there are risks that come with sport. There are risks associated with participating in football, but those risks need to be balanced against the need to keep people safe.

This debate is welcome, and I am grateful to my right hon. Friend Ian Blackford and colleagues who secured it. I put on record my gratitude to Tony Higgins, who was mentioned earlier. He gave a helpful briefing, which I attended, detailing the issues around football and other sports and neurodegenerative diseases. It was thought-provoking, particularly in relation to the health impacts on people who are at their work. I usually look at football through a different lens—I am enjoying the sporting element—but we cannot take away from the fact that the people on the pitch who we watch in football stadiums and on the telly are doing their jobs. Perhaps it is because we are accustomed to looking at it through that particular lens that we are maybe neglecting to consider the welfare of those participating. As a football fan, this is not the situation I want for the sport that I enjoy so much. I cannot think that fellow fans would want their enjoyment of football to be at such a significant cost to health. Things need to change, and it is high time that we saw that happening.

I was pleased to hear Grahame Morris mention women’s football. I had a fantastic constituency visit a couple of weeks ago to the wonderful Busby Girls AFC. It is a new and young club, but it already has hundreds of girls out there playing. Seeing that made me incredibly happy, and I say that as someone who is still smarting, four decades on, from being told at school that girls do not play football and having my football confiscated. I do not think I will ever let go of that issue. Girls do play football, and it absolutely is for girls. Hats off to all the folk at Busby for the brilliant work they are doing.

It is heartening that we can watch women’s professional football and enjoy it much more easily now, because it is there for us all to see. We do not have to hunt it out so much; there are so many more opportunities to see women at the top of their game playing football, and so many young girls are inspired by that. That is to be encouraged.

The challenge is that we cannot be entirely clear about the impact that heading the ball has on women and girls and exactly how it is different from men. I have looked at that question, and the answer is we do not know enough about it. We know it is not good, but we do not know the detail that underlies that, and that is unacceptable. I am aware of reports about Sheila Parker, who captained the England women’s team in the early 1970s. She was renowned, apparently, for her heading of the ball with frequency, gusto and accuracy. Her family believe that that has caused significant damage to her health. I send my best wishes to Sheila and her family, but it makes me think, and that kind of sad situation is a glaring example of the thing we cannot escape: we just do not know what the impact is on women of heading a football, and the more that we see women playing football and the more that women are playing football, the more pressing it is that we close the gap in research, and sharpish. Women and girl footballers deserve far better, so research and further discussion are necessary as a matter of urgency.

It is not only girls’ clubs that need us to focus on this issue. I also recently visited Giffnock Soccer Centre, which is doing fantastic work at all levels and bringing the whole community into the footballing world. I never like to miss an opportunity to speak about the Mighty Arthurlie in Barrhead. All these clubs and all the other great clubs in East Renfrewshire and all other constituencies also deserve our attention. We have heard clearly that this issue does not just affect those playing at professional level, and the hon. Member for Easington quoted stark figures on brain injury in amateur athletes. We need to focus on this issue at all levels of football, not just the highest levels. I say the highest levels, but as my right hon. Friend the Member for Ross, Skye and Lochaber mentioned, I am a lifelong and very enthusiastic Dundee United fan. That can be character-building—that is probably the most constructive way for me to describe it.

Photo of Kirsten Oswald Kirsten Oswald Shadow SNP Spokesperson (Women), Shadow SNP Spokesperson (Equalities)

My hon. Friend points out that there are other teams that give us grey hair.

Photo of Chris Stephens Chris Stephens Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Immigration)

My hon. Friend seriously believes that supporting Dundee United is character-building, but it is not as character-building as being a Partick Thistle supporter. You need nerves of steel when you go to the theatre of dreams, Firhill stadium.

Photo of Kirsten Oswald Kirsten Oswald Shadow SNP Spokesperson (Women), Shadow SNP Spokesperson (Equalities)

My hon. Friend is tempting me to giggle in an unparliamentary manner, which I will avoid doing. I will go back to the serious remarks made by my right hon. Friend the Member for Ross, Skye and Lochaber in opening the debate. I thought that his speech was powerful and timely, and he made some important points. I was delighted that he spoke about Frank Kopel. I said earlier in the debate that Frank Kopel was a hero of mine. He was a shining star in an era of shining stars at Dundee United. We were at the pinnacle of our success—I am sure those times will come again—and it was a joy for a football-mad wee girl to watch Frank and his fellow players at that time.

My right hon. Friend also spoke powerfully about the huge contribution of Frank’s wife, Amanda Kopel. She has made a huge difference to so many people. She is a giant, just like Frank, and they have both made their mark. We really owe them, and all of the families who have experienced the utter sorrow of what dementia and other neurodegenerative diseases do, to keep on at this subject.

We know that there is a higher incidence of these terrible diseases among people who play football. The figures noting which football positions people have played in show that, without doubt, there is a link. Despite the availability of very clear evidence over a number of years, it is a shame that more concrete action has not been taken. I would like to see concrete plans to minimise damage in the future. We cannot keep repeating the mistakes of the past.

It is time to consider reclassifying this as an industrial injury. It is absolutely clear what is happening. It is time to look at what all of the structures and guidance for men’s and women’s football say, and make sure that the appropriate levels of safety and support are built in. It is also time that we all change the way we think about football, so that it can remain a safe and enjoyable pastime well into the future.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 1:31, 14 Medi 2023

First, may I congratulate Ian Blackford on introducing the debate, all Members who have made contributions, and those who will reply from their Front Bench? I look forward very much to the Minister’s response. I do not mean to put any pressure or expectation on him, but we are very fortunate to have a Minister who always tries to give us a response that is constructive and helpful. We as MPs are trying to garner a response for our constituents. I know that he will listen to all of the points of view put forward and then respond in a way that helps us.

We have asked the Government to investigate the links between football and sport-related neurodegenerative disease. A 2019 public study revealed that football players were at increased risk of diagnosis of neurodegenerative disease. The risk increase was observed for Alzheimer’s disease and other dementias, but not for all types of neurodegenerative disease, and for outfield players but not goalkeepers. As others have said, if three or four of the 11 who play in a team do not have it but the others do, there must be an issue. The call for this to be classified as an industrial injury is heavily backed in Northern Ireland as well, so it is important for me to be here to give that Northern Ireland perspective.

Last year, some of Northern Ireland’s most iconic footballers reunited to raise funds for Dementia NI at the Spirit of ’82 event in Belfast. It was held in memory of their good friend and teammate, the legendary Northern Ireland manager Billy Bingham, who had been living with dementia for 16 years before he passed away on 9 June 2022. I do not think there is much between my age and that of the right hon. Member for Ross, Skye and Lochaber, but I am old enough to remember Northern Ireland playing at the World cup in Spain in 1982. I had the opportunity to meet all the football players and Billy Bingham, who was an inspiration to me at that early age. He was an inspiration on the pitch as a footballer, and he then became an inspiration as a manager.

I was also in Mexico in 1986, which was before I got married—everything changes when we get married, and we are not able to get away the same as we used to—and on coming home I had the opportunity to get the autographs of the Northern Ireland team and Billy Bingham. A Brazilian football supporter and I swapped a Brazilian shirt and a Northern Ireland shirt, so I have in my office a shirt with the autographs of all the Northern Ireland team of 1986 plus Billy Bingham. I pass that shirt every day and remember very clearly that he was a player who inspired me and inspired us all, yet he passed away as a result of the game he played so well. It is important to be here today to speak on behalf of the Billy Binghams of this world and others who have suffered and passed away.

It is fantastic that high-profile footballers recognise the link. That is also true of retired managers such as Sir Alex Ferguson and Alex McLeish. They were great players who we all looked up to as young boys and young men. That emphasises the importance of investigating this link further and gathering the evidence.

A study has found that footballers are 50% more likely to develop dementia than the rest of the population —that is evidence, factually based and cannot be ignored—fuelling calls to restrict rules for heading a football. Classifying it as an industrial injury would mean that former footballers suffering with the disease would be able to claim certain benefits for industrial injuries that occurred in the workplace. Their employment and the source of their income is the sport that they play. I support those calls, given the evidence, which is becoming clearer. My belief has been reinforced by all Opposition and Government Members who have spoken today. They have been galvanised by what they have heard in their own constituencies and from their own personal experience. Chris Stephens spoke of what Rangers football club is doing. It is really important to have that in place.

The other evidential base is from football in the States—or soccer, as they call it. I find it hard to get my head around the word “soccer”, because we call it football. In the US, they have imposed guidelines limiting players’ exposure to heading, despite controversy over whether dementia is caused by heading the ball. The fact is that, as has been said, they have introduced precautions. The hon. Members for Easington (Grahame Morris) and for Glasgow South West referred to evidence from the universities. There is quite clearly an evidential base in the United States of America.

Photo of Chris Stephens Chris Stephens Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Immigration)

I have always wanted to intervene on the hon. Gentleman. He has mentioned Billy Bingham and footballers in Northern Ireland. I am sure he will agree that it is important to note that the wages in Northern Ireland football are not at the elite level that we read about in all the sensational headlines in the newspapers. Does he therefore agree that access to the industrial injury benefit will help former footballers and their families?

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

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?

Photo of Grahame Morris Grahame Morris Llafur, Easington

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.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

Ian Blackford and I are of a certain vintage, and therefore probably remember those footballs better than most. 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.

Photo of Steven Bonnar Steven Bonnar Shadow SNP Spokesperson (DEFRA Team Member) 1:42, 14 Medi 2023

It is always a pleasure to follow Jim Shannon, who I believe has a wee soft spot for one of the Glasgow teams, and not Partick Thistle.

It is a great pleasure to speak in this debate on such an important subject, given that so many young people across these islands partake in football-related activity on a regular basis. I thank all Members from across the House for their heartfelt contributions. It is clear that we all love the game of football, but it is also clear that we want improvements in this area for former footballers.

I congratulate my right hon. Friend Ian Blackford not only on securing such an important debate, but on his informed contribution. He knows, as I do, that this issue is keenly felt in Scotland, with high-profile public campaigns from the families of those affected, as well as world-leading pioneering research carried out in our Scottish universities. Such research undertaken by the University of Glasgow has found that professional footballers are three and a half times more likely to die of neurodegenerative diseases than the general population—three and a half times more likely to die of dementia, Alzheimer’s or other associated diseases. A previous study from the same university in 2021 found that defenders are five times more likely to develop dementia than the general population are.

Those of us who have played the game at any sort of level—competitive or otherwise—or who are just passionate about the sport will know that heading the ball is an art form in itself and an intrinsic part of the game. It is a skill that not many who play the game can fully master: a mighty last-ditch clearance by a committed defender; a leap and flick on to the back post; or my own favourite, the diving header goal—a majestic sight. These studies show us that they are also dangerous. That is why we must be confident that we are doing everything we can to ensure the safety of all the young people who enjoy football today, to protect their health now, in the long term and in later life.

As my right hon. Friend mentioned, Billy McNeill was one such defender—a man with a glittering playing career in the game. He always comes to mind when discussing dementia in football. He was a hero to many, myself included. Born in Bellshill, he was the first man from the United Kingdom to put his hands on the European cup and hold it aloft. He was world-renowned for his heading capabilities. In 2017 his family announced he was suffering from dementia, and in 2019 he sadly passed away. I would like to take this opportunity to place on record my gratitude to the Billy McNeill Commemoration Committee in Bellshill for the fantastic work it has done and continues to do in raising awareness of Billy’s life and of dementia in football, and in ensuring that the story of the great Billy McNeill will be told for generations to come.

A study published in 2019 in the New England Journal of Medicine, jointly funded by the SFA and the Professional Footballers’ Association Scotland, compared the causes of death of more than 7,000 Scottish male former professional footballers born before 1976 against those of more than 23,000 matched individuals from the general population. It was the first to definitively identify a link between football and dementia. Responding to those findings back in 2019, the head of Alzheimer Scotland welcomed the findings of the team led by Dr Willie Stewart, stating that they provided

“what can only be described as conclusive evidence that there is a definitive link between playing professional football and a higher incidence of dementia and other neurodegenerative diseases.”

Like many colleagues, I met Tony Higgins of the PFA Scotland—and of Hibernian folklore—here in Parliament a few months back, and heard about the real-life examples of former footballers facing ill health. The PFA Scotland is committed to this issue not only through funding excellent studies such as the one I mentioned, but by investing in long-term aftercare for former footballers and their families, many of whom played the game at the very highest level but in an era that did not bring the financial rewards or comforts that many of today’s players enjoy.

Photo of Christine Jardine Christine Jardine Liberal Democrat Spokesperson (Scotland), Liberal Democrat Spokesperson (Women and Equalities), Liberal Democrat Spokesperson (Cabinet Office)

The hon. Member is making a very powerful speech, among many powerful and important speeches, about a sport that we all love. We have talked a lot about professional and elite football, but when it comes to the young— I declare an interest, as my nephew plays junior football—there is not the same financial reward, but the same danger is involved in heading a football. Do we need to take a much broader approach and ensure that those at all levels, right down to youth football, are encouraged to tell players about the dangers?

Photo of Steven Bonnar Steven Bonnar Shadow SNP Spokesperson (DEFRA Team Member)

The hon. Lady makes an excellent point. Boys and girls of five and six in young and junior football are the professional players of tomorrow. We need to protect them right the way throughout their involvement in the game, because that will be for the benefit of all. Football brings so much joy and goodness to our communities—we all know that—but we must safeguard our young players.

A study in Sweden published earlier this year, which has been mentioned, concluded that male football players who had played in the Swedish premier league had

“a significantly increased risk of neurodegenerative disease compared with population controls. The risk increase was observed for Alzheimer’s disease and other dementias…and among outfield players, but not among goalkeepers.”

That further solidifies what we know about the game and what the Scottish studies told us. The risks have been known for several years now. Studies as early as 2017 showed the greater risk of dementia among pro footballers, particularly defenders. No time should be wasted in moving forward with further research to properly define the main risk factors and what must be done to minimise them. But we are not much further forward at all from 2017. It is unfortunate that despite evidence having been available on this issue for several years, we are still to see more concrete action taken. There have, of course, been some changes in light of those studies, such as children younger than 11 not being taught to head the ball in training conducted by the SFA, but is that really going far enough? Another way to look at that statistic is that we are still currently allowing children aged 11, 12 and 13 to persistently head the ball in training.

Another progressive step, it could be said, is the introduction of concussion substitutions in the English premier league, a new rule that allows for a permanent substitution to be made if a player suffers a head injury. The new rule was approved in January 2021. So far, I am aware of only one attempted use of the rule so far in England. However, there was an error in the paperwork which meant that the concussion substitute could not in fact be utilised. It was interesting to hear comments about that from Tottenham Hotspur manager, Ange Postecoglou. If we are going to do this right, we must ensure that safety, not paperwork, is the most important thing. I know of no concussion substitutions taking place in Scotland yet, although we have adopted the five substitutions rule—up from the previous three subs per match. That encourages managers to use a substitution should a player take a knock to the head during a match.

Other advice on heading the ball seems to be limited. While lighter footballs are now commonplace, as Grahame Morris pointed out, they travel a lot faster and are hit a lot harder in the modern game. We must ensure we do everything we possibly can to protect young individuals now, as well as in later life.

Some campaigners have been calling for a complete ban on the practice of heading the ball to eliminate the increased risk of dementia among footballers. We have all heard about the love we have for the game today. I do not know how that is manageable or workable in the professional game. As I said, heading the ball is an intrinsic part of the match. Some will tell us that rugby, mixed martial arts and boxing also come with heightened health risks—there is the potential for serious injury, and perhaps even fatality. That is undeniable. There must always be a balancing of the sport against the risk. We as legislators and those who govern the game should always seek to make things safer wherever we possibly can.

Photo of Stephanie Peacock Stephanie Peacock Shadow Minister (Digital, Culture, Media and Sport) 1:52, 14 Medi 2023

I congratulate Ian Blackford, Douglas Ross and my hon. Friend Grahame Morris on securing this important debate.

Football is at the heart of so many of our communities, bringing people together in both victory and defeat. At all levels, playing football brings immense benefits to our physical health, mental health and sense of belonging. But despite its contribution to our society, culture and economy, there is now increasing evidence that footballers in both the men’s and women’s game are at greater risk of dementia. Indeed, as Anna Firth suggested, former footballers may be 3.5 times more likely than others to die from a neuro- degenerative disease. In recent years, we have seen many of our beloved former players live with, and tragically die as a result of, dementia. That link must be taken seriously. Action is needed to prompt new research to inform our understanding of the issue and to ensure that responsibility is taken across the board for the welfare of players at every level.

That action matters. It matters for the former players and their families who have already experienced the life-shattering impacts of dementia, often without any recognition or support. It matters for players in the midst of their career, who must be equipped with accurate information and supported in taking preventative measures. And, of course, it matters for families up and down the country, so that adults and children alike can continue to participate in football and feel certain they are enjoying its benefits, as Kirsten Oswald highlighted in the context of the women’s game.

Research is vital to progress in both the prevention and treatment of football-related dementia. Published in the same year as Alan Shearer’s ground-breaking documentary “Dementia, Football and Me”, the 2017 University College London and Cardiff University study was among the first to identify a connection between professional footballers and dementia. Since then, studies from the University of Glasgow, the Drake Foundation and the University of East Anglia have only solidified our understanding of that link, as my hon. Friend the Member for Easington highlighted. Those studies, alongside the tireless campaigning of former footballers and their families, have been absolutely crucial in prompting change.

From the advice that children under 12 should no longer head footballs in training to the newly established Brain Health Fund, it is to the credit of every researcher and campaigner involved that the first protections and support measures have now been put into place. However, that momentum must continue. Further analysis will be critical to ensure the sport is able to take the correct preventative measures, and to offer meaningful support to those already impacted. I therefore look forward to hearing from the Minister what the Department has been doing to encourage and support research, as well as to work with football governance to ensure that it is ready to take any necessary actions as soon as possible.

Photo of Stuart Andrew Stuart Andrew Assistant Whip, Parliamentary Under Secretary of State (Department for Culture, Media and Sport), Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Equalities) 1:54, 14 Medi 2023

I, too, congratulate Ian Blackford, Grahame Morris and my hon. Friend Douglas Ross on securing this important debate. I thank all Members for the constructive manner in which it has been held. I would also like to take this opportunity, if I may, to welcome my new opposite number, Stephanie Peacock. I look forward to working with her very closely on the important issues we will be facing. I also put on record my thanks to her predecessor, Jeff Smith, who was extremely constructive and very easy to work with. On that note, there has been much coverage of the fact that the new shadow Secretary of State has not attended a football or rugby match before, so may I take this opportunity to extend my plus-one to the next game I am invited to?

I have enjoyed the cross-party approach to the debate. The hon. Member for Easington talked about the England win in 1966 under a Labour Government. Well, this Conservative Government are very proud of the tremendous successes and efforts of the Lionesses.

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber

It is important that we applaud the growth and success of the women’s game, and reflect on how much things have changed. In Scotland, we often think about a woman called Rose Reilly, who was not permitted to play football in Scotland and had to go abroad. She ended up as the captain of the Italian women’s team that won the World cup. Thank goodness people can now play for Scotland or for the Lionesses. We should make sure that we get behind women’s football and support it, including in relation to dementia and other such diseases.

Photo of Stuart Andrew Stuart Andrew Assistant Whip, Parliamentary Under Secretary of State (Department for Culture, Media and Sport), Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Equalities)

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.

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.

Photo of Grahame Morris Grahame Morris Llafur, Easington

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?

Photo of Stuart Andrew Stuart Andrew Assistant Whip, Parliamentary Under Secretary of State (Department for Culture, Media and Sport), Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Equalities)

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 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 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 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.

Photo of Chris Stephens Chris Stephens Shadow SNP Spokesperson (Justice), Shadow SNP Spokesperson (Immigration)

That is a very helpful response from the Minister and we would certainly welcome that. Could he perhaps facilitate some discussion with the IIAC and hon. Members who might be interested? I think a number of us would be interested to have such a discussion, if he could feed that back. We could then report back to our constituents. I welcome the comments that he has just made.

Photo of Stuart Andrew Stuart Andrew Assistant Whip, Parliamentary Under Secretary of State (Department for Culture, Media and Sport), Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Equalities)

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.

Photo of Grahame Morris Grahame Morris Llafur, Easington

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.

Photo of Stuart Andrew Stuart Andrew Assistant Whip, Parliamentary Under Secretary of State (Department for Culture, Media and Sport), Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Equalities)

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.

Photo of Ian Blackford Ian Blackford Scottish National Party, Ross, Skye and Lochaber 2:13, 14 Medi 2023

I thank all hon. and right hon. Members who have participated in this debate, and I thank the Front Benchers for their contributions, too. My goodness, this has been an example of how the House can come together across parties. After the hon. Members for Easington (Grahame Morris) and for Moray (Douglas Ross) appeared with me before the Backbench Business Committee, within 24 hours, 28 Members had sponsored the debate. This issue and the love of football strike at the heart of so many Members. There is an appreciation for the travails that so many football players have faced after suffering terrible brain injuries over the past few decades.

I applaud the Minister for his considered and constructive response. My goodness, there is an opportunity for the House to demonstrate the scale of our concern to the Industrial Injuries Advisory Council, representing the interest of all our constituents. I reiterate the comments of my good friend, my hon. Friend Chris Stephens, that it may be helpful for us to represent those concerns direct to the advisory council, which I hope is watching and has listened to our deliberations this afternoon, recognising that there is a case for it to act at pace because so many people are suffering.

We commend all the actions that have been taken, including the financial support provided by the Football Association in England, but people are suffering today. People have suffered for far too long, so let us make sure that the advisory council completes its work and concludes from the overwhelming evidence that these injuries must be seen as industrial injuries. We, as legislators, can then fulfil our responsibility to look after our constituents who need support.

Question put and agreed to.

Resolved,

That this House
asks the Government to investigate the links between football and sport-related neurodegenerative disease.