The number of medics and physiotherapists offering their services free of charge to our national game is in a sharp decline.
New Zealand Rugby has confirmed to the Herald the “general health workforce shortage” in the country is affecting the availability of doctors and physios “at all levels ofthe game”.
And former All Blacks physio Malcolm Hood – who last season stepped in to help save the life of a badly injured teen, and helped another with a severe spinal injury – says one factor is colleagues are concerned they could face sanctions for being “out of scope of their practice”.
Hood’s stated growing reticence of medicos offering their services comes as rugby officials look to arrest an alarming slump in the registered players in New Zealand, including a massive 25,676 who have walked away from the game in recent seasons.
Former All Blacks physio Malcolm Hood says the big drop in physios and other medical specialists sideline at rugby grounds is a concern. Photo / Michael Craig
The veteran physio has also witnessed a marked drop in health workers volunteering for sideline duties at club and schoolboy rugby, something that led to him stepping in to give immediate care to a seriously injured teen while watching his grandson play First XV rugby.
“A number of my colleagues now are so concerned about practising outside the scope of practice, they are not involved in rugby,” he told the Herald.
“They have become so worried about the bureaucracy of practising outside of scope of practice, that they have stepped away. People are apprehensive about overstepping the mark with their treatment.
“In my case, it involved going to treat a boy who had his trachea knocked out [dislocated].
“Now, that boy survived, he was blinking lucky. But if he hadn’t survived, I would have been facing a medical disciplinary board. I would have been found innocent [because I was qualified in what I did] but would still have had to face that board [Physiotherapy Board of New Zealand].”
Scope of practice covers what contexts physios – who can be called doctors by completing advanced studies – can work in depending on their education and practice experience.
Physiotherapy organisations say the drop in the number of physios voluntarily involved in rugby is down to workload and fears of burnout. Photo / File
Anyone who was volunteering at any sporting event – including schoolboy or grassroots rugby – would need the “appropriate background” and recent working experience to handle any issue they tried to treat.
“If you had someone who spent most of their time in practice behind a desk – and there is nothing wrong with that . . . tonnes of physios practice as clinical advisers for ACC or insurers – but they weren’t on the tools so to speak every day, we might have some concerns of those sort of practitioners having a go on the weekends,” Dunne said.
“It is not in the core of what they do every day.”
Dunne added the PBNZ had no research that might show any reduction in physios volunteering their time, saying that was not something it monitored.
‘Burnout’ fears, stretched health force affecting grassroots sport
PNZ also did not keep statistics which could highlight a drop-off.
But the organisation’s president Kirsten Davie said in the current environment – where the health system is increasingly stretched and amid cost-of-living rises – she would not be surprised if that was the case.
Former All Blacks physio Malcolm Hood says the fact first aid care is not available at all grounds hosting rugby games is putting some parents and players off the game. Photo / Neil Reid
“Because the health sector is under so much pressure, it is about balancing that sort of burnout and being able to assist in the weekend,” she said.
“From my point of view with my staff, they are keen to be involved at that grassroots level. It is just trying to manage it [so] that they are not getting burnt out as they are working intensely during the week and then they are also giving up quite a bit of their time on the weekend.”
Working within scope was “imperative” and physios had to be mindful of being asked to handle something “wider than that”.
Chair of Sports and Exercise – a special interest group for PNZ – Richard Jarratt said volunteering on the sidelines used to be part of a “rite of passage” for physios dreaming of eventually landing a role with a prominent sports team.
But in the past the numbers involved were “significantly more” than are now, he said.
“The dropout is probably more physiotherapists, one, being significantly worked at work, and then, two, getting to the weekend and being less likely to be giving up voluntary time,” Jarratt said.
Player drain ‘worrying’, ex-All Blacks physio says, amid health and safety concerns
Hood has spoken out over his fears the sport he loves so much – and which has played such a big part in his life – would lose more players because of safety fears, combined with a lack of first aiders, at games at the community level.
New Zealand Rugby has been looking at the issue of player loss for successive seasons.
The sporting body gave itself a fail mark in its 2022 annual report for failing to both increase the overall number of players (it dropped by more than 10,000 from 158,409 in 2021 to 147,847) and the number of female players (dropping from 27,562 to 25,298).
The 2022 NZR annual report said the Covid-19 pandemic was one of the reasons behind the most recent drop-off.
At a time when parents are increasingly becoming nervous about their kids playing rugby, Hood said just the sight of a physio or first aider at a ground could allay some of those fears.
Hood said the player drop-off was “absolutely worrying”.
“How can so many people drop out of rugby? The fact of the matter is that mothers think that soccer is a non-contact sport, rugby is a contact sport”.
During three years of following his grandson’s First XV side, he never saw a first aider at matches.
“So I looked after both teams [playing],” Hood said.
“Now, I didn’t go as a medical person, I went as a grandfather to watch my grandson play footy. But I am actually doing the medicine for two teams.”
A snake keeps John Mills, left, Malcolm Hood and Buck Shelford company during the 1986 Cavaliers tour in South Africa. Photo / Malcolm Hood
But as they grew into their mid-teenage years, contact collisions increased in impact. As that increased, so too did the chance of more severe injuries.
“The reality of it is, people are asking, ‘where are the zambuks [referring to St John volunteers who used to be regularly sideline] and other medical volunteers?’, Hood said.
“If rugby doesn’t start to take a really good look at the grassroots medical care, it is going to lose more players. There is no question in my mind and in the minds of many of my colleagues who I talk to, about that.
“The number of people who say to me, ‘I am not letting my boy play rugby because there is too much impact and no medical support for them’ is growing.
“And sooner or later, some politician will come up and say ‘no sport in New Zealand shall take place unless there is a designated and qualified first aider’.”
NZ Rugby looks to upskill its own volunteers in sideline injury care
A spokesperson for New Zealand Rugby said one of the drivers for a reduction in the availability of doctors and physios was “a general health workforce shortage”.
“We agree with Physiotherapy NZ’s comments about the pressure physios are under with increased workloads amid wider health system issues,” the spokesperson said.
“However, in terms of scope of practice, we are more than comfortable that physios are working within their scope of practice in their roles as pitch-side medics and we are very grateful to all health care professionals who play a role in looking after our players and keeping them safe while participating in rugby.”
The courses are rugby-specific and are delivered by practitioners with rugby expertise.
“The Fair courses are voluntary and open to anyone in the rugby community – volunteers, coaches, referees, physios, players, sports coordinators, parents, and everyone else interested,” the spokesperson said.
NZ Rugby now has its own initiative for training volunteers to provide first aid at grassroots games. Photo / Rachel Canning
“We trained and certified 186 Fair medics across the country in 2023. These courses are on top of NZ Rugby’s already compulsory RugbySmart and Small Blacks courses for all registered coaches and referees.”
In 20922, 117 volunteers gained the Fair qualification.
Jarratt – who has previous experience working with New Zealand Cricket and Canterbury Rugby – also said Sports and Exercise was also looking to upskill members.
It offers a sideline trauma course available for physios who are involved in sports and covers areas not taught at undergraduate level.
Jarratt said the course was a positive thing for physios who were going to be sideline at sports events across the grades.
Neil Reid is a Napier-based senior reporter who covers general news, features and sport. He joined the Herald in 2014 and has 30 years of newsroom experience.
