Football and Dementia

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.

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?

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 the Member for East Renfrewshire (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.

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.

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.

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?

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.

I am of the same generation as the right hon. Gentleman.

What?!

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.

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.

I thank the right hon. Member for Ross, Skye and Lochaber (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.

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

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

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

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.

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.