Mr. Omar Hassanien:

Many of the questions relate to the amateur game and I will leave those to Dr. McLoughlin. I would like to clear up one misunderstanding regarding the question around with whom the ultimate decision lies. The simple answer is with the team doctor. The GAA and rugby are the very much same in this regard.

Issues were raised around coaches and management. When I refer to management, I refer to team management and administration, not medical management. Coaches and management should not be involved because they should not have influence over the decision. With more money coming into the game in countries such as France and owners coming in with their money, we need to ensure they are separated from medical decisions. Coaches who want their star player for a particular game or in subsequent weeks should be separated 100% from that decision. There should not be any pressure, therefore, from coaches or management. It may have existed in the past but it should not exist in this day and age. With regard to subsequent weeks, we have the gradual return to play policy in rugby. The coach should be separated from getting into a medic's ear or a player's ear to say, "You're okay, mate".

I refer to the issue raised around referees. The team doctor and not the referee is the final decision maker. However, the referee is often in a better position. I reiterate my colleague's words: "If in doubt, recognise and remove any doubt" or "If in doubt, sit out". The referee might often recognise that doubt having seen the collision and, therefore, he should advise the team doctor but, ultimately, the doctor will always be the final decision maker in that regard.