High court allows rugby brain injury case to go on

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0:30Tonight podcast from Friday the 21st of August. The High Court has ruled that lawsuits brought by more than 500 former rugby players over neurological injuries can proceed. We'll hear from one of them. The Panama Canal joins the Strait of Humoz as a key transit point for world shipping that's going to become less accessible, but for a very different reason. Why is El Nino going to gum up the traffic? We're live in Washington DC where the roads are being turned into an IndyCar racetrack. At Donald Trump's behest, it's to help celebrate 250 years of American independence, but one of the art galleries is nervously boarding up some of its buildings.

1:06We'll debate Channel 4's documentary on ADHD, which has sparked a furious reaction for suggesting it's a sociological rather than a neurological condition. And I've been to meet the young David Lloyd George and Winston Churchill on stage, of course. They've an invitation for the Churchill-admiring President of the United States. Find out what it is by staying with us. World Rugby, along with four British governing bodies across Rugby Union and Rugby League, have failed in their attempt to end lawsuits involving more than 500 former players from both codes. They'd argued that the claimant's former lawyers had repeatedly failed to provide medical records.

1:43In a written ruling at the High Court, Judge Jeremy Cook said the claims could proceed, providing the documents are now produced. He said individual claimants are blameless for the failure to produce them so far. The ex-players believe conditions such as dementia, motor neurodisease and chronic traumatic encephalopathy, known by the acronym CDE, can be caused as a result of injuries sustained in playing rugby. They think the authorities have not done enough to minimise the risk. The governing bodies themselves deny breaching a duty of care to protect the players from injury, and they say player health is their top priority.

2:18I've been speaking to the former Wales Rugby Union player Alex Popham, A flanker, he had a 13-year professional career. He received a life-changing diagnosis at the age of 40. I asked Alex when he first realised something was wrong. It was my wife, Mel, who was picking up on things. We were having important conversations, and an hour, two hours later, the following day, I had no recollection of these conversations. If I did too much, I would lose my temper over the smallest of things, and I was just putting it down to everyday stress. And when I went on a bike ride from my house that I've done over 100 times, I had a blackout moment on this bike ride and was quite upset and scared.

3:04Well, you mean you just didn't know where you were going or why you were there? Well, I knew why I was there. I knew I was on my bike, but I just didn't know which direction to go. So I rang my wife, Mel, and then she said, look, go on Strava and cycle home the way you've just come. and as I got home and walked through the front door, I was upset and that's when I admitted to myself that there was something wrong and the following day called the doctors and from there I had months of testing before getting the diagnosis. And what is the diagnosis you've had? So I've been diagnosed with early onset dementia and probable CTE.

3:44The early onset dementia, that diagnosis came when you were how old? Well, both came when I was 40 over a Zoom call because of COVID. Of course, yeah. A lot of people have heard of the accusation that dementia can be linked to injuries caused in contact sports. We have a lot of cases of people who's developed motor neurone disease again and have suggested this link. But what is CTE? Because I think that's probably a less known condition. So CTE is basically punch drunk. Right. Boxers and punch drunk has been known for over 100 years. And the conversations we're having in rugby now were happening in boxing 100 years ago.

4:28Can you explain what the kind of symptoms are of CTE? Because I think nobody can tell whether someone has definitely got it, sadly, until after they've died and their brain can be dissected. But what are the symptoms that are associated with it? So short-term memory loss, concentration, aggressive outbursts, addictive personalities with using alcohol or drugs to get through a day. One thing I should have said earlier, I suffer with sensory overload. So you and I talking now is OK. But if there were other noises or a telly on in the background, I struggle to switch the background noise off and concentrate on our conversation.

5:12So, yeah, it just makes everyday living pretty tough. And the legal action is in part, I guess, so that you can get some kind of funding to help support you in the future at a time when you might need more care. yeah definitely and uh i mean life's not easy at present i work but i only work two days a week spread over the five just because my brain capacity can't put up with working full time other players have lost everything some people are sofa surfing some are homeless some unfortunately are no no longer with us there's been 42 suicides since I've been diagnosed and we need to stop this happening to the numbers it is.

5:56Let me put to you what the governing bodies say. One thing they say is that they're striving all the time to make the game as safe as it can possibly be. What is it you want them to do that they're not doing at the moment? Well, to return after being KO'd, they say it's 12 days, but there is loopholes that you can return in six. is just crazy when independent research shows a minimum of 28 days needs for that brain to recover. Players are just playing too much, too often. I get that. So in other words, some of the rule changes that they've made, which they say are to reduce the risk of permanent brain injury, you just think are inadequate.

6:38Yeah, and it's just the mileage on the brain from the age of nine when you can start contact, like these sub-concussive hits, every contact, it doesn't have to have the brain involved or the head involved, are still causing the brain to rattle around inside. So we just need to increase that to 16. There may be people listening, particularly rugby fans, who say, look, this is a contact sport. If it was a sport without scrums, for example, a sport without tackling, it wouldn't be rugby. Yeah, but we're not saying that. I still love rugby as a sport, but the changes that we want to make are off the pitch.

7:18They're Monday to Friday. They're not actually in the game, apart from when a player has a brain injury, the player's given the correct rest. Minimum number of games per season, not going over that amount. The game seems to be growing in the length of the seasons. It used to be that it'd be from September to April. Now it's almost a 12-month calendar that these players are playing. The players are bigger, they're faster, they're stronger. These impacts are getting bigger and that needs to be reduced massively. And what about the argument that players are choosing to play this game? And that's just people's freedom.

7:54That's their right to do that if they choose to do it. Yeah, if they choose to do that, but they need to be told the truth. And we weren't. We weren't educated on this issue. Concussion, as they call it, I don't like that word because it softens what's going on. It was treated as a joke. when you saw stars you would just help yourself to some sniffing salts and you would just carry on you weren't told of the long-term implications that you could suffer in later life i think if this all is put out there to players and they still then choose um i think other sports wouldn't allow them to go back on but all the protocols are player led rugby players are gladiators they want to be on that pitch and they want to play but if there's a baseline test that they don't return to play until it shows in black and white that they can return the sport would be a lot safer and that currently isn't happening that's alex poppin who with his wife mel founded head for change a charity supporting those who developed neurodegenerative diseases after careers in sport in a joint statement issued after today's court ruling world rugby the rugby football union and the Welsh Rugby Union said they hoped the litigation could now move forward in the best interest of the players and the sport.

9:11Coming up in the next half hour here on The World Tonight, a play about the early political alliance between Churchill and Lloyd George. Now its legacy is with us to this day. We first did this show about four years ago in Edinburgh and I think in a sense it feels more relevant today, perhaps with what's happening politically, than it did even just four years ago. But yeah, it's that notion of one person's belief, as it were. I mean, it can have such a shattering effect. That's to come. But before that, amid warnings that this year's El Nino is already raising temperatures and could lead to 2027 being the hottest year ever recorded, the Panama Canal is preparing to impose a restriction on shipping.

9:53Rainfall is down by one third on the average between May and August of this year. The canal authorities have announced They're going to cut the number of ships allowed to pass through every day. Linking the Pacific with the Atlantic, the canal carries about 3 % of global trade. The alternative route would add thousands of kilometres to the shipping journey. Coupled with the continued uncertainties over passage through the Strait of Hormuz and the likelihood of more drought as a result of El Nino, which warms the sea and affects the weather, the Panama Canal decision is likely to add further to business costs.

10:25Let's hear now from Professor David A. Gantz. He's a fellow in trade and international economics at Rice University's Baker Institute for Public Policy in Texas. Professor Gantz, thank you so much for being with us. First, can you give us a kind of an explanation of how these factors affect the ability of the canal to operate? Well, the Panama Canal, as some of your listeners are probably aware, is very different from Suez. Suez Canal, 120 miles long, Red Sea to the Mediterranean sea level. The Panama Canal is 50 miles long, but when a ship enters from the Pacific, it's raised 85 feet through a series of locks, goes across Gatun Lake, and comes down 85 feet to the Atlantic.

11:11How does it get up and down? fresh water is used to operate those locks. That's the problem. So if you have a water shortage, you have a problem. Yeah, and we clearly are having a water shortage and it's likely to get worse. They're saying that they're going to reduce the number of ships transiting from 36 a day to 32 by mid-September. That doesn't sound very dramatic. Well, I think by itself, if things don't get worse and if they don't also reduce the draft from around 50 feet down below that, which means ships can carry less goods, it may not be. But when similar things happened in 2023, 2024, they reduced transits to 22 ships at one point.

11:56So it could get worse. That's the real concern, I think. What are the impacts on trade if that route, if more ships have to choose alternative routes to that one? Well, obviously, if you have to take routes which are longer and take longer time and use more fuel, shipping costs go up. And the canal is probably most important for the United States and for South American countries like Brazil, which are either shipping to or receiving from the Far East, particularly China. Because if you're on the east coast of the United States or the east coast of South America and you want to ship goods, soybeans for Brazil, all sorts of things from the U.S.

12:41to China or Vietnam, the easiest way to do that is through the canal. Yeah. I was looking at one bit of information that suggested a gas tanker from Houston to Japan, which takes 26 days if it goes via Panama, would take 45 days if it went around the Cape of Good Hope. So it's kind of an extra nearly three weeks. I don't know what the difference in time is, whether it's 45 days or something. Less than that, there's no question that it's much further. Right. Yeah. And one only has to look at a map or a globe to see that. The Panama Canal Authority has acknowledged that, quote, some ships which transited recently have paid amounts exceeding$1 million at auction to meet their specific market needs.

13:27Presumably there are those companies who will pay whatever it takes to be able to use the canal. I think there have been a few payments of something close to$4 million. So, yes, I think you're correct. I think most companies obviously want to keep the cost down to whatever it normally is around a million dollars at a time because they don't want to have to pass those additional costs on to their customers. So that's probably the thing. There's a big difference between most of the ships, I understand it, have reservations, but sometimes there are auctions off of specific slots. And that's where the really large numbers appear to come from.

14:08Could this be a big headache for the U.S. federal government as it as it tries to keep inflation down and costs down in the U.S.? So one more problem for the current administration as it tries to deal with the inflation caused by, I guess, tariff policy, the Iran war and maybe some other factors as well. So, yes, I think it's very important to the administration that there not be an increase in shipping costs to and from Asia. Professor David A. Gantz, fellow in trade and international economics at Rice University's Baker Institute. Thank you. Now to something that underlines how decisions made by politicians here a century ago are still affecting the world today.

14:49It's a play which returned to the stage this month and which could be about to head across the Atlantic. It's all about the relationship between two men, one called David and one called Winston. I am glad to have an opportunity at this time of crisis of addressing so many thousands of people whom I cannot meet face to face. Marriage is the greatest and the oldest partnership in this world. It is one of the very few institutions that enable people whose dispositions and temperaments are exactly opposite to each other to live in perfect harmony. Two wartime prime ministers, Lloyd George and Churchill, rivals but also friends.

15:39Their relationship around the time of the First World War is the subject of a play that's just entering its final week here at the Tabart Pub Theatre in West London. And I'm just heading inside to see what it's all about. Step through this door. Step back in time. Oh, oh, you've drawn the old block too. Oh, you've never supported me. You've let me take the rap. A fine friend you are in a fix. All I want to do is win the war, Winston. I've been at these new tasks day and night providing munitions to the army. There's no question of personal glory or blame. I will be blamed! I will take the fall.

16:19And you do not care. You do not care whether I'm trampled underfoot by my enemies. You do not care for my personal reputation. No. I don't even care for my own at the present moment. The only thing I care about is that we win this war. Dammit! Where's my whiskey? Nick Helligan, you're the director. Tell me first of all about how you decided your treatment, the staging of this play. Well, it came to me. Robert Lloyd George, who of course is the great grandson of David Lloyd George, actually approached me at Edinburgh. He'd seen some stuff we'd done in Edinburgh. And he sent a first script, which was quite long and had a cast of about 40.

16:55The kind of secret or the thing that really made me feel it would work as a piece was when I found out about a woman that actually Lloyd George had an affair with. I felt that there were so many massive events, you know, how do you deal with the First World War, the Second World War, Ireland, I mean, the whole kind of gamut of world politics. It had to really be a personal story, and she was the key, really. So when I found her, I thought I'll have her as the kind of the storyteller. So you turned a 40-hander into a 3-hander? Yes, yes, that's right. That's about right, yes. And, of course, it means I don't have to pay 40 actors, which is also a shame, because we all love paying actors.

17:30You've got three very good actors. We've got two of them with us now, straight from the stage, Peter Swales and Joe Ems. Peter as a character who's a bit of a drunk, Joe as a character who was certainly a woman, I think. Yeah, yeah, that was fun to research. I mean, I knew little of David Lloyd George, to be honest. And for me, the way in, you know, it was the personal challenges, the family turmoil and, you know, having a mistress and how he coped with all these things. He falls in love and then there's a possible pregnancy. and don't want to spoil the show. And then suddenly it's back to war, back to politics, back to all these things and juggling these things.

18:06And so that was a way in. Is there a challenge in particular in playing Churchill, Peter, because he is somebody who people think they know so well and he's had more of a legacy in terms of popular image than maybe Lloyd George has had? Yeah, to be blunt. Because I think everybody comes with a preconceived idea ultimately. And I think that's what's been really interesting about the play, I feel is that the preconceived idea is very much kind of like Second World War period, which the play as a whole doesn't touch on. It's not a caricature, you know. It's been a real nice creative process to play with that, actually, yeah.

18:39Were you at all surprised, the three of you, how many things that we still talk about today, like Ireland, like what was then called the Palestine Mandate, were things that these two men had such a critical role in contributing to and arguably made decisions that are still having an echo to this day? Yeah, it's quite humbling in some ways. Yeah, it's quite humbling that, you know, the whole Palestine thing. It's also slightly frightening in that arguably we didn't, when I say we, the UK didn't have to go into the First World War. And it was the relationship between Lloyd George and Churchill that meant we did and the bloodbath that followed.

19:17And I actually feel, we first did this show four years ago in Edinburgh, and I think in a sense it feels more relevant today, perhaps with what's happening politically, than it did even just four years ago. But, yeah, and it's that notion of one person's belief, as it were. I mean, it can have such a shattering effect. Does it play over the future? Well, yes, hopefully, yes. It looks like we're going to America. Hey, yes, land of the brave and home of the... whichever way around it is. Free. So, yeah, we've been invited to go to Florida at the moment. And just this week, I was in Edinburgh, someone was talking about us going to Texas.

19:53So I mean, and of course, he's very well known, of course, certainly Churchill anyway, in the States. Donald Trump often references him. Oh, I wasn't aware of that. He'll be in the audience now. I didn't realize that. Look out for the breadcrumbs. Special appearance in the White House, if you're in luck. Yeah, well, invite him, perhaps. Or maybe he can invite us, if you're listening, Don. We'll let you know what comes of that. Director Nick Hennigan and actors Peter Swales and Joseph Hems, archive courtesy of British Pathé. The last performance of Winston, David, is at the Tabard next Saturday.

20:26You're listening to The World Tonight. It is now 26 minutes past 10. If you're listening to us live, that is the main headline so far. The High Court has ruled that hundreds of former rugby players can go to trial against, or can continue with their case rather, against the sport's governing bodies. They claim that those governing bodies didn't do enough to protect them against head injuries during their playing careers. Get more with BBC Podcasts, wherever you listen. Be the first to listen to your favourite shows like Evil Genius, Good Bad Billionaire and You're Dead to Me with a subscription to BBC Podcasts Premium on Apple Podcasts.

21:06You can also enjoy a range of our podcasts ad-free with an Amazon Music subscription.

21:15Now to a documentary about ADHD which has provoked an online furore and a complaint to the broadcasting regulator Ofcom. On Tuesday, Channel 4 broadcast a programme called The Great ADHD Myth? The presenter was Dr Max Pemberton, an NHS psychiatrist, for the last 25 years. The current understanding of ADHD, that it's a neurodevelopmental disorder, meaning that people's brains are wired differently, is not supported by the evidence, according to some of the most respected experts in the field. The feelings, the struggles, the experiences are real. The explanation is false and I would actually argue unhelpful.

21:57I've spent the last 25 years researching the history of ADHD. The disorder is, to a certain extent, a social construction. Well, ADHD UK, a charity which has made the complaint, disputes that. Channel 4 argued it was, quote, legitimate for conventional understandings to be challenged. Let's discuss that with Gina Rippon, Emeritus Professor of Cognitive Neuroimaging at the Aston Brain Centre, Aston University in Birmingham. And Dinesh Bugra, who is Emeritus Professor of Mental Health and Cultural Diversity at the Institute of Psychiatry, Psychology and Neuroscience at King's College London. We're grateful to you both for joining us on The World tonight.

22:43Let me begin with you, if I may, Gina Rippon. What's wrong with that approach, challenging conventional understandings? Well, I think if you're going to challenge it, I mean, there's nothing wrong with an attempt to challenge something, but you need to follow due process, really, to make sure that the arguments you're making are sound. You know, it is a neurodevelopmental condition. It would be hard to think how you would overturn the evidence that that is exactly the case. But if that's what you want to do, then you really need to use proper scientific procedure. And I think the, and I have called it in quotes documentary that we saw on Tuesday, bears no resemblance to any proper challenge.

23:31Dinesh Bougra, you contributed to the program. Do you go along with Max Pemberton's assertion there? I think there are several things that we need to bear in mind. I mean, first and foremost, we need to recognize that ADHD exists and people are affected by it. But the question then is, why have we got such high numbers now? What has caused that? How do we try and make sense of the numbers? And how do we help people who may be suffering? And I think it's a very complicated, complex issue, because we need to take three steps back in the sense as to why now? You know, why is there an epidemic of ADHD?

24:18Why are so many people seeking help? And part of the challenge that we need to address as professionals is about diagnosis creep, that the diagnosis has become loser. It has become a loser in the sense that not losing, if you see what I mean, but it has become less rigid. And it has led to a lot of people seeking help from the Internet and making self-diagnosis. Right. And there was an element in the program where Max Premerton offered himself up on the Internet and got apparently diagnosed by someone. And Gina, there was a question mark at the end of the title. Did you think it was sufficiently there in the content?

25:12No, I mean, well, clearly the statement was in the title. And, you know, I've written about the sort of responsibility of scientists reporting what they find and being careful about the language they use. And the whole framing of the approach to this documentary before we even saw it was that they had decided what the answer was going to be. And this documentary was devised in order to prove it. And I think one of the comments made just earlier that ADHD exists, actually the whole documentary was really demonstrating in a very irresponsible way with a misuse of, again, in quotes, evidence, that their aim was to demonstrate that there wasn't any such thing.

26:02and that was the message that people were worried was going to be given out before the documentary was even shown and certainly the message that came across when it was shown. Dinesh, is that how you felt after you saw the programme? Because obviously you contributed, like any contributor, you don't know how your contribution is going to be used. You take that on trust, as it were. Did you feel that is how the documentary came out? I think the documentary challenged some of the issues that people are confronted with. And yes, of course, you've got only a fixed time and fixed number of experts to speak to.

26:42So you get a very broad view. You don't get a nuanced view, which is what you need. And you need that kind of understanding as to what is going on. And for me, the example of that young boy who... Yes, that case was very important in the story, wasn't it? Just briefly, a young boy who's been on medication for his ADHD symptoms, who his family wanted to try off the medication to see if they could give him a life experience without it. Exactly. And what was very clear, that school failed him, in the sense that the school, the educational system did not meet his needs. And that's the question that we need to address as a responsible society.