What do the conductor of the London Mozart players, a Michelin-starred chef, the surgeon who treated the survivors of an Everest disaster, a leading UK barrister and Max Clifford have in common? Superficially, not much. However this week the Risky Business conference brought these people, among many equally varied others, to speak to healthcare professionals about risk. In the words of Allan Goldman, the conference’s director: “We hope that you will leave this event “juiced” with new ideas to take back to your organisation to improve patient outcomes.”
In a cluster of speakers talking about human factors, and what to do when things go wrong, was Dean Richards, the England/Lions Rugby Union player and Director of Rugby Leicester and Harlequins. What went wrong for Richards was fairly spectacular, having been extensively played out in the press and even acquiring its own Richard Nixon-homage moniker. He was the orchestrator of “Bloodgate,” where, in the quarter finals of the 2009 Heineken Cup, a member of the Harlequins side under Richards’ direction faked a blood injury to facilitate a tactical substitution. “On the day we looked at this and thought let’s run with it, let’s cheat,” he said yesterday. The discovery of the manoeuvre led to a twelve month ban for the player Tom Williams, a £260,000 fine for the club, a two year ban for their physiotherapist, a suspension and General Medical Council hearing for the club’s doctor and a three year ban for Richards.
Richards admitted he’d been reluctant to speak at Risky Business, but 19 months after “Bloodgate” he wanted to share the lessons he’d learnt.
“The first thing I’ve learnt is not to do it,” was his overall admission. More specifically, he said he wished he’d followed his gut instincts throughout the incident and aftermath. These urged him not to fake the substitution in the first place, and then to admit the fault straight away, rather than denying wrongdoing in his first hearing, and only coming clean in the second. Alongside this, taking fuller responsibility was another lesson learnt. “If you’re ever in that situation, just hold your hands up – it was my fault, I did wrong,” he advised. Richards also said he was going to be more prepared for the media in future. He wasn’t ready for the onslaught, and wanted to have more control over his own publicity. Finally, he recommended good old-fashioned apologies.
But Richards’ lessons weren’t just personal, and he explained the wider impacts that “Bloodgate” has had – extending these as far as sport as a whole. He was keen to stress the changes that had happened to rugby over his career: “When I first played as a 16, 17, 15 year-old anything happened on a rugby field. You only had a referee, you didn’t have a touch judge, no cameras, you didn’t have anyone who could side you. Anything could happen in those days.” Rugby only became a professional sport in 1995, and is becoming increasingly lucrative, and Richards sees the changes made after “Bloodgate” as important in the sport’s maturity.
Since the episode, the Harlequins have constructed a new code of conduct, and a whistle-blowing policy Richards described as “fantastic”. They now undertake an annual review, involving everyone in the club, and Richards said these changes have had a big impact, serving to make everyone involved more accountable.
To rugby, he said, the scandal came as a big shock. The regular checks, balances and processes which needed to be addressed were addressed and brought in, signalling an attitude much more befitting of a professional sport than a laissez-faire “anything goes” one. The European Rugby Cup felt prompted to undertake a disciplinary review.
How much Richards managed to “juice” the audience is hard to tell, how much a rugby club can be compared with a hospital or the sport with evidence-based medicine tricky to define. But ending his talk with “I hope you don’t fall into the same trap as I did,” he certainly got one of the biggest applauses of the day.
Harriet Vickers is a multimedia intern with the BMJ.