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The Hazards Of Not Removing Hazard

The Hazards Of Not Removing Hazard

Following Chelsea’s 2-2 draw with Swansea in their opening game of the season, controversy has (not for the first time) surrounded Jose Mourinho’s post-match reaction. The Chelsea manager could barely conceal his fury at his medical staff for going onto the field to provide treatment for Belgian midfielder Eden Hazard in the closing minutes of the match – a time when the player’s not inconsiderable skills were needed in the search for a winning goal. In post-match interviews Mourinho branded the medical team “impulsive and naive”, adding, “even if you are a kit man, a doctor, or secretary on the bench, you have to understand the game.” Remarkably, The Telegraph then reported that the “accused” party, Chelsea first-team doctor Eva Carneiro, is to have a “re-tasking of duties” and will no longer have a role on the Chelsea bench, and that first-team physiotherapist Jon Fearn’s match day role is also in Mourinho’s crosshairs.

The Burness Paull Health and Safety team’s armchair football pundit Adam McCabe and resident doctor Ashok Rebello debate the merits of Jose’s actions.

Were the medical team “impulsive and naive” to go onto the pitch?

Not in our view. Jose Mourinho’s point is that tending to Eden Hazard during stoppage time deprived Chelsea of a key player at a crucial time in the match, especially given that they had already been reduced to ten men with the earlier sending off of their goalkeeper. Chelsea were at home (where they nearly always win), under pressure from their fans and from opponents Swansea, trying to see the game out whilst already being a man down. Swansea stood to gain from Hazard’s “removal” not only from a defensive point of view – by having fewer attacking players to deal with – but also offensively given that it left Chelsea more exposed if they were put under pressure. However, the primary concern of the medical staff in any football team – rightly – is the wellbeing of the players, not the match result. 

Chelsea FC has a legal duty to ensure the health and safety of their employees whilst at work. Professional football players are at work when playing a match. Players can get hurt during a match and prompt medical care helps to minimise the effects of this. Doctors are required by the GMC to put the care of the patient first and take prompt action if they consider that patient safety, dignity or comfort is being compromised. In the challenge by Swansea’s Gylfi Sigurdsson, Eden Hazard took a blow and went down clutching his leg and appeared to be in some pain. The medical team appropriately went onto the pitch to assess Hazard and thereby fulfilled their duty of care. 

Mourinho claimed that, “You have to know you have one player less, and when you go to the pitch to assist a player you must be sure that the player has a serious problem. I was sure Eden had not a serious problem.” Did the medical team need to go onto the pitch?

Firstly, Jose Mourinho is not a doctor (at least in so far as we are aware) so his views of Hazard’s injury are irrelevant. If Mourinho is insinuating that Eden Hazard was feigning injury, then that would reflect more poorly on the player, and also his manager for condoning it, rather than Eva Carneiro and Jon Fearn.  Secondly, the fact of Chelsea’s already being “one player less” at the time was nothing whatever to do with the medical staff and all to do with a reckless challenge by (and resultant red card for) their goalkeeper. Fundamentally, non-playing personnel cannot stray on to the jurisdiction of the pitch without the referee’s permission. The team doctor or club therapist can be summoned by either the player or the referee.  The Independent reported that before the medical team went onto the pitch, the referee turned to the Chelsea bench twice to signal the need for medical assistance. The medical team could not be expected to ignore this instruction. No matter how slight (or non-existent) the injury is, the rules state that a player receiving treatment must be removed from the field of play until the referee signals that he or she can return. It seems, then, that either Hazard himself has asked for treatment or the referee has made the decision for him. Either way, that is not the fault of the medical staff. 

Irrespective of Mourinho’s assessment of Hazard’s injury, the medical team has a duty of care to their patients. They must exercise their own clinical judgement and cannot let the opinion of the manager interfere with that duty. The Chelsea manager stated that this was the first match of the season and so the players were not yet in top condition. Therefore the likelihood of an injury may have been greater. Eden Hazard appeared to be in distress and was clutching his leg following the challenge. Whilst the aim of the club is to win matches, this cannot be at the expense of safety. Health and safety law is clear on this. The medical team are under an obligation to put the care of the patient first. Jose Mourinho’s conduct could be construed as sending out a message that the result must be achieved at all costs. Is that the kind of message that a senior figure in an organisation should be sending out?

Might Mourinho’s comments and actions here send out the wrong message regarding player safety?

On one view, yes. The bottom line is (or, in clichéd football player interview parlance, “at the end of the day”), medical staff have to make split-second judgements on injuries and treatment at pitch-side, as do referees when assessing whether players require medical treatment. It was only the quick-thinking reactions of and instantaneous treatment provided by medical staff, including a cardiologist who was present as a spectator, which saved the life of Bolton Wanderers’ Fabrice Muamba in March 2012 when he suffered cardiac arrest during a match. And Premier League goalkeeper Petr Cech received very serious head injuries in an on-pitch collision – while playing for Chelsea in 2006 – which require him now to wear head protection during play.

Jose Mourinho, whilst undoubtedly a very successful football coach, is also a master of what some may call the dubious art of “gamesmanship”: almost a week later the media focus is still on “Hazard-gate” rather than any tactical shortcomings of Chelsea in the match. But there is a difference between deflecting blame from your team, on the one hand, and what appears to be a very public “scapegoating” and punishing of two medical professionals who were by all accounts simply doing their jobs, on the other. There is a lesson here in “Hazard perception” going forward – it is surely not the job of Jose Mourinho to medically assess player injuries any more than it is the job of medical staff to advise football coaches on the merits of a 4-2-3-1 formation. Just as the health, safety and welfare of, say, a construction worker or offshore worker must not and should not be devalued by their employer in times of economic downturn, the safety of football players cannot be dependent on what the result on the pitch is at the relevant time. After all, “it’s only a game”...

Adam McCabe

Ashok Rebello