Interview: Dr James Robson, Scottish national rugby team doctor

Coaches come and go, players circulate in and out of fashion but one man alone seems to be a permanent fixture within the Scotland squad, Dr James Robson.

• Dr Robinson rushes to the aid of a player

His association with the national team has stretched back over 20 years now, first as the physiotherapist and latterly as the team doctor. He is also part of the Lions' fixtures and fittings, having toured with the British and Irish side on the last five occasions. To mark his outstanding contribution to the field of sports medicine, Robson was recently awarded a Fellowship by the Royal College of Surgeons, a rare honour for a non-surgeon.

He's a softly-spoken, unassuming character who nevertheless exudes the quiet confidence that comes naturally to all genuine experts. Robson wants to talk about the International Rugby Board's second Medical Conference that he attended last month in London which, he reveals, was really the first.

"It was called the second global conference but I was there last year and maybe nine or ten unions sent a representative," explains the doctor. "This year there were 28 different countries in London including Germany, Hong Kong, Samoa and all the usual suspects. In reality this was the first truly global conference.

"The four home unions already exchange best practice and suchlike," continues Robson. "The medical care you get in Dublin or London will be pretty much exactly the same as it is in Edinburgh or Cardiff, but some of the smaller countries really had their eyes opened by what we were doing."

The conference took place over three days, concluding with a keynote speech on the final day from former Scottish international Thom Evans on, you guessed it, catastrophic injury and emergency care best practice. I put it to Robson, widely credited with saving Evans' life in Cardiff back in February (above), that the winger was fortunate to hurt himself in such a high-profile match because there is precious little medical expertise where most players ply their trade. Many clubs' medical cover starts and stops with a tube of Deep Heat and a roll of Elastoplast.

"You're right," says Robson, "which is why we need more people to attend basic first aid courses that are widely available. It's important not just in sport but across society as well. I am talking about something different from David Cameron, but we each have an obligation to a bigger society, to be better prepared to help people. We have a duty of care to one another and we can all learn a few simple techniques to help."

Robson doesn't have far to go to find an anecdote to support his case, since the day before our interview one of Murrayfield's groundsmen had successfully intervened in a life-threatening situation at the stadium.

The SRU have made two significant changes to make the game safer in recent years. They rolled out their "Are You Ready to Play Rugby?" programme, even though it's not yet mandatory for players, and they sought to minimise physical mis-matches at age group rugby by insisting that players under 16 play U16 rugby while players under 18 are not allowed to play senior rugby without passing various strength tests.

Both initiatives were in response to a spate of serious spinal injuries in Scottish rugby, with three recorded in just four seasons. The good news is that there has been none since September 2008 although it's far too early to start making any grand claims just yet. In a rugby community as small as Scotland's these numbers were way off any statistical chart so presumably that was no more than an aberration, a blip in the records? Robson is too canny to jump to any such conclusion.

"We can't be sure, because the body of evidence is simply too small," he replies. "That is why the IRB has started, from 1 January, 2011, a brand new standardised data collection system for all spinal injuries. All nations will have to provide set data on neck injuries so that the IRB has sufficient data to make sound judgments."

The idea is that with a larger database the law makers will be better able to target the danger areas on the field. While Robson concedes this sort of database should have been started a decade or more ago - "in hindsight everyone would wish for better data collection" - he praises the authorities for making a start, however tardy. He also talks about an IRB joint study with Bath University into the forces in the set scrum, while acknowledging that since the touch-pause-engage system has become standard practice the tackle has overtaken the scrum as the single most dangerous area for catastrophic injury.

As a result of too many of what he calls "high, high-speed tackles" the doctor's preference is for outlawing any tackle above the nipple line simply on the basis that it gives the tackler some leeway for making a mistake. If he/she gets it wrong by a few inches the tackled player's neck/head should still be out of the firing line.

That is just one example of foul play but Robson wants to see an end to all illegal activity on the pitch on the basis that players are often injured by what they least expect.

At the end of the November conference the IRB issued a statement putting education at the centre of improvements in player welfare. Scottish rugby is fortunate to have one of the game's leading medical practitioners doing just that.