BMA criticises increased funding for boxing

BMJ 2012; 345 doi: (Published 21 December 2012) Cite this as: BMJ 2012;345:e8678
  1. Nigel Hawkes
  1. 1London

The British Medical Association has criticised the decision by UK Sport to award greatly increased funding to boxing in the run up to the next Olympic Games.

“It’s a setback to our campaign against boxing, and it’s worrying,” said Vivienne Nathanson, director of professional activities at the BMA. “We worry about how many go into it without knowing the risks.”

British boxers did very well at the London Olympics, winning three gold medals, a silver, and a bronze, putting them top of the medal table. This represents something of a rebirth for amateur boxing in the United Kingdom, which in 2004 sent a single representative to the Athens Olympics, Amir Khan, who came home with a silver. Half of this year’s 10 team members won medals.

UK Sport has adopted the policy of rewarding the successful; and boxing’s share of the pot for the four year cycle between Olympic Games is to rise from £9.5m (€11.7m; $15.4m) to £13.8m, a 45% increase, which is bettered only by water polo, whose more modest grant rises by 54%. The biggest losers were basketball and wrestling, which lost their grants entirely, and, among more mainstream sports, swimming, which had a disappointing Olympics in London and suffers a 15% drop in funding as a consequence.

The BMA’s opposition to boxing is long standing and was reiterated at the annual representative meeting in 2012. The policy originated in 1984, and a series of reports has followed, the most recent in 2008.1

“We haven’t changed our view,” Nathanson said, “but getting any movement has been very difficult. What really worries us is that we see boxing promoted as if it’s a low risk activity, whereas it carries considerable risk. You can’t repair brain damage once it occurs.”

Other sports such as horse riding also carry risks, she acknowledged, but boxing was different because the injuries in other sports were accidental, while the whole purpose of boxing was to inflict injury. “Hits to the head are a deliberate part of the sport, and you can’t protect the head,” she said. “If it’s done often enough it will cause damage.”

Nor did the benefits of boxing in promoting discipline and fitness outweigh the risks, in her view. “You can get the same benefits from any sport, without the risks of boxing.”

Charlotte Leslie, Conservative MP for Bristol North West, disagrees with the BMA’s view on boxing. A former boxer herself (and daughter of Ian Leslie, a consultant orthopaedic surgeon at Bristol Royal Infirmary), she founded the All Party Parliamentary Group on Boxing and has become one of the sport’s most eloquent defenders.

The sport provided the element of risk that children needed but were being denied in the playground and schoolroom, she wrote in the Daily Telegraph in 2008. “It teaches that actions have consequences, as they do in the world beyond school. It teaches that if you don’t move quickly, you can get hit. And it hurts a bit. But it is measured risk in a supervised environment. Contrast that with the uncontrolled violence on many of our streets on a Saturday night.”

She argued that boxing unashamedly recognised the aggression and frustration common in teenagers and gave it an authorised physical outlet. “It reaches the places other sports don’t reach and gives young people who have never been good at anything a sense of worth and self-esteem . . . They no longer feel that they have to pick fights, but can walk away. Boxing endows them with the confidence to give school a go and make job applications.”

The BMA Board of Science’s most recent update of its policy says that the evidence of brain damage is far less clear cut in amateur boxers, who include those who fight in the Olympics.

A systematic review of observational studies in amateur boxing published in the BMJ in 2007 found “no strong evidence” of chronic traumatic brain injury, though the studies it included varied in quality, and some did show evidence of damage.2

The authors, led by Mike Loosemore of the English Institute of Sport and doctor to the UK boxing, fencing, and bobsleigh teams, evaluated 36 papers and found that the better the studies were, the less likely they were to show any evidence of brain damage.


Cite this as: BMJ 2012;345:e8678