Newcastle United defender Fabian Schar suffered a clash of heads with a Georgia player at the weekend but was allowed to continue playing

While FIFA pontificates about whether there should be 48 teams rather than 32 at the already ludicrously disruptive 2022 World Cup in Qatar, football’s global governing body should be focusing on far more pressing matters.

The images of Georgia’s Jano Ananidze inserting his fingers into the mouth of Newcastle United defender Fabian Schar to prevent the Switzerland international swallowing his tongue over the weekend were dramatic – and, to a certain degree, heroic.

But it was what happened next which was so horrifying. Both Schar and Jemal Tabidze – the Georgia player with who the Newcastle centre-back sickeningly clashed heads – received treatment, with the latter seeing his head heavily bandaged, yet the pair were permitted to play on.

After the game, Schar readily admitted that he had no recollection of the clash which left him temporarily unconscious, and that his skull was still “humming” from the impact.

This shows just how far behind the times football is when compared with other sports; and the stark reality is that player welfare, most particularly concerning head injuries, is in urgent need of reform.

It is true that 20 years ago Schar would have been lauded for how ‘hard’ he was for continuing, but scientific and medical evidence shows that this macho attitude needs to be shelved for the good of players’ health.

American football is miles ahead of any other sport when it comes to head injuries, but rugby union is fast catching up, too.

Since 2015, the Head Injury Assessment (HIA) protocol has been adopted into rugby’s laws, and it has radically reformed how potential concussions are assessed.

Now, whenever there is a suspected incident of head impact on a player, then referees, team-medical staff, and also independent matchday doctors who are given access to video replays, determine whether there needs to be further assessment.

If that is the case, then a player can be temporarily substituted while they are assessed for concussion – the tests, conducted by a doctor, take around 10 minutes to complete – and then they are allowed to return if they pass, or are replaced permanently if they fail the assessment.

But that is just the start of the process; after the game, players who have suffered a knock to their head are regularly evaluated – and, if a player does suffer concussion, they are prevented from training for a minimum of eight days, though it can be significantly longer depending on the severity of each individual case.

FIFA’s regulations in football do allow for a maximum three-minute stoppage for players suspected of suffering a concussion, they allow for a doctor to determine whether an individual can continue playing, while they also permit another medical professional to aid in the assessment process by watching in-match video replays.

And, although FIFA’s protocol states that players should be prevented from training for at least six days following a concussion, the global governing body last year rejected the idea of adopting a temporary-substitution system similar to that used in rugby.

This is not to say the game’s leaders are not attempting to address the issue; there have been steps taken at both national and international level to do so.

The Football Association’s own concussion guidelines stress that “at all levels in football, if a player is suspected of having a concussion, they must be immediately removed from the pitch, whether in training or match play”‘

But, not only are these regulations nowhere near radical enough, they are rarely enforced as stringently as they should be.

If you include the Schar incident at the weekend, three examples of head injuries involving Newcastle players immediately spring to mind this season alone.

When the Magpies lost 1-0 at home to Brighton & Hove Albion in October, Federico Fernandez and Glenn Murray suffered a sickening clash of heads.

While Murray was rushed to hospital – and thankfully did not suffer a serious injury following excellent medical care at the Royal Victoria Infirmary – Fernandez was inexplicably allowed to continue, despite appearing groggy.

A similar situation unfolded at the London Stadium just a few weeks ago, too, when Magpies right-wing-back Javier Manquillo and West Ham United left-back Aaron Cresswell clashed heads.

Manquillo received lengthy treatment on the pitch, had a white bandage wrapped around his head, but was allowed to continue.

Cresswell, meanwhile, was clearly not right after the incident – but he was allowed to continue playing, before eventually being withdrawn once it became clear he was still disorientated. How he was ever permitted to return to play in the first place was beyond comprehension/

Three years ago, Aleksandar Mitrovic was physically restrained by Newcastle’s medical staff during the 1-1 Tyne-Wear derby draw with Sunderland after suffering a head injury, and the Magpies rightly took the decision to end the game with 10 men, given that they had used up all three of their substitutes – even though the striker had pleaded with Rafa Benitez to allow him back on. But this should become the norm, rather than the exception which proves the rule.

It is deeply disturbing that, despite all of the evidence now pointing to a link between head injuries in sport and future brain diseases such as dementia, football has not been nearly radical enough with its reforms.

Alan Shearer’s excellent ‘Dementia, Football and Me’ documentary – during which the Newcastle legend admitted he was concerned by the impact heading the ball throughout his career could have on his future health – was broadcast almost 18 months ago, to widespread acclaim.

Yet the issue of concussion caused by head injuries is even more pressing than that, and it is alarming that incidents such as the one involving Schar are still a far-too-regular occurrence.

Footballers and sportspeople like Schar naturally want to carry on playing following such incidents, but the decision needs to be taken out of their hands.

Far-reaching reforms are necessary, and they are needed immediately. Player welfare has to be the utmost priority, and football must look to other sports for inspiration about how best to tackle this urgent issue.