AAMT Bulletin – July 2014Education, General, Government, Industry
An update on developments in the massage therapy industry
As the leading industry group representing massage in Australia, we have a significant stake in this process. The AAMT Bulletin will keep you informed about developments and the ongoing contributions of the AAMT.
Reviews and regulation
In AAMT’s submission to the Federal Competition Review, the AAMT outlined a number of regulatory impediments to competition that restrict access and further integration of massage into mainstream health services.
Two areas of regulation under the Safety Rehabilitation and Compensation Act 1988 (SRCA) and the Veterans’ Entitlements Act 1986 do not recognise qualified Remedial Massage Therapists as health providers.
Limited to Veterans’ general healthcare entitlements under Medicare, only registered Allied Health practitioners such as physiotherapists, chiropractors and osteopaths are recognised and authorised to administer massage therapies. However, in many cases Physiotherapists are not specifically trained in massage therapy.
As a result Veterans within the service cannot access massage therapy directly through a qualified Remedial Massage Therapist.
Members who have left the Service can access massage therapy from a qualified massage therapist privately.
Importantly, Veterans can also gain access to remedial massage through Health Funds, such as Medibank Private, that recognise and cover massage as a health service, when it is provided by a qualified massage therapist with Fund Provider status.
Remedial Massage Therapists are more qualified to provide remedial massage services than health professionals, as they have specific training and can hold qualifications that include a diploma, Advanced Diploma or University Degree. The AAMT believes that the two pieces of legislation are a restraint on market access and competition on the provision of massage services. They prevent qualified Remedial Massage Therapists from accessing markets that involve some form of government service or support.
This prevents public patients from accessing the best and more cost effective massage health services in government-supported health markets.
Recently AAMT prepared a comprehensive submission to the Australian Health Ministers’ Advisory Council (AHMAC) public consultation about the creation of a National Code of Conduct for Healthcare Workers (the Code). AAMT also participated in the recent public consultations and those held previously.
The Code is a significant step towards a national registry and guide for the conduct of natural health practitioners.
The Code includes provisions for the prosecution of individuals who have been shown to have committed a sexual offense, or other serious offense such as fraud. This includes National Register and Prohibition Orders for those found guilty of a serious breach of the Code.
This is vital in helping to close the loopholes in the current regulatory framework. However, questions remain as to how detection, monitoring, early intervention and management of individuals with a history of misconduct is to be effected.
Apart from the threat of prosecution as a possible deterrent, it is unclear how the Code and proposed legislative framework will curb opportunities for such individuals to operate below the radar of legislation, the Code, National Registry and Associations, as they do now.
The Code also relies heavily on the existing legislative framework which has failed to address these issues in the past.
Until an official complaint is made supported by evidence that warrants prosecution and inclusion in the National Registry, the proposed Code provides no opportunity for Associations to confidentially cross check the behavioural history of individuals with other Associations, and does not enable cooperative monitoring, early intervention or management in order to lessen the very real risk of a serious breach, such as sexual misconduct, being perpetrated.
Currently, some individuals are noted by the Associations when complaints are reported to them, however, this information remains confidential and inaccessible to other massage and natural health associations.
This is significant because a lack of information and evidence can lead to a history of misconduct going un-reported and a large number of complaints unprosecuted which often leads to an escalation of offenses towards serious misconduct.
Questions remain as to how the Code will assist or improve the sector’s ability to detect and manage these individuals and better protect patients and therapists from the serious risk that they present.
A recent series of raids by Victoria Police on what the police term ‘massage parlours’, masquerading as legitimate massage clinics but providing unregistered sexual services highlights the need for an urgent review of the regulations governing the massage sector.
The issue of offering sexual services has sullied the reputation of the legitimate massage sector for many years.
The credibility of remedial massage therapy clinics, their legitimate place as health service providers and safety of the public and practitioners is difficult in a solely self-regulated profession.
Current legislation enables the prosecution of individuals who have been shown to have committed a sexual offense, or provided an unregistered sexual service in Victoria, but it has not redressed this problem.
AAMT supports Australia’s governments in seeking to establish an enforceable obligation for those claiming to provide massage through the new draft National Code of Conduct for Health Care Workers as a positive first step. However, in its current draft form, the Code is limited in its application and is unlikely to redress the current loopholes.
AAMT is seeking a collaborative approach with all State, Territory and Federal Governments where, in addition to the National Code, professional associations have the opportunity to monitor practitioners registered under a Standardised Title of Practice that clearly states to the public their professionalism and education standards.
Anyone outside of the Single Massage Register would not be deemed as a professional remedial therapists, making it easier for law enforcement agencies to identify illegal brothels and take appropriate action.
This would also make a clear statement to the public as consumers and will help them ensure they are being treated by legitimate remedial massage therapists.
Clinical research is crucial to better health delivery and access to a more efficient health system for the benefit of all Australians.
The clinical evidence supporting remedial and therapeutic massage is substantial but as a low hanging fruit there are still many opportunities in research that would benefit the health care needs of many Australians. For example, an RMIT Study1 commissioned by the AAMT found that further research into the benefits of massage therapy for infants, depression and post-natal depression, labour pain, fibromyalgia, premenstrual syndrome, urinary symptoms in multiple sclerosis, myofascial pain and knee osteoarthritis, presented many opportunities.
It is in these areas of health care that massage can offer even greater benefit and where we hope some funds from the proposed Medical Research Fund announced in the 2014 Federal Budget will be directed.
Unlike other sectors of health such as pharmacy, typified by a small number of large corporations with resources to conduct Cochrane level clinical trials, the massage sector is characterised by small businesses, and associations funded through membership.
Studies into the effects of massage indicate that massage offers significant benefit as an intervention at the primary care stage that provides relief from the symptoms of conditions of injury, chronic illness and muscular skeletal conditions affecting the aged.
While such trials and investigations provide highly valuable data, only a small proportion can be included in Cochrane-type analyses of efficacy and conclusive clinical benefit. Until recently, few clinical trials examined or measured the biological effects of massage, focusing on subject reporting by the patients in the areas of pain, stress, sleep anxiety, and general wellbeing.
Higher academic qualifications within the massage sector required to attract funding from the NHMRC or similar bodies is not common, limiting opportunities for robustly conducted trials that would shed greater light on the benefits of massage as an evidence-based modality.
In response, the AAMT has supported a world-first researcher development program — the International Complementary Medicine (CM) Leadership and Capacity Building program with the Sydney’s University of Technology. This offers the opportunity to enhance research capabilities in the areas of massage that promise significant benefits for patients and the health.
Administered by the Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), applications from interested researchers are now open.
1. Dr Kenny CW Ng, Member Australian Association of Massage therapy and Prof Marc Cohen, School of Health Sciences, ‘The Effectiveness of Massage Therapy: A Summary of Evidence-Based Research’, RMIT University, Melbourne.
The First Results of the ABS’ Australian Health Survey have found arthritis as the top long-term health condition experienced in Australia in 2011–12.
The ABS found that around 3.3 million people (14.8% of the population) present with the musculoskeletal conditions involving arthritis and osteoporosis.
These conditions are one of the major causes of chronic pain and disability in Australia. The conditions can lead to joint inflammation, stiffness, disability and deformity with a significant impact on everyday life.
For both conditions, prevalence is higher among women than men (17.7% compared with 11.8%) in arthritis and more than twice the proportion of females (5.3% compared with 1.2% of males) suffering from Osteoporosis.
Source: Australian Health Survey: First Results.
Australian Association of Massage Therapists Ltd
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