Saturday, October 3, 2009

Professional Practice

Blog 5: Legalities - Consider legal requirements relevant to massage practice in New Zealand.

How the future of Massage Therapy will be determined via law, lies in the hands of current and future massage therapists, and can be strongly influenced by these individuals should they decide to lobby for or against any proposals made by parliament affecting the healthcare industry.  Massage Therapists are currently bound by several laws relating to healthcare provision, namely the Privacy Act, Health & Safety in Employment Regulations Act, Consumer Guarantees Act, Medicines Act, Health & Disability Commissioner Act, HPCAA and the Injury Prevention, Rehabilitation and Compensation Act.

The Privacy Act 1993 is relevant to Massage Therapists due to the need to keep clients details and information confidential and holding personal information securely.  Accuracy/correction of information and limited use/disclosure of information all matter greatly under the Privacy Act 1993 and must be adhered to by Massage Therapists for the simple reason that they are legally bound by the Act, as they are providing a healthcare service (massage).  

The Health & Safety in Employment Regulations Act 1995 outlines basic workplace safety, OSH principles, hazard identification and job competency, which in the context of massage therapy mainly applies to a situation in which more than one therapist works and outlines the duties of employees and employers.
Of course, this legislation would additionally apply to sole traders due to the need for safe workplace practices in all business forms.

Under the Consumer Guarantees Act 1993, the section most relevant to MTs would be Part 4: Supply of Services.  This again states the requirement that the service provided is of acceptable quality and performed with at least an average level of competency on the part of the therapist.  It also outlines the rights of the consumer in relation to the service they are under the impression they will receive according to advertising and other promotional material.

The Medicines Act 1981 restricts the prescription of medications by MTs (as we are not authorized prescribers) but outlines the rights of massage therapists in advising clients of alternative natural health products or herbal remedies under the exemptions clause in Part 2 of the Act: Dealing with Medicines and Medical Devices.

Another Act of note is the Health and Disability Commissioner Act 1994 which is in place to "promote and protect the rights of health consumers and disability services consumers", and covers relevant sections such as the rights of the massage client when receiving a health/disability service, advocacy, complaints and investigation procedures related to said service.  Therefore, adhering to this particular act is paramount to the integrity and legitimization of Massage Therapy as a healthcare profession.

Lastly, the Injury Prevention, Rehabilitation and Compensation Act 2001 covers the claims and entitlements process in the case of workplace accident or injury in New Zealand (ACC).  This debars lawsuits related to the above situation, and provides cover for those who suffer a workplace-related injury and subsequently require individual, social and vocational rehabilitation.  In the therapeutic massage industry this is more relevant to employees and clients.

How can I as an individual MT influence the development of government policy & laws that are supportive of the profession?

The Health Practitioners Competence Assurance Act 2003 remains a recent topic of some debate, around which massage therapists are often divided, as they are with the Therapeutic Products and Medicines Bill.  These examples address issues we may face in the future relating to the standardization of an industry currently in its infancy, of which the main appeal is the often intuitively guided processes and relaxed approach to holistic health.
There are however, massage practitioners serious for recognition as registered healthcare providers with an equal level of professional clout as physiotherapists, chiropractors and other medical professionals.  Recognition under the HPCAA would allow this, but in doing so would standardize many of the processes currently non-standardized (e.g. pay rate) which could jilt massage from its position in the alternative healthcare field into a more mainstream medical position.

The Therapeutic Products and Medicines Bill 2006 (Trans-Tasman regulation of therapeutic products bill) main listed aims are to regulate complementary medicines and medical devices.  This is intended to meet international best practice standards, and to improve international reputation by "enhancing closer economic relations and facilitating trade".  However, the drawbacks of this bill are the augmented compliance costs which may result in the removal of many smaller businesses trading in alternative health products, and thus favouring corporate providers and pharmaceutical companies.
The main argument of the New Zealand Health Trust (2009) is that natural health products are different in chemical composition (Gagnier et al, 2006) to pharmaceutical medications, and are relatively low risk, so therefore do not require regulation.  

Knowledge of the current laws binding massage therapists are crucial to professional conduct as healthcare practitioners, and it is only through active participation and solidarity on the part of all Massage Practitioners in an association (MNZ) that any real change can be effected in the future, that will subsequently shape and alter our profession.  

References

Elluminate: Understanding Legal Process (24th September, 2009) Otago Polytechnic Massage Therapy Diploma Course.

Gagnier, J., Boon, H., Rochon, P. & Moher, D.  (2006) Reporting Randomized, Controlled Trials of Herbal Interventions: An Elaborated CONSORT Statement.  Annals of Internal Medicine, 144 (5).

My own thoughts.

NZ Health Trust.  (2009) NZ Health Trust Proposed Bill.  Retrieved on the 7th October, 2009 from: http://www.nzhealthtrust.co.nz/proposed_bill.html

Parliamentary Counsel Office (2009) Consumer Guarantees Act 1993.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/act/public/1993/0091/latest/viewpdf.aspx

Parliamentary Counsel Office (2009) Health and Disability Commissioner Act 1994.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/act/public/1994/0088/latest/DLM333584.html

Parliamentary Counsel Office (2009) Health and Safety in Employment Regulations 1995.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/regulation/public/1995/0167/latest/viewpdf.aspx

Parliamentary Counsel Office (2009) Health Practitioners Competency Assurance Act 2003.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/act/public/2003/0048/latest/DLM203312.html

Parliamentary Counsel Office (2009) Injury Prevention, Rehabilitation and Compensation Act 2001.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/act/public/2001/0049/latest/DLM99494.html

Parliamentary Counsel Office (2009) Medicines Act 1981.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/act/public/1981/0118/latest/DLM53790.html

Parliamentary Counsel Office (2009) Privacy Act 1993.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/act/public/1993/0028/latest/DLM296639.html

Parliamentary Counsel Office (2009) Therapeutic Products and Medicines Bill 2006.  Retrieved on the 7th October, 2009 from: http://www.legislation.govt.nz/bill/government/2006/0103/latest/versions.aspx

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