Chiropractors

Meeting report

HEALTH PORTFOLIO COMMITTEE
3 October 2000
CHIROPRACTORS, HOMEOPATHS AND ALLIED HEALTH SERVICE PROFESSIONS SECOND AMENDMENT BILL

Documents handed out:
IFP proposed amendments to the Bill (see Appendix 1)
Chiropractors, Homeopaths & Allied Health Service Professions Second Amendment Bill

SUMMARY
The meeting dealt mainly with the proposed amendments to the Bill that were drawn up by the Inkatha Freedom Party. A concern that was raised by all committee members was the lack of clarity in the difference between a profession and a service. Dr Jassat (ANC) felt initially that Chiropractors and Homeopaths had been over-represented in the composition of the proposed Allied Health Professions Council of South Africa. Dr Rabinowitz (IFP) voiced strong opposition to this view and stated that the representation of established bodies was necessary so that they would not be overrun by other more dubious practitioners. She went on to state that it was a necessity to rectify any problems at an early stage as they would prove more difficult to overcome in the future. The meeting was adjourned early as the NCOP had to use the venue to discuss the same draft Bill. Members of the Committee were urged to stay on and contribute by the chairperson.

MINUTES
The Chairperson, Dr Nkomo (ANC), welcomed all to the meeting and noted that Dr Rabinowitz had raised certain matters that she would like to discuss regarding this Bill and he noted her expertise in this area.

Dr Jassat (ANC) stated that he believed that the composition of the envisaged Allied Health Professions Council of South Africa as in Clause 6 of the Bill was skewed in favour of Chiropractors and Homeopaths.

Dr Rabinowitz (IFP) replied that she differed with Dr Jassat on this and proceeded to hand out copies of her proposed amendments to the Bill. She explained that the body of holistic healing was growing bigger and bigger and that there was a need for a stricter way in which to define this health profession. The aim of the proposed legislation would be to ensure that members admitted to the Council had attained a certain level of qualification before being admitted. She felt that the groups that had been included in the Bill for the Council had been chosen because their professions had stood the test of time, had substantial texts and an established pharmacopoeia. Dr Rabinowitz (IFP) said that these professions could not be compared to crystal therapy or prostitution, which have also been considered good for an individual's health but do not meet the above requirements.

The Chairperson affirmed that there was no undue rush to push the Bill through.

Ms Kalyan (DP) raised the point that a person who went for a Swedish massage could bill this activity to their Medical Aid. She stated that these therapists would only have attended a six-month course and that claiming from a Medical Aid for such treatment could be viewed as fraudulent behaviour.

The Chairperson suggested that the more detailed enunciation about such concerns as professional standards could be dealt with in the Regulations to the proposed legislation.

Ms Kalyan (DP) stated that the definition of a profession should be tighter than that of a service.

Dr Jassat (ANC) added to the debate by affirming the idea that definitions could be widened under the Regulations as suggested by the Chairperson.

Dr Rabinowitz (IFP) said that the Bill mentioned 'any other therapy'. This could lead to any amount of quackery being grouped under holistic therapy. This she said might lead to the established professions, that Dr Jassat believed were over-represented, actually being overrun by these other forms of therapy. She believed that a distinction needed to be made between a person that had attended a three-week course and somebody who has studied for six years.

The Chairperson said that the Council would be the guardian of established professions against charlatans. He suggested that a body like the South African Qualifications Authority could verify these professional qualifications. He also went on to mention the requirement of the number of hours an individual had spent in training for a profession to be considered when defining the status of the various actors.

Dr Rabinowitz (IFP) stated that when things are not done correctly the first time around it would make it even harder to correct when these problems arose second time around. She provided an example of how in the past non-white people were unjustifiably denied the right to practice as qualified Homeopaths due to an inferior training system. These individuals were then allowed to gain temporary status as qualified Homeopaths if they had attended a minimal amount of extra training. In this way these inadequately prepared individuals were allowed to practice and were not struck off the register. This problem was never corrected and as a result this problem is still relevant in contemporary society. She went on to state that there were more and more, predominantly white, people practising holistic healing and it would become progressively harder to discover who had done the recommended hours if the problem were not corrected.

Ms Kalyan (DP) suggested that a proper definition to distinguish between a profession and a service would help to clarify matters. She felt that the Council would be the body that dealt with the qualifications of its members.

Dr Rabinowitz (IFP) said that she had tried to work out a definition but felt that the matter should be taken to the experts. A tentative definition proposed by her included the requirements of established texts, codes of practice and a pharmacopoeia for a group to be termed a profession.

Dr Jassat (ANC) raised the issue that African herbal medicine would not have any established texts and this would therefore bar the people who subscribe to this practice from the Council.

The Chairperson stated that this was a different matter that had been dealt with in a report on traditional healers.

Dr Rabinowitz (IFP) asked members to delete her fifth proposed amendment from their documentation. She raised as an important issue the proposal to delete the subclause within Clause 7(c) of the Bill that gives the Minister the power to terminate the membership of a Council member. Dr Rabinowitz felt that the Minister would be given power that was too arbitary.

The meeting had to be adjourned early, as the NCOP Select Committee dealing with Health had a meeting in that venue. The NCOP were discussing the same Bill and members of the Portfolio Committee were invited to stay on and give input.

Appendix 1:

AMENDMENTS TO CHIROPRACTORS, HOMEOPATHS AND ALLIED HEALTH SERVICE PROFESSIONS BILL. IFP 03/10/2000.

1. k. Delete and add:

Profession means any health profession with an established & internationally recognised pharmacopoeia, generally acceptable tents and enforceable standards and codes of practice.

l. Complementary therapies falling outside this definition, that attempt to prevent alleviate or treat disease shall be constituted into Boards.

 

13. The Council may invite Chairpersons of such Boards to council meetings where said chairpersons shall not have voting rights.

 

 

6. Page 7 Line 27. Amend amendment of Act 63 of 1982 amended by section 7 of Act 40: 1994 as follows:

 

Delete 7c (g)

9. Page 8 line 1… 10 A Add

5g Remuneration of members referred to in 5c will not exceed a specified amount laid down by the Council in its annual budget, in terms of regulations which the Minister will prescribe..

14. Amend 16 by replacing (page 11 line 58) after profession concerned "the Council shall prevail"