Study On The Status Quo And Recommendations For The Devolvement Of Chinese Medicine And Acupuncture In Australia

ObjectivesThe purpose of this study is to explore the status quo of Chinese medicine/acupuncture in Australia,allowing for an in-depth understanding of the development of the profession in Australia and addressing complications which have stalled its development.This study will benefit the Australian local Chinese medicine/ acupuncture profession and management authorities;can be the positive and negative references for other countries in regulation of Chinese Medicine and acupuncture;and the Chinese government in the strategic global deployment of Chinese medicine and acupuncture.MethodsThe history of Australian Chinese Medicine and Acupuncture can be divided into three periods.The Australian gold rushes in 1850 to the1970s;the 1970 s to the implementation of the registration of Chinese Medicine/Acupuncture;and post-legislated Chinese Medicine/Acupuncture.The status quo and problems existing of Chinese Medicine and Acupuncture in Australia.The status of Chinese Medicine and Acupuncture in Australia refers to its current legal status,benefits on treatment rebate,practice status of Chinese Medicine Practitioners/Acupuncturists and the status of professional societies.Recommendations for the development of Chinese Medicine and Acupuncture in Australia.Recommendations are made by studying the Australian Health Registration Acts,Competition and Consumer Law,ASX Listing Requirements for IPO,and letters from the Federal Minister for Health and a Member of Parliament regarding to the status of Chinese Medicine and Acupuncture on Medicare Benefits Schedules.Historical data is from the local History Museum and ‘A Brief History of the See Yup Society of Victoria,Australia(1854-2004)’.Some of the historical documents of Chinese Medicine and Acupuncture are first-hand information from the study author who has practiced Chinese medicine and acupuncture in Australia for 30 years,and was directly involved in the TCM Registration Submission Committee prior to the legislation of Traditional Chinese Medicine in late 1990’s.Information on the development of Chinese medicine and acupuncture in Australia is mainly obtained from the official data released by Australian Government departments and its agencies.The Australian Health and Medical Registration Act and related information are also obtained from official sources released by government departments and its agencies.By studying the history of Chinese medicine and acupuncture in Australia,in particular after the implementation of the Chinese Medicine Registration Act,we can compare the differences in legislation between Chinese medicine/acupuncture and the 14 other Australian registered health care professions.A letter released by Mr Robert Clark MP,addressed to him from the Hon Greg Hunt,Australian Federal Minister for Health regarding Chinese Medicine introduction into the Medicare Benefits Schedules.This letter outlines the process to include Chinese Medicine and Acupuncture into the Medicare Benefits Schedules.A survey was issued to Australian Chinese medicine practitioners/acupuncturists regarding the three major policy changes made by the Chinese Medicine Board of Australia(i.e.the language use in Health Record Guidelines,names of Chinese medicine prescription and restriction of use prescribed drugs),and the exclusion of Chinese Medicine and Acupuncture into the Medicare Benefits Schedules.1.Evaluation the necessity of ‘Chinese Medicine registration Act 2000’.2.Comparing the registration contents and model via study from ‘Medical Act 1894’to‘Medical Practitioners Registration Act 2001’and ‘Chinese Medicine Registration Act 2000’.3.Study Chinese Medicine/Acupuncture profession,specially study the Status Quo of Chinese medicine and acupuncture associations in Australia,and assess impacts to its profession.4.Study the suitability of ‘Competition and Consumer Act 2010’.5.Study ‘Medicare Benefits Schedules’ and the letter of Minister for Health,explore the probabilities of Medicare Rebates of Chinese Medicine/Acupuncture.6.Analysis from the perspective of political economy to assess the probability of IPO in ASX.ResultsBy studying the status quo of the Chinese medicine/acupuncture profession in Australia,and suggesting recommendations which addresses the complications which have stalled its development,this study will benefit the Australian local Chinese medicine/ acupuncture industry and management authorities;and the Chinese government in the strategic global deployment of Chinese medicine and acupuncture.The Australian government decided to legislate the registration of Chinese medicine and acupuncture,to improve the regulation of Chinese medicine/acupuncture and protect public interests.The resulted in qualified practitioners practicing under standardised guidelines.As an alternative health care profession,legislation by the local government has ensured the sustainability of the profession,by preventing a prohibition of Chinese medicine and acupuncture practice from occurring.Two of the common complaints from Chinese medicine/acupuncture practitioners in Australia are the unreasonableness of new guidelines affecting the profession and the exclusion of Chinese Medicine/acupuncture from the Medicare Benefits Schedule(MBS),which all other 14 health-care industry receives.The regulations from the Government are not compatible with the profession,where it still excluded from the MBS.This has contributed to a stalled development of this profession in Australia.The existence of a large amount of Chinese medicine and acupuncture societies in Australia is the root cause for these unfavourable situations.The societies present in the profession are fragmented,whichleads to the inability to integrate resources effectively and deal with regulations affecting the profession.This has resulted in many missed opportunities for the development of the profession.For example,unreasonable guidelines from the CMBA,application for Medicare Benefits Schedules,the certification system for private health insurance rebates,etc.The integration of Chinese medicine societies is recommended.A unified Chinese Medicine and Acupuncture society provides a platform for the development of the Chinese Medicine and Acupuncture profession.This platform will allow for the cultivation of leaders within the profession to voice the opinions of Chinese medicine and acupuncture practitioners in order to influence and negotiate guidelines affecting the profession.The study of the requirements of an IPO(Initial Public Offering)in the ASX(Australian Securities Exchange)showed that Chinese medicine/acupuncture in terms of law,market,capital,management and staff skills,is suitable for the development to an enterprise and also IPO.The commercial development of Chinese medicine/acupuncture in Australia will be beneficial to the local Chinese medicine/acupuncture industry.This will increase the industry’s influence on the government and society and improve the status of Chinese Medicine and Acupuncture globally.It is worth for the profession to pursue.“By 2030,the synergistic effect of traditional Chinese medicine in the cure of disease and its synergistic effect in the treatment of major diseases will give full play to its central role in the rehabilitation of the disease.” [Section 1(Improving TCM)of Chapter IX(Give Full Play to the Unique Superiority of Traditional Chinese Medicine)of “Health China 2030” issued by the Central Committee of the Communist Party of China and the State Council in late October 2016].These are the guidelines for the deployment of Chinese medicine and acupuncture industry.It is found that there are contradictions between the registration of Chinese medicine/acupuncture and the interests of the Chinese medicine profession.Recommendations are as follows: Integrate into one Chinese Medicine and Acupuncture Association in Australia.When one of our associations complained that Chinese medicine/acupuncture is not included in theAustralian government’s Chronic Diseases Management(CDM)under the Medicare Benefits Schedules(MBS),Mr Robert Clark MP replied and suggested,‘To pursue this further,you may therefore be able to reach out to Chinese Medicine associations and other peak bodies,to see if they are willing to make an application to the Medical Services Advisory Committee(MSAC)for Chinese Medicine or Acupuncture to be listed on the MBS for some or all treatment situations.’ This shows potential for TCM to be included in the schedule and expresses the importance of the need to further Chinese medicine and acupuncture in Australia.At the same time,it shows that no application has been made to MSAC for TCM or acupuncture to be included into the MBS.This suggests a lack of responsibility among the numerous professional associations,due to the dispersion of power.The integration of all the Chinese medicine and acupuncture association in Australia can further develop the profession in Australia,by increasing the organisation for TCM gaining inclusion in the MBS.There is no legal basis to initiate a lawsuit against the Government and its agencies for the exclusion of Chinese medicine/acupuncture in the Medicare Benefits Schedules.Many Chinese medicine practitioners and acupuncturists suggest that a violation of fair competition laws has occurred due to the exclusion of its profession in the Medicare Benefits Schedule despite being a legislated profession.However,the Competition and Consumer Act 2010 only applies to companies operating in federal or federal power and federal public corporations.It does not apply to the federal government or its federal agencies.Chinese medicine profession are required to provide scientific experiments and clinical evidences to prove the effectiveness,the costeffective estimates and the safety of Chinese medicine/acupuncture when applying to the Medical Services Advisory Committee(MSAC)for inclusion into the Medicare Benefits Schedule.These suggestions are from the Office of Minister for Health and are the paths for the Australian Chinese medicine profession to be included in the Medicare Benefits Schedules.There are already numerous scientific experiments and clinical evidence regarding the efficacy and safety of Chinese medicine/acupuncture.Hiring an actuary to make a cost-effective estimateis likely to be needed.Following the Health Minister’s recommendation to submit an application to MSAC will result in the further development of the Chinese Medicine and Acupuncture profession,and lead to the inclusion of Chinese Medicine in the Medicare Benefits Schedule.The enterprise-type management,or IPO,is a long-term plan to make Chinese medicine and acupuncture profession/industry become larger and stronger.The Chinese medicine/acupuncture industry in Australia should develop from individualised operations to enterprise group-type operations,and potentially list on the ASX(Australian Securities Exchange).An IPO could be successful following an integration of multiple Chinese medicine and acupuncture clinics to form an enterprise.The purpose of Chinese medicine/acupuncture IPO,should be in accordance with the "Health Related Industries" model.This may include:Developing a standardized Chinese medicine/acupuncture clinical group,usage of Australia’s GMP international standard to develop a pharmaceutical factory,introduction of a new type of nursing homes which utilises Chinese medicine to care for Australia’s aging population,combining the advantages of TCM and Australia’s growing tourism industry to develop TCM health tourism bases;to make use of the advantages of Chinese medicine/acupuncture in the rehabilitation of the disease and the provisions of the Australian health care benefits schedules to establish an integrated traditional and western medicine rehabilitation centre,or a Chinese and Western medicine hospital.Some recommendations for against the ‘Dry Needling’: Prof Baoyan LIU,Chairman of World Federation of Acupuncture-Moxibustion Societies released an open letter on 13 March 2016,stating that the point-of-pain therapy(later named as "dry needling")is the same as acupuncture point theory which has a history of more than 2,000 years;‘dry needling’practices are the same as traditional acupuncture methods in tendons therapy and ‘thick needle oblique acupuncture therapy’;‘dry needling’uses the same needles as acupuncture.The definition of acupuncture is ‘the insertion of needles into humans or animals for remedial purposes’ as stated on the ‘WHO International Standard Terminologies on Traditional Medicine in theWestern Pacific Region’.Therefore,‘dry needling’ is one method of acupuncture.‘Guidelines on Basic Training and Safety in Acupuncture’ from WHO requires that a non-medical acupuncture practitioner must have 2 years of full-time training,about 2,500 hours,of which 1000 hours must be clinical practice.‘Dry needling’ is a method of acupuncture,the risks are exactly the same as acupuncture.Therefore,practitioners engaged in‘dry needling’ practices must undergo rigorous training and assessment.ConclusionsThere are loopholes in the Australian law "Chinese Medicine Registration Act 2000" that does not prohibit the practice of acupuncture by a non-registered acupuncturist if the performer does not claim he or she is an acupuncturist.Therefore,“dry needling” is not prohibited in Australia.To solve this problem,the Chinese medicine associations in Australia should unite to carry out a revision of the Chinese Medicine Registration Act 2000 and stipulate that the use of acupuncture needles /non-syringes needles to penetrate the human body must be performed only by a registered acupuncturist.