Aromatherapy Association of South Africa

Transcription

1 Aromatherapy Association of South Africa Tel: (031) P O Box 21941, Fax: (031) Bluff, 4036 COMPETITION COMMISSION : SOUTH AFRICA Participation in the Market Inquiry into the Private Health Care Sector Attention: Mr Clint Ollermann Inquiry Director The Market Inquiry into the Private Healthcare Sector Physical address: Trevenna Campus Block2A Fourth Floor 70 Meintjies Street Sunnyside Pretoria Postal address: The Competition Commission Private Bag X23 Lynwood Ridge, 0040, South Africa Telephone number: +27 (0) submissions@healthinquiry.net Stakeholder Registered profession with the Allied Health Professions Council of South Africa: Therapeutic Aromatherapy Submitted by: Aromatherapy Association of South Africa (AromaSA) representing its membership who are therapeutic aromatherapists providing a healthcare service, registered with the Allied Health Professions Council of South Africa (AHPCSA) in terms of the Allied Health Professions Act 63 of AromaSA contact details: National Chairperson: Jessica Hart Postal Address: 14 Fernleigh Road Charles Mowat Ave Ext Pinetown, 3610 Telephone number: +27 (0) hart2@telkomsa.net National Secretary: Sharon Petzer Postal Address: P O Box 21941, Bluff, 4036 Telephone number: +27 (0) Sharon@petzer.org.za

2 A. Stakeholder - AromaSA: introduction and historical information. B. Value of therapeutic aromatherapy within the private healthcare system. The Aromatherapy Association of South Africa (AromaSA) was formed in October 2011, as a result of the merger between the Aromatherapy Society of SA and AromaForum. In terms of the AromaSA constitution full membership is open to all duly qualified Therapeutic Aromatherapists who are registered with the Allied Health Professions Council of South Africa to practice therapeutic aromatherapy in South Africa. Membership is voluntary and current membership stands at 41.3% (81 out of 196) of registered therapeutic aromatherapists. As such, therapeutic aromatherapists in South Africa are regarded as Allied Health Professionals in terms of Act 63 of The use of infused aromatic oils for the treatment of conditions dates back to Dioscorides who described the properties of many such oils in his De Materia Medica. Distilled essential oils and hydrolats have been used more for their medical properties than as aromatic fragrances since the eleventh century with the invention of the cooling condenser which separated pure essential oils from aromatic waters. i In the late 1800s, when the role of micro-organisms had been identified as the cause of many diseases, the first recorded laboratory test on the antibacterial properties of essential oils was carried out. This was prompted by the fact that the incidence of tuberculosis amongst the workers who processed flowers and herbs in France was unusually low. Similar studies were undertaken on the effect of essential oils on the micro-organisms of glandular and yellow fever. Further proof of the value of essential oil came from Gattefosse, a French chemist, who suffered severe chemical burns to his hand and arm resulting in gangrene. By applying lavender essential oil to the areas the wounds healed rapidly and amputation was prevented. Gattefosse then used essential oils for the treatment of soldiers during World War I. ii Due to the lack of antibiotics, Dr. Jean Valnet, an army surgeon, used essential oils as antiseptics on wounds of soldiers in the Indo-China war. ii Marguerite Maury, a French biochemist also carried out research on how essential oils helped skin elasticity and integrity and assisted wound healing. Maury advocated the use of essential oils externally, diluted in vegetable (fixed) oils, in combination with massage. ii This is one of the main application routes used by therapeutic aromatherapy in South Africa. For most people a hospital stay is a frightening experience and even within the private sector hospitals are seen as being inhospitable due to understaffing. Whilst nursing staff turn patients at set times their schedule does not allow for massaging the patients and many end up with bedsores. The inclusion of therapeutic aromatherapists as part of the healthcare team could go a long way to reintroducing hospitality and holism back into our hospitals. C. Research Much research exists as to the benefits on both the use of essential oils and massage in the reduction of stress and anxiety. iii iv v According to Dr Jane Buckle more than 400 small pilot studies have been undertaken in the United States of America which has led to accepting aromatherapy as part of the holistic nursing care. v PubMed lists 60 research papers on the chemopreventive effects and

3 cytotoxic activities of extracts from Boswelia (frankincense) essential oil vi and the improvement of quality of life for cancer patients using vii viii therapeutic aromatherapy massage. A study undertaken by the Brighton University in 2010 concluded that Benchmark Thyme essential oil rapidly killed MRSA in vitro. As a result a small patient-centred trial was carried out at a private UK hospital with pleasing results. ix A research project is currently taking place at the Red Cross War Memorial Children s Hospital in Cape Town on the enhancing effect of therapeutic aromatherapy massage on hospitalized children, particularly burn victims. x D. Education, training and career opportunities Much research into the antimicrobial efficacy of essential oils (including essential oils derived from indigenous plants to South Africa) is carried out through the Department of Pharmaceutical Studies, University of Witwatersrand (Prof. Sandy van Vuuren) and Tshwane University of Technology (Prof. Alvaro Viljoen). An extensive list can be provided if required. Internationally training in aromatherapy varies tremendously. In the UK 3 month part-time course at NVQ level 3 prepares the student to work in a beauty environment whereas a one year, 1200 credit professional qualification prepares the student to pursue a career in private practice or seek employment within the NHS or specialist clinics. Although statutory registration is not required, registration with The Aromatherapy Council is required in order to practice. In the USA there are two levels of training: Foundation, Level 1 is at a basic level covering 30 hours, Level 2 is aimed at professional certification covering 200 hours of training. A curriculum is being developed to accommodate Level 3 training for clinical aromatherapy. No statutory registration is required at present but each state sets standards for granting licences for the various hands-on professions, including aromatherapy. Many aromatherapists are employed in the spa and healthcare environment as well as in private practice. Training requirements in Canada differ from east to west. In French Canada training as a certified aromatherapy health professional is 450 hours, in addition to a qualification in anatomy and physiology, whereas in British Columbia three levels of training are offered - basic, advanced and professional. Career opportunities for a professional aromatherapist include working in holistic medicine or high-end wellbeing spa environments. In South Africa training requirements leading to registration with the Allied Health Professions Council of South Africa as a Therapeutic Aromatherapist is a 240 credit (2,400 hour) qualification. The only career opportunity for registered therapists is limited to opening their own private practice treating pre-diagnosed conditions on referral of another healthcare provider, health maintenance or palliative care. As this is not sustainable many therapists are forced to practice therapeutic aromatherapy on a part-time basis whilst being fully employed in another profession.

4 Main theories of harm as applying to competition issues E. Market power and Historically the inclusion of therapeutic aromatherapy as part of the distortions in relation healthcare team in both public and private hospitals has been due to to healthcare the altruistic nature of the therapist. Many therapists also happen to be facilities practicing nurses and are able to use their aromatherapy knowledge on the wards whilst some therapists volunteer their services at public and/or private facilities such as The Red Cross War Memorial Children s Hospital, Sarah Fox Children s Home and various hospices. In the book Aromatherapy for Health Professionals, Shirley and Len Price refer to the work carried out at St Luke s Hospice, Groote Schuur Hospital (haematology unit) and several other sites in South Africa. xi Although the information is now a little out of date as these were Aroma Care or training institution projects which have come to an end due to lack of funding and/or institutions closing, this book is an excellent source of reference as to the inclusion of aromatherapy in the healthcare systems of other countries. F. Market power and distortions in relation to healthcare practitioners G. Barriers to entry and expansion at various levels of the health care value chain within the regulatory framework Allied Health Professions may not legally associate with private or public hospitals, although public hospitals are generally tolerant of therapeutic aromatherapists carrying out treatments on patients at the request of, and the cost to, the patient. Furthermore, a conflict exists between Rule 9 of the Health Professions Act which provides for a practitioner to help or support a person registered under or the Allied Health Professions Act, but prohibits a practitioner from sharing his or her rooms with a person or entity not registered in terms of the Act. As opposed to these restrictions, the Allied Health Professions Act has no similar prohibition about sharing rooms. On the contrary, Rule 49 of the Regulations to the Allied Health Professions Act enables partnerships between Allied Health practitioners and practitioners registered under the Health Professions Act. These provisions however, are limited to a practice room. In a private hospital setting, as long as these rooms are separated by walls and each have a separate entrance door, i.e. not interleading, the practitioners may practice along side each other. An aspect of this is seen with a similarly worded restriction in the Pharmacy act, yet ward rounds consisting of a multidisciplinary health care team (Including doctors, pharmacists, physiotherapists) take place at hospitals. Despite the provisions of Chapter 2: Bill of Rights, Section 27 (1) (a) of the Constitution of South Africa, everyone has the right to have access to health care and (2) the state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights the citizens of South Africa are not entitled to make use of the healthcare providers of their choice. Allied Health Professions, including therapeutic aromatherapists are precluded from offering quality, cost effective, conservative health care to the citizens who choose complementary over allopathic health care. Therapeutic aromatherapy has over several years attempted to achieve a standardized treatment tariff and codes for recognition by and reimbursement from medical aid schemes. The National Department of Health has replaced the Board of Healthcare Funders in this regard and have set unattainable minimums for survey responses which has resulted in a negotiation stalemate. Nevertheless AromaSA is continuing

5 to work on procedure and descriptor codes with a view to negotiating directly with medical aid schemes. Regarding medical schemes - allied health professionals working within the private sector have very little option but to operate within the prevailing context, since they are not in a strong position to contract independently with health insurance/medical schemes, as the relationship within conventional medicine providers and hospitals are more lucrative and ostensibly simpler to administer. The relatively small number of allied health professionals exacerbates the problem, which structurally reduces the opportunities for alternative contracting arrangements with medical schemes. H. Conclusion The Regulatory and legal framework within which Therapeutic Aromatherapy has to function is generally satisfactory and as a profession has gained acceptance and trust from the public and consumer (patient) however some restrictions have a negative impact on the scope and service of the profession: 1. The restriction by the Health Professions Act (Rule 9) of sharing of facilities which in effect reduces possible career opportunities; 2. The restriction by the Regulations of the Allied Health Professions Act to practitioners sharing premises only with other registered practitioners. This effectively prohibits therapists from working in wellness spas as generally the treatments offered in such facilities are not statutorily regulated; 3. The difficulties related to recognition by medical aid schemes which restrict potential consumers (patients) to only those who are able to personally afford treatments. Submitted : 30 th October 2014 Jessica Hart National Chairperson: AromaSA References: i [last accessed 28 October 2014] ii Battaglia, S. Complete Guide to Aromatherapy 2 nd Ed: 2003, International Centre of Holistic Aromatherapy, Brisbane, Australia iii [last accessed 28 October 2014] iv [last accessed 28 October 2014] v [last accessed 28 October 2014] vi [last accessed 28 October 2014] vii [last accessed 28 October 2014] viii [last accessed 28 October 2014] ix Tisserand, M. Benchmark Thyme vs MRSA, AromaSA Journal, Issue 1, Spring 2010 x O Flaherty, L. Aromatherapy Massage at the Red Cross War Memorial Children s Hospital: enhancing relaxation in hospitalized children, particularly burn victims, Botanica2014, Dublin, Ireland xi Price, S & L Aromatherapy for Health Professionals: Churchill Livingstone 2007 ISBN 13: