Published in Physio Matters magazine August 2008: the 1949 Physiotherapy Act – which changed us from masseurs to physiotherapists and gave us state registration – survived for more than 50 years and provided most of us with the professional basis for our practice.
The 2003 Health Practitioners Competence Assurance Act (HPCA) that now governs the conduct of physiotherapists in New Zealand is notable because it repealed one of the oldest pieces of profession-specific legislation to exist on the statute books.
The 1949 Physiotherapy Act – which changed us from masseurs to physiotherapists and gave us state registration – survived for more than 50 years and provided most of us with the professional basis for our practice. Indeed, to have entered the Dunedin School as an eighteen-year-old prior to 1949 would now make you 73 years old, and although many survive, their recollections of life under the Masseurs Registration Act (MRA) is, inevitably, fading.
The MRA was introduced in 1920 to organise the diverse collection of variously trained masseurs and manipulators, bone setters and “rubbers” that were practicing around the country. A three-year moratorium was imposed on those wishing to register as members with the Massage Registration Board (MRB), after which time anyone wishing to call themselves a masseur needed to take a full course of study at the School. (It is interesting to note that between 1913 and 1920, students who went through the school entered practice without registration – there was, therefore, no real advantage to a full course of study until the MRA came into effect).
A little over 300 masseurs entered the Register of Members and operated under a well defined scope of practice that defined massage as “the use by external application to the human body of manipulation, remedial exercises, electricity, heat or light, for the purposes of curing or alleviating any abnormal conditions of the body” (Abel, 1938, p. 7).
The MRA created the position of Registrar (whose primary role was as General Inspector of Hospitals) and a Registration Board (which would later become the Physiotherapy Board), both of which entered into a tripartite arrangement with the Massage Council – the Otago University-appointed management board of the school.
These organisations effectively governed the profession until the middle of the twentieth century. But increasingly there were calls for greater autonomy and self-determination, and as the 1930s drew to a close, the profession sought much more control over its governance. Fate then intervened, diverting people’s attentions away from professional concerns (as it had done before between 1913 and 1920) to the outbreak of the Second World War, and it was not until 1949 that the masseurs got their wish for a piece of legislation to consolidate their position as the principal providers of state-sponsored physical rehabilitation.
The 1949 Act mirrored, in many ways, the MRA that had preceded it. It created a new Physiotherapy Board and defined physiotherapy (now “the use by external application to the human body of massage, being the manipulation of the soft tissues of the body, passive movement, remedial exercise, electricity, heat, light, water or other physical agents for the purpose of curing or alleviating any abnormal condition of the body” (Abel, 1950, p. 18). It protected the title and practices of massage and physiotherapy, and reinforced the penalties for anyone breaching these laws. It also went further than the MRA in defining a course of study and the qualifications necessary for study. The Board became the arbiter of training and examination – replacing the responsibilities of the Massage Council and giving the profession autonomy over all aspects of training, registration and discipline.
It will be interesting to see, in years to come, whether the move away from the Physiotherapy Act, to a collectivist contract with other professions under the HPCA, serves the profession as well as the MRA and the Physiotherapy Act.
By David Nicholls
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