Traditional Chinese medicine has been practised in Australia since the influx of Chinese migrants to the Australian gold fields in the 19th century. Its popularity is growing, as reflected by the proliferation of traditional Chinese medicine practitioners, training courses, and professional associations during the last decade.
Approximately one billion Australian dollars are spent on complementary/alternative medicine each year (206). A 1996 study reported that 48% of the population has used complementary/alternative medicine at least once, There are approximately 2500 chiropractors practising in Australia (45).
In December 1995, the Victorian Department of Human Services commissioned a study on the practice of traditional Chinese medicine. The study found that traditional Chinese medicine accounts for an increasing percentage of total health care services. There are at least 2.8 million consultations each year, representing an annual turnover of over 84 million Australian dollars. In 1995, over 1500 primary practitioners reported their principal health occupation as traditional Chinese medicine. This number was expected to almost double by the year 2000, with the graduation of over 1100 students from qualifying programmes for traditional Chinese medicine. There are 23 professional associations representing different segments of traditional Chinese medicine.
Traditional Chinese medicine is provided to patients of all ages, including infants. Two out of three patients are female, 50% have a tertiary education, and over 80% have English as their first language. Although 44% of cases are rheumatological or neurological in origin, traditional Chinese medicine treats a broad range of complaints. Over 75% of patients are treated for a recurrent problem of at least three months' duration.
Seven Australian territories - Capital Territory, Northern Territory, Territory of Christmas Island, Territory of the Cogos (Keeling) Islands, Norfolk Island, South Australia, and Western Australia - grant allopathic physicians an exclusive monopoly on medical care by prohibiting the practice of medicine by unregistered or unqualified persons (207). No provisions directly govern the practice of traditional Chinese medicine, although practitioners are regulated in part by various state and/or federal regulations and guidelines.
In New South Wales, Queensland, Tasmania, and Victoria, there is general freedom to practise medicine or surgery, but it is tempered by a number of restrictions. For instance, unqualified persons may not recover fees or treat venereal diseases. In addition, New South Wales makes it an offence to treat cancer (a similar prohibition exists in Victoria), tuberculosis, poliomyelitis, epilepsy, diabetes, and other specific diseases.
In Australia, there is a long history of efforts by associations of chiropractors and osteopaths to obtain statutory recognition for their professions. This is reflected in the laws regulating chiropractic and osteopathy. In certain Australian states, chiropractors are specifically exempted from the allopathic physicians' monopoly to practice medicine. For instance, the Medical Act 1894-1968 of Western Australia prohibits persons other than allopathic medical practitioners from practising medicine or surgery, "provided that this paragraph shall not apply to a person practising as a... chiropractor who gives... chiropractic advice or service" (208). Chiropractic and osteopathy are the subject of specific legislation in South Australia, Capital Territory, Victoria, and New South Wales (208). In Victoria, chiropractors and osteopaths must hold an approved degree or diploma in order to be registered by the territorial board. Although registration is not compulsory, only registered persons and allopathic medical practitioners are permitted to recover fees or charge for their professional services.
In 1974, the Australian Parliament set up the Committee of Inquiry into Chiropractic, Osteopathy, Homeopathy, and Naturopathy. The Committee published an extensive report in 1977 (209).
In New South Wales, the re-enactment of the Medical Practitioners Act 1938 as the Medical Practice Act 1992 (210) resulted in several amendments to the 1938 text. The growing acceptance of traditional medicine was at the root of changes to a number of prohibitions on the cures and treatments offered of by non-allopathic practitioners.
In 1998, the Therapeutic Goods Act was established with the objective of providing a national framework for the regulation of therapeutic goods in Australia, particularly to ensure their quality, safety, efficacy, and timely availability. Most products claiming therapeutic benefit must be registered with the Australian Register of Therapeutic Goods before being sold in Australia. The Therapeutic Goods Administration is responsible for administering the Act (211).
In 2000, the Therapeutic Goods Administration developed the Guidelines for Levels and Kinds of Evidence to Support Claims for Therapeutic Goods (1). The Complementary Medicines Evaluation Committee recognizes two types of evidence to support claims on therapeutic goods: scientific evidence and traditional use. The extent of required evidence depends on the claims made for the product. For the Committee, traditional use refers to written or orally recorded evidence that a substance has been used for three or more generations for specific health-related or medicinal purposes. Some exceptions to this requirement are made for homeopathy. The regulations include clauses for the use of medicines as one component of a multifaceted treatment, the use of treatments that combine a number of traditions, and the use of treatments that are recent modifications of traditional therapies. Traditional therapies are considered to include traditional Chinese medicine, traditional ayurvedic medicine, traditional European herbal medicine, traditional homeopathic medicine, aromatherapy, and other traditional medicines.
Education and training
The number of traditional Chinese medicine programmes offered by universities and private colleges is growing. Programmes, some of which lead to diplomas, range from 50 hours to over 300 hours. There are also traditional Chinese medicine programmes available for qualified allopathic practitioners. These range from 50 to 250 hours. The Royal Melbourne Institute of Technology, the University of Technology at Sydney, and the Victoria University of Technology have degree programmes in traditional Chinese medicine. These programmes are offered within the schools of Applied Science or Health Science.
Acupuncture was first offered as a formal education programme in Sydney in 1969 with the founding of the privately owned school, Acupuncture Colleges, Australia (212). This programme subsequently formed the basis of the Diploma of Applied Science (Acupuncture) accredited by the New South Wales Higher Education Board in 1987 and the four-year Bachelor of Applied Science (Acupuncture) accredited by the New South Wales Higher Education Unit in 1992. Following the same programme, the Victoria University of Technology began offering a Bachelor of Health Science (Acupuncture) in 1992. The Royal Melbourne Institute of Technology, the University of Technology at Sydney, and the Victoria University of Technology also offer Master's degrees and graduate diplomas in acupuncture (213).
With growing acceptance of acupuncture by the public and by allopathic practitioners, graduates are able to play a larger part in the public-health sector of the community, working in allopathic hospitals, community health centres, and in areas of specialized health services. The Bachelor of Health Sciences in Acupuncture prepares graduates for this role in general health care (213).
Training in homeopathy has been from the level of the FHom of London (53). There are two chiropractic colleges recognized by the World Federation of Chiropractic (81). Naturopathy, European herbalism, homeopathy, and nutrition are taught at the Southern Cross University in New South Wales (213).