Features Education Regulations
National Regulation

Historically, within the massage therapy (MT) profession, vying for legislated regulation (LR) has been an undertaking surmounted by a strong massage therapy association(s) or other professional leaders with unity of vision and strength of will. A hideous amount of work, volunteered hours and financial resources are invested into putting an application together.

Before any profession can apply for LR, there has to be a legislative framework in place within the province or territory in which that profession is located. Currently, the Northwest Territories and Prince Edward Island provincial governments have proposed developing umbrella legislation for a number of health and social services professions in their respective provinces, thereby providing a mechanism for (currently non-regulated) professions to apply for LR. What this means is that, at this time, an application can’t even be put forth for consideration.

In provinces that have a legislative framework in place – but where the profession is not currently legislated – there are MT associations actively engaged in pursuing LR (e.g., Alberta, Manitoba, New Brunswick, Nova Scotia and Saskatchewan). It is not unusual for a provincial government to request that an application be submitted by only one association/group or by the association/group that represents the greater majority of the members of the profession (in this case, practising MTs) within that province.

Some provinces have several MT associations; thus, submitting an application may require multiple associations to work together as a unified front or the strongest  association (the one with the most members) may choose to go forward without the support of or collaboration with the other associations.

Some provinces are still struggling with establishing a unified front amongst those practising the various forms of massage therapy and across the active associations within that province. Differing views (for example, applying for multi-category versus single-category models) and reluctance to regulate appear to be the collaboration stall points. Reasons for reluctance include: discord surrounding what the change will mean (e.g., fees, exams, professional standards, accountability); and questions of whether or not the benefits outweigh the cost of LR (i.e., financial and other associated responsibilities). 

Some provinces have achieved unity and are currently compiling the necessary information and documentation in order to file an application.

In some cases, massage therapits in a province have submitted an application and have had their application returned numerous times due to missing information or lack of necessary documentation.

How the process works
Once an application is approved by the Ministry of Health of the province in question, a bill must be drawn up. Upon its completion, the bill is then read the specified number of times and voted on in the House of Assembly. (For more information on the legislative process,  the Nova Scotia government covers this well on its website at http://nslegislature.ca/index.php/proceedings/how-a-bill-becomes-law/ .)

All told, this arduous process takes several years to decades.

Regarding the information that is necessary, interestingly, one of the biggest challenges has been convincing the powers that be of the potential risk of harm posed by non-regulated providers offering massage therapy services and providing adequate supporting documents and data.

Another interesting twist preventing MTs in a province from achieving regulation has presented itself in Saskatchewan. One of the obstacles the Massage Therapy Association of Saskatchewan (MTAS) has bumped up against is the fact that the association members have always conducted themselves in the same manner as a legislated province. In past meetings, the Saskatchewan government has expressed that they are very impressed with MTAS’ bylaws, complaints and discipline process, and with the standards of practice and ethics that they maintain.  Unfortunately, an “If it’s not broke why fix it?”

message has been conveyed; that is, the government now wonders, why bother to vie for regulation?    

Why bother?
So, why should we care and why should we bother to apply for LR?

Although all concerned will surely applaud no longer having to collect and relinquish additional funds for the government (i.e., HST/GST), the collective value of MT being regulated in more than the current three provinces goes far beyond this.

Moving toward national LR presents many benefits for both the public and the profession. Some examples of these are professional accountability and assured educational, practice and code of ethic standards (which in turn support public protection), enhanced credibility, credential recognition, title protection, labour mobility, inclusion in CAM discussions/projects, funding for research, greater accessibility (coverage and tax deduction options)  and, potentially, more university-based educational bridging opportunities for those who have interest in this option.

Unity as a profession affords us strength in numbers, which in turn provides us with greater autonomy and a greater ability to chart our own professional course – it gives us more control over deciding what we want for the future of our profession and how we want to get there!

“It seems that when making plans to move forward, the movers and shakers take along the essentials. I have sat in the audience at international conferences where initiatives for integrative medicine are being discussed with a generous dose of proposed interprofessional education and collaboration in the planned mix and the explicit message is that the regulated CAM professions will be invited to dialogues and proposed projects. Mutual and equal players, decision-makers and implementers seem to share the common ground of legislated self-regulatory status – if we believe in the value of the work we do isn’t it a shame that it is limited in any mutable way?” –Donelda Gowan-Moody

GPS-ing the non-legislated MT jurisdictions
Alberta: This province began its LR process over a decade ago. The Alberta associations were directed by the Minister of Health and Wellness to form a Transitional Steering Committee (TSC), which currently consists of representation from the MTAA, RMTA, AATM and NHPCA. In 2009, the TSC began working together to create the Schedule A, regulations, policies and bylaws needed for the profession to become regulated in the province. Currently, a draft Schedule A – which includes such information as a practice statement, protected titles, fines and transitional matters – has been drafted by the TSC.

Once the TSC agrees that the draft is complete, it will be reviewed by the Alberta government, legally drafted and then distributed to all other stakeholders in the province for their consideration. Once consultation has concluded, the schedule will be voted upon and subsequently the Health Professions Act will be amended to include MT. Under ideal circumstances, this type of process can take a few years for formal Regulation to be fully achieved. (Statement from Chandra Kastern, MT, Communications Coordinator MTAA)

Manitoba: MTAM has been working toward legislation since 1973. On May 2, 2012, MTAM submitted an application and it is awaiting review by the health minister. MTAM’s application is consistent with the goals of Canada and its provinces to obtain full “Labour Mobility” for the profession. The MTAM looks forward, with optimism, to the completion of the application process and the transition toward the establishment of a new “Regulatory College” for Massage Therapists in Manitoba.

New Brunswick: The NBMA-AMNB began regulatory pursuit efforts in 1994. More recently the NBMA-AMNB and ANBMT created a Joint Legislation Committee for the sole purpose of pursuing regulation. The process to bring the bill to the province’s legislature is currently active.
Northwest Territories: Massage therapy would not be one of the first professions addressed under the proposed umbrella legislation; however, the proposed act would be expected to contain a mechanism for other professions to apply to become regulated in the future. Although the NWTMTA is not specifically pursuing legislation at this time, its members do support the development of this legislation and will participate in the process as opportunities become available.

Nova Scotia: This is currently one of the provinces where unity across associations has not been realized (citing possible differing views of the need for, or path to, regulation). MTANS has made some attempts to legislate; however, setbacks have been experienced (e.g., gaps, or missing information). More recently, the Legislation Committee and the MTANS Board have been working to create the documents that are needed to meet the requirements of the Nova Scotia Department of Health and they intend to reapply once the necessary documentation is gathered and paperwork completed.

Prince Edward Island: The PEIMTA has been asking the government since the late 90s to look into regulating the profession of MT. The umbrella legislation project within the Health Professions Act is currently under development. MTs in the province understand that a bill will be put forward in the provincial legislature, hopefully this fall. After the bill passes, MTs, as well as others (e.g., naturopaths, dental hygienists), will be invited to submit an application to the provincial government. The PEIMTA will be submitting an application when the opportunity becomes available.

Quebec: This is also one of the provinces where unity across associations (over 30) has not been realized. It appears that part of the barrier to provincial recognition and accreditation in is a lack of a clear identity for the profession and fragmentation (differing views and education/training differences).* The FQM (Fédération québécoise des massothérapeutes) began regulatory inquiry in 1992. More recently [02/2012] the FQM submitted an application for legislation and state that they are currently the only association in Quebec vying for MT regulation. During the most recent election campaign the FQM sent letters to all the different parties to ask their position on the MT regulation issue. They received very interesting answers, especially from the winning party (the Parti Québécois) who is open to exploring the case again – because they acknowledge that the profession has evolved and changed. The FQM will be initiating discussions with this new government and they are firmly committed to professionalizing the practice of MT in Quebec.** Currently FQM membership is available as a multi-category option [i.e. various levels of education/training]. In vying for regulation a single-category model will be put forth using the 2200h/Competency profile as a guide.

• * Martine Frigon – Massage Therapy in Quebec. Massage Therapy Canada magazine – Summer 2011
• **Statement from: Sonia Zennaf, Analyste et coordonnatrice de projets spéciaux – Fédération québécoise des massothérapeutes (FQM)

Saskatchewan: In 1995, the amalgamation of the [then] three provincial associations (to form MTAS) was prompted by the sole purpose of pursuing regulatory status. The reality of the situation is that as the province grows and as MT increasingly becomes a mainstream and legitimate health-care choice, the need for regulation grows.  The Saskatchewan government has a template legislation process, which makes the application procedure more streamlined. An application is in process and MTAS is fairly optimistic about its proposal.

What is the Canadian Massage Therapy Alliance (CMTA)
The CMTA is a nationwide alliance composed of provincial professional associations from both legislated and non-legislated jurisdictions (MTABC, MTAS, NBMA-AMNB, MTANS, PEIMTA, NLMT  and NWTMTA). The CTMA provides a forum for collaboration to advance massage therapy as a health-care profession in Canada. One mandate of the CMTA is to encourage the [legislated] regulation of massage therapy in every province and territory and to assist non-regulated jurisdictions in their quest to become regulated.

Cathy Ryan, RMT, has maintained a diverse, treatment- oriented massage therapy practice and an extensive postgraduate training roster since 1990. Cathy is a longstanding member of provincial massage therapy associations and has served as a subject matter expert and examiner trainer at the CMTO’s provincial licensing examinations. Currently residing and working in beautiful B.C., Cathy maintains a private practice, teaches and writes massage therapy related material and is the managing editor for TouchU.ca; an online source providing accredited continuing education for touch professionals and students. Cathy can be reached at: cryanrmt@gmail.com or via www.touchu.ca.