Chiropractic history in SA

The South African Medical and Dental Act was promulgated in 1928. As Chiropractic was relatively unknown in those early years, no provision whatsoever was made for the inclusion of Chiropractic services under this Act. Indications are that there were only four or five chiropractors from the United States of America and Canada who had set up some form of private practice in this country in the early 1900’s. Those practices and their following grew and several new practices were established in the ensuing years. We understand that the majority of those early pioneers had graduated from Chiropractic Schools in the USA.

By 1960 the Chiropractic profession had grown quite considerably and it became apparent that legislation should be sought to govern and control the profession. In 1962 a private members bill was introduced in Parliament by a Mr B J van der Walt seeking legal recognition for Chiropractic. Dr Albert Hertzog who was Minister of Health at that time appointed a Commission of Inquiry into Chiropractic. The members of that commission were unfortunately more medically orientated and totally unfamiliar with Chiropractic principles or practice. Their investigations never included interviews with any Chiropractic experts and no training facilities or Chiropractic Institutions of learning were ever visited. Needless to say, the findings of this commission proved to be most damning to our profession. Dr Hertzog fortunately realised too that this report would do neither the profession nor the public any good and promptly shelved the report where it lay for the next eight years.

In the interim chiropractors sensing the need for organisation were busy forming different associations. Not unlike events in the USA and elsewhere the phenomenon of so-called “straights” and “mixers” reared its ugly head with each camp claiming to represent true chiropractic. Coupled with this situation it was also found that many unqualified persons were also conducting “chiropractic” practices. Legislation was necessary.

In 1970 Dr Carel de Wet was approached to institute positive legislation for Chiropractic. He was decidedly against any form of complete recognition and immediately drew on the 1962 Report which he presented in Parliament. The chiropractic profession and many patients lobbied very strongly for recognition and many heated debates followed in Parliament. The outcome of these debates was Act 76 of 1971, better known as the Chiropractors Act. Now although this Act granted recognition to qualified chiropractors, it also effectively froze the profession by not allowing any further chiropractors to register and practice in this country. The South African Medical and Dental Council (SAMDC) and the Medical Association of South Africa (MASA) considered this a great triumph as they firmly believed that Chiropractic would now gradually phase out completely. The Chiropractic Association of South Africa (CASA) remained optimistic and were actually in favour of this Act for several reasons. Firstly it granted the profession a degree of legal recognition and it further made it possible for the Association to now set about getting its house in order and establishing ethical control over the profession.

The Minister of Health further informed us that once our house was in order we could return to the negotiating table. Further good came about from these developments in that the Minister of Health refused to grant the profession any interviews until they “spoke with one voice”. Thus it came about that chiropractors in South Africa set aside their ideological differences and that the Chiropractic Association of South Africa was formed.

In February of 1977 after further representations to the Minister of Health, Dr Schalk van der Merwe, CASA was set the task of answering to the 1962 Report and the various debates in Parliament. The subsequent memorandum of the Developments within our Profession and the Rebuttal to the ’62 Report took our Association two years to complete and cost the profession several thousand rand. Copies of these documents were presented to various health interest groups, Parliament, the SAMDC, and MASA.

By now our profession had reached a most critical stage. Of the 176 qualified doctors of chiropractic registered under the Chiropractors Act, there were now only about 102 left in actual practice. Scarcely enough to satisfy the needs of a public becoming more and more aware of the benefits of Chiropractic care. Many good men within our profession such as Dr Andries Kleynhans and Dr Scott Haldeman had emigrated. Our profession was indeed dying!!

ON the 22nd of March 1980 we were granted an interview with Dr LAPA Munnik, Minister of Health. We sketched in detail the background of our struggle and stressed that it was now of paramount importance if chiropractic was to survive that legislation be introduced enforcing our ethical rules and re-opening the Chiropractic Register. Dr Munnik was most sympathetic and seemed to understand our predicament. Our Ethical Rules were subsequently published in the Government Gazette on the 1st July 1980.

The Chiropractic Association of South Africa has always held that in the interests of the health of our nation it was better to foster good relations with all other health disciplines, and especially that of the medical profession. To this end a meeting was arranged with the S A Medical and Dental Council on the 6th March 1981. A certain amount of interest was displayed in our profession and a further meeting with more health interest groups as well as representatives of the medical profession was arranged by the Minister of Health on the 10th August 1981 in Cape Town. At this meeting a substantial amount of evidence was presented in support of Chiropractic as well as a most commendable testimony from Dr Andries Kleynhans who flew out from Australia for this occasion. The meeting was considered to be highly successful. The SAMDC being the advisory body to the Department of Health were now set the task of advising the Minister as to the merits and possible inclusion of Chiropractic under the health disciplines of our country.

In November of 1981 we learned to our total dismay that the SAMDC had voted by 17 votes to 16 against the inclusion of Chiropractic. They rejected Chiropractic as being unscientific and having no place whatsoever within the realm of “medicine”. To this very day they still have not submitted any reply to our afore mentioned Memorandum.

A recent letter from the Secretary-General of the Medical Association simply indicated that he was “not at liberty” to avail us of copies of their reply!!

Other professions such as Homeopathy, Osteopathy, and Naturopathy also sought legal recognition. Dr Munnik realised that control over these various professions was necessary and after due deliberation proposed a Statutory Board virtually identical in power to the Medical Council (SAMDC). This Associated Health Professions Board would exercise strict control over the various health disciplines not covered under the Medical and Dental Act of 1928 and would also act as an advisory body to the Minister of Health. The Medical Council and Medical Association were up in arms about this move but were unable to prevent the successful passage of the Associated Health professions Act, Act 63 of 1982, through Parliament. Chiropractic had now gained statutory recognition.

The Associated Health Service Professions Board met for the first time in Pretoria on the 9th of August 1982. The members of the Board appointed by the Minister of Health constituted two Medical Practitioners, one Advocate and Professor of Law, one Educationist, one Osteopath, one Naturopath, three Homeopaths, and five Doctors of Chiropractic. The chiropractors being Drs Reg Engelbrecht and Chris Diedericks (Palmer Graduates), Drs Glynn Till and Mario Milani (Lincoln Graduates), and Dr Brian Peters (CMCC Graduate). This AHSP Board now effectively controlled all matters relating to the various “non-medical” disciplines and has been instrument in liaison with the Chiropractic Association of South Africa in passing further legislation regarding ethical and professional conduct. During 1982 a small delegation of the Board was sent to Europe and to the United States to investigate the various training facilities available to students of chiropractic and the other disciplines. They were also to assess the different standards of education as well as the entrance requirements of the various institutions.

In August of 1982 a new Minister of Health was appointed. This man, Dr Nak van der Merwe, was also the Member of Parliament for the constituency in which the President of the Chiropractic Association, Dr Reg Engelbrecht, was resident. Needless to say our President immediately requested an interview with the new Minister who promptly responded by paying a personal visit to the consulting rooms of Dr Engelbrecht.

This was surely a historic first for Chiropractic in this country and we firmly believe that during that specific interview, where many crucial questions were asked, answered, and pondered upon and where on the spot evidence concerning our profession was available, tremendous strides were made towards the ultimate re-opening of the Chiropractic Register. The Chiropractic Association further persisted in exploring all possibilities of constructive dialogue between the medical and chiropractic professions. Of major significance was an invitation extended to our president to attend a Spinal Instruction seminar in May of 1984 by the Orthopaedic Association of South Africa.

Inroads have also been made concerning positive contact with the Physiotherapy and Nursing Associations.

The AHSP Board and the Council of CASA continued in their drive for re-opening the register and several further meetings were held with Dr Nak van der Merwe. We stressed that the re-opening of the register was long overdue and that our profession had complied in absolutely every aspect of the tasks it was set by the previous Minister of Health. Dr van der Merwe agreed that we had acquitted ourselves most admirably of our tasks and assured our president that everything possible would be done to present a bill calling for the registration of new chiropractors during the current parliamentary session. Enthused by this encouraging news the CASA set about compiling as much documentation and evidence as possible and accordingly submitted this information to a great number of parliamentarians. Wherever possible personal contact was made with key figures in Parliament. Our hopes were dashed when we learned of the death of Dr Nak van der Merwe on the 24th April, 1985. A true and personal friend had been lost and the likelihood of the Amendment Bill still being presented during the current parliamentary session rapidly faded.

Dr LAPA Munnik, former Minister of Health, was appointed as Acting Minister of Health. He was quite familiar with our struggle and immediately took up the reigns on our behalf. Once more all systems were go!! The Medical Association opposed the proposal of introducing an Amendment Bill in favour of Chiropractic perpetuity and furnished members of Parliament with voluminous documentation against Chiropractic. This evidence was fortunately quite outdated and we found it a relatively simple task to prepare and submit our rebuttal which was well received in Parliament. The CASA president (Dr Reg Engelbrecht) as well as the AHSP chairman (Dr Mario Milani) and other delegates travelled to Cape Town on several occasions where they presented further evidence to the Standing Committee on Health matters and also held meetings with certain key figures. These efforts encouraged and supported Dr LAPA Munnik in his determination to now have our Bill finally approved in Parliament.

On Friday evening the 7th June, 1985 we learned that our Bill had been approved in Parliament with very little opposition!!! Our struggle was over!

The Associated Health Service Professions Amendment Act, as this new legislation was known, is possibly one of the finest pieces of Chiropractic legislation in the world today. We have endured a long and difficult struggle about which many more tales of deceit, frustration and broken promises could be told. We have learned much in the process and are now determined to present and maintain an absolutely superior image of Chiropractic. Our house is in order and we aim to keep it that way!!

This Act made provision for the registration of new Chiropractic Practitioners who were duly qualified as per the standards set by the AHSP Board. Chiropractic Students of chiropractic were also required to register with this Board. (Now the AHPCSA – Allied Health Professions Council of South Africa).

The Chiropractic Association of SA has assisted in establishing the training standards which by some persons may be considered to be too high. We are however of the opinion that to lower our standards would be to lower the image and respect for our profession which we have gained.

We now face a new era and need to firmly establish our positioning in the Scientific and Health community. Continuing Professional Development (CPD) is now legislated and remains a responsibility of the Chiropractic Association to provide for affordable and accessable opportunities for CASA members. By steadily improving our knowledge and understanding of our profession, and by reasoning rationally we can prove beyond any doubt that Chiropractic Practitioners are indeed an integral part of the total Health Care System.

The first Chiropractic Faculty was established at the Durban Institute of Technology in 1983. A few years later, the Wits Technikon faculty was established and South Africa has since produced many excellent graduates. The above institutes are now renamed as the Durban University of Technology and the University of Johannesburg. National accreditation of the course presented at both institutions was achieved in 2008 and international accreditation with the European Council on Chiropractic Education (ECCE) followed in 2010.