Jakarta approves healthcare reform challenged by doctors and nurses

The aim is a greater presence in the country's peripheral areas and the strengthening of prevention and specialist medicine. But the opening up to foreign doctors and the possibility for patients to file malpractice claims is causing controversy.

Jakarta (AsiaNews) - The Indonesian House of Parliament approved the new health law on Tuesday 11 July, despite massive street demonstrations by several health workers in front of the parliament building.

It is a framework law reorganising Indonesia's healthcare system, strongly contested by some bodies including the Indonesian Medical Association and the Indonesian Nurses' Association for a number of points including easier access to the healthcare profession in Indonesia for foreign doctors, the possibility for patients to file criminal complaints against healthcare workers for negligence, and the cancellation of the obligation for the state to allocate 5% of its budget to the healthcare sector.

Addressing the protesters, Indonesian Health Minister Budi Gunawan Sadikin - former director of the state-owned Mandiri Bank - said he was open to dialogue on the implementation of the measure.

"This health law will be a new chapter in building the health system nationwide, including in remote and border areas and archipelago territories," the minister said, adding that the Indonesian Ministry of Health is serious about building the foundations of the health service in the country.

Among the stated objectives are the transition from the simple treatment of illnesses to a vision that also looks at prevention; a better distribution of healthcare personnel throughout the country; the integration of technological systems used in healthcare facilities; and transparency in payments.

But it is above all the cancellation of the compulsory 'permit' issued by the Indonesian Medical Association to practise the profession, which could open the doors more easily to doctors from abroad, that is causing discussion. It must also be said that today, Indonesians who can afford it still prefer to go abroad for treatment (e.g. to Singapore) rather than go to local hospitals.

With the new law, Indonesia also aims to increase the supply of medical specialists, a key issue for the local healthcare system. Compared to other South East Asian countries, the ratio of medical specialists to population in Indonesia is 0.12 per 1,000 people, while in other countries it is 0.20. The number of generalist doctors in Indonesia is also only 0.62 per 1,000 people, far below the World Health Organisation standard of 1 doctor per 1,000 people.