Indonesia gears up to allow foreign medical specialists to practise in the country

Indonesian President Joko Widodo said that competition is very important to improve health services. - AFP

JAKARTA (The Jakarta Post/Asia News Network): Indonesia is gearing up to allow foreign medical specialists to practise and be based in the country. Observers say the move would boost healthcare quality and accessibility in the world’s fourth-most populous country of 280 million people.

President Joko Widodo told The Straits Times over lunch on March 15 that regulations towards this end would be outlined in new legislation, with a Bill currently being deliberated in Parliament.

“Competition is important. Very important to improve (health) services,” said Mr Widodo at the presidential palace.

Quizzed further on the contours of the proposed legislation, Mr Widodo said he preferred to leave it to Parliament and did not wish to disclose the details before Parliament ratified the new health Bill.

An MP deliberating the so-called health omnibus Bill told The Straits Times that if all goes well, Parliament could pass the Bill into law by end-April.

“The purpose of bringing in foreign specialists is also to curb the traffic of middle-class and rich Indonesians going overseas to seek treatment,” the MP said on condition of anonymity.

He added that among the conditions expatriate doctors would be subject to is a requirement that they work only in hospitals owned by foreign investors and must transfer knowledge to local colleagues.

On possible nationalist voices criticising the move to allow foreign doctors to practise in Indonesia, he said: “In 1998, when Indonesia opened up its banking sector, there were worries foreign bankers would dominate the sector’s workforce. We all witnessed that didn’t happen at all.

“Logically, hospitals would not hire all expatriate doctors and operate inefficiently here. They would probably bring in three to five,” the MP added.

The health omnibus Bill seen by ST stipulates that foreign medical specialists would be eligible to get a work permit with three years’ validity, which would be extendable by only one year.

In addition, foreign medical specialists seeking to work in Indonesia must go through an adaptation programme in an Indonesian health facility before starting professional work. Those who have practised overseas for five years are exempt.

Singapore-based public health specialist Dr Jeremy Lim called Indonesia’s plan a game-changer, noting that it will unlock the supply side of the healthcare equation from both quality and quantity perspectives.

“Indonesia has massive ‘demand-side’ needs, which are currently being addressed in part by Indonesians seeking care outside the country,” said Dr Lim, a director at the National University of Singapore’s Saw Swee Hock School of Public Health.

Affluent Indonesians frequently head to Singapore, Malaysia, the United States and Europe for medical services.

Medical expert Dr Prijo Sidipratomo, the former chairman of the Indonesian medical doctors’ association (IDI), said the government should take a more broad-minded approach towards improving the whole chain of services available at hospitals – as opposed to addressing the paucity of doctors alone – if it wants to improve standards.

“A medical doctor works in a team. It’s not a one-man show. He needs professional nurses and supporting staff – both medical and non-medical,” Dr Prijo told ST.

Professor Frans Santosa, the head of the advisory board at IDI’s medical ethics council, praised the proposed transfer of knowledge under the Bill.

However, he took issue with the planned scrapping of the existing system of medical practice permits that doctors must renew every five years, calling the plan not well-thought-out.

“What if a surgeon whose physical state declines continues to work on a surgery table? Every doctor having to go to the IDI office every five years shouldn’t be a problem. Patient safety is priority,” said Prof Frans.