The Indonesian Medical Association (IDI), a staunch opposition of the omnibus Bill on health, has once again demanded lawmakers stop the Bill deliberation, arguing that if passed, it may risk undermining the role of medical associations.
The omnibus health Bill seeks to bring in sweeping changes to the health sector by supplanting 10 existing laws, including the 2004 Medical Practice law, the 2009 Health Law, the 2009 Hospitals Law and the 2014 Health Workers Law.
IDI members along with thousands of health workers from four other prominent medical associations in the country, namely the Indonesian Dentists Association (PDGI), the Indonesian Nurses Association (PPNI), the Indonesian Midwives Association (IBI) and the Indonesian Pharmacists Association (IAI), recently staged a protest against the proposed Bill.
They threatened to stage yet another protest in the near future should lawmakers continue the deliberation of the Bill.
One of the protesters’ main points of contention is lawmakers’ plan to scrap a regulation stating each medical profession can only have one medical association to represent them: the IDI for doctors, the PDGI for dentists, the IBI for midwives and the PPNI for nurses.
“Scrapping this regulation is a clear attempt to diminish the role of medical associations. It will also create discord among medical professionals, which will eventually harm the public,” IDI spokesperson Beni Satria said.
“The current regulation that clearly stipulates one medical association for each medical profession offers better protection (for health workers),” he added.
Deputy chairman of House of Representatives Commission IX, overseeing healthcare and manpower, Emanuel Melkiades Laka Lena, said lawmakers were trying to formulate the best arrangements so even though there would be more than one medical association for each medical profession, they could still represent health workers’ aspirations well.
Some proponents of the omnibus Bill have argued it would end the IDI’s monopoly over some bureaucratic processes new and existing doctors need to go through to obtain permits allowing them to practise medicine.
Under existing regulations, doctors are required to have both a registration letter (STR) from the Indonesian Medical Council, a non-structural body that answers to the president, and a medical practice permit (SIP) from local health agencies to work.
The requirements for an STR include a competency certificate and a letter of recommendation, both issued by the relevant medical professional associations.
The SIP, on the other hand, is only valid for one place of practice and is only active as long as the STR remains valid.
In 2017, a group of doctors challenged the regulation stipulating the IDI as the sole medical association to represent doctors with the Constitutional Court but they lost the case.
Deby Vinski, deputy chairman of the All-Indonesia Doctors’ Association (PDSI), a splinter group from the IDI, said the IDI’s monopoly over the process of acquiring medical practice licences has led to Indonesia’s severe lack of doctors.
According to the government, Indonesia needs around 130,000 more doctors, as the country currently has a ratio of 0.4 doctors per 1,000 people, far below the one to 1,000 ratio recommended by the World Health Organisation (WHO).
Should the current iteration of the omnibus health Bill be passed, the authority to issue a competency certificate would fall to the central government and doctors would no longer be required to have one SIP for each place they practise in.
The government has also proposed lawmakers scrap provisions requiring doctors to have letters of recommendation issued by relevant medical professional associations to acquire their SIPs.
IDI had denied claims it held a monopoly over the process of doctors’ medical licence issuance, arguing that although it held an exclusive right to issue some documents needed for doctors to practise medicine, its authority remained fairly limited.
Rimawati, a medical legal expert from Gadjah Mada University, said the IDI had relatively greater authority compared to other associations for medical professionals like the PPNI or the IBI.
Rima argued currently there was no check and balance system for the IDI’s authority, making it prone to abuse and conflict of interests. She also said there was no transparency or standardised system on the issuance of letters of recommendation.
Although Rima said the presence of more than one medical association to represent doctors could be a step forward to limit potential abuse of power, she said the government should also formulate a clear regulation so that all associations apply the same standard in issuing competency certificates or letters of recommendation. — The Jakarta Post/ANN
