The Health Bill of Indonesia was recently approved by the Indonesian Parliament, granting permission for foreign medical specialists to practise and establish themselves in the country.
The new legislation aims to streamline bureaucratic procedures for general physicians to become specialists. It also introduces regulations for the collection of the nation’s biomedical and genomic data, allowing its processing overseas for the first time.
During the plenary session, Parliament speaker Puan Maharani stated that seven factions supported the Bill, while two were against it. However, according to Indonesian administrative law, President Joko Widodo must sign the Bill within a month to make it an official law.
One of the reasons for inviting foreign specialists is to reduce the number of middle-class and wealthy Indonesians travelling abroad for medical treatment, as frequently observed in countries like Singapore, Malaysia, the United States, and Europe. The Ministry of Health believes that this measure will help address the issue.
The final draft of the Bill, received by The Straits Times on 10th July, outlines that foreign doctors must undergo a competence evaluation and obtain a practice licence from the health minister. Upon receiving the licence, they can then undergo an adaptation process at a local healthcare facility. However, Clause 235 of the Health Bill exempts foreign specialists with a minimum of five years’ experience abroad or recognised expertise in specific fields, supported by a strong portfolio, from the competence evaluation and adaptation process.
The Indonesian Medical Association (IDI) strongly opposes the Health Bill, claiming that the association was not properly informed about the plan. Some medical professionals have staged street protests, expressing concerns about potential job loss and the impact on healthcare quality in the country.
Apart from foreign specialist provision, the Health Bill amends various existing laws related to healthcare, including the 2004 medical law, the 2009 health law, the 2009 hospitals law, and laws concerning physicians, dentists, nurses, and midwives.
Another significant change introduced by the Bill is the elimination of the requirement for general physicians to obtain a recommendation from the influential IDI to become medical specialists. This process was seen as burdensome and involved excessive bureaucracy.
Health Minister Budi Sadikin highlighted the need for improvement in the health sector, citing the pandemic as a wake-up call. The government aims to address the shortage of medical staff by increasing their availability across the country and simplifying the licensing process. Additionally, the Bill eliminates the need for Indonesian doctors to renew their registration licence (STR) every five years, allowing it to remain valid throughout their careers.
The Health Bill also includes a provision that restricts the sharing of biomedical and genomic data overseas. Sharing such data is only permitted under specific conditions, including patient and health minister approval, and a declaration that the purpose is for research and that the necessary technology is not yet available in Indonesia.
Before the introduction of the Bill, there were no regulations governing the sharing of biomedical and genomic data overseas, allowing any party to do so without legal consequences, as stated by the Health Ministry.
The Bill also mandates that foreign doctors or specialists practising in Indonesia must participate in mandatory programmes involving technology transfer and knowledge sharing. They will be granted a three-year licence that can be extended for one additional year.
Dr Prijo Sidipratomo, a former chairman of IDI, suggested that the government should take a comprehensive approach to improve the entire range of hospital services rather than solely focusing on addressing the shortage of doctors. He emphasised the importance of a team-based approach, highlighting the need for professional nurses and support staff, both medical and non-medical, to elevate standards in the healthcare system.