KSP LEGAL ALERT
Publication
KSP LEGAL ALERT
Pros and Cons of the Health Law to Labor
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In July and August 2023, thousands of workers who are members of the All-Indonesian Trade Unions held demonstrations to convey their rejection of the 2023 Indonesian Health Law (Health Law). There are several problem points that have drawn various responses to the Health Law, both pros and cons.
The first issue is related to mandatory spending. Based on the Health Law, the government removed the health budget allocation of at least 10% from the previous 5%. The government’s goal of abolishing this is so that mandatory spending is based on the government’s budget spending commitment, not based on the size of the allocation. On the other hand, this provision is not in accordance with the Mandate of the Abuja Declaration of the World Health Organization (WHO) and TAP MPR RI X/MPR/2001 regarding health services. This provision will also be detrimental to the community which will worsen the quality of health facilities, especially in underdeveloped, frontier and outermost (3T) areas.
The second issue is related to the ease of granting licenses for foreign doctors, this provision differentiates the requirements for foreign doctors and Indonesian doctors who are diaspora and wish to return to the country to practice. The provision states that opening a practice in the country requires a temporary Registration Certificate (STR), Practice Permit (SIP), and Minimum Practice Requirements obtained from the Indonesian Doctors Association (IDI). However, if the diaspora or foreign doctor has graduates from specialist education, these requirements may be waived. The government’s goal of implementing this provision is related to the lack of specialist doctors in Indonesia. On the other hand, this is considered to be dangerous because specialist doctors can operate without recommendations from IDI to determine the doctor’s ethics and morality. This issue also intersects with the new requirements for obtaining SIP in the Health Law which no longer require health certificates and recommendations from professional organizations. This eliminates the authority of the IDI and the filtration of health workers in Indonesia.
The next issue is the restrictions that are made. The first limitation is related to professional organizations regulated in Article 314 Paragraph (2) of the Health Law, which stated that each group of medical workers and health workers can only form one professional organization. The second limitation is related to the Indonesian medical council and the Indonesian health worker council, which according to Article 239 Paragraph (2) of the Health Law, stated that the councils are responsible to the minister, from those previously were responsible to the president. The government’s goal of implementing these provisions is for efficiency and effectiveness. Due to these existing restrictions, IDI questioned the details of the regulation of this single professional organization and was concerned about the strength of the professional organization, which is now partly being taken over by the ministry.
The final issue of concern is related to the criminalization of health workers. The Health Law regulates criminal penalties for medical personnel or health workers who commit gross negligence resulting in serious injury to the patient as stated in Article 462 Paragraph (1). The government implements this to protect patients from the mistakes of medical personnel or health workers. On the other hand, this provision can result in the criminalization of health workers because there is no detailed explanation regarding points of negligence.
Responding to these issues, IDI considers that the new regulations in the Health Law have the potential to destabilize the health system by facilitating foreign doctor permits which enhance the investment ecosystem and eliminating mandatory budgets.
Behind the issues that become problems, with the passing of the Health Law, the Ministry of Health has improved a number of aspects of the Health Law, among others:
1. Changing the focus from treatment to prevention
2. Facilitate access to health services
3. Encouraging the health industry to be independent in the country
4. Prepare a health system that is responsible for facing disasters
5. Increase the efficiency and transparency of health financing
6. Correcting the shortage of health workers
7. Simplify the licensing process
8. Protect health workers in particular
9. Integrate health information systems
10. Encouraging the use of the latest health technology
The current Health Law aligns 11 health sector laws with current and future developments. The Health Law is expected to improve access, quality and equity of health services in Indonesia.
In July and August 2023, thousands of workers who are members of the All-Indonesian Trade Unions held demonstrations to convey their rejection of the 2023 Indonesian Health Law (Health Law). There are several problem points that have drawn various responses to the Health Law, both pros and cons.
The first issue is related to mandatory spending. Based on the Health Law, the government removed the health budget allocation of at least 10% from the previous 5%. The government’s goal of abolishing this is so that mandatory spending is based on the government’s budget spending commitment, not based on the size of the allocation. On the other hand, this provision is not in accordance with the Mandate of the Abuja Declaration of the World Health Organization (WHO) and TAP MPR RI X/MPR/2001 regarding health services. This provision will also be detrimental to the community which will worsen the quality of health facilities, especially in underdeveloped, frontier and outermost (3T) areas.
The second issue is related to the ease of granting licenses for foreign doctors, this provision differentiates the requirements for foreign doctors and Indonesian doctors who are diaspora and wish to return to the country to practice. The provision states that opening a practice in the country requires a temporary Registration Certificate (STR), Practice Permit (SIP), and Minimum Practice Requirements obtained from the Indonesian Doctors Association (IDI). However, if the diaspora or foreign doctor has graduates from specialist education, these requirements may be waived. The government’s goal of implementing this provision is related to the lack of specialist doctors in Indonesia. On the other hand, this is considered to be dangerous because specialist doctors can operate without recommendations from IDI to determine the doctor’s ethics and morality. This issue also intersects with the new requirements for obtaining SIP in the Health Law which no longer require health certificates and recommendations from professional organizations. This eliminates the authority of the IDI and the filtration of health workers in Indonesia.
The next issue is the restrictions that are made. The first limitation is related to professional organizations regulated in Article 314 Paragraph (2) of the Health Law, which stated that each group of medical workers and health workers can only form one professional organization. The second limitation is related to the Indonesian medical council and the Indonesian health worker council, which according to Article 239 Paragraph (2) of the Health Law, stated that the councils are responsible to the minister, from those previously were responsible to the president. The government’s goal of implementing these provisions is for efficiency and effectiveness. Due to these existing restrictions, IDI questioned the details of the regulation of this single professional organization and was concerned about the strength of the professional organization, which is now partly being taken over by the ministry.
The final issue of concern is related to the criminalization of health workers. The Health Law regulates criminal penalties for medical personnel or health workers who commit gross negligence resulting in serious injury to the patient as stated in Article 462 Paragraph (1). The government implements this to protect patients from the mistakes of medical personnel or health workers. On the other hand, this provision can result in the criminalization of health workers because there is no detailed explanation regarding points of negligence.
Responding to these issues, IDI considers that the new regulations in the Health Law have the potential to destabilize the health system by facilitating foreign doctor permits which enhance the investment ecosystem and eliminating mandatory budgets.
Behind the issues that become problems, with the passing of the Health Law, the Ministry of Health has improved a number of aspects of the Health Law, among others:
1. Changing the focus from treatment to prevention
2. Facilitate access to health services
3. Encouraging the health industry to be independent in the country
4. Prepare a health system that is responsible for facing disasters
5. Increase the efficiency and transparency of health financing
6. Correcting the shortage of health workers
7. Simplify the licensing process
8. Protect health workers in particular
9. Integrate health information systems
10. Encouraging the use of the latest health technology
The current Health Law aligns 11 health sector laws with current and future developments. The Health Law is expected to improve access, quality and equity of health services in Indonesia.
