Indonesia row over hiring of foreign doctors

INDONESIA - Angry that their hospital had hired two Malaysian orthopaedic specialists,
doctors at a state hospital on the outskirts of Jakarta lodged a protest with local assemblymen.

The blowback was swift: five of the protesting doctors had their contracts terminated by the
hospital, while another 18 were issued warning letters.

The case in South Tangerang has attracted national attention, and sparked a debate over the
hiring of foreign doctors, which is against the law in Indonesia but widely practised.

Local doctors say the foreign doctors are illegally taking their jobs. But hospitals say there are
simply not enough local specialists and argue that the needs of their patients should come first.

Dr Zaenal Abidin, the national chairman of the Indonesian Doctors' Association (IDI), told The
Straits Times the latest incident is not an isolated case. "We have received numerous reports
from colleagues that the hospitals they are working at had foreign doctors," Dr Zaenal said.

"The excuse was the foreign doctors were on a charity mission, but it was later discovered that
they practised commercially without a permit."

Private and government hospitals sometimes bring in foreign doctors to treat patients, he said,
taking advantage of the government's weak monitoring and law enforcement.

The IDI is the professional body for the country's 113,000 doctors. It earlier raised concerns
about foreign doctors, including some from Singapore, offering consultations to patients here.

The complaints come at a time when private hospitals and clinics are sprouting to cater to a
growing middle class.

But this trend has not been matched by an adequate supply of qualified and experienced doctors,
so several state hospitals have hired foreign doctors to fill gaps.
Some private hospitals have foreign specialists fly in and discreetly treat patients several days a
week.

South Tangerang health officials say they engaged the Malaysian specialists because they had
the expertise to train local doctors. The provincial chapter of IDI is now preparing a lawsuit
against the city administration in South Tangerang.

Strict rules apply for foreign doctors who do work in Indonesia: they must register with the
Health Ministry and have a recommendation from their home country's doctors' association.

Even then, they can come here only to speak at seminars, and work in hospitals strictly to
transfer and share knowledge. The IDI claims many foreign doctors regularly flout the law by
treating patients.

Observers say the growing demand for foreign doctors is not surprising.

Indonesia has about one physician for every 2,200 people. And every year, only about 5,000
doctors graduate from 72 medical schools across the country. The ideal number is 10,000 new
doctors every year, according to Professor Leva Akbar, the dean of the medical school at
Bandung Islamic University.

Yet the market for medical care for the well-heeled has been growing in the past few years.
Business groups like Mayapada, Sinar Mas, and Lippo have all invested in private hospitals.

Still, Indonesia has only about 1,600 hospitals and 9,500 community health centres (puskesmas)
for its population of 250 million.

With the shortage of both doctors and facilities, some Indonesian patients feel the government
should lift the restrictions on foreign doctors working here.

"The interests of patients should be the priority. The nationality of a doctor should not matter,"
said Ms Pusparyanti Sjamsuddin, 49, a housewife who survived breast cancer after she was
treated at the Parkway Cancer Centre in Singapore's Mount Elizabeth Hospital a decade ago.
She still travels to Singapore every six months for medical care.

"At least a third of the patients visiting my doctor at Parkway come from Indonesia," said the
Jakarta resident. "Imagine, if the doctor can instead work in Indonesia one or two days a week,
how much accommodation and airfare costs can be saved by the patients?"
My Opinion :
1. Dissatisfaction towards local doctor

To get over this problem, I think there are two cases that have to be concerned. They are
RATIO and QUALITY. Ratio between doctors and patients can be solved if numbers of
doctors increase at once they are spreaded out to secluded area. Besides, skills and
knowledges of doctors can not be ignored. All medical faculty in Indonesia, both come from
private and state university, have to reach the best grade of quality. In Indonesia usually
mentioned as A accreditation. The two important things, ratio and quality, have to happen
simultaneously because it will make nothing when they are separated.

An increase in the number of doctors without doctors spreading to remote areas will cause
public dissatisfaction. People in remote areas will choose to seek treatment in other areas that
are felt to be closer and adequate. On the other words, the presence of doctors in the country
will be ignored by the community.

2. Weak monitoring and law enforcement

Government need to assert the rules that have been validated. Government is necessarily to
be brave to give severe punishment against the foreign doctors which breaks up the law. It
similarly means they underestimate our law by doing what they want without any permission.
They have to be consistent with reasons they bring when they practice in Indonesia. If they
want to do some charity mission, then do it truly. Do not take advantage by utilize the
chance.
Government also expected to be more alert with doctors in its area. Do not let local doctors
live sufferly on their own land.
Multilateral cooperation, such as ASEAN, should be built as good as possible. Countries
have to comply under the law so that the prosperity can be reached together.

3. One vision
Even though they come from different nationalities, local doctors and foreign doctors
should work together in bringing health to the community. Both groups must comply
with applicable regulations so that good intentions do not cause problems that are
detrimental to certain groups.
.