Doctors not immune to GATT

Doctors not immune to GATT

JAKARTA (JP): Indonesia's doctors should begin preparing
themselves for greater competition from abroad, which is required
under the General Agreement on Tariffs and Trade (GATT), Minister
of Health Sujudi said yesterday.

The minister, himself a physician by training, prescribed
introspection as a preparatory treatment for doctors as the era
of free competition looms.

Sujudi said doctors should take a hard look at themselves. "We
have to ask ourselves why patients here like to seek medical
services overseas," he said yesterday.

"Patients want to know about the medicines they are told to
take, and why they need surgery," he said after installing new
second-echelon officials in the ministry. "Patients are getting
more critical, and maybe they are finding services abroad more
satisfactory."

"Medical staff must build the trust of their patients," he
added.

The issue of greater foreign competition surfaced during a
seminar on the impact of foreign investment in the health sector
held by the Indonesian Medical Association (IDI) this week.

The association urged the government to weigh the advantages
and the disadvantages of opening Indonesia's health sector to
foreign investors, which is required under GATT.

Sujudi said the government advocated the use of local
personnel, as far as possible, in the health sector.

He said that his ministry would be working together with the
Ministry of Manpower to draw up new regulations on the employment
of foreign medical personnel in the country.

The regulations would be ready before 2020, the deadline for
the implementation of the GATT in the health services sector, he
added.

One of the requirements facing medical personnel seeking to
work in Indonesia is that they pass local examinations to ensure
a minimum standard, he said. "Another criteria is fluency in
Bahasa Indonesia."

The current regulations allow foreign doctors to work in
Indonesia only in positions that cannot be filled by Indonesians.
Under the new GATT such a broad restriction will not be
permitted.

Doctors at the seminar warned that opening the doors to
foreign doctors could mean that those doctors entering would be
of "third grade quality."

A number of local companies have already joined up with
foreign investors in building health institutions. For instance,
Singapore-based Gleneagles and a local consortium, PT Nusa Medika
Perkasa, which includes the Lippo City Development group, plan to
build 15 hospitals in various cities.

Sujudi stressed that the main employment rules still applied
for the time being, notwithstanding that the companies had been
granted investment approval.

"Requests to employ foreign personnel are only allowed if they
can prove that local staff with the necessary skills are not
available," he said.

The chairman of the medical association, Azrul Azwar, said
that one benefit of foreign investment would be better quality
services as a result of "sharper competition." However, this
would also lead to higher costs, he said.

"Patients will have to be prepared to pay more," he said.

Azrul said a regulation on health services rates was needed.

Sujudi said, however, that regulating rates was not yet
possible.

"The possibility of regulating rates depends on insurance," he
said. Only 15 percent of the population has health insurance.

An official from the Ministry of Trade, Painan Nainggolan, who
also spoke at Thursday's seminar, urged the health community to
show a "clear commitment" in facing the free flow of services.

"The health community must be actively involved in
multilateral agreements to ensure the most benefits" for the
country, Nainggolan said. (anr)