Free trade feared to threaten health jobs

Free trade feared to threaten health jobs

Debbie A. Lubis, The Jakarta Post, Jakarta

The country could face massive unemployment among professional
health workers and inadequate health services for poor people if
the government does not provide clear regulations on standards
for health professionals, experts warn.

Sudarto Ronoatmodjo, dean of the school of community health at
University of Indonesia, said on Monday the influx of foreign
health workers and health services in the country was inevitable
in the free trade era, which had just begun to varying degrees
across member countries of the Association of Southeast Asian
Nations (ASEAN).

Currently, the country has 1,145 state-run and private
hospitals, and 132,978 health workers, of which some 21,017 are
medical doctors.

"AFTA (ASEAN Free Trade Area) has already taken effect and we
still have no regulations at all in the health sector. The
country will certainly see jobless health workers. I believe that
our health workers and service providers will lag behind their
foreign counterparts if there are no clear standards," he told
The Jakarta Post.

Sudarto was speaking on the sidelines of a discussion on
hospital repositioning in the free trade era.

He said regulations that standardized the quality of health
workers and hospitals would help the country select the
appropriate human resources.

"We should prevent unqualified doctors and health workers from
providing services to the public. The rules will require
government to screen foreign health workers before allowing them
to operate here.

"We also need to set a benchmark for our health workers so
that they can easily enter the foreign market if they wish to
work abroad," he said.

Separately, Hasbullah Thabrany, head of the department of
hospital administration, said the country's poor people would
have a tough time getting "friendly" health services since
hospitals in the free trade era would compete to provide better
services at higher prices.

He said the absence of clear rulings on hospitals and health
care management may mean patients would pay for unnecessary
medical services.

"In many cases, health workers suggest that patients take
unnecessary medication in a bid to boost the hospitals' revenue
from technology use and bonuses from pharmaceutical companies.
Without rulings, we cannot control such practices," Hasbullah
said.

Hasbullah emphasized that the rulings should also help the
poor secure access to any hospital in accordance with the
Constitution that guarantees everyone the right to enjoy health
services.

"A high-ranking health ministry official who suffers a heart
attack could die in his car because hospitals do not trust his
driver that he has the money to pay the medical fees. How ironic.

"We can imagine how many poor people will suffer and die if
hospitals neglect their social duties in this era of
globalization," he said.

Abdul Gani Abdullah, director general of law and regulations
at the Ministry of Justice and Human Rights, said that the
government, especially the Ministry of Health, could propose
government regulations on hospitals and regulations instead of
waiting for a law.

"Endorsing a law takes time because it requires many processes
and procedures at the House of Representatives. I am convinced
the first draft of such a government regulation can be drafted
within two weeks," he said.

The General Agreement on Trade and Services (GATS) in the
World Trade Organization (WTO) allows, among other things, tele-
diagnosis of patients in one country by medical doctors from
another country and mobility of human resources in the health
sector.