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.