Interpreting the Constitutional Court's Ruling on Medical Collegia

The Constitutional Court’s ruling on Case 111/PUU-XXII/2024, filed by Prof. Dr. Djohansjah Marzoeki, dr, SpB, and Case 182/PUU XXII/2024, filed by PB IDI and a group of doctors, has affirmed the state’s efforts to strengthen the position and role of collegia within the realm of science, as well as a form of the state’s constitutional responsibility as mandated in Article 34, paragraph (3) of the 1945 Constitution of the Republic of Indonesia, to provide adequate health services and public service facilities.

In its legal considerations, the court affirmed that these efforts are realised through an institution whose establishment is carried out inclusively and accountably, in order to create a better health ecosystem. In this context, the position of collegia must be understood as remaining within the framework of state responsibility, so that its establishment must also be overseen by the state in order to guarantee access to adequate health services.

Notably, the court’s ruling also emphasised the importance of the court reaffirming that the position of collegia in Law 17/2023 has been strengthened with a different concept of establishment compared to previous laws, in this case Law 29/2004, because collegia are no longer established by professional organisations, but by groups of experts in each discipline of health science, who have their own autonomy and independence in developing branches of science and educational standards for medical and health personnel.

Based on this, although the Constitutional Court’s ruling does not elaborate further on the operative part of the ruling, it is clear that the concept of collegia is no longer based on the old rules that gave rise to various collegia established by professional organisations.

This is further reinforced by the court’s rejection of the judicial review of Article 451, which states that ‘Upon the entry into force of this Law, the collegia established by each professional organisation shall remain recognised until the establishment of the collegia’ as referred to in Article 272, which is established under this Law.

It is affirmed that the norm of the aforementioned article is part of the Transitional Provisions, which broadly determine transitional matters as referred to in Annex II, number 127 of Law 12/2011, with the aim of avoiding the occurrence of constitutional rights being harmed by the addressees due to the enactment of the new law.

As a transitional norm, the existence of collegia established by professional organisations is only temporary until the establishment of collegia under the Health Law.

What about collegia that have been established after the enactment of the Health Law? In the operative part of the ruling and in various legal considerations, there is no mention of the court’s opinion on the collegia that have been established. This is because, from the aspect of authority, the Constitutional Court is not authorised to assess the validity of the establishment of institutions that fall within the jurisdiction of the state administrative court, by assessing both the aspect of authority and the procedure for issuing the decision on establishment.

The Constitutional Court only conducts a judicial review of the norms of the Law against the Constitution. The norms of the Law relating to collegia that are subject to judicial review and correction concern the arrangement of the institutional position with the principle of independence, namely by placing the original position of collegia as an element of the council into an element of council membership.

This does not immediately abolish the collegia version of the Health Law that already exists, but clarifies the institutional position, so that there are no longer interpretations and doubts about the independence of the collegia.

This is affirmed in the court’s consideration, which states that it is inappropriate to place collegia as an element of the council because, in its position as an element, within the bounds of reasonable reasoning, it shows and at the same time justifies collegia as subordinate to the council.

Moreover, placing collegia as an element of the council is not in line with Article 270, letter c of Law 17/2023, which has determined that collegia is part of the element of council membership.

In this regard, the Court needs to affirm that in carrying out its duties and functions, collegia is accountable to the president in the president’s position as head of state through the council.

Once again, this affirms the interpretation of the Constitutional Court’s ruling that the ruling does not mean dissolving collegia that have been established validly under the Health Law, but rather clarifies its institutional arrangement, and this is further emphasised that the operative part is also in accordance with Article 270, letter c of the Health Law itself.

The affirmation of the independence of collegia is central to the interpretation of the Constitutional Court’s ruling, but the Constitutional Court itself does not assess whether the collegia established under the Health Law has been independent or not.

This affirmation of independence actually strengthens the background of the establishment of the Health Law, which is also included in its legal considerations, that this law provides a more proportional arrangement of institutional relations between the community, medical personnel, health personnel and the government, so that it is oriented towards the community, and is a form of government responsibility to guarantee and protect the right of citizens to receive quality health services.

The important role of collegia in drafting competency standards for medical and health personnel and in drafting curriculum standards for the training of medical and health personnel, which will ultimately become the main benchmark for issuing competency certificates by collegia for medical and health personnel.

This shows the recognition of the ability and readiness of medical and health personnel to perform medical procedures, which are only given to those who have gone through various stages to become professional medical and health personnel.

Therefore…