Indonesia passes Health Bill into law, allowing foreign doctors to practise locally

JAKARTA – The Indonesian Parliament on Tuesday passed into law a Health Bill that allows foreign medical specialists to practise and be based in the country. 

The new law will also simplify bureaucratic processes for general physicians to become specialists and, for the first time, will regulate the collection of the country’s biomedical, genomic data for processing overseas. 

“Seven factions are in support of the Bill and two are against,” said Parliament Speaker Puan Maharani, who presided at the plenary session. 

Under Indonesian administrative law, President Joko Widodo must sign the Bill within a month to officially turn it into law.

One purpose of bringing in foreign specialists, among others, is to curb the flow of middle-class and rich Indonesians going overseas to seek treatment, the Health Ministry said earlier.  Affluent Indonesians frequently head to Singapore, Malaysia, the United States and Europe for medical services.

A final draft of the Bill – received by The Straits Times on July 10, a day before Parliament’s ratification – stipulates that foreign doctors must pass a competence evaluation before they can be issued a licence by the health minister. With the licence, they can undergo an adaptation process at a local health facility.   

But foreign specialists who have practised at least five years overseas or are widely considered experts in certain fields –supported by a strong portfolio – are exempted from the competence evaluation and adaptation process, the Health Bill’s Clause 235 says.  

There was strong resistance to the Health Bill by the Indonesian Medical Association (IDI), which said it had not been properly informed about the plan. Some medical professionals have staged street protests over the Bill, voicing concerns that it would put their jobs at risk and affect the quality of health services in the country.  

The new Health Bill amends the 2004 medical law, the 2009 health law and other laws on physicians, dentists, nurses and midwives. 

Another major change the Bill offers is the scrapping of the requirement for general physicians to get a recommendation from the powerful IDI to become medical specialists – a process which entails “annoying red tape”, an MP earlier told The Straits Times. 

“The pandemic was a wake-up call that prompted us to realise there are many (things in the health sector) we need to improve,” Health Minister Budi Sadikin told Parliament after the passage of the Bill. “We want to move from having a lack of medical staff to having adequate medical staff spread out equally across the country. We also want to simplify the licensing process.”

The minister also said that when a local doctor is issued his registration licence, locally called STR, it will be valid throughout his career. Previously, the STR had to be renewed every five years, involving more red tape for Indonesian doctors.  

The Health Bill also introduces a ban on the sharing of biomedical, genomic data overseas.   

Sharing of such data is allowed only if certain conditions are met, including getting approval from the patient and the health minister, and declaring that the purpose of the data sharing is for research and the technology required to do the intended research is not yet present in Indonesia, according to the Bill’s Clause 361.  

Before the Bill was introduced, any party may share biomedical, genomic data overseas without breaching any law because there were no regulations governing the action, according to the Health Ministry. 

The Bill also stipulates that foreign doctors or specialists practising in Indonesia need to engage in mandatory programmes involving the transfer of technology and sharing of knowledge, and that they receive a three-year licence that can be extended for only a year.

Dr Prijo Sidipratomo, a former chairman of IDI, told ST that the government should take a broader approach towards improving the whole chain of services available at hospitals – as opposed to addressing the paucity of doctors alone – if it wants to lift standards.

“A medical doctor works in a team. It’s not a one-man show. He needs professional nurses and supporting staff – both medical and non-medical,” Dr Prijo said.