Dio Suhenda, Jakarta – The Indonesian Medical Association (IDI) and allied groups have threatened to strike if lawmakers pass the omnibus health bill into law, a sweeping piece of legislation that would bring divisive changes to the country's health sector.
On Monday, seven of the nine party factions on House of Representatives Commission IX overseeing health agreed to bring the bill to an upcoming plenary session for passage.
The IDI, however, wants the bill brought back to the drawing board. If lawmakers press on with the enactment, the country's largest medical association has threatened, in addition to the strike, to file a judicial review of the bill alleging that its deliberation lacked transparency.
"We will continue our campaign [against the bill], and staging a strike is an option we are seriously considering," IDI chairman Mohammad Adib Khumaidi said during a press conference on Monday, as quoted by kompas.com. "[The strike] is not for our own interests or for our profession but for the interests of the public."
Tens of thousands of doctors belong to the IDI, and the potential strike would also involve health workers from four allied medical associations: the Indonesian Dentists Association (PDGI), the Indonesian Nurses Association (PPNI), the Indonesian Midwives Association (IBI) and the Indonesian Pharmacists Association (IAI).
"Frankly speaking, we don't know the contents of the bill [that was endorsed by Commission IX] or whether or not our opinions have been considered," Adib said. "It's clear to see that the [deliberation process] is legally flawed."
A coalition of over 40 civil society groups has voiced opposition to the bill as well, arguing that there has not been any meaningful public participation in its deliberation.
The Prosperous Justice Party (PKS), one of the two parties that opposed the bill at Monday's meeting, also cited rushed deliberation as their reason for voting against it.
The omnibus health bill seeks to supplant 10 existing laws regulating the country's health sector, including the 2004 Medical Practice Law, the 2009 Health Law and the 2014 Health Workers Law.
The government claims the bill is key to addressing the problems plaguing the country's health sector, which include a lack of specialist doctors. The bill would seek to redress that particular issue by allowing certain hospitals to offer their own postgraduate programs and by permitting foreign talent to make up for staff shortages.
But medical associations say these arrangements could result in an overabundance of doctors in the long run, arguing that the root of the problem instead lies with the government's poor distribution of health workers.
Associations have also raised concerns that the bill will undermine their role, as at least one draft would allow multiple associations to represent the same medical specialty.
They also criticized a provision in the bill that transferred the power to issue competency certificates from medical associations to the government, although some observers have lauded the move as a way to end the IDI's monopoly over these bureaucratic processes.
Meanwhile, the Democratic Party, the other party opposing the bill, said its removal of an existing provision that requires 5 percent of the annual state budget to be spent on the health sector could result in generally poorer health care. Health Minister Budi Gunadi Sadikin has countered that this would instead stamp out the mismanagement of funds.
The plenary vote on the bill was initially scheduled for Tuesday, but House Speaker Puan Maharani said the time "was not right". She promised that the bill would be passed into law in another plenary session during the House's current sitting period, which ends on July 13.
Speaking at the conclusion of Monday's meeting of Commission IX, Budi claimed the health bill would provide a foundation for health reform in the country and that it had gone through sufficient public consultation.
"The government has conducted 115 public discussions [...] that were attended by 1,200 groups of stakeholders and a total of 72,000 participants," Budi said.