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Doctors, schools blamed for poor services
Inconsistent standards and unethical recruitment methods in the health industry are to blame for Indonesia's costly yet ineffective medical services, a study says
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Inconsistent standards and unethical recruitment methods in the health industry are to blame for Indonesia's costly yet ineffective medical services, a study says.
The study, jointly conducted by Indonesian and Australian researchers between March and September this year, found that doctors' "uncontrolled freedom" in setting prices and employment standards has led to the cost blowout and poor quality in services across the country.
"Doctors can charge unreasonably high prices for their services without patients' having any idea what is reasonable. The price of medical treatment in a Jakarta state hospital could be significantly higher than in a private hospital in Malaysia," the study coordinator, Hasbullah Thabrany from the University of Indonesia, told press in Jakarta on Thursday.
He said measures ensuring the quality of medical services were very weak, with audits rarely carried out into hospitals' performance.
Hasbullah said doctors should also just focus on one practise, instead of multiple areas, because it was leading to discriminative practices based on a patient's financial status.
"The current system is seeing doctors treat wealthier patients above all others. This is a threat to the quality of medical services, which should be equal for all," he said. An increase in government remuneration has been suggested as a way of enticing doctors to stay in one just area.
Civil servant doctors are paid the same salary as other civil servants in Indonesia, while a fresh-graduate state doctor may receive as little as Rp 1.2 million (US$100) per month. Low incomes have forced doctors to expand their services to multiple areas, though under the 2004 Medical Practices Act one doctor is limited to working in three places.
Hasbullah said a lack of standards also plagued the recruitment and education process of would-be doctors. Medical schools, he argued, where becoming "liberal" and selecting students based on their financial status instead of abilities.
The study recommended the government immediately reform its overall medical workforce management policy.
Secretary general of the Indonesian Doctors Association (IDI), Zaenal Abidin, said there were no standards for medical services in the country and the Health Ministry had not yet developed a regulation for the industry.
He said doctors should obey ethical standards set by the Indonesian Medical Council.
Concerns have been raised over the growing trend in medical schools to recruit students based on financial capacities and said the IDI had been urging lawmakers and the government to fix the situation.
"Such a selection process will produce graduates who only care about money. It will create problems because doctors are directly involved in people's wellbeing," he said.
The study into the quality of medical services is among nine other research projects being developed this year under the Australia-Indonesia Governance Research Partnership (AIGRP) program. The results of the studies will be presented before industry experts on Dec. 1.
