[Public Hospital] Regulator, operator separation ‘important’

Elly Burhaini Faizal

Gadjah Mada University School of Medicine professor of public health Laksono Trisnantoro said in Yogyakarta that Indonesia might fail to provide the sufficient health services needed to compete amidst the tighter global competition among health service providers without separating entities responsible as the operators and regulators of public hospitals.

“Public hospitals may see no improved professionalism as long as they work under an entity that functions both as regulator and operator,” he told a discussion on public health management held by the Health Ministry.

Professionalism is needed in the health sector as it is one of the sectors that maintains a strong commitment to minimizing errors in their services, he said.

“Health service is extremely sensitive to any errors,” she said.

Laksono said the present problem is that public hospitals remain under the coordination of the Health Management Efforts Directorate General at the Health Ministry, which is working both as regulator and operator.

According to Laksono, public hospitals should not become the technical management unit (UPT) of the Health Management Efforts Directorate General. “There should be a separation between regulator and operator of public hospitals at the ministry,” he said, implying that the directorate general should serve only as the regulator.

In Indonesia, health is a market-based sector. Traditionally, entities involved in the country’s health service interacted by using a market approach. They also received relatively small subsidies from the government.

However, in the last several years, the government has tried to reduce the market approach to its provision and assistance for health service by providing subsidies both for people and public hospitals.

“We’ve seen a growing subsidy, especially for those who come from low income families, in the form of community health security (Jamkesmas) and the childbirth insurance program, Jampersal,” said Laksono.

A universal health subsidy plan has also been prepared by the government and the legislative body. The universal social insurance will be given to all citizens — poor or not.

“It’s time for the government to be more specific in posing as regulator in providing health services,” he said.

Lukman Sukarma, deputy minister on administrative and bureaucratic reform, said the Health Ministry should build the leadership needed to accomplish its health reform objectives.

“Only with strong leadership can we influence people to do great things and motivate them to be more creative in achieving common goals,” he said, adding that reforming the health sector toward more professional services was not an easy task because it needed significant changes, not only in medical skills, but also in human character.

“Such changes should be well-managed to anticipate any risk failure caused by resistance against change,” Lukman said.

Source: The Jakarta Post