(Left to right) Feri Amsari and Laksono Trisnantoro as experts presented by the Petitioners, and Mudjtahid Ahmad as the Petitioners\' witness each provided expertise and testimony at the judicial review hearing of the Medical Practice Law on Wednesday (19/12) in the Plenary Courtroom of the Constitutional Court. Photo by Humas MK/Ganie.
The state is responsible for the provision of adequate health care facilities and public service facilities as set out in Article 34 paragraph (3) of the 1945 Constitution. Because of the importance of health for the community, the state is responsible for proper health services, including the regulation of professional medical organizations that is not separate from the state\'s efforts. This was conveyed by Ferry Amsari, constitutional law expert of the Andalas University, who was present as expert for the Petitioners in the follow-up judicial review hearing of Article 1 number 12 of Law Number 29 of 2004 on Medical Practice on Wednesday (19/12) in the Plenary Courtroom of the Constitutional Court.
The case registered as No. 80/PUU-XVI/2018 was requested by 36 individual citizens consisting of lecturers, retired lecturers, and professors in the field of medicine. The Petitioners claimed that Article 1 numbers 12 and 13 as well as the Elucidation to Article 1, Article 29 paragraph (3) letter d, and Article 28 paragraph (1) of the Medical Practice Law could potentially harm the constitutional rights of the Petitioners. Feri further stated that doctors in the professional organizations must be able to create good working atmosphere so that there will be optimal health services for the public. In other words, the state has the role of regulating the medical professional organizations to provide optimum health services to citizens.
"Through the a quo law, the objectives of IDI shall be designed in such a way that it can provide optimal services for the community. Therefore, professional organizations can act professionally in these services in accordance with the mandate of the Constitution," Feri said before a hearing chaired by the Chief Justice of the Constitutional Court Anwar Usman, in the presence of the eight other constitutional justices.
Nature of Constitutional Court Decisions
Feri also stated that the Constitutional Court\'s decision was binding on everyone. Although it was realized constitutionally in Decision Number 10/PUU-XV/2017 on the Medical Practice Law, many members of the public did not understand it. Through the decision, Feri added, the Constitutional Court viewed that there were problems in the management of the medical professional organizations. The Court stated that IDI could not self-regulate, but based on the theory of power, something in the organization of medical profession was distorted. In addition, the Court also outlined aspects of community supervision towards the medical professional organization, both of which strongly correlate. This means that the Court considers that without medical professionalism, the right to public health insurance will be disrupted. "So, the medical professional organization must obey the order of the Constitutional Court in its operation so that it does not make rules for its own organization," Feri explained.
Healthcare System
Gajah Mada University health policy and management expert Laksono Trisnantoro, who was also presented by the Petitioners, said that there was a need for limit on IDI\'s authority based on the system implemented by WHO. According to him, actors in the health system can actually be from the Government, private sector, and quasi-governmental institutions such as the Indonesian Medical Council (KKI). Thus, there could be conflicts among health system actors that might hamper the implementation of decisions in the health services.
Laksono observed that to produce a good healthcare system, leader would be highly important. In this case, the leader of a medical professional organization must be a competent doctor so as not to risk the provision of good health services to the community. "Given the existence of IDI as a self-regulating body, it [has led] to monopoly, which [is] the root of problems, with the numerous petitions at the Constitutional Court," he explained.
Therefore, IDI\'s position in the future, Laksono added, is expected to go beyond the limits of its self-regulation and through the role of the Government. In other words, the Government plays a supervisory role in obtaining competent doctors, while IDI deals with operational work or human resource management in increasing the professionalism of doctors, and the collegiate councils are independently managed to focus on re-certification with supervision by KKI. "So [the healthcare system] will not rely on IDI without supervision. This restriction will be good for the development of IDI that is beloved by its members, and will trigger the development of professional organizations to further provide added value to the [healthcare system] in Indonesia," Laksono hoped.
Not a King
Mulya Mujtahid Ahmad, who had served as Chairperson of the PB IDI in 2000–2003, as the Petitioner\'s Witness stated that the idea that IDI was the only medical professional organization and no other medical professional organizations were allowed was still strongly held by many. In his experience, Mujtahid had observed that there was misinterpretation of IDI in relation to other medical professional organizations. In 2003–2015, he added, IDI\'s statute/bylaws were adjusted to the comply with the a quo law. Then, in 2015 they were gradually amended, to the point that IDI became equal with the Medical Ethics Honorary Council (MKEK), the Professional Services Development Council (MPPK), and the Indonesian Academy of Medicine (MKKI). "So, IDI [shall be] guardian and not king of the IDI professional organization," Mujtahid said.
The Petitioners had previously said that Article 1 number 12 of the law on the definition of the phrase "Indonesian Doctors Association" was interpreted narrowly solely as the Executive Board of the Indonesian Doctors Association (PB-IDI) at the national level. Whereas, according to the Petitioners, within IDI there are several autonomous organizations, such as the Medical Ethics Honorary Council (MKEK), the Professional Services Development Council (MPPK), and the Indonesian Academy of Medicine (MKKI). They considered the definition of IDI in the a quo article had placed those organizations as subordinates of the PB-IDI, especially the MKKI, resulting in PB-IDI\'s authority intervening the academic/medical field. If the a quo articles are not corrected, PB-IDI will seize control of the medical field from upstream to downstream due to the lack of checks and balances mechanism among institutions within IDI, as practiced by IDI seniors in the 2000s. Therefore, the Petitioners requested that the Constitutional Court justices declare the articles being reviewed conditionally constitutional.
Before closing the session, Justice Anwar stated that the next session would be held on January 14, 2019 at 11.00 a.m. to hear the testimony of the president\'s representative as witness. (Sri Pujianti/LA/Yuniar Widiastuti)
Thursday, December 20, 2018 | 17:38 WIB 197