Testimonies of two witnesses from the Government, Fitri Hudayani as the Head of Nutrition Service Installation of Central National Hospital Dr. Cipto Mangunkusumo (RSCM) Jakarta and Lia Asti Sugiyanti during the continued hearing of judicial review on Health Law, Thursday (19/9/2024). Photo by MKRI/Bayu.

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Jakarta, MKRI—A continued judicial review hearing of Article 212 paragraph (2) of Law No. 17 of 2023 on Health (Health Law) was held on Thursday, September 19, 2024. The hearing combined two cases: 49/PUU-XXII/2024 and 50/PUU-XXII/2024. Deputy Chief Justice Saldi Isra led the hearing, which was accompanied by seven constitutional justices.

The agenda for the hearing was to hear testimonies from the president/government witnesses. Fitri Hudayani, the head of Nutrition Service Installation at the Central National Hospital, Dr. Cipto Mangunkusumo (RSCM) Jakarta, explained human resource management based on the competence and qualification of each position. For example, the Nutritionist working under Inpatient and Outpatient Nutrition Care requires a Clinical Authority Letter (SKK) issued by RSCM and signed by the President director. The SKK requirements are an active Registration Certificate (STR) and a valid Practice License (SIP). Nutritionists who have not obtained SKK are assigned to manage food planning, production, and distribution.

 “Nutrition Service Installation of the Central National Hospital of Dr. Cipto Mangunkusumo has 66 nutritionists with qualifications, among others, 5 nutrition diplomas graduated, 32 nutrition bachelor’s degree graduates, 2 nutrition master’s degree graduates, and 17 dietician professionals, and 6 dieticians with master’s degree in nutrition. Based on the existing employee composition, 34 hold academic education based on Law No. 17 of 2023 on Health and Government Regulation No. 28 on the Implementation of Law No. 17 of 2023 on Health. Hence, these workers must continue to take Dietician Professional Education to perform their duties directly to the patients (hands-on),” Fitri said before the Court.

Anticipating the Impact of Health Law

Fitri added that in anticipating the implementation of Law No. 17 of 2023 on Health and the Government Regulation No. 28 on the Implementation of Law No. 17 of 2023 on Health, the head of the Nutrition Service Installation must adjust accordingly, including the regulation under Circular Letter from General Director of Medical Workers No. HK.02.02/F/2123/2024 on the Adjustment of Educational Qualifications for Medical Workers with Academic Background following the enactment of Law No. 17 on Health. The regulations oblige medical workers to take Dietician Professional Education under two scenarios: regular education and Past Education Recognition (RPL). Meanwhile, the arrangements are made based on the STR validity, employee status, and length of service.

She opined that the RPL program is feasible because it can be done without leaving their duties where learning can be done online and based on cases in each working place. In terms of funding, the RPL education only requires cost for one semester. At the end of the RPL Education, participants will take a competence examination and the professional certificate required to obtain STR. Currently, there are 10 academic nutritionists that are undertaking the RPL Education

“Because the RPL Education is required for Nutritionists who have a minimum experience of 5 years, the other who has not fulfilled the requirements take regular education with funding from the Ministry of Health,” Fitri stated.

STR Not Needed

The next witness from the government is Lia Asti Sugiyanti, graduate of health nutrition profession in 2010 and started working in 2011-2012 as the head of nutrition installation in a hospital in Makassar. She provided nutrition care and nutrition consultation to patients in Makassar. While working there, she needed STR to support her daily process in carrying out her work.

In 2015-2022, she returned to work as a unit manager at a catering company in Jakarta and was assigned to a hospital in Jakarta. During this assignment, she did not need an STR because she worked directly with patients every day. “I was in charge of managing all kinds of operational needs such as managing the unit, preparing kitchen and nutrition personnel, managing food ingredients to be used, helping the hospital in terms of food service to patients. In 2022 until now I worked as Head of Operations and a dietician in one of the catering companies in Jakarta and I coordinated all operational services and managed nutritionists throughout Indonesia where I did not need an STR in carrying out this work,” she said.

Responding to the testimony of the two witnesses, Constitutional Judge M. Guntur Hamzah asked whether this policy specifically applies to those already working at the Ministry of Health, or whether this funding is also provided to graduates in the health sector who wish to obtain an STR. Are there individuals who are prevented from obtaining an STR because they have not attended the relevant professional education. In addition, Guntur also asked at the time of completion whether there were provisions to follow the Professional Education or at the time of completion there were no provisions so that the competency test was immediately carried out and then after the competency test obtained an STR.

Answering the question, Fitri said that academic staff are Bachelor's degree graduates who have not continued their professional education. As for those who have less than 5 years of service and work in the service area, she said they are included in regular education. This is because they have not yet met the qualifications of RPL Education.

“Dietician graduates have existed before the enactment of Law No. 17, with the first institution being UGM and followed by other institutions. The graduates have existed since the issuance of Law No. 17,” Fitri answered.

In addition, Fitri also said that based on the time span for the transition for the next five years, she did a mapping by considering the validity period of the STR, which prioritized RPLs whose STRs would soon expire and then the farthest for the validity period of the STR.

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Kurnia Nurfitrah as the Petitioners' legal counsel in Case No. 49/PUU-XXII/2024 said that the Petitioners suffered a loss because the amendment to Article 212 paragraph (2) of the Health Law prevented health worker undergraduate students from obtaining a Registration Certificate (STR) directly after graduating from the undergraduate program. In fact, during the education period of the undergraduate program, students have chosen a concentration in a study program that suits their interests and expertise with the aim of getting the appropriate job.

The Petitioners feel harmed by the sudden enactment of Article 212 paragraph (2) of the Health Law without transitional provisions. Therefore, in their petition, the Petitioners request the Court to exclude the provisions of Article 212 paragraph (2) of the Health Law for students who are registered as undergraduate health worker program students before the enactment of the article a quo (8 August 2023).

Testimony of Circumcision Expert

The Petitioner of case No. 50/PUU-XXII/2024, Iwan Hari Rusawan, argued that Article 212 paragraph (2) of the Health Law only accommodates professional education and higher education. This resulted in the Petitioner, who works as a circumciser, not having the opportunity to prove and register his ability in the competence examination, so he could not apply for an STR, so the Petitioner was not recognized as a health worker. As a result of not being able to have an STR, the Petitioner cannot apply for a license to practice, which is needed to carry out religion-based beliefs for a living, for example, opening a circumcision clinic.

 In his petitum, Iwan asked the court that the provisions of Article 210 paragraph (1) and paragraph (2) of the Health Law exclude medical personnel and health workers based on culture, local wisdom, and religion that have gained recognition from the Indonesian people since before the existence of universities in Indonesia.

Author: Utami Argawati.

Editor: N. Rosi.

PR: Fauzan F.

Translator: Rizky Kurnia Chaesario (NL)

Disclaimer: The original version of the news is in Indonesian. In case of any differences between the English and the Indonesian versions, the Indonesian version will prevail.

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