By Ahmad Pathoni, dpa
Jakarta (dpa) - The plight of a woman who was jailed briefly after
sending an email to friends expressing her dissatisfaction with a
hospital's service has turned the spotlight on Indonesia's healthcare
system.
Prita Mulyasari, 32, was detained for three weeks in May after a
hospital about 30 kilometres west of Jakarta filed criminal charges
against her for accusing it of denying her access to her medical
record and laboratory test results in the email that later ended up
on mailing lists and popular social networking site Facebook.
Prita, a bank clerk with two young children, was earlier fined
30,000 dollars under the civil code for defaming the hospital.
She was cleared of criminal defamation charges by a court last
month following an outpouring of support from the public and
politicians campaigning for the July 8 presidential election,
including a Facebook appeal signed by more than 150,000 people, but
the case has highlighted concerns about the country's health sector.
Hundreds of thousands of rich Indonesians prefer to seek medical
treatment overseas, reflecting their distrust in local healthcare
standards.
But the majority of Indonesians are not covered by health
insurance and poor people often have no access to medical treatment,
despite efforts by the government to provide low-cost healthcare for
them.
'Indonesia doesn't have a healthcare system at all,' said Kartono
Mohammad, a senior doctor and former chairman of the Indonesian
Medical Association.
'There is no institution that controls the quality of healthcare
and hospitals are not regulated,' he told a discussion with foreign
correspondents.
Even patients who can afford treatment have very little protection
from medical malpractice or poor service, he said.
Unlike Singapore, Indonesia does not have a medical council that
governs and regulates the professional conduct and ethics of medical
practitioners, he said.
'In the event of a dispute between a patient and a healthcare
provider, the patient has nowhere to go and the notoriously corrupt
legal system doesn't help,' Kartono said.
Last year the government launched an ambitious scheme to provide
universal health coverage for Indonesia's population of 220 million
and the World Bank said so far the country has already provided
coverage to an estimated 76 million poor and near poor.
But the World Bank, in a report released in May, said the full
impact of the programme had not been assessed or felt and the
shortcomings of the health system could make the implementation of
the scheme ineffective.
Ajriani Munthe Salak, a campaigner for the Legal Aid Institute for
Health, an organization acting as an advocate for victims of medical
malpractice, said the health scheme for the poor was too complicated
because patients have to produce various letters certifying they are
poor.
'People could die before they get treatment. We have to change the
situation. The system is appalling,' Ajriani said.
Ajriani said her organization had handled about 500 cases of
malpractice since it was founded in 1999, but the number was 'a tip
of the iceberg' because many cases went unreported.
She said people were also discouraged from taking legal action, or
following through cases, because it often took years for cases to
reach settlement.
Kartono said in many cases, patients made deals with doctors or
hospitals and were given cash compensation in exchange for not filing
lawsuits.
Another problem is that doctors often testify in favour their
colleagues embroiled in malpractice cases by saying that they had
followed proper procedures, Kartono said.
Farid Hussain, the Health Ministry's director general for health
services, declined to comment.
Mariani Akib Baramuli, a legislator from a House of
Representatives' commission dealing with health affairs, said
lawmakers were currently discussing bills on medical practice,
hospitals and patient protection.
She said legislators had difficulty in coming up with a
satisfactory definition of medical malpractice but hoped the
legislature could pass the bills before its term ends in October.
'We realize there are problems and we're trying to address them,'
she said.
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