Southeast Asian countries to allow free flow of doctors

Abstract

In a part of the world made famous by wars and natural disasters, bureaucratic controls to stop outsiders practising medicine are fi nally being prised apart. Not in the name of health, but in the name of free trade. After years of talking about it, in 2015 the ten-member Association of Southeast Asian Nations (ASEAN) will implement a common market that will, among other things, allow professionals from each member to work in the other nine countries. Among the key areas targeted is health. New agreements covering medicine, dentistry, and nursing are all due to come into eff ect. It promises eventually to transform the way medicine is practised throughout the bloc. For its largest member, Indonesia, it is a sea change, applauded by many and feared by some, including some Indonesian doctors. Not long ago, Indonesian law placed a blanket ban on foreign doctors. Only Indonesian citizens could practise medicine in Indonesia. Founding President Sukarno urged Indonesia to shake off three centuries of Dutch colonialism and strive for self-suffi ciency in all things, including health care. This goal ultimately found its way into law. For decades, the only exceptions were a few doctors employed specifically to look after foreigners, usually by large foreign corporations such as mining companies, usually with substantial numbers of expatriate staff . Meanwhile, Indonesia’s health system struggled; millions of poor Indonesians had little or no health care. Some small, remote islands had no doctors at all. But while ASEAN was slowly discussing liberalisation, cracks began to emerge. In 2004, the law, at least on paper, was changed to permit foreign doctors to work in Indonesia. However, implementation of that law has been slow and has met with a strong resistance. Even after natural disasters such as the 2004 Indian Ocean tsunami that devastated Aceh province in Sumatra, foreign doctors have often struggled to get permission to come to Indonesia to help.