TRI HESTY WIDYASTOETIDIRECTOR OF REFERRAL HEALTH SERVICES

THE ASEAN SERVICES TRADE FORUM 2019Tokyo, November 26th - 27th 2019

MINISTRY OF HEALTH REPUBLIC OF INDONESIA

INDONESIAN DEMOGRAPHIC MAP

Source: https://sig-dev.bps.go.id/webgis/tematikinteraktif

MINISTRY OF HEALTH REPUBLIC OF INDONESIA

HEALTH DEVELOPMENT PROGRAMMES

INCREASING THE ACCESS & QUALITY

OF HEALTH SERVICES

Increasing maternal & child

health, Family Planning, &

Reproductive Health

Acceleration of nutritional

improvement for the

community

Disease Management Improvement

Strengthening GERMAS

(Indonesia Health

Community Movement)

Increasing Health Services and Food

& Drug Surveillance

Reduce maternal & infant mortality rate

Increase Family Planning & Reproductive Health

Communicable Diseases Management

NCD’s management

Strengthening health services at the primary & referral level

Compliance & increasing the capacity of health human Resources

Developing healthy environment

Strengthening GERMAS Promotion

Reduce stunting2

1

2

34

5

Priority Program

Priority Action

Priority Project

Compliance & increasing the competitiveness of pharmaceutical & medical equipments supplies

Increasing the effectivity of food & drug surveillance

Strengthening governance & health financing system

HEALTH SERVICE FACILITY TYPES

GP/Dentist independent practiceGP : 8.876 D: 2.104 (March, 2019)

Health centers9.993 HCs (March, 2019)

Clinics8.841 clinics (March, 2019)

Hospitals2.843 hospitals (Oct, 2019)

Dispensary/Pharmacy28.233 D/P (March, 2019)

Blood transfusion facility420 BTF (March, 2019)

Medical/clinical laboratory12.271 M/CL (March, 2019)

Optical10.000 opticals (March, 2019)

Traditional & complementary medical facilities

Total Accredited Hospitals: 2.398

Source : RS Online & KARS Web October 2019

DASAR6% MADYA

12%

UTAMA13%

PARIPURNA36%

PERDANA

33%

HOSPITALS’ NATIONAL ACCREDITATION

TERAKREDITASI

84%

BELUM TERAKREDITASI16%

ACCREDITED HOSPITALS ACHIEVEMENT

TOTAL HOSPITALS 2843ACCREDITED 2398

NON-ACCREDITED 445

KARS INTERNASIONAL

20%

JCI77%

ACHS3%

HOSPITAL’S INTERNATIONAL ACCREDITATION

KARS INTERNASIONAL 8JCI 31

ACHS 1TOTAL 40

HOSPITALS’ CONDITION IN INDONESIA

61

424

1464

801

58 35

CLASS A CLASS B CLASS C CLASS D NON-CLASS D PRATAMA

Number of Hospitals Based on Class

Source : RS Online Okt’ 2019

22282408 2487 2600

2799 2813 2843

2013 2014 2015 2016 2017 2018 Okt'2019 PERDANA 798DASAR 150MADYA 292UTAMA 295PARIPURNA 863TOTAL 2398

THE DISTRIBUTION MAP OF RADIOTHERAPY FACILITIES

RSUP Adam Malik Medan RS Vina Estetika Medan RS Murni Teguh MedanRS Sembiring Delitua

RSUP M. Djamil Padang RS Andalas Padang

RSUD Arifin Ahmad PekanbaruRSU Awal Bros Pekanbaru

RSUP M. Hoesin Palembang

RSUD Abdoel Moeloek Lampung

RSUPN Cipto MangunkusumoRSUD Pasar Minggu Jakarta RSUP Persahabatan Jakarta RS Kanker Dharmais Jakarta RSPAD Gatot SubrotoMRCCC Siloam Jakarta RS Pusat PertaminaRS Siloam Simatupang JakartaRS Gading Pluit Jakarta

RS Santosa KopoBandung RSHS Bandung RSUD Al Ihsan Bandung

RSUP Dr. SardjitoRS JIH Yogyakarta

RSUP Kariadi Semarang RSUD Margono S PurwokertoRSUD Moewardi Surakarta RS Ken Saras Semarang RSUD Tugurejo Semarang RS Indriati Solo BaruRS Dadi Keluarga PurwokertoRS PKU Gombong

RS Syaiful Anwar Malang RSUD Sutomo SurabayaRSAL Ramelan Surabaya RS Adi Husada Surabaya RS Lavalette Malang

RSUP Sanglah Denpasar

RSUD Nusa Tenggara Barat

RS AW Syahranie

RS Ulin Banjarmasin

RS Kandaou Manado

RSUP dr Wahidin SudirohusodoRS Universitas HasanuddinRS Islam Faisal Makassar

Total Facilities : 46 hospitalsTotal Equipment : 69 unitLinac : 47 units ; Co-60 : 19 units ; Tomotherapy : 1 unit, Gamma knife : 2 unitsDistributed through 17 ProvincesMegavolt vs 1 mio population ratio : 1 : 3,87

RS. Siloam Karawaci Tangerang

VERTICAL HOSPITALS WITH CARDIOSURGERY CARE

RSUP Adam Malik Medan

RSUP M. Djamil Padang

RSUP M. Hoesin Palembang

RSUP Fatmawati

RSUP Persahabatan

RSUPN Cipto Mangunkusumo

RSUP Dr. Hasan Sadikin Bandung

RSUP Sardjito Yogyakarta

RSUP Sanglah Denpasar

RSUP Wahidin S Makassar

HOSPITALS WITH CATH LAB SERVICES

178130Hospitals

Cath Lab in

5

13

3

5 3

1 3

35322 11 1

36 20 5 3

1

3

1

2

6

4

THE DISTRIBUTION OF CARDIOVASCULAR CARE

TOTAL: 14 HOSPITALS

10 hospitals provide this care

4 hospitals is still developing this care

RS M. Djamil Padang

RS dr. Soetomo

RS Ciptomangunkusomo

RSPAD Gatot Subroto

RS Cikini

RS Hasan Sadikin RS Sardjito

RS Kariadi

RS Moewardi

RS Sanglah

RS Adam Malik

RS M. Hoesin

RS Prof. Kandou

RS dr. Wahidin

THE DISTRIBUTION OF KIDNEY TRANSPLANTATION CARE

THE DISTRIBUTION OF TELEMEDICINE

Tele – Radiology consulting provider

Tele – EKG consulting provider

Tele- consultation consulting provider

Tele – USG consulting providerIn 2012

In 2014

In 2016

In 2017

In 2018

www.temenin.kemkes.go.id

PROVINSI SUMATERA UTARA (Danau Toba)RSUD Porsea

PROVINSI BANGKA BELITUNG (Tj.Kelayang)RSUD Marsidi Judono Belitung

PROVINSI BANTEN (Tj.Lesung)RSUD Berkah Pandegelang

PROVINSI DKI JAKARTA (Kepulauan Seribu)RSUD Kepulauan Seribu

PROVINSI JAWA TENGAH (Borobudur)RSUD Muntilan

PROVINSI JAWA TIMUR (BROMO)RSUD M Saleh Probolinggo

PROVINSI NTB (Mandalika)RSUD Praya

PROVINSI NTT (Pulau Komodo)RS Pratama Labuan Bajo

PROVINSI SULAWESI TENGGARA (Wakatobi)RSUD Wakatobi

PROVINSI MALUKU UTARA(Morotai)RSUD Morotai

Kelas D Kelas C Kelas BNon Kelas

INDONESIA MEDICAL TOURISM IN 10 FAVOURITE TOURIST DESTINATIONS

Regulation : Directorat General Health Service No HK.02.02/III/5355/2017, date 3 November 2017

CENTRAL GOV’T BUDGETING

LOCAL GOV’T BUDGETING

TRANSFERRED FUNDING(Special Allocation Fund)

Public – Private Partnership (PPP) Scheme

FOREIGN GRANTS’ FUNDING

Optimising and the

Harmonization of the Budgeting

Source

BUDGETING

FEP 70% for 10 countries ASEAN with geography restricted(east indonesia except Makasar and Manado)

RCEPFEP 51% for countries New

Zealand, Jepang, Korea,Chinadan India without geography

restrictedIA-CEPA

FEP 67 % for Australiawithout geography restricted

IEU-CEPAFEP 67 % for Uni Eropa Countries

without geography restricted

THE INDONESIA COMMITMENT FOR HEALTH SECTOR

ASEAN-JAPAN CEPAPROSPECT FOR HEALTHCARE

INVESTMENT IN INDONESIASector or Sub-Sector Market Access National Treatment Additional

CommitmentsHorizontal Section

HEALTH RELATED AND SOCIAL SERVICES

General conditions on health related and social services :Commercial presence of the foreign service provider is permitted only through health institution which is registered in Indonesia and must establish partnershipwith local partner. Establishment limited to the cities of Medan and Surabaya

Hospital services(only for specialistic and super specialistic medical care/more specific than specialistic medical care, provided by hospital of more than 300 beds)(CPC 9311)

1) None

2) None

3) As indicated in the Horizontal Section and General Conditions:- The hospital shall be managed by Board of Directors chaired by Indonesian medical doctor- Approval subject to the social function of hospital services offered- The medical services shall be provided by persons with medical licenses issued by Ministry of Health and Health professional organization/council- Foreign health professionals are obliged to transfer medical knowledge and professional capabilities to Indonesian health professional as consultant only- A non Indonesian health professional employed as managers or as technical experts shall have at least two Indonesian under studies during his/her term

4) Unbound

1) None

2) None

3) The health professionals shall be Indonesian.

4) Unbound

PROSPECT FOR HEALTHCARE INVESTMENT IN INDONESIA

(Presidential Decree No. 44 year 2016)

No. Business Field KBLI Conditions

331 Patent medicine industry 21012 Foreign capital ownership: Max. 85%

332 Medical Equipment Testing Institution

71205 Foreign capital ownership: Max.67%

333 Acupuncture Service Facility 86901 Foreign capital ownership: 49%

334 Pest Control / Fumigation Service 86903 Foreign capital ownership: 67%

335 Medical and Ambulatory Evacuation Service

86904 Foreign capital ownership: 67%

336 Narcotic manufacturer (pharmaceutical industry)

21012 Subject to a special license from the Ministry of Health

337 Narcotic pharmaceutical wholesaler 46693 Subject to a special license from the Ministry of Health

No. Business Field KBLI Conditions

338 Traditional Medicine Processing 21022 Domestic Capital 100%

339 Traditional Medicine Industry / Natural Extract

21022 Domestic Capital 100%

340 Raw material pharmaceutical wholesale business

46693 Domestic Capital 100%

341 Pharmacy, drugstore, health equipment store and optician

477224772347733

Domestic Capital 100%

342 Basic medical clinic services: Private maternity hospital, clinic general medical service/public medical clinic, residential health service, and basic health service facility

861038610486109

Domestic Capital 100%

PROSPECT FOR HEALTHCARE INVESTMENT IN INDONESIA

(Presidential Decree No. 44 year 2016)

No. Business Field KBLI Conditions343 Hospitals 86103 a. Foreign capital ownership: 67%

b. Foreign capital ownership from investors from ASEAN countries: Max.70%; andc. Can be conducted in all capital cities of provinces in Eastern Indonesia, except Makassar and Manado

344 Specialist medical clinics: Clinic specialized medical services (CPC 9312), clinic specialized dental service (CPC 9312), nursing service with CPC 93191, other hospital service (medical rehabilitation clinic)

86109862028620386901

a. Foreign capital ownership: 67%b. Foreign capital ownership from investors from ASEAN countries: Max.70%; andc. Can be conducted in all capital cities of provinces in Eastern Indonesia, except Makassar and Manado

345 Medical equipment supplier 46693 a. Foreign capital ownership: 49%b. Subject to a special license from the Ministry of Health

PROSPECT FOR HEALTHCARE INVESTMENT IN INDONESIA

(Presidential Decree No. 44 year 2016)

No. Business Field KBLI Conditions346 Medical equipment industry: Class A (medical

cotton, bandage, gauze, cane, IV drip pole, sanitary pad, adult diaper, patient’s bed, wheelchairs)

21012 a. Foreign capital ownership: 33%b. Subject to a special license from the Ministry of Health

347 Medical equipment industry: Class B (Surgical mask, syringe, patient monitor, condom, surgical glove, hemodialysis fluid, PACS, surgical knive)

21012 Subject to a special license from the Ministry of Health

348 Medical equipment industry: Class C (IV catheter, X Ray, ECG, patient monitor, orthopedic implant, contact lens, oximeter, densitometer)

21012 Subject to a special license from the Ministry of Health

349 Medical equipment industry: Class D (CT Scan, MRI, cardiac catheter, cardiac stent, HIV Test, Pacemaker, Dormal Fillers, Ablation Catheter)

21012 Subject to a special license from the Ministry of Health

350 Bank and laboratory of tissue and cellular 86903 Subject to a special license from the Ministry of Health

In the event that the Indonesian Standard Classification of Business Fields (KBLI) includes more than one business field, then provisions as referred to in Appendix III is only applicable to the business fields stated in the column of business fields.

PROSPECT FOR HEALTHCARE INVESTMENT IN INDONESIA

(Presidential Decree No. 44 year 2016)

E-Katalog / e-Purchasing

PROSPECT FOR HEALTHCARE INVESTMENT IN INDONESIA

National Commodity

Local Commodity

SectoralCommodity

Link : https://e-katalog.lkpp.go.id/home

Deg

ree

of P

rivat

e S

ecto

r Ris

k

Design - Build

PP

P M

odel

s

Operation & Maintenance

Build - Finance

Build – Finance - Maintain

Lease – Develop - Operate

Design – Build - Operate

Design – Build – Finance - Maintain

Design – Build – Finance - Operate

Design – Build – Finance – Operate - Maintain

Build – Own - Operate

Concession

Degree of Private Sector Involvement

Design – Build – Finance

19

PPP IMPLEMENTATION MODEL

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