PRIVATE SECTOR HEALTH CARE IN INDONESIA - Health Systems ...

of ISFI, the apotek would be a member of GP Farmasi. GP Farmasi estimates that large chain pharmaciescurrently represent less than five percent of the pharmacy market. While the drugseller (toko obat) inprinciple has no specialized education (unlike pharmacists who have specialized training), they arenonetheless potentially good partners since the shop owner is more reliably in the shop. The owners oftoko obat tend to feel more responsible for providing recommendations, and must maintain hisreputation within the community. Pharmacy owners and pharmacists, on the other hand, are seldom inthe pharmacy.While GP Farmasi should be involved in programs involving pharmacists and drugsellers,they do not appear interested in a role enforcing pharmacy standards.9.6 INDONESIAN HOSPITAL ASSOCIATION (PERSI)PERSI represents all public and private hospitals in Indonesia. There are 1300 members ofPERSI, but only about 10 percent are fee-paying. PERSI has a branch office in each province, whichindependently runs seminars, courses, and other programs. At central level, there is an annual seminarand hospital exposition (primarily hospital equipment and pharmaceuticals) which generates the bulk ofthe central level funding. It is not officially involved in licensing, but in some districts, the PERSI branch isasked to provide a recommendation before a license is issued.Some recent PERSI initiatives aimed at improving hospital quality include:• Establishing a national Patient Safety Committee that includes representatives from consumergroups, legislative bodies, universities, professional associations, etc.• Conducting a pilot program with KARS for PERSI and PHO to conduct regular monitoring ofhospitals after the KARS accreditation is issued.PERSI does provide input to policy discussions that affect hospitals, but its level of influenceis unclear. It participates in discussions with Askes regarding fee setting, but does not play a role as anegotiator. It tries to mediate complaints to Depkes, but it has no power to influence the finaldecisions. It also has been involved in discussions regarding RDU, but is not involved in any specificprogram. PERSI realizes that cost of medicines in hospitals is increasing, and is happy to support use ofgeneric drugs but reports that sometimes distribution is a problem. It also believes that the distributionchain is “too long” and that adds to the cost.Although PERSI appears relatively organized, it is unclear the extent to which it wants arole in actively monitoring hospitals. Nonetheless, it could be an important partner in developingand disseminating standards to its members, and facilitating discussions with Jamkesmas onreimbursement policies.40