Health. The Minister of Health, Budi Gunadi Sadikin, recently claimed that the stagnation in the distribution of specialist doctors across Indonesia is caused by repeated constitutional challenges to the Health Law (Law No. 17 of 2023).
However, Nanang Sugiri, a legal representative for the challengers in Constitutional Court Case No. 143/PUU-XXIII/2025, strongly rejects this narrative. He argues that the real problem lies in the ambiguity of key legal norms within the law itself — not the lawsuits.
Core Issue: Dual System for Educating Specialists
At the heart of the legal challenge is a significant shift introduced by the Health Law. Under the new regulation, educational hospitals (“hospital-based”) — not just universities — are permitted to run specialist and sub-specialist medical education programs.
Nanang and the petitioners argue that this change (espoused in Article 187, paragraph 4, and Article 209, paragraph 2) risks creating a dual-structure system. Universities have traditionally been the academic foundation, while teaching hospitals provide the clinical setting. By allowing hospitals to independently administer education programs, the legal clarity about who is responsible for academic standards is weakened.
Structural Problems, Not Litigation
Sugiri points out that the stagnation in distributing specialist doctors is driven by long-standing structural challenges, such as:
- Uneven facilities across teaching hospitals
- Insufficient clinical mentors (supervising specialists)
- Unequal distribution of medical residents
- Lack of incentives for specialists to serve in remote or underserved regions
He emphasizes that even if the current constitutional lawsuit were dropped, these core problems would persist. “This is about distribution and financing — not about whether a material review is happening,” he said.
Missing Regulatory Clarity
According to the challengers, when the government presented its expansion plan to the Constitutional Court, it failed to clearly define several fundamental regulatory standards:
- Accreditation criteria for education institutions
- What constitutes a “qualified” institution to run a specialist education program
- Standard curricula for specialist programs
- Clear boundaries of responsibility between universities and hospitals in both academic and clinical training
Without those norms clearly spelled out, Sugiri warns, the quality of medical education could suffer.
Why the Constitutional Review Matters
The petitioners argue that their case is not a roadblock to public policy but a legal safeguard. They are asking the court to examine whether the Health Law aligns with:
- The national higher education system
- The established role and authority of universities vs. hospitals
- Minimum academic and clinical standards for specialist training
- The constitutional rights of medical students (future specialists)
- The public’s right to receive competent medical services
Nanang insists that the review is crucial for ensuring regulatory coherence. Rather than rewriting entire programs without accountability, the court should demand clear, consistent rules that uphold both medical education quality and patient safety.
Conclusion
In short, the legal representatives challenging Law 17/2023 assert that the obstacles to increasing the number and spread of specialist doctors in Indonesia are not due to the fact that the law is being litigated — but because the law itself lacks clarity in critical areas. They argue that only a properly resolved constitutional review, with precise norms specifying roles, standards, and accountability, can lay a solid foundation for improving specialist doctor training and, ultimately, access to specialist care across the country.
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