Erin Lloyd is Technical Advisor for PT Affinity Health Indonesia, a part of global Australian healthcare group Ramsay Health, which has hospitals in Australia, the UK, France, Malaysia and soon, China. In Indonesia, RS Premier Hospitals are in Bintaro, Jatinegara, and Surabaya.
Erin, how did you get started in healthcare, and what led you to the role in Indonesia?
I trained as a nurse, working in Australian hospitals in a variety of roles from clinical work to quality to training, before taking my Masters of Health Management. I joined the Ramsay Group in 1995. The opportunity came up in 2007 for a Technical Advisor based in Bintaro, and I applied. I was attracted to the challenge of the role – as well as the amazing travel opportunities living in Indonesia offers!
What does the role of Technical Advisor involve?
My job is all about standards, quality and policy – I am here to advise on these areas from an expat’s perspective and to help train the teams. My major focus for the last five years has been achieving the Joint Commission International Accreditation (JCI) standards for hospitals. We can now say we are one of 665 accredited organisations in 61 countries who meet this global, best-practice framework. One outcome of this has been to increase the number of expats seeking treatment with us (though this is not an express goal of ours), as well as the number of surgeries we do.
What is the group’s position in the private healthcare market in Indonesia? How do you differentiate?
We believe we are at the top of the market with regards to standards. Occupancy of the hospitals is good, but there is always room for improvement. We set ourselves apart with our focus on infection control. Our practices in this area put us ahead of other hospitals – who would probably admit to that themselves! Thankfully so far we have had no major disasters, because we focus on mitigating risks.
How do you rate the standard of healthcare in Indonesia today, and what are the main challenges the industry faces?
It is evolving. I’ve seen major changes in my time here. Now, more and more hospitals are getting international accreditations, and this will improve standards. Nursing training is improving too, which is positive. Things are heading in the right direction, though lots of challenges remain: firstly, getting good doctors for more specialised areas like oncology or complex surgery can still be difficult. Along with that, you also need other trained specialists like ICU and rehab experts, and even nurses and auxiliary services like dieticians.
A big problem is getting equipment into Indonesia, from complex machines to basic things like beds. Medical equipment—as well as actual medicine—is taxed extortionately as a ‘luxury’. This is certainly hurting Indonesia’s ability to compete regionally. Finally, infrastructure here remains a challenge for healthcare, as it does for many industries.
Many Indonesians still choose to go abroad for care. Why is this and do you think it will change in future?
Yes, expats almost always go abroad for care, and in our hospitals around 40% of Indonesians also choose Singapore or elsewhere. Firstly, certain specialist areas like oncology are not perfect yet. Secondly, and perhaps more importantly, doctors’ communication is an issue.
Traditionally, smart people become doctors, which is right – but you also need strong communication skills.
We recognise this and invest in training for our doctors. Of course, people also go abroad for clinical ability, but again we are addressing that through knowledge, training and infection control.
When do you see that Indonesia will be able to compete with its regional neighbours for healthcare?
Hard question! We think perhaps another ten years or so. Accreditations like the JCI will make a big difference. Since it is evidence-based best practice, doctors and staff are more engaged because they can understand the ‘why’. For us, a big challenge in getting our accreditation off the ground was getting buy-in from the staff; management worked hard at this. We also made significant financial commitments in things like training hours. It will take time, but Indonesia can do it!
There will be an increase in offsite care – digitalisation is undoubtedly the way of the future. I’d like to think we will have thirty hospitals in our group by then (if the rules and regulations around the purchasing process are relaxed), all linked through telemedicine. One of the major reasons to pursue growth in Indonesia is to provide opportunities for staff as they continue to upskill, otherwise I fear we lose people and our investment in them.
What impact do you think the national Badan Penyelenggara Jaminan Sosial (Social Security Healthcare Provider) scheme will have on your business?
I think the BPJS will be great for Indonesia. It is still early days, but everyone deserves the basic right of access to care. I hope that patients will learn to value the public sector and to use it. Currently, we aren’t accepting patients from the scheme, but we are considering it.
If even a country like the US had a rocky start with Medicare, do you think it is wise of Indonesia to try and roll the BPJS out all at once?
Yes, I do, from a quality perspective. Everyone deserves access to care, regardless of location – and if you tried to split it, where would you start? Inequality is already an issue, with citizens of larger cities like Jakarta more able to get care than those in rural areas. The BPJS should ease that.
What’s the best part of your job?
The best part of my job is the people I work with. We have achieved a lot as a team. I keep going back to it but with something like JCI accreditation, you can only succeed through a big team working together well. Now, as a group we work more cohesively instead of in silos. It is very rewarding.
Thank you Erin. To get in touch, please email [email protected]