Best Practice Aplikasi Sistem Kontrak dalam Program Sister Hospital NTT
Untuk memicu diskusi Tahap II ini, saya menyampaikan sedikit pengantar dengan judul:
Best Practice Sistem Kontrak dalam Program Sister Hospital NTT
Program Sister Hospital NTT dimulai pertengahan 2010 akan segera berakhir di tahun 2015 ini. Dalam perkembangannya, tercatat 10 Rumah Sakit besar di luar NTT pernah dan atau masih terlibat dalam program tersebut. Dalam perspektif model kontrak yang baru pertama kali dilakukan di Indonesia, berjalannya sistem kontrak tersebut selama lebih 5 tahun merupakan sesuatu yang luar biasa.
Pendekatan yang dilakukan adalah kontrak 2 level. Level 1: donor agency (dalam hal ini AIPMNH) mengontrak rumah sakit besar. Level 2: rumah sakit besar tersebut kemudian "mengontrak" tim tenaga kesehatan (terdiri dari dokter spesialis/residen senior kebidanan, kesehatan anak, dan anastesiologi, serta paramedis terkait PONEK). Dengan demikian, secara konseptual pendekatan kontrak yang diterapkan adalah "institution-based contracting" untuk level 1, dan "team-based contracting" untuk level 2. Sebagai perbandingan, pendekatan kontrak yang biasa dilakukan saat ini adalah "individual-based contracting" atau "team-based contracting" tapi tidak dalam payung "institution-based contracting."
Satu faktor penentu yang penting dalam program tersebut adalah dimungkinkannya mekanisme penunjukan langsung (tanpa lewat lelang terbuka) dalam menentukan provider (dalam hal ini rumah sakit besar). Hal ini dimungkinkan karena pihak AIPMNH atau AusAID (kini DFAT) memiliki aturan tersendiri dalam masalah ini.
Dari perspektif best practice, peluang tersebut memberikan sumbangan penting bagi pengalaman implementasi model kontrak inovatif di Indonesia.
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