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"Besarnya pengaruh peraturan perundangan terhadap kehidupan rumah sakit, menjadi dasar untuk meninjau kembali kebijakan perumahsakitan tersebut. Dalam pelaksanaannya, peraturan perundangan dibagi dalam 2 sistem, yaitu : sistem sentralisasi dan otonomi daerah. Dalam sistem sentralisasi, kekuasaan atau kewenangan berada di tangan Pemerintah Pusat, sedangkan dalam otonomi daerah kekuasaan atau kewenangan berada ditangan Daerah. Untuk melihat dan mengenali bagaimana sistem tersebut diterapkan dalam dunia perumahsakitan, khususnya dalam perizinan perumahsakitan dilakukanlah sebuah studi kasus. Studi kasus ini dianalisa secara kualitatif. Peneliti mengumpulkan dan menganalisis peraturan perundangan perizinan RS yang berlaku saat ini, kemudian peneliti melakukan klasifikasi peraturan perizinan RS berdasarkan siklus hidup rumah sakit (peraturan perundangan mengenai rencana dan bangunan, peraturan perundangan mengenai organisasi dan manajemen, peraturan perundangan mengenai hasil pelayanan, peraturan perundangan mengenai akreditasi dan sertifikasi, peraturan perundangan mengenai peran serta masyarakat, dan peraturan perundangan mengenai sanksi dan penutupan). Setelah mengetahui dan mengelompokkan peraturan perizinan RS, kemudian kewenangan diidentifikasi dan diklasifikasikan kedalam sistem sentralisasi dan otonomi daerah sesuai yang tertulis didalam peraturan perundangan itu sendiri. Lebih lanjut, penulis memberikan saran-saran mana kewenangan yang dapat diserahkan kepada daerah mana yang masih tetap menjadi kewenangan Pusat. Hasil penelitian, pertama ditemukan ada 27 peraturan perizinan perumahsakitan. Keseluruh peraturan tersebut tersebar dalam berbagai sumber, tidak terorganisir dan tidak sistematik. Kedua, mayoritas otoritas dipegang oleh Pemerintah Pusat, hanya 2 (dua) yang menjadi kewenangan daerah. Melalui penelitian ini, saran yang diajukan adalah pertama, mengorganisir dan mengumpulkan semua peraturan perundangan perizinan RS kedalam satu peraturan perizinan yang lengkap yang mencakup keenam langkah siklus hidup RS. Disarankan dibuat secara sistematis dan jelas (termasuk semua kualifikasi dan persyaratan, juga biaya untuk mendirikan RS). Kedua, sebaiknya dibuat kebijakan satu pintu.Ketiga, agar segera dipertimbangkan untuk menyerahkan beberapa kewenangan Pusat kepada Daerah menjadi kewenangan daerah. ......Great impact of rules and laws on hospital life became the reason to reconsider the hospital rules and laws. On practicing rules and laws there is a system of authority. This system is divided into 2: centralization and district autonomy. In centralization system, the power is in Central Government's hand, while in district autonomy is in districts. To see and to understand how the centralization and district autonomy works on the hospital licensing regulations a study was conducted. This case study was analyzed qualitatively. The researcher gathered and analyzed all the hospital licensing regulations which prevail now, then classified them into hospital's life cycle (regulations of planning and building, regulations of organization and management, regulations of service output, regulations of accreditation and certification, regulations of participation of society, regulations of sanction and closing). After knowing and grouping all the hospital licensing regulations, then the writer identified and classified the regulations into centralization and district autonomy as it was written in the rules and regulations. Furthermore the writer gave suggestions about which one can be handed over by the Central Government to district autonomy and which one was still in Central. It was found, firstly that there were 27 hospital licensing regulations. All these regulations were scattered in many sources, not well-organized, and not systematic. Secondly, the majority of the authorities were hold by the Central Government, only 2 matters were district's autonomy. By this research, the writer suggested some ideas of ways out. First, to organize or to gather all the hospital licensing regulations, and to make it into one complete regulations that covers all the six steps of hospital life cycle. It was suggested to organize it systematically and clearly (including all the qualifications and the requirements, and also the expense for building or malting a hospital). Secondly, it was suggested to arrange or to make it into one door policy. Thirdly, soon consider to hand over some authorities from Central Government to district autonomy to be the District's autonomy."

"Pencemaran Sungai Siak di Propinsi Riau merupakan salah satu isu strategis lingkungan hidup yang ditimbulkan akibat pelaksanaan pembangunan dan ekonomi yang cenderung dilakukan secara eksploitatif tanpa memperhatikan upaya menjaga kelestarian lingkungan hidup.Tujuan penelitian ini adalah untuk mengetahui sejauh mana tingkat pencemaran Sungai Siak serta peran Pemerintah Daerah Kabupaten Siak dalam pengendalian pencemaran Sungai Siak. Selain itu juga untuk mengetahui kontribusi masyarakat dan industri dalam pencemaran Sungai Siak, serta terbentuknya kerangka dasar kebijakan pengendalian pencemaran Sungai Siak.Penelitian ini dilakukan dengan pendekatan analisa kualitatif dan analisa kuantitatif Analisa kualitatif dilakukan dengan wawancara mendalam terhadap responden dengan analisis content. Analisa kuantitatif menggunakan data sekunder dengan menganalisa hasil penelitian JICA tahun 2000, Bapedalda tahun 2001 dan PPLH tahun 2002 UNRI tentang Sungai Siak.Hasil penelitian menunjukkan telah terjadi pencemaran Sungai Siak yang ditandai dengan penurunan kualitas air sesuai hasil penelitian, yakni kadar BOD 28 mg/1, COD = 67 mg/1. Hal tersebut melebihi standar yang ditentukan dalam PP Nomor 82 Tahun 2001 yaitu kadar BOD = 2 mg/l dan COD =10 mg/l.

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Analysis of Management Policies of Siak River Pollution in Relation with District Autonomy Process in the Siak RegencyPollution of the Siak River in the Province of Riau is one of the strategic environmental issues which are caused by infrastructures and economical development that tends to be done exploitatively without considering efforts to preserve the environment.

The objectives of this study are to find out how high is the pollution level in Siak River and the pollution management by the Local Government of Siak Regency. Moreover, to examine the contribution of the community and industries to the pollution of Siak River, and to build evidences for management policies regarding the pollution of Siak River.

This study is carried out using qualitative and quantitative analysis approaches. Qualitative analysis is performed through in-depth interviews toward the respondents using content analysis. Quantitative analysis uses secondary data through analyzing the result of studies carried out by MCA in 2000, Bapedalda in 2001, and PPLH UNRI in 2002 concerning Siak River pollution.

The results of this study suggests that there has been pollutions in the Siak River as shown by the decreasing water quality, that is the BOD level = 28 mg/l, COD = 67 mg/I. This is beyond the standards of BOD = 2 mg/l and COD = 10 mg/l which determined by Gov. Reg. 82 Yr. 2001.

The Government's roles on managing pollutions of Siak River are yet optimized, especially in the course of surveillance and development. This is strongly related to the insufficiency related to quantitative and competencies of human resources and budget. The industrial sector has yet to fully comply with the regulations and law concerning the environment. This is signified by the research result of BOD and COD level of all industrial waste are above the regulation of liquid waste quality, with BOD level approximately between 92 mg/l to 861 and COD level approximately between 195 mg/l to 1268,8 mg/l. As according to the regulation of Riau Governor concerning Liquid Waste Quality for the Industries is regulated that BOD level is between 75 mg/1 to 100 mg/l and COD level is between 125 mg/l to 350 mg/l.

From the result of the questionnaire toward 28 respondents who lived on the banks of Siak River, it was discovered that 64% of them uses Siak River to dispose of manure, and 71% throw away of their garbage.

The Policy Officers have yet to implement the Environmental regulations entirely; it is considered important to arrange the bases of policies concerning pollution management in Siak River which refers to Gov. Reg. No. 23 Yr. 1997 of the Environment, Gov. Reg. No. 82 Yr. 2001 of the Water Quality Management and Water pollution Management. Siak River management should better be managed integrated involving every Regency along the Siak River, changing the development patterns from backyard to front yard, establish water recognition and water quality accordingly, establish Liquid Waste Quality, carry out tight and consistent surveillance, and institute sanctions to those who break the regulations.

Bibliography: 29 (1953-2002)"