Privilege speech on the occasion of National Health Workers Day
May 7, 2012
I rise to avail of the privilege hour to discuss a very important and urgent matter – the state of our health workers.
Today is national health workers day. At this point I would like to greet the health works who are present in the gallery – happy Health Workers’ Day po!
The law mandating this, Republic Act 10069, was authored by former Bayan Muna congressman Satur Ocampo in the 14th Congress. Its aim is to give due recognition to the contribution of our doctors, nurses and other health workers and professionals in providing quality health care for our people.
This morning, members of the Alliance of Health Workers and other health groups decided to mark health workers day by marching to Mendiola to present their plight and express their demands to the executive. This afternoon, they were supposed to hold a dialog with Departmet of Health (DOH) officials. At the Mendiola rally, our health workers had a very apt and vivid representation of their situation and that of the country’s health care system. May dala po silang hospital bed na may pasyenteng comatose. Sabi nila, naghihingalo at halos patay na ang health care system natin.
Baka sabihin ninyong O-A ang ating mga health workers. Pero hindi lang sila ang may ganitong pananaw. Kahit po ang Asian Development Bank, sa kanilang malaking meeting noong isang linggo, ay nagsabing malala na ang lagay ng ating sistemang pangkalusugan.
The ADB observed that almost 70% of our health workers are in the private sector, serving only 30% or 29.2 million of the population. In contrast, only 30% of our health workers are in government, catering to 68.3 million Filipinos.
To quote the ADB, in its paper, Country Partnership Strategy: Philippines 2011-2016 – “a two-tier system exists in the health sector: the private sector for the rich (mainly located in the urban areas) and the public system for the poor.”
Ganito rin ang sinasabi ng ADB sa serbisyong pangkalusugan. “Access to health care is noted to be inversely related to wealth, with the lowest wealth quintile generally having less access to antenatal care, skilled birth attendance, institutional deliveries, immunization, and contraceptives.”
More disturbing health sector data from ADB: six out of ten Filipinos die without medical attention, and four out of ten babies are delivered by untrained hands. Financial protection for the poor is inadequate.
Nearly half of health care costs are paid out-of-pocket. In fact, compared to other Southeast Asian countries, the Philippines has one of the highest out of pocket share at 54.7% and one of the lowest government share at only 34.7%.
The Aquino administration is singing the same tune so-to-speak, when it comes to assessing the overall health situation in the country, particularly in the aspect of delivery of basic health services. It is recornized in the Aquino Administration’s healthcare agenda that the poorest of the population are the main users of govemment health facilities and that this means that the deterioration and poor quality of many government health facilities is particularly disadvantageous to the poor who needs the services the most. It was stated clearly in the aha that the country’s health infrastructure needs a boost given the gaps in health facilities.
Ngayon, kung nagkakapareho tayo ng tingin sa problema, dapat pareho din ang solusyon. Subalit, sa bahaging ito, kagulat-gulat na naiba ang tono ng gobyerno at ng ADB. While recognizing that there is a need to attract more health professionals to work in the government sector –– which largely caters to poor patients –– the government has an existing freeze hiring policy for health workers. Hindi lang mababa ang sweldo, puro casual at job orders na lang ang kinukuha.
Recently, the executive implemented a series of regulations that reduced further the benefits of health workers. And while both government and the ADB acknowledge the chronic underfunding in health, its solution is not to increase public spending but, ironically, decrease funding and then privatize the health care system.
Last December, the Department of Budget Management issued National Budget Memorandum No. 112 that reduced the subsistence allowance for health workers from P50 a day or P1,500 a month to P30 per day or an average cut of about P700 a month.
Pati yung laundry allowance, hindi pinatawad. It went down from P150 per month to P125 per month. Ano ho ang kahalagahan ng subsistence at laundry allowance? Dahil nga mababa ang sweldo nila, malaking bagay ang kaunting dagdag para matiyak ang pagkain nila ng tatlong beses isang araw. Importante rin sa ating health workers na laging malinis ang pananamit.
Vigorous protest from health worker groups forced the DOH to come up with its own circular reinstating the allowances but to be sourced from agency savings. Ang problema, paano kung walang savings? Eh dati naman hindi dependent sa savings ang mga allowances na ito.
Another casualty is the hazard pay of our health workers. Dapat lang silang tumanggap ng hazard pay dahil talaga namang peligroso magtrabaho sa mga ospital at ma-expose sa sari-saring sakit. Pero alam n’yo ho bang mula enero, hindi pa nabibigay sa kanila ang kanilang hazard pay? Hinihintay pa daw ng approval ng DBM when this is already mandated by law at dati ay automatic nilang nakukuha.
In fact, binawasan po ang hazard pay ng mga doktor na tumaas ang salary grade dahil sa SSL 3, from 25% to only 5% kahit sinasabi sa SSL 3 na hindi dapat mabawasan ng sweldo o benepisyo ang sinuman dahil sa pagpapatupad ng batas.
The situation is equally apalling when it comes to our public hospitals and health facilities. Even as the Aquino Administration constantly reiterates its commitment to better the health delivery system in the country, the reverse appears to be happening. Today, as we celebrate national health workers day, our health workers continue to fight against budget cuts in public hospitals and public health services.
The government is eyeing zero subsidy for maintenance and other operating expenses for public hospitals by 2014, and zero subsidy for personnel services by 2020, based on the DOH Financing in Health presentation in 2010. Inadequate funds explain the dismal state of public hospitals in the country.
On top of all these, the Philippine government health sector will be facing its greatest challenge this year: the privatization of government hospitals.
The Aquino Administration and its allies in the Senate prefer to call it “corporatization.” Pero kahit ano pa ang tawag, pareho ang resulta sa malao’t madali: wala ng charity ward sa Pilipinas.
Essentially, corporatization is privatization in the form of public-private partnership (PPP) projects in government hospitals and facilities. It will involve outsourcing of equipments, supplies, and personnel that will further increase the cost of health services. DOH secretary Enrique Ona himself admitted that health services cost would increase with public private partnerships.
The ADB also promotes the privatization of the health sector, providing in 2004 a $200-million loan for the Health Sector Development Program (HSDP) to systematically advance and accelerate the privatization and commercialization of hospitals and the health care system in the country. Tapos, sinasabi nila na kailangang gawing mababa ang presyo ng gamot at gamutan sa Pilipinas.
Most recently, Sen. Franklin Drilon filed Senate Bill 3130, also known as the National Government Hospital Corporate Restructuring Bill. In the guise of modernization and efficiency, the bill will “corporatize” – meaning, it will allow the entry of private corporations that will jointly manage with the government some 26 public hospitals. These hospitals include the Philippine Orthopedic Center (POC), San Lazaro Hospital (SLH), the Research Institute for Tropical Medicine (RITM), to name a few.
At present, there are modes of healthcare privatization already being implemented by the Aquino Administration at the expense of Filipino patients. There is the University Physicians Medical Center – a private health facility operating within the Philippine General Hospital compound. Another is the subcontracting of basic hospital services, like radiology or dialysis. There is also the sale of the Welfareville property in Mandaluyong City, which includes the National Center for Mental Health, only to give way to a new mall and high-end residential buildings.
The hospitals will be income-generating entities, thus self-perpetuating and allegedly not dependent on government subsidy for its operations and personnel. But it will also make it imposssible for them to give free services and treatment to those who cannot afford it.
And please, the government should not say that the needs of the poor will be handled by Philhealth because we all know Philhealth cannot fully pay for the expenses incurred by a patient, rich or poor. Hindi kaya ng pondo nila ang sumagot ng buo sa ganitong gastusin. As experienced by many Philhealth indigent beneficiaries, they needed to shell out money because of the limited coverage.
On the part of health care workers, they are also under threat as privatization could result in mass lay-off, reduction of benefits, and suppression of health workers’ rights. This usually happens when government institutions are transformed to business enterprises. Imbes na serbisyo, tubo na ang motibo.
In this light, how can we make health workers day really meaningful for our health workers?
Let us begin by joining them in their call for the immediate and proper implementation of the Magna Carta for Health Workers, specifically the provisions on job security, wages, benefits and working conditions.
Let us join them in their call for a P6,000 minimum salary increase.
Let us support our government nurses’ demand for a salary grade upgrade to SG 15 or P24,000 a month based on the Nursing Act of 2002.
Let us support the call of government doctors for upgrading to salary grade 24 or approximately 50,000 per month. These will ease the burden of health workers struggling for a living who save the lives of patients.
And let us continuously oppose the privatization of our public health care system and instead invest in better facilities, better training and bettere salaries and benefits for health workers.
Again, may we have a meaningful Health Workers Day. Mabuhay ang mangagawang pangkalusugan! #