Philippines in midst of ‘health care crisis’

MANILA, Philippines — Health workers’ groups warned on Friday that the government’s health programs are bound to falter if it fails to address the “health crisis” besetting the country.

In addition to outbreaks of infectious diseases, the groups said the health sector remains grossly underfunded with hospitals still understaffed and personnel still underpaid.

Maristela Abenojar, president of the Filipino Nurses United, said that one of the culprits is the onerous practice of contractualization, especially in government hospitals.

Nurses are no longer willing to work in the country’s hospitals because, aside from being unprotected by law, they are also overworked and underpaid, Abenojar said.

Abroad or different industry

Quoting a study done by the Philippine Nurses Association in 2017, Abenojar said there are 31,396 nurses working in 800 public hospitals, 35,365 in 1,172 private hospitals, and 23,547 in community health centers.

She noted, though, that the majority of registered nurses are either abroad (around 150,000) or working in other industries, such as call centers (roughly 30,000).

Recent Department of Health (DOH) data also showed that the country’s health care worker-to-population ratio is less than half the standard of the World Health Organization (WHO).

The WHO recommends that there should at least be 45 health workers for every 10,000 persons. But in the Philippines, the ratio is at only 19 per 10,000.

“Why did we come to this situation? Because there’s a lack of plantilla positions. Understaffing persists. There is no shortage of nurses. There is only a need to improve their working conditions,” Abenojar said.

12 hours of work

As a result, the Alliance of Health Workers (AHS) said those who remain in hospitals are forced to work at least 12 hours just to ensure that patients are cared for.

However, AHS president Robert Mendoza complained that health workers compensation remained at the range of P18,000 to P21,000 despite the additional workload.

“Health workers have been unhealthy and uncared for despite [sometimes] enduring 16 hours of duty. We have seen a historical increase in the number of contractual health workers receiving floor wages without security of tenure, few or absent benefits but with huge workloads,” Mendoza said.

The realities in the health sector, Abenojar said, should make the government rethink its priorities because the situation is nothing short of a crisis.

“There are a lot of DOH programs that will not be implemented properly if there’s not enough personnel. That alone should already make the government think about its priorities, that this is an urgent and vital matter that should be addressed,” she said.

Recently, several lawmakers raised concerns over cuts made in the DOH’s and Philippine General Hospital’s (PGH) 2020 budget amid a surge of infectious diseases and a health care program that is still unproven.

Budget cuts

Although administration lawmakers promised to restore the budget cuts, the All UP Workers Union-Mania (AUPWU) argued a 2020 budget without cuts would still be way off the P10 billion it needs to “render quality health care for all its patients.”

AUPWU president Eliseo Estropigan said the PGH’s operating requirement is currently at P5 billion but its budget for 2019 is only at P3.2 billion.

For 2020, the Department of Budget and Management only programmed P2.8 billion for the country’s premier tertiary hospital.

In the general appropriation bill sent to the Senate, the House of Representatives added only P200 million for the PGH.

Estropigan said a P10-billion budget would allow the PGH “to hire more nurses, health workers, provide free medicines for indigent patients, [and] purchase respirators and other life-saving medical equipment.”