MPOC Scheme, Transforms Health Care Services for Profit

Press Statement
January 25, 2013

References:

Mr.  Jossel I. Ebesate, President Alliance of Health Workers: Mobile Number: 09189276381

Mr. Sean Velchez, President NOHWU-AHW, Mobile Number: 09067360468

The pre-bidding for the Modernization of the Philippine Orthopedic Center (MPOC) by the Aquino government this January 25 will mark the transformation of the country’s health care delivery from a citizen’s right to health to a privilege affordable only to a moneyed few. The sale of Philippine Orthopedic Center (POC) is the test case of the privatization of health care delivery in the country.

The MOPC project will cost Php 5.69 B for the 700-bed capacity super-specialty tertiary orthopedic hospital to be built near the National Kidney and Transplant Institute in Quezon City. Of the amount, Php 5.43 B will come from the private investor/s through public bidding. 

DOH Secretary Ona has repeatedly denied that privatization is the very essence of Pnoy’s Public-Private Partnership Program that is gobbling up even the services to the most basic right of the Filipino people. However, the items for MPOC bidding clearly suggest what is expected of the program:

1. Planning, designing and construction of a minimum of 700-bed capacity super-specialty tertiary hospital providing orthopedic clinical services and allied services;
2. Procurement, installation, management, operations and maintenance of modern diagnostic and clinical equipment;
3. Procurement, installation, management, operations and maintenance of IT facilities;
4. Operation and maintenance of the entire facility including diagnostic center, out-patient departments, in-patient departments, and all other activities related to the operations of the hospital;
5. Provision of appropriate administrative and ancillary services (clinical laboratory, imaging and radiology, sterile supplies, pharmacy) of the advanced level that is commensurate with the specific clinical specialties practiced in tertiary care;
6. Provision of teaching and training facilities for basic and advanced clinical care and management of specialized and sub-specialized forms of treatment, highly specialized surgical procedure and intensive care as well as care on the specific prevalent diseases in the locality pertaining to the specialty offered by the hospital. This includes continuance of the existing residency training programs which includes among others the Orthopedic Surgery Residency Training Program as accredited by the Philippine Board of Orthopedics which is currently being provided by the existing Philippine Orthopedic Center; and
7. Provision of appropriate qualified staff.

With the huge amount involved in the project vis-à-vis the complex structures and activities of the modern hospital, the poor patients will not have a chance of enjoying the services they have now at POC. This is how privatized health institution will exclude the poor as priority patients. Even the POC staffs are not assured of their security of tenure.

The sale of POC will become the milestone of health care privatization. Clearly, this is the government’s abandonment of its responsibility to people’s right to health in favor of the impositions of the World Bank, IMF and other International financial institutions on the heavily indebted countries like the Philippines. Privatization of POC and eventually the health care system of the country will further marginalize the poor in the health care delivery. More hospitals like the RITM, San Lazaro Hospital are up for PPP. The 26 public hospitals nationwide are for corporatization, another form of privatization.

DOH’s assures the public that Philhealth is the solution to the health problems of the poor. However, experiences among the ordinary people in the different parts of the country prove otherwise. Philhealth is an insurance, thus business. It should be just an option not a replacement for the government’s responsibility to people’s right to health. A right such as the right to health should not be made a commodity for profit for big local and foreign capitalists, in fact the constitution mandated the government to provide for a quality and affordable health services to all the people. With the impending privatization through PPP of the Philippine Orthopedic Center and transferring the construction of a new modernized orthopedic and trauma hospital, operation, maintenance and the provision of qualified staff to the private sector for the next 25 years, the government, not only reneged on such mandate, it practically turn its back to the very people that it is supposed to be serve.

The affected public health workers, and the ordinary people therefore that will be directly affected by such abandonment of government responsibility have the right to fight back and defend for their right, our right to health. We call on the people to be with us in our collective assertion for our right to health. ###

Health Workers’ Call – Ona Resign!

PRESS STATEMENT
November 24, 2012

Reference:

Mr. Jossel Ebesate, RN
President Alliance of Health Workers
Mobile No. 0918-9276381

Mr. Robert Mendoza, RM
Secretary General Alliance of Health Workers
Mobile No. 0932-4649757

“Depende, depende sa usapan,” was Sec. Ona’s response to a TV interview regarding status of the health workers’ security of tenure with the corporatization of public hospitals. Straight from the Sec. Ona’s mouth, this is the most blatant and eloquent proof of his ultimate disregard for the welfare of the health workers - the front liners in the health care delivery. Health workers’ security of tenure is among the contentious aspects with the privatization of public hospitals and health care delivery.

The Alliance of Health Workers (AHW), for the interest of the public especially the poor, clarifies its stand vis a vis his statements point by point:

1. Corporatization is not privatization, for us the name does not matter; it could be by any name. What matters is –how will health delivery be availed by the patients, will it be free upon the control of public hospitals by private partner investors? Our experience with the corporatized GOCC hospitals – the National Kidney and Transplant Institute (NKTI), the Philippine Heart Center (PHC) and the Lung Center of the Philippines free services are no longer available. At NKTI, the “no pay, no hook policy” has been the norm for patients undergoing dialysis. At PHC, a long list of patients, mostly indigents are waiting for operation and a number died along the wait.

2. Services will improve, according to Sec. Ona. It is a YES, no doubt. Private investors will improve their facilities to achieve a high level of competition for a lucrative return of investment. But will they be free? With GOCC’s as example, NO is the sure answer! Improved facilities do not translate into free services for patients especially the poor. Private investors’ main concern is a fat ROI, the very essence of their being private and not delivery of free public services.

3. PhilHealth will take care of the patients’ needs. At the very least, this is a very debatable issue. DOH endorses Philhealth as almost a ”cure all” for the Filipinos’ health problems. On the ground, however, experiences prove otherwise. If only Sec. Ona listens to what really is the true effects of this pre-need plan on the poor Filipinos’ health needs. Philhealth is part of privatization of health services, thus also for profits.

Sec. Ona claims, we do not understand or refuse to understand what he is saying to which we say, “We do understand you, but not believe you!”. More so, we gather information from both local and international experiences, compare and analyze data which led us to conclude what we are pointing out to him.

We might as well say,” Sec. Ona does not understand or refuse to understand our side”. Our message is clear and simple. When private investors are in control of hospitals and health facilities and health services are all paid for with no free services even for the indigents, it is privatization. DOH Health Financing Scheme clearly says that by 2020, public hospitals are fully corporatized with zero subsidy from the government.

We reiterate that we do not focus on terminologies like PPP, corporatization, privatization. These will just mislead people. Our bone of contention are the implications of these government neoliberal policies and programs, zealously implemented by Sec. Ona, to the Filipino people’s constitutional right to health which is government’s and not private investors’ responsibility. And the health workers’ security of tenure, the front liners in the health care delivery system that has not even been considered in the government's plan to privatize public hospitals.

Thus, Ona resign! is a most fitting call.#

Privatization Kills

Press Statement

November 19, 2012

References:

Mr. Jossel I. Ebesate

National President, AHW

Contact No: 09189276381

Mr. Sean Vilchez

President, National Orthopedic Center Employees Association-AHW
Contact No: 09497767142

Health workers and members of various organizations including those from urban poor communities capped their week-long “kalampag” against privatization of health with a black coffin inscribed with “Privatization Kills” to dramatize the death of public health care system and its adverse effects to people’s health.  The “Privatization Kills” coffin was paraded in front of DOH and Malacanang this Monday, November 19 for the National Day of Protest Against Privatization of Public Hospitals and Health Services.

   

From DOH the group marched to Malacanang to deliver a strong message to President Benigno Aquino III to stop the privatization of public hospitals and health services. Leaders and members of trade unions, peasants, women, government employees, students, teachers, health professionals and religious joined the march and the program at Mendiola.

“Pnoy’s health policies are so insensitive to the already dismal health situation of the people. “Privatization kills” is the most fitting description of his PPP program; sale of public hospitals like the  Philippine Orthopedic Center and Mental Hospital and privatization of health care with the corporatization of 26 public hospitals nationwide,” Jossel Ebesate, Alliance of Health Workers (AHW) president declared. 

                       

Health leaders took turns in assailing the “Death” of public health care and its ill effects on the patients, the health workers and the Filipinos in general especially the poor.  “The poor patients at Jose Reyes and San Lazaro will be further deprived of health services they so badly need. Mental patients will be dislocated and their treatment uncertain after the Mental hospital is sold. At worse, they might add to the increasing number of “taong grasa”.  What will happen to the crippled and disabled who have been confined for a long time at the Orthopedic Center with its sale  as part of  P’noys privatization of health?,” lamented Sean Velchez, president of NOHWU & Spokesperson of Network Opposed to Privatization (NOP).

        

“The people will continue to oppose P’noy’s privatization of public hospitals and health services.  The Aquino administration must stop yielding to the impositions of international financial institutions such as the World Bank and the Asian Development Bank to cut budget for social services to pay the country’s huge foreign debts.  Health is a basic human right and it is the government’s main responsibility to ensure this right!  ” concluded Dr. Geneve Rivera-Reyes of the Health Alliance for Democracy (HEAD).

In Baguio City, a delegation of health workers of Baguio General Hospital (BGH) trooped to the City Hall to support the City Council’s resolution against corporatization of BGH. A program was held to protest corporatization at the People’s Park. Protest actions were held in Samar, Iloilo and Davao to express their vehement opposition to Aquino’s policies and programs to privatize health.### 

AHW to DOH Secretary Ona: Defend Health Workers Rights and Benefits

Press Statement
November 11, 2012

Reference: Mr. Jossel I. Ebesate
National President
Contact No. 09189276381 

The Alliance of Health Workers (AHW) warily considers the recent assurance of the DOH Secretary Ona, "that by the end of this year, all of these so-called doctorless municipalities will be filled." Wary because, while such move has been long overdue, Ona himself admitted that some of these physicians would serve up to 50,000 population which is more than doubled the WHO prescribed doctor to population ratio of 1:20,000. But we are much more wary on the lack of support by the Department of Health to these municipal doctors.

To recall, sometime ago, a doctor and a graduate of the UP College of Medicine assigned somewhere in Agusan  came in conflict with the local military while in pursuit of his duties and functions. DOH merely reassigned said doctor to the DOH Regional Office without even seeking an investigation to uphold the right of said doctor. This also left the municipality without a doctor for some time.

Just recently, the Department of Health sits idly as personnel of the entire Municipal Health Office of Tarragona, Davao Oriental are being harassed by the local officials led by the Mayor of Tarragona. To date, the Municipal Health Officer is given termination order without due process and the salaries of rural health midwives and other local health workers withheld, also without due process. Unbelievably, the root cause of all these harassment was their petition to the Sangguniang Bayan for the release of their monetary benefits provided under the Magna Carta of Public Health Workers (RA 7305).

We therefore challenge DOH Secretary Ona, to immediately intervene, in behalf of our fellow public health workers in Tarragona, Davao Oriental. We are further challenging him to safeguard the rights of all public health workers in the country, including their monetary benefits as provided by law.#

Position on House Bill 6145 and Other Bills on Corporatization of Public Hospitals

Position Paper (edited) submitted by the Alliance of Health Workers to the Committee on Health, House of Representatives, Philippine Congress upon its invitation for public hearing (eventually postphoned) on September 4, 2012.

September 3, 2012

Reference:

Jossel I. Ebesate, RN

National President

We, the public health workers nationwide, under the Alliance of Health Workers strongly oppose the recent attempts of the government to corporatize public hospitals through House Bill 6145, House Bill 6069 and Senate Bill 3130. These bills are anti-people and anti-health worker thus will worsen the dismal state of people’s health.

The corporatization bill filed by Rep. Raul Daza will transform 26 public hospitals into public corporations run as private hospitals. It is similar to all other previous corporatization bills like HB 6069 filed by Rep. Anthony Rolando Golez, Jr. and Senate Bill 3130 filed by Sen. Franklin Drilon that gives  fiscal autonomy to hospitals to raise income for its operations thereby cutting off its dependence on government subsidy. These hospitals include the DOH flagship hospitals and almost all major public hospitals/medical centers in Manila Manila and regional centers as follows: Cagayan Valley Medical Center, Veterans Regional Hospital, Baguio General Hospital and Medical Center, Ilocos Training and Regional Medical Center, Region I Medical Center, Dr. Paulino J. Garcia Memorial Research and Medical Center, Jose B. Lingad Memorial Medical Center, Batangas Regional Medical, Bicol Medical Center, Bicol Research Training and Teaching Hospital, Quirino Memorial Medical Center, Jose R. Reyes Memorial Medical Center, Rizal Medical Center, Amang Rodriguez Medical Center, San Lazaro Hospital, Vicente Sotto Memorial Medical Center, Eastern Visayas Regional Medical Center, Corazon Locsin Montelibano Memorial Regional Hospital, Western Visayas Medical Center, Northern Mindanao Medical Center, Zamboanga City Medical Center, Southern Philippines Medical Center, Cotabato Regional and Medical Center, CARAGA Regional Hospital, Davao Regional Hospita, and the Mayor Hilarion A. Ramiro, Sr. Regional Training Hospital.

These bills essentially turn public hospital and its services into income generating and for-profit institutions. By opening the management of the public hospitals to private members means that private investors will make sure that there will be a return of investment and profit, and rendering health services will only come second.

Corporatization is not for the benefit of the people. Corporatization of public hospitals will mean no free health services and higher rates of services. This means deprivation of health services to the poor who are majority of the population. It would result to collateral of properties for payment of health services, or becoming chronically ill or dying without seeing a doctor.

The much touted Philhealth, as a safety net to pay for health services, is not the solution. Its coverage is limited to only 23 regular cases and limited number of catastrophic illnesses. Worse, even a liberal appreciation on Philhealth coverage showed that it could only cover for 30%-40% of the total cost of health services of regular members, outside of the Philhealth’s Sponsored Program. Thus, the resulting increase of health services as a result of the corporatization of public hospitals will be felt more by about 60% of our people who are outside of the lowest 20% of our population (covered by the sponsored program) and the richest 20%. This assumption is based on the data of the DOH itself where about 80% of our people relies on public health facilities especially these 26 public hospitas (for tertiary care) that will be corporatized.

Corporatization will not care for the wellbeing of health workers. Just like any private business, corporatization will streamline its expenses. This means security of tenure of health workers is threatened and will be replaced by contractual which is happening now. Salaries and benefits of health workers are being threatened. Down grading of positions, offer of early retirement and streamlining of health workers will soon be a standard procedure.  Doctors to the Barrios Program (where the RN-HEALS program is included) of the Department of Health is a form of contractualization and exploitation on health workers.

Corporatization is privatization. Lundqvist[1] (1991), say that it is sufficient that one of these functions (i.e., the financing, production or regulation) is transferred to private management to say that a privatization has taken place. Considering that the corporatization as designed in HB 6145, HB 6069 and SB 3130 calls for the transfer of health financing and production to the private sector, therefore corporatization is by itself the privatization of the corporatized hospitals. It is relying more to private business to operate the public hospitals, and the government is abandoning its responsibility to provide quality health services to the people as called by the Constitution.  The government is reneging on its responsibility to adequately provide for public hospitals through the shrinking budget allotment.  Providing health services for free is not dole out since people pay their taxes and should be returned to them through the form of services.  If the government could afford to pay hundreds of billion pesos for foreign debts and modernization of the military, why it cannot afford to develop and modernize public hospitals and health facilities that will save millions of lives? 

Corporatization is in fulfillment of the government’s plan to fully remove subsidies to public hospitals’ Maintenance and Other Operating Expenses (MOOE) by the year 2014 and including Personal Services (PS) by 2020 (Pnoy-DOH’s Health Care Financing Strategy 2010-2020).

Our CALLS:

1. Scrap bills that are for corporatization/privatization of public hospitals!
2. Allot 5% of Gross Domestic Product (GDP) or the amount of P527B by 2013 to fund for people’s health.  Provide adequate budget allotment for public hospitals to ensure and improve facilities, equipments, supplies and medicines. Fund health workers’ benefits.
3. Stop revenue enhancement schemes in public hospitals!
4. Stop privatization and entry of private business in different departments and functions of public hospitals.
5.  Fill up unfilled plantilla positions and create new plantilla positions to provide for adequate health worker to patient/population ratio. 

[1] Lundqvist, Lennart J. 1991: Dislodging the welfare state? Housing and privatization in four European nations., as cited by Falkenberg, Helena in  “How privatization and corporatization affect healthcare employees’ work

climate, work attitudes and ill-health”, 2010, Stockholm, Sweden.