Health Workers to DOH: You will find the poor in public hospitals, not at the ivory tower of profit-driven health care

Statement

We from the Alliance of Health Workers are alarmed at the news article titled "DOH: where are the poor?" (PDI, 8/1/2013).

It is incomprehensible that the DOH "could not locate the addresses of the poor in order to deliver their PhilHealth cards..." while the government is proposing P35B for the premium of PhilHealth sponsored members for 2014, a whooping 180% increase from P12.6B allotted in 2013.

The P35 million subsidy targets only the “selected poorest of the poor” by the government’s standard, or those earning below the P52 daily or Php7,821 monthly poverty threshold for a family of five (NSCB, April 2013). This practically leaves all other poor Filipinos. By IBON Databank estimates, poor Filipinos would number some 38-68 million (IBON, July 2013) or 41-73% of the 92 million estimated population in 2012, way above the 26.8 million poor Filipinos by NSCB standard. 

The proposed P35B for PhilHealth subsidy is more than three times the total budget allotment for the 70 DOH-retained hospitals in 2013. Instead of looking for the “poor” through “mapping” or any other complicated methodologies the government could just put this huge amount to the severely underfunded government hospitals, health units and stations, where poor patients go for treatment.  This could make a big difference in the availability of medicines, supplies and equipment badly needed by the poor patients.

The poor are really not difficult to find, if the government and DOH would only go beyond their showcase of private investors-propelled "improvement" of public hospitals and facilities through privatization. If only Secretary Ona and the Aquino administration would go down to the communities and public hospitals and health facilities, and see and feel for themselves the actual situation, they would not only see the poor, they would also realize how irrelevant and how dangerous their health privatization programs are to the health and lives of the poor Filipinos.

Reference:

Mr..Jossel I. Ebesate, RN

National President

Alliance of Health Workers

09189276381

Health Workers to DOH: Stop deceiving the public, stop privatization of public hospitals

Press Statement

July 27, 2013

Reference:

Mr. Jossel I. Ebesate, RN

Contact No: 09189276381

The Alliance of Health Workers (AHW) told the Department of Health (DOH) to stop deceiving the public in pursuing public-private partnership (PPP) of public hospitals and health services.

“PPP, modernization, or whatever the DOH calls it, the fact is, the government is allowing private investors to profit from health service provision in public hospitals. Public health service provision is the duty of the government,” said Jossel Ebesate, national president of the Alliance of Health Workers.

Ebesate reacted to the statement of DOH Secretary Enrique Ona on Friday, July 26, that the DOH  was “not in favor of privatization”.

 

Ebesate stressed that if indeed the government is indeed not for privatization it should have funded the modernization and improvement of public hospital facilities years ago, instead of passing this role to profiteering private investors. He said that since 1990s, the government through the DOH has been trying to privatize hospitals to cover up for its failure to adequately fund public hospitals and provide for accessible health services to the people.

“The DOH through the years is just changing the terms and packaging, but it is the same privatization policy pushed by the previous administrations.

“Once private investors are allowed into social services like health, whether through PPP, corporatization, or outright sale, the primary purpose is huge profit generation, thus replacing service orientation. This has been proven time and again, most recently with the dramatic increases in water bills as result of privatization of water services,” said Ebesate.

“The DOH is doing a disservice to the Filipino people by consciously making it appear that PPP will benefit the people. The poor people’s experiences in public hospitals up for privatization prove otherwise. Based on our experience in most public hospitals, PPP of selected services only jacked up the price of health services at the expense of our poor patients,” Ebesate, explained.

Ebesate said that Secretary Enrique Ona was further confusing the public by lumping up medical mission initiatives with privatization of health services. #

Closure of Manila’s City Hospitals Will Hurt the Poor

PRESS STATEMENT

July 19, 2013

Reference:

Mr. Jossel I. Ebesate

National President, AHW

Mobile No: 09189276381 

We, health workers in different hospitals under the Alliance of Health Workers, oppose the plan of Mayor Joseph Estrada to close some city hospitals “to lower government expenses and save money.”

The idea to close city hospitals as expressed two Fridays ago (July 5) by the mayor of Manila,  is cruel and heartless. This will negatively affect many poor patients in Manila who rely on these hospitals for services. The six city hospitals, namely Gat Andres Bonifacio Memorial Medical Center, Ospital ng Maynila, Ospital ng Sampaloc, Ospital ng Tondo, Sta. Ana Hospital, and Justice Abad Santos Mother and Child Hospital serve those who cannot afford expensive private health services. Ospital ng Maynila, for instance,  serves more than a thousand out-patients per day and accommodates more than 300 in-patients during peak seasons even if its bed capacity is only 300.

If any of this city hospitals will be closed, residents who usually lacks or even have no means to provide for their basic needs such as food, clothing and shelter  would further delay or worst stop seeking treatment.  This may spell the difference between life and death for most patients.

Closing any of the city hospitals would further add up to the long queue and overcrowding in public hospitals under the national government in the city such as the Philippine General Hospital, Jose R. Reyes Memorial Medical Center, Dr. Jose Fabella Memorial Hospital and San Lazaro Hospital.

This dismal situation in terms of funding, staffing and infrastructure of public hospitals is brought about by the continuing neglect and misprioritization by the national government in the national budget.  Instead of addressing the grave lack of funds, the national government devolved and privatized health services to the detriment of the public.

Public hospitals are built primarily to serve the public.  The government, both at the national and local level, is duty-bound to ensure that free, affordable, and accessible public health services are provided to the people. Public hospitals should be improved and developed by the government to better serve the people.

Adequate funding, not closure, will make our public hospitals more relevant and responsive to the needs of the people. Unless the national  or the local government has the political will to really serve the people through adequate, free, affordable and accessible health services, health for all will remain as it is - a dream.#

UP Kilos Na Condemns the Imposition of Charges on Previously Free Laboratory Procedures for Class D Patients of the Philippine General Hospital

July 16, 2013

UP Kilos Na supports the All-UP Workers Alliance and the Alliance of Health Workers in condemning the imposition of charges on previously free laboratory procedures for Class D patients of PGH and for adding new requirements to avail for free of succeeding examinations previously availed of free of charge. These changes are contained in the July 4, 2013 Memorandum of PGH Director Jose C. Gonzales with the subject: “Revised Rates of the Department of Laboratories.”

The memo details the “revised rates” for laboratory exams in PGH starting July 12, 2013. Prior to this issuance of the memorandum, 192 of 254 laboratory procedures/examinations were free for Class D patients of PGH. Now with the new policy, only 44 are free for the FIRST examinations. Payment for the succeeding examinations “maybe (underscoring ours) waived upon the recommendation of the Department Chair and the submission of the following documents for the purpose of requesting for a guarantee letter:

1. Clinical Abstract with a therapeutic plan and approximate cost of treatment
2. Personal letter of the patient or family to the congressman of his/her place of residence requesting for financial assistance. “

Class D patients in PGH are those whose monthly income is around or below the National Capital Region minimum wage rate.  Also included in Class D are those who are recent victims of fire, floods and other natural disaster and patients with chronic debilitating disease or catastrophic illness. In PGH’s charity wards and charity ICU, almost 98% of the patients are Class D.

PGH has already a system for the processing of a Class D category which is handled by its Medical Social Services Department (MSSD). It already takes a tremendous amount of time to line up for the various requirements to prove one’s abject poverty and to be categorized as Class D patient in PGH. The policy related to changes in the laboratory fees of PGH as contained in the memo clearly makes it more difficult for the poor to access the services of the PGH. This new policy will further add to the travails of our poor: request for reconsideration from the Chair of a PGH Department and a letter for financial assistance from the congressman or representative of his/her province.

The reduction of the number of free laboratory examinations for Class D patients and the additional requirements to avail of free service for succeeding examinations are being implemented at a time when the allocation for Maintenance and Other Operating Expenses (MOOE) of PGH has increased from P305.549 million in 2012 to over twice that amount to P616.903 million for 2013! This budget increase is partly due to the strong public support for the call and mobilization of the UP community for greater state subsidy for UP and PGH.

UP Kilos Na supported in 2010 the fight of Dr. Gonzales against his unjust ouster as PGH Director by the Roman Administration. The issue was principally against the violation of the principles of democratic governance of the Roman administration for unseating Dr. Gonzales who was democratically elected by the BOR and who had already taken his oath of office as Director. But UP Kilos Na support for Dr. Gonzales was his stand against the setting up of a private medical laboratory in the guise of providing clinics for PGH doctors inside the PGH compound.

In 2010, when a forum was held at the Philippine General Hospital on the proposed transformation of FMAB into a private facility run by the Daniel Mercado Medical Center, Dr. Jose Gonzales, then not holding any administrative position spoke against such move. A report by Krizia C. Borromeo of that meeting posted on September 28, 2010 on the MEDICS, the official student publication of the UP College of Medicine (http://www.upmedics.com/2010/09/pgh-privatization-will-fmab-bring-more.html, accessed 15 July 2013) quoted Dr. Gonzales as saying that “PGH is a service hospital for economically depressed patients who can’t afford to see private doctors.” Further, he is quoted as saying “May karapatan ang mahihirap. We should do our part to serve the people..kung hindi walang mangyayari. The public-private partnership will not solve the root cause of the problem—inefficiency.”

But now PGH Director Jose C. Gonzales considers free laboratory services to the poor inefficient and under the guise of “rationalization” and “efficiency” has in fact imposed charges on previously free availment of procedures and added bureaucratic layers to the process. While ostensibly this new policy is supposed to discourage PGH doctors from ordering unnecessary laboratory procedures for poor patients, it has in fact further shifted the burden to the poor patients who now have to pay or to beg for a waiver from the Department Chair. The memo came out in inopportune time when health inequalities in our society are becoming more blatant. The new policy only worsened the already unhealthy state of many of our society’s poor population, and trounced their right to health. Coupled with the increase in charges in the pay wards and private rooms of PGH, the “ospital ng bayan” is now trodding the path of private hospitals which are profit centers with charity patients.

UP Kilos Na condemns this betrayal of PGH Director Jose C. Gonzales of his promise to make PGH more accessible to the poor; to find ways to reduce the long lines faced by poor patients seeking PGH’s services and to stand up against commercialization of PGH such as the FMAB scheme of the previous PGH Administration. Instead under the guise of rationalization, increasing efficiency and preventing superfluous orders for laboratory examinations, he is now implementing a scheme of requiring poor patients to pay. Rather squeezing the poor of every ounce to recover costs, health care should be given to them for free! The brunt of state abandonment of our health care and services must not be passed on to the poor.

UP Kilos Na therefore urges PGH Director Jose C. Gonzales to rescind this discriminatory anti-poor policy. We call on administrators, faculty, and staff of PGH to forge strong solidarity with other progressive sectors of our society to clamor for higher health budget! Together we should stand to arrest the deteriorating health of our health services! The duty of health professionals is not just to save lives but to prevent the subjection of lives to contrived unhealthy and dehumanizing conditions!  

Health groups negotiate with DOH; protest the privatization of public hospitals

Press Release
July 15, 2013

References:

Dr. Julie Caguiat, NOP convenor, 0946-2278218

Mr. Jossel Ebesate, RN, AHW National President, 0918-9276381

Health workers, practitioners and community organizations under the Network Opposed to Privatization of Health Services (NOP) formally sought negotiations with Department of Health (DOH) Secretary Enrique Ona today to stop the privatization of public hospitals.

"This is not the first time we speak out against privatization of public hospitals. Still we are hoping DOH Secretary Ona will hear us out, in behalf of all the poor Filipino patients who are depending on our public hospitals for treatment. This is all about the health and lives of our people. We cannot just give up with this fight," said Dr. Julie Caguiat, convenor of NOP and Executive Director of Community Medicine Development Foundation.

Among those projects being protested by the group include the public-private partnership of Philippine Orthopedic Center, the sale of National Center for Mental Health, the proposed PPP projects in different hospitals nationwide, and corporatization of hospitals. The groups also raised questions on the proposed modern hospital complex in the DOH compound that will transfer the Jose Fabella Memorial Hospital, and supposedly "modernize" Jose R. Reyes Memorial Medical Center, and San Lazaro Hospital.

"We are for the improvement and development of public hospitals and health facilities, but this should be done by the government itself and be geared towards providing free, accessible and affordable health services especially for the poor.

“The Aquino government’s highly touted PPP program for public hospitals, which is just a sanitized name for privatization, is anathema and an abandonment of the government’s constitutional mandate to protect and promote the people’s right to health. The interest for insatiable profits by big business is in contradiction to the very essence of existence of public hospitals, which is to provide quality, affordable and accessible health services for all the people," said Jossel Ebesate, national president of Alliance of Health Workers.

Anti-privatization groups raised concerns that the entry of private investors in public hospitals and health services will further raise the cost of health services in public hospitals and displace poor patients.

“By letting private corporations take over public hospitals’ operations in the guise of “modernization, efficiency, and financial viability”, the government in effect has made profit instead of service as its priority. The much-touted Philhealth subsidy for the people cannot replace the state- run public health facilities and services,” Dr. Caguiat said.

Aside from NOP, other groups expressed opposition against the privatization of public hospitals and health services, including urban poor, workers, women, and most recently the church groups.#