THE Department of Health (DOH) admitted on Wednesday that healthcare migration continues to seriously impair healthcare service in the country, with the Congressional Policy and Budget Research Department (CPBRD) citing a lack of livable wages and just benefits, job instability, and a lack of security of tenure and employment opportunities as health workers’ reasons for leaving the Philippines.
During the budget hearing of the DOH and its attached agencies, Health Secretary Teodoro Herbosa said the agency provided a solution to keep Filipino nurses and doctors working in the country.
“We are improving our options for the career of nurses because globally, other countries—post-Covid 19—are also building and strengthening their health systems, and their solution is to hire Filipino nurses because our nurses are world-class,” said Herbosa.
In its agency notes, the Congressional Policy and Budget Research Department (CPBRD) called on the DOH to address the migration of health workers.
“The DOH must stem the steady migration of healthcare workers to other countries by addressing the problems these workers often cite as their reasons for living: lack of livable wages and just benefits, job instability, and lack of security of tenure and employment opportunities,” the House think tank said.
The CPBRD said the country experienced an outflow of 15,000 to 20,000 nurses per year, while some 10 percent of nurses in private hospitals resigned from their jobs.
Meanwhile, the DOH said the country has an annual shortage of 127,000 nurses and 114,000 doctors. “On the salary, we cannot compete, but we can compete on other options like a better career path, scholarships for master’s programs, and PhDs,” Herbosa told lawmakers.
“We also find a way to get them health insurance other than PhilHealth. We like to find a way to get them private health insurance for them and their family. Maybe even housing—there is a proposal for housing for nurses so we can [stop their] desire to leave the country,” he said.
ALSO, the CPBRD noted DOH’s many unfilled positions from 2021 to 2022, with 21,500 out of 96,144 authorized posts in 2022.
“Most vacant positions are with the OSEC—19,986 in 2021 and 21,438 in 2022. For PNAC [the Philippine National AIDS Council], 26 remained vacant out of the 32 authorized positions in 2022,” said the CPBRD.
“This situation needs serious consideration, particularly on how the agency could effectively perform its functions with very limited human resources [only six out of 32 authorized positions], considering that HIV remains a critical problem in the country and is also one of the fastest-growing epidemics in the Western Pacific,” it added.
Moreover, the think tank said the number of unfilled positions in the entire department has been significantly high in 2021 and 2022, “raising the question of whether the positions are redundant or if the department no longer requires the positions. The department could have allocated these resources to other more critical expenditure items or spend creating positions more relevant to the agency, especially during the Covid-19 pandemic.”
For his part, Herbosa said the DOH has signed a memorandum with the Commission on Higher Education to address the vacant positions, which include retooling board non-passers. “We are also trying to look after those who just missed the board exam. We have a new proposal called Clinical Care Associate wherein CHED partners with several higher education institutions. We will hire the nurses who are under board to add to the workforce at salary grade 9, but the private sector is funding their review at something like P25,000 per nurse. If they pass, we will hire them at salary grade 15 to fill the vacant items,” he said.
“The department is committed to fulfilling these unfilled positions. We will make an effort to do that,” he said.
Meanwhile, Herbosa admitted that the agency has sought additional funds to finance around P1.6 billion in Covid-19 emergency allowance for health workers.
“We requested additional money [from the DBM] because the total funding requirement is P63 billion. With a P22-billion budget for 2022, P19.4 billion for 2023, and P20 billion for the NEP 2024,” he said.
“Last April, the Department of Health wrote the DBM and we are still awaiting their approval of a few billion pesos from the unprogrammed funds of DOH to be used for the [Covid-19] health workers emergency allowance,” he added.
FOR 2024, the DOH’s proposed “agency proper” budget for 2024 will suffer a P10-billion cut.
The health sector will receive P306.1 billion, including PhilHealth’s P101.5 billion, next year.
Affected by this budget reduction are four Quezon City-based hospitals: the Lung Center of the Philippines (P561 million from P835 million), the National Kidney and Transplant Institute (P1.2 billion from P1.7 billion), the Philippine Heart Center (P1.8 billion from P2.1 billion), and the Philippine Children’s Medical Center (P1.4 billion from P2.1 billion), which will face a combined cut of almost P818 billion.
President Marcos wants to replicate these hospitals in the regions.
With this, lawmakers are calling for the restoration of this budget cut affecting hospitals.
Under the DOH’s budget, DOH hospitals in Metro Manila as well as DOH regional hospitals and other facilities will be allotted P17.6 billion and P49.8 billion, respectively. The Philippine General Hospital, specifically, will receive a total of P5.7 billion.
As part of efforts to ensure that health facilities remain up-to-date, P23.0 billion will be allocated to the Health Facilities Enhancement Program (HFEP).
Some P4.8 billion will be set aside for the Prevention and Control of Communicable Diseases to cover the implementation of programs and projects aimed at preventing and curbing the spread of infectious diseases.
On the other hand, P1.7 billion will be provided for the Prevention and Control of Non-Communicable Diseases to procure medical supplies needed for the treatment and control of non-infectious diseases, such as cancer and mental illness.
On top of the P1.0-billion appropriation for the Cancer Control Program under the Prevention and Control of Non-Communicable Diseases, P1 billion will also be provided for the Cancer Assistance Fund. The government also allocated P8.3 billion for Family Health, Immunization, Nutrition, and Responsible Parenting to implement programs for immunization (P7.1 billion), family planning and reproductive health (P750 million), oral health (P212 million), and nutrition (P76 million).
The National Health Workforce Support System will be allocated P18 billion to bolster the healthcare workforce and equip them for deployment in remote and depressed areas to provide promotive and curative services.
Also, a total of P20 billion will be provided for the health emergency allowance and Covid-19 compensation package for eligible healthcare and non-healthcare workers.
Under the funding of the DOH, the government will provide P683 million to fund the Mental Health Commodities for 124,246 patients.
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