Part Two
THREE years ago the Philippine government launched the Nurses Deployment Program (NDP) to replace the Registered Nurses for Health Enhancement and Local Service (RN Heals).
The latter was implemented in 2011 “to tackle the lack of skilled and experienced nurses in the rural and underserved areas of the country,” the Department of Health (DOH) said.
The new program, the NDP, aims to improve local health systems and support the country’s attainment of universal health care, the DOH added. “It also aims to give opportunities to the growing number of unemployed nurses in the country.”
According to the DOH, nurses enrolled in the NDP were assigned to areas covered by the Conditional Cash Transfer (CCT) Program, a poverty-alleviation strategy hatched under President Gloria Macapagal-Arroyo’s administration.
The nurses were on a “Contract of Service” arrangement renewable every six months for a maximum of two years based on a “very satisfactory” performance rating.
Higher salaries are also given to them equivalent to a Nurse 1 position. The higher salary is provided because the budget for employing nurses has doubled as sin taxes increased, the DOH said, quoting Center for Health Development (CHD) Bicol Director Gloria J. Balboa.
“This makes them hired-employed rather than deployed after they are awarded with certificates of employment.”
Before, nurses in the RN Heals program received a monthly allowance of P8,000 from the DOH and P2,000 from the rural health unit, community or hospital where they were assigned.
The DOH said the NDP can hire nurses at higher-than-usual salary rates because the work is a short-term contract: the longest is one year with two six-month contracts. The idea is to provide experience and eventually absorb the good performers in the available permanent government posts, Health Secretary Paulyn Jean B. Rosell-Ubial explained.
Deployment
AROUND 12 percent of the deployed nurses are eventually hired into permanent posts in government hospitals or public health offices. However, Ubial has admitted the NDP reduced the number of hired nurses by 6,970 in 2017.
Still, she said, “Nobody will really lose their job [for those currently hired in the program] because the nature of such hiring is on a contractual basis, not a permanent one.”
“The proposed 2017 budget for the program raised their salaries and therefore, after adjustments, resulted in fewer hires,” Ubial explained. In contrast to the nurses, only 70 percent of the slots for doctors in the Doctors to the Barrios (DTTB) deployment program were filled up in 2016. This means that despite the available positions and funds backing the DTTB, 30 percent of the available slots remained vacant.
The DOH’s deployment program for doctors, nurses, midwives, dentists and medical technologists is generally successful, Ubial said.
In recent years the supply of nurses in the Philippines markedly increased in response to high demand for nurses in foreign countries facing shortages. Some doctors even retrained to become nurses just to go abroad, she added.
However, with a decline in demand for nurses in overseas market, there is an increase in local unemployment of nurses, Ubial has said.
Anti-deposit law
THERE’S a specter haunting hospitals: Republic Act (RA) 10932.
Owners have expressed fear of possible bankruptcy following the signing of RA 10932, otherwise known as an “Act Strengthening the Anti-Hospital Deposit Law”. The law, which amends Batas Pambansa (BP) 702, increased the penalties for the refusal of hospitals and clinics to administer appropriate initial medical treatment in emergency or serious cases.
Private Hospitals Association of the Philippines (PHAP) President Rustico Jimenez said the “provisions present in the new law [are] too oppressive to the private hospitals.”
“Why do we need to have this kind of law, which is too oppressive?” Jimenez, also a physician, said. “It will also cause bankruptcy in small hospitals, especially in the provinces.”
Under the law, any official, medical practitioner or employee of the hospital or medical clinic who violates the provisions of this Act can be imprisoned for not less than six months and one day but not more than two years and four months. Violators found guilty also could be fined with not less than P100,000 but not more than P300,000.
Higher penalties of imprisonment of four to six years, or a fine of not less than P500,000 but not more than P 1 million, or both, are imposed upon directors or officers of hospitals or clinics responsible for the formulation and implementation of policies or instructions violative of this Act. Three repeated violations, added RA 10932, shall result in the revocation of the health facility’s license to operate by the DOH.
Legal impact
JIMENEZ said there was no need to increase the penalty because they are also doing their part to help the poor patients.
He said of the 17 cases of complaints filed in the last 10 years (BP 702 was enacted
in 1984), “only one was decided and never implemented because of the scarcity of hospitals, especially in the provinces.”
“So what we are doing is to refer to them, for example, in one area or in a province. You have a big hospital there, you refer all the CT scans, MRI, there instead of [asking them to go] to Manila,” Jimenez explained. “Of course, the patients usually are on the lower income group. Especially in our areas around Manila Bay, there are a lot of informal settlers and these are the cases that are hard to treat.”
He admits hospitals are not supposed to turn down all those patients. “You have to treat them but they will not be able to pay us,” Jimenez said. “That’s why we refer all these to Asec. [Health Assistant Secretary Elmer G.] Punzalan.”
In return, Jimenez said Punzalan will call the public hospital that are equipped enough to accommodate the patient.
“If the patient [is] still in the hospital, we advise them to go the [Philippine] Charity Sweepstakes [Office] because they can get funds there [however] limited.”
To be concluded