The ‘Corporatization’ of the Public Health System

The CLMMRH, a case study

The Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH) started as a district hospital. It became a regional hospital in the late ‘80s. But according to sources, its status was elevated without the standards of a regional hospital being fully satisfied. These include having separate buildings for each medical function, standard medical equipments, a 300-bed capacity, a certain number of doctors, nurses & health staff, including resident doctors, among others.

In mid ‘90s, the CLMMRH was listed as one of the pilot hospitals out of 38 priority state-run hospitals nationwide by the Department of Health (DOH) for its privatization cum corporatization thrust. Since 1998, it has carried out sweeping changes in hospital management and systems in accordance with the government’s health reform agenda.

But after several years of experimentation, CLMMRH has only turned for the worse.

The envisioned hospital modernization and delivery of affordable and quality services did not materialize. Inside sources who requested anonymity said the new buildings were erected from 1997 to 2000 but their construction was reportedly full of irregularity. The medical isolation building for one remains unfinished despite the P10 million spent on its construction. Three other buildings remain under-utilized and one, which is supposed to be a modern laboratory building, remains empty of modern equipment.

Today, patients, including children and infants, are cramped in small, old and dilapidated wards. Many lie in the corridors, vulnerable to passing people who may be carriers of communicable diseases.

Higher cost of services

Out-patients are now required to pay a minimum of P30 per consultation. A nursing aide tells the patient to first pay before being taken to the doctor. This was not the case before, a nursing staff said.

Meanwhile, the hospital pharmacy often does not have basic medicines like paracetamol and aspirin, and supplies like syringes and dextrose. Indigents and PhilHealth cardholders interviewed by Bulatlat said even hospital patients are often told to go outside and buy their prescribed medicines and supplies.

A midwife interviewed by Bulatlat confirmed this, saying some nurses and doctors at the emergency room would often give purchase orders to their new patients with specific instructions to buy them at private drugstores outside of the hospital.

The midwife scored the lack of the most basic medicines and supplies which could be crucial in the immediate treatment of some deadly illnesses.

Health system in crisis

The Philippine health sector is in a state of calamity. For decades, the health system reflects the ill state of the people and the wrong priorities of the national government & leadership.

Data obtained by Bulatlat revealed that from 1986 to 2004, government spending for health has dropped significantly. In 1997, health appropriation was 2.9% of the national budget. It was reduced to a mere 1.5% in 2004. This year, national budget for health has dropped further to 1.3%.

The bigger chunk of the national budget goes to paying off foreign debts (up to 40 percent of the budget in the past, and more than 60% this year) and funding military spending (15-20 percent).

The much-hyped efficiency, better and affordable health services under the HSRA never came. The opposite happened.

Profit has dictated the supply and distribution of vital medicines and vaccines, and the accessibility of medical facilities. Increasingly, it will determine the thrust of the country’s health care system and services. (Bulatlat.com)

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