Health workers from Pasig General Hospital (Photo courtesy of Filipino Nurses United)

At a time when health infrastructure and concerns of health workers demand to be addressed, the Philippine government takes a sharp turn and reveals it true priorities.

By JANESS ANN J. ELLAO
Bulatlat.com

MANILA – Health advocates belied government claims that the proposed budget for 2021 will prioritize health-related COVID-19 response as budget allotment remains way below international recommendations on public health funding.

While the proposed P127.29 billion ($2.6 billion) budget for the health department is higher than this year’s, it currently stands at 0.6 percent of the country’s Gross Domestic Product and 2.8 percent of the entire proposed budget. Health advocates have been recommending at least five percent of the country’s GDP be allocated for health. But with a pandemic at hand, they said that at least 10 percent should be allocated.

The Department of Health currently ranks eight among the line agencies in terms of highest budget, behind the Department of Interior Local Government and the Department of National Defense, which will take 5.4 percent and 4.6 percent of the pie, accordingly.

Read: Duterte’s COVID-19 response, no sense of urgency

“The proposed DOH budget will not curb the COVID-19 pandemic because it is too small and cannot meet the health needs of the people and the public health system that is driven by crisis,” Robert Mendoza, national president of the Alliance of Health Workers (AHW), said.

Priorities?

Health workers highlighted that while P1.2-billion ($24.67 million) was added to the maintenance and other operating expenses (MOOE), at least 23 hospitals will be subjected to budget cuts ranging from P4 million ($82,000) to as much as P209 million ($4.3 million).

To get the biggest cuts are the Southern Isabela General Hospital, Gov. Celestino Gallares Memorial Hospital, and Don Emilio del Valle Memorial Hospital. In Metro Manila, Tondo Medical Center is set to get a P71.96-million ($1.49 million) cut in the proposed 2021 budget.

Even COVID-19 referral centers such as the Lung Center of the Philippines and Dr. Jose N. Rodriguez Memorial Hospital will get a P12.29-million ($252,600) and P83.9-million ($1.7 million) slash respectively.

MOOE in hospitals are allotted for medicines, supplies, and utilities of government agencies. Health advocates have long lamented that lower MOOE forces public hospitals to increase costs of laboratory procedures and to enforce other income-generating schemes to sustain operations.

Only one public hospital under the health department, the Governor Celestino Gallares Memorial Hospital, is set to receive a 1.5-billion ($30.8 million) capital outlay. The rest, like in recent years, will get none.

At a time where health infrastructure need to be in place, independent thinktank Ibon Foundation noted the sharp decrease in the Health Facilities Enhancement Program, which is set to receive P4.8 billion ($98.66 million) compared to its P8.4-billion ($172,66 million) budget this year and to its 2018 budget amounting to P30.3 billion ($622.8 million).

Instead of funding health infrastructure and allocate funds that will address the chronic understaffing in public hospitals, the 2021 budget will instead allocate more funds to the corruption-laden state public health insurance system. PhilHealth, which is proposed to receive public funding amounting to P71.3 billion ($1.47 million) in 2021, has been under public scrutiny anew over new anomalies on its COVID-19 response.

Chronic understaffing not addressed

In the proposed budget, the Philippine government is proposing to allot P16.6 billion ($341.2 million) funds for its Human Resources for Health, where at least 26,000 are estimated to be hired. This, however, does not refer to plantilla positions that remain unfilled year in and year out.

For decades, the Filipino Nurses United noted that augmentation of workforce in the health sector is the usual excuse for hiring contractual health workers under the guise of “job order,” (JO) “contract of service,” (COS) and the “Nurse Deployment Program.”

Read: Nurses push for mass hiring, safe space amid increasing COVID-19 case

“However, nursing jobs in both hospitals and public health are vital and essential, not piecemeal, “pakyaw” or temporary nature of work as government defines it. Therefore no nurse deserves to be JO, COS or contractual for more than a year or even decades,” said the nurses’ group, adding that the consequent creation of regular plantilla positions with appropriate and adequate budget is “urgent and mandatory.”

The Alliance of Health Workers said there remain 14,553 plantilla positions that have yet to be filled.

Curiously, the budget for epidimiology and surveillance program will be slashed further, from P247.3 million ($5.1 million) in 2019 to P101 million ($2.1 million) in 2020 and now 97.4 million ($2 million) under the proposed 2021 budget. The World Health Organization has long noted that this program has a network in place from the central office down to the city levels. This could have been tapped during the onset of the virus.

Read: Under a fragmented health care, Philippines is ill-equipped in combating COVID-19

Contact tracing in the context of COVID-19 and when systematically applied, the WHO said, can break the chains of transmission and control disease outbreaks.

Where the country stands

With the proposed budget, advocates estimate that there is only P3.16 ($0.06) allotted per Filipino per day for their health-related concerns – barely enough to buy a tablet of paracetamol.

How ordinary Filipinos will benefit from the reported foreign loans that the Philippine government signed to supposedly address the pandemic, including loans from World Bank and Asian Development Bank, remains a question.

Health workers also highlighted that the increase in salary is due to the second tranche of the 2019 Salary Standardization Law and has nothing to do with COVID-19 response. There are also no budget that will provide for the long-demanded mandatory and regular testing for health workers, both those employed in the hospital and in the villages, nor provide them with benefits and hazard pay.

Still, while health workers are insulted and even demoralized with the series of pronouncements that the government is issuing in light of its COVID-19 response, it is “nothing compared to the urgency and gravity of the crisis being faced by our sick and economically devastated countrymen that should be seriously addressed by an adequate, socially caring and disaster-responsive national budget.”