Philippine Daily Inquirer, 24 February 2014
By Jocelyn R. Uy
MANILA, PhilippinesâThe Department of Health (DOH) has assured charity patients that they would still be accommodated even if plans of the government to privatize the Philippine Orthopedic Center (POC) were to push through.
Health Secretary Enrique Ona said the hospitalâs indigent patients would not be left out, stressing that 70 percent of its beds would be allotted for the sponsored programs of the state-owned Philippine Health Insurance Corp. (PhilHealth).
âThis one is very clear-cut. Of the 700 beds, 70 percent or more than 400 shall be allocated for the [PhilHealth] sponsored programs,â Ona told reporters in a recent interview.
The health chief also clarified that under the PhilHealth program, patients would not be obliged to pay anything.
âUnder the program, it is âno balance billingâ for all its members [so] that means everything will be taken care of by PhilHealth and patients will not be billed beyond what PhilHealth is required to pay by law,â Ona explained.
The P5.6-billion modernization program for the POC, the first government hospital to be privatized, is under the Aquino governmentâs public-private partnership scheme. The project was awarded to Megawide Construction Corp. and World Citi Consortium.
A multisectoral group earlier this month filed a petition in the Supreme Court, asking it to stop the government from pushing through with the project.
But Ona said the POC, which is the countryâs only hospital specializing in orthopedic disorders, would not be privatized per se as the DOH would continue to oversee its management.
The Philippine Star, 22 February 2014
By Dr. Willie T. Ong
One of the controversial issues in health is the modernization of the Philippine Orthopedic Center (POC) under the Public Private Partnership (PPP) program of the government. Because of the complexity of the issue, the public has not been getting the correct information on the matter.
Facts concerning the new POC
POC will not be privatized. Some groups are claiming that POC will be privatized. This is simply not true. To explain briefly, privatization means that the government sells a property and lets the private group dictate the price and services rendered. For the new POC, government will retain ownership of the hospital, will continue to regulate services and will get majority of charity beds for the poor. Hence these three points make it very different from the old privatization scheme.
Government will retain ownership of hospital. This is the most important difference between privatization and PPP.
Government will regulate services given. The DOH will head a governing council that will oversee how the hospital is run. The government is not relinquishing control to the private sector.
Government is assured of 70% or 490 PhilHealth-Charity beds for the poor. This is written explicitly in the contract, which the private sector must follow. This is to correct false reports that only 10% will be devoted to charity.
How the private sector will benefit
Private sector has 30% or 210 private beds. The private sector can earn money from the private cases, without putting the poor at a disadvantage.
Private sector does not need to spend much for marketing. This is because it will get the Philippine Orthopedic Center branding already.
Orthopedic cases are on the rise because of the aging population. Hence, high technology surgeries, implants and treatments will now be offered to all Filipinos. Each of us can potentially benefit from having a modern orthopedic center.
Efficiency can give rise to profits. By performing operations quickly and safely, the new POC can serve an estimated four times more patients.
How the government and poor will benefit
New building and facilities built at no cost to the government and the peopleâs taxes.
New building and facilities built quickly in 2 years. Otherwise, Filipinos will have to wait 15-20 years if and when a modern POC would be built. With the present budget, there is no way P5.6 billion can be spent on one hospital alone.
Poor patients will get quality care and medical costs will be shouldered by PhilHealth.
Poor patients will now be operated on faster because of hospital efficiency.Â At present, patients at the old POC stay an average of 22 days in the hospital. In a world class and efficient facility, the average hospital turnover will be reduced to 4 to 5 days only. Thus, four times more poor patients can be served in the new hospital.
Why are some groups opposing?
The main reason for the opposition to the new POC is the fear of losing jobs. The DOH has repeatedly assured the thousands of POC employees that no one will lose their jobs.
However, DOH Secretary Enrique Ona explains that the employees will have three options. One, they can continue working as government employees in the new Philippine Rehabilitation Center (where the old POC is located). Two, for those of a certain age, they can opt for early retirement. Third, they can apply for a position in the new POC.
It is foremost in the DOHâs goal that poor patients will be guaranteed medical services and will not be turned away.
Secretary Ona says, âWe have learned the lessons of PPP in other countries. We have studied this contract meticulously to ensure that the poor will not be disadvantaged. If we donât go into this PPP project, I see no way for the POC to be modernized in the next 15 to 20 years. Are we willing to wait for that time and let our patients continue to suffer?â
In 25 years, the PPP contract will expire and the modernized POC will be returned to the government. By that time, in the year 2039, the government will have the option to continue the contract, or to manage it as a fully government-run facility.
âI believe that in 25 years, thousands of Filipinos would already have benefitted from the new POC. I will not be around to witness it anymore. But I want to assure everybody that I have tried my best, with the resources we have, to improve the delivery of health services for our people,â says the DOH Secretary.
Inquirer.net, 19 February 2014
By Tetch Torres-Tupas
MANILA, Philippines â The Supreme Court ordered MalacaĂ±ang to answer the petition to stop the government from pushing through with the privatization of the Philippine Orthopedic Center (POC).
High Courtâs Information Chief Theodore Te said the high court gave MalacaĂ±ang and other respondents 10 days to comment.
Aside from President Benigno Aquino III, other respondents include Health Secretary Enrique Ona, Health Undersecretary Teodoro Herbosa, Public Private Partnership Center, Jan Irish Villegas, project manager, Modernization of the Philippine Orthopedic Center, National Economic Development Authority, NEDA-Investment Coordinating Committee and Consortium of Megawide Construction Corporation and World City Medical Center.
Petitioners led by indigent patients and health workers and other organizations said theÂ privatization violates the constitutionally guaranteed rights to health care and equitable access to health services.
The âModernization of the PhilippineÂ OrthopedicÂ Centerâ project is under the Public-Private Partnership scheme of the AquinoÂ administration â the first government hospital to be privatized. The project costing P5.6 billion was awarded to Megawide Construction Corp. and World Citi Consortium.
The petitioners said the Stateâs responsibility to provide and ensure a basic social service âshould not be relinquished to a private entity through privatization or commercialization of a government hospital to the prejudice of the poor and underprivileged.â
The POC is a DOH-retained hospital. It is the countryâs only hospital specializing inorthopedicÂ disorders including cases of spinal cord injuries. It is being privatized as part of President Aquinoâs Private Public Partnership (PPP) project of funding even social services.
Under the winning bid, the âmodernizedâ POC is allowed to allocate only 70 beds for service (indigent) patients and 420 for sponsored (PhilHealth) patients â compared to the current 562 beds or 85 percent capacity for indigent patients. The new management would have an option not to accommodate non-paying patients if the 70 beds are already occupied.
POC employees also face the possibility of losing their jobs. The contract makes the workforce private, such that those who wish to remain in government service have to transfer to another DOH hospital. Those who choose to stay at POC are not assured that they will be absorbed.
Petitioners included doctors and nurses from the Network Opposed to Privatization of Public Hospitals and Health Services (NOP), Council for Health and Development (CHD), Nars ng Bayan Community Health Nursesâ Association, Alliance of Health Workers (AHW), Health Alliance for Human Rights (HAHR), Peopleâs Health Movement, Community Medicine Â Practitioners and Advocates Association (COMPASS); Head Alliance for Democracy (HEAD), leaders of citizensâ groups Makabayan, Gabriela, Kalipunan ng Damayan ng Mahihirap (KADAMAY), Kilusang Mayo Uno (KMU), and congressmen from Bayan Muna and Kabataan partylist.
Philippine Daily Inquirer, 18 February 2014
NiĂ±a P. Calleja
MANILA, PhilippinesâThe bidding for the project to design and build a new government-run Dr. Fabella Memorial Hospital has been canceled for lack of a go-signal from the National Economic and Development Authority (Neda), health officials announced on Monday.
Health Undersecretary Teodoro Herbosa said Health Secretary Enrique Ona had ordered the bidding canceled after the Department of Health (DOH) was told that the approval of the Neda Investment Coordination Committee was needed for projects that cost upwards of P1 billion.
Herbosa said the budget allotted for the transfer and modernization of the state-run tertiary maternity hospital to its new site in Sta. Cruz, Manila, was pegged at P1.5 billion, which made it necessary for the agency to seek Neda approval.
In a memorandum circular dated Dec. 23, 2013, the Department of Budget and Management announced that the scope of the Investment Coordination Committee and the Neda Committee on Infrastructure will cover major capital projects costing P1 billion and above, instead of the P500 million project floor cost.
The winning bidder in the Fabella project, J. D. Legaspi Construction (JDLC), had submitted a bid of P742,888,888.88 to the DOH bids committee during the June 26 bidding. It later filed a case in the Makati Regional Trial Court to compel the DOH to honor the deal.
Herbosa said the DOH was back to doing a feasibility study on the project before it could submit a new proposal to the Neda.
âWe were able to get the nod of the Neda technical board. At the Cabinet committee level, there was a suggestion that we pattern the project after the governmentâs classroom projects. The facility will be built by the private sector then we will pay them over time in tranches,â he explained.
Once the Neda, which is headed by President Aquino, gives the green light to the project, the DOH will start a new bidding process for the Fabella hospital, the third time it is doing so.
Asked to comment on the 13-page JDLC petition, Herbosa said: âThey should compel Neda, not us.â
He added: âThe secretary or the head of the procuring agency has the right to cancel the bidding for any purpose he sees fit.â
The aging Fabella Hospital, sometimes described as a âbaby factoryâ for the sheer number of infants born there, is set to be transferred from the old Bilibid compound on Lope de Vega Street to the DOHâs San Lazaro compound on Rizal Avenue, Manila.
When the hospital is rebuilt under a public-private partnership (PPP) arrangement, it will no doubt provide modern delivery services to its mostly indigent patients, a prospect that would also jack up fees,Â according to some groups.
âExperience tells us that PPP projects are bound to make the cost of public services higher, further disenfranchising the poor,â said Joms Salvador, secretary general of Gabriela, the militant party-list womenâs group.
Fabella has always been the go-to maternity hospital for the poor. PhilHealth members do not have to pay a centavo, except in instances that exceed the agencyâs case rate allocation. The Philippine Charity Sweepstakes Office has an office there to help indigents. Social welfare assistance is also available.
Philippine Daily Inquirer, 15 February 2014
By NiĂ±a P. Calleja
MANILA, PhilippinesâAll 72 Department of Health (DOH)-run hospitals in the country are candidates for the public-private partnership (PPP) program of the government, ostensibly aimed at reforming the countryâs health system.
Health Secretary Enrique Ona said this on Friday as opposition grows to the privatization of the public health sector, which critics say is being done under the guise of PPP projects.
âAll of our DOH hospitals are candidates for PPP. But we have a lot of options how to do this. For example, we can subject to PPP major equipment, such as CT (computed tomography) scans and MRI (magnetic resonance imaging), and even our oncology centers,â Ona told a media forum.
He stressed that the health departmentâs recourse to PPP, a flagship program of the Aquino administration, was a broad strategy to modernize the countryâs public hospitals.
There are 72 DOH-run hospitals and more than 700 district and provincial hospitals across the country.
Ona defended the governmentâs move to privatize the tertiary 700-bed Philippine Orthopedic Center (POC) and award the build-operate-and-transfer (BOT) project to Megawide Construction Corp. and World Citi Inc.
âWe want to modernize the Philippine Orthopedic Center. How much will it cost us? Probably at least P3 (billion) to 5 billion to have a modern hospital,â he said.
Ona said he foresaw the new POC under the PPP to be the most modern orthopedic hospital not only in the country but in the entire Southeast Asia.
âWe have already studied this based on the experience of others. We have looked into all the gaps and difficulties,â Ona said.
In describing the modernization of the POC through PPP, the health chief said the country would have a modern hospital essentially without the difficulty for the government to spend for it or borrow money for it.
âIf we are going to do this through mere government funds, we would need to borrow money,â Ona said.
Various groups, including the National Orthopedic Hospital Workersâ Union-Alliance of Health Workers, Network Opposed to the Privatization of Public Hospitals and Health Services, Kilusang Mayo Uno and Bayan Muna Rep. Neri Colmenares, have gone to the Supreme Court to stop the POCâs privatization.
Under the BOT arrangement between the DOH and the private companies making up the consortium that was awarded the PPP project, the consortium will design, build, finance, operate and maintain the facility until the end of the 25-year concession period, and then return the hospital to the DOH.