Posts Tagged ‘PPP in Health’

PPP helps meet target to halt malaria spread

The Philippine Star, 10 April 2014


MANILA, Philippines – An overlooked area of potential for harnessing public-private partnerships (PPP) in the Philippines is healthcare. Proof of success and sustainability of PPPs in this sector is the current National Malaria Control Program (NMCP), a concerted effort of the Department of Health and local government units (LGUs), together with private enterprises, non-profit organizations and benefactors.

The NMCP has successfully reduced sickness and deaths due to malaria by 83 percent and 93 percent, respectively, as of end-2013 compared to 2005 figures.

These reductions were achieved ahead of the 2015 deadline set by the sixth UN Millennium Development Goal (MDG), which is to halt and reverse the spread of malaria by 50 percent.

From 46,342 confirmed cases recorded in 2005, malaria cases were down to only 7,720 in 2013. Over the past four years, five more provinces have been declared malaria-free: Camarines Sur, Batanes, Dinagat Islands, Romblon, and Batangas, bringing the total to 27.

There are 10 other provinces that have not registered any malaria case for three or more consecutive years, and are now primary candidates for attaining a malaria-free status.

While malaria continues to be a health burden in 53 provinces across the country, putting an estimated six million Filipinos at most risk for contracting the infection, especially children, indigenous peoples, and residents of far-flung areas, the strides that the NMCP has achieved are nothing less than remarkable and impactful. The program’s underlying PPP framework is considered pivotal to its enduring success.

The Movement Against Malaria (MAM) is the country’s current campaign toward malaria elimination. It showcases the viability of PPP in healthcare, and is supported by the grant for malaria of the Global Fund to Fight AIDS, TB, and Malaria.

Pilipinas Shell Foundation Inc. (PSFI) – the social development arm of the Shell companies in the Philippines (SciP) – is the principal recipient of the Global Fund grant, which manages MAM in partnership with the DOH, LGUs, community health workers, and volunteers.

The DOH provides technical expertise and overall direction to MAM, while LGUs have been tapped to provide additional resources for the program, including human resources, coordination, transportation, allowances for health workers, and other logistics.

Shell’s involvement in malaria control could be traced back in Palawan as far back as 1999. While the construction of the Malampaya gas-to-power project was underway, Shell Philippines Exploration B.V. (SPEX) and its joint venture partners, the Philippine National Oil Co.–Exploration Corp. and Chevron Malampaya Llc., simultaneously launched a grassroots campaign called Kilusan Ligtas Malaria (KLM).

KLM was the product of a broad stakeholder consultation led by the SPEX joint venture partners, PSFI, and the provincial government of Palawan. Local leaders and residents had identified malaria as a major burden in their community, causing almost 80,000 Palaweños to become sick, and hundreds to perish.

The success and effectiveness of KLM did not escape the attention of the Global Fund, which provided PSFI its first grant for a malaria control program covering five provinces (Palawan, Apayao, Quirino, Sulu, and Tawi-Tawi) from 2006 to 2009.

In 2010, PSFI received recognition for its outstanding management of the program, which also led to another grant by the Global Fund, expanding its coverage to 40 of the 53 malaria-endemic provinces in the country.

“Just as Shell has found its own unique role in the Philippines’ Malaria Control Program, I am certain other enterprises, big or small, have roles to play in malaria as well, not only in the Philippines but across the Asia-Pacific,” said SciP country chairman Edgar Chua to private sector players in support of malaria elimination during the Sixth Regional Meeting of the Asia-Pacific Malaria Elimination Network held recently in Makati City.

Shell has committed to MAM its expertise in community engagement, partnership building, financial management, and procurement and distribution of supplies and logistics, which include long-lasting insecticidal nets and malarial drugs. Religious use of the mosquito nets lined with insecticide remains to be the best way to prevent malaria.


Fear not the PPP for public hospitals

Malaya, 01 April 2014

By Ducky Paredes


IN the House of Representatives, two lawmakers filed a bill against the privatization of government hospitals to ensure that health care services are affordable and accessible to Filipino people.

Reps. Rufus Rodriguez (2nd District, Cagayan de Oro City) and Maximo Rodriguez Jr. (Partylist, Abante Mindanao) say House Bill 3994, to be known as Government Hospitals’ Privatization Act, prohibits the Secretary of the Department of Health to privatize, sell or offer for sale all government hospitals.

The lawmakers reacted to reports that the National Orthopedic Hospitals in Quezon City and other government hospitals were being offered for “privatization” under the Public-Private Partnership Scheme of the government.

“While it is true that the government is experiencing difficulty in infusing the much needed funds to continually upgrade and acquire sophisticated and advanced medical equipment, it is a reality that majority of the people rely on these government hospitals for their medical and health needs,” Rodriguez said.

Rodriguez said the corresponding increase in medical costs would ensue once the privatization of government hospitals is pursued and the increase in cost of hospitalization will be an additional burden to the poor.

Are the Congressmen Rodriguezes right? Is their HB necessary to stop this government from making health care so expensive to be beyond the ordinary citizen’s means?




According to Health Secretary Enrique Ona, in fact, all 72 Department of Health (DOH)-run hospitals in the country are candidates for the public-private partnership (PPP) program of the government.

“All 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,” Ona says.

He stressed that the health department’s recourse to PPP, a flagship program of the Aquino administration, was a broad strategy to modernize the country’s public hospitals.

There are 72 DOH-run hospitals and more than 700 district and provincial hospitals across the country.

The tertiary 700-bed Philippine Orthopedic Center (POC) will be renamed “Center for Bone and Joint Diseases, Trauma and Rehabilitation Medicine,” and the build-operate-and-transfer (BOT) project awarded to Megawide Construction Corp. and World Citi Inc.

“We 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,” 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.

“We have already studied this based on the experience of others. We have looked into all the gaps and difficulties,” Ona says.

In describing the modernization of the POC through PPP, Ona says the country would have a modern hospital essentially without the difficulty of spending or borrowing money for it.

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 for 25 years. At the end of the 25-year concession period, the hospital is returned to the DOH.

During the 25-year program, there will still be free services for the poor even as the modernized hospital makes its money from other patients as a return on their investment.

There is nothing to fear about the government’s plan. It will modernize our hospitals without forgetting its public services for everyone, including the destitute.




Here is an explanation from Atty. Sherry Ann N. Austria, the Director of Policy Formulation, Evaluation, and Monitoring Service (PFEMS) of the PPP Center:

“The private sector involvement in the delivery of public goods or services makes PPP indisputably and confusingly similar to privatization. Despite this similarity, both concepts differ in various ways.

“The vital distinction between PPP and privatization relates to ownership of an infrastructure asset or facility. When a publicly-owned asset or facility is privatized, the ownership is permanently transferred to the private sector together with the concomitant attributes thereof like operation and control. This asset or facility is viewed as better managed or owned by the private sector. However, regulatory control remains with the government. In PPP, ownership is retained by the government save in cases of Build-Own-and-Operate and Rehabilitate-Own-and-Operate contractual arrangements. In privatization, the ultimate objective is to shift the responsibilities to the private sector. This is not the case of PPP projects. Government retains ownership of the projects as well as defines the extent of private sector’s participation in a PPP project.

“The government remains accountable to its citizenry for the provision of a particular service in a PPP project. In privatization, accountability to provide service is oftentimes transferred to the private sector while the public sector gets paid for selling its assets. In the case of PPP, the private sector gets paid for delivering an asset or facility.

“Another difference between PPP and privatization is on how risks are being allocated to both the government and private sector. In PPP, risks are assumed by the party that is best able to manage and assume the consequences of the risk involved. The same does not apply in a privatized asset because the private sector assumes all risks associated with the project.

“The distinction between PPP and privatization is quite explicit: ownership. In the case of the Modernization of the Philippine Orthopedic Center (POC), this is clearly and distinctly a PPP project. What this means is that the POC is and will always remain as a government-owned hospital. It will however be built and operated by a private company who will bring in its vast expertise and resources to make POC a more reliable and efficient government hospital.

“By undertaking its modernization plans through PPP, the iconic Philippine Orthopedic Center will now have a new lease on life– reenergized by the private sector’s capital and competencies. Government undertakes PPP projects to make sure that our people will get the best possible service it deserves from its government at the least cost to the Filipinos. “

DOH: Poor patients to benefit from hospital modernization

Philippine Daily Inquirer, 24 February 2014

By Jocelyn R. Uy


MANILA, Philippines—The 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 hospital’s 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).

“This one is very clear-cut. Of the 700 beds, 70 percent or more than 400 shall be allocated for the [PhilHealth] sponsored programs,” 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.

“Under the program, it is ‘no balance billing’ 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,” Ona explained.

The P5.6-billion modernization program for the POC, the first government hospital to be privatized, is under the Aquino government’s 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 country’s only hospital specializing in orthopedic disorders, would not be privatized per se as the DOH would continue to oversee its management.


Public misconceptions on Orthopedic Center modernization

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 people’s 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. 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 DOH’s goal that poor patients will be guaranteed medical services and will not be turned away.

Secretary Ona says, “We 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 don’t 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?”

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.

“I 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,” says the DOH Secretary.


Palace asked to answer plea vs privatization of orthopedic center, 19 February 2014

By Tetch Torres-Tupas


MANILA, Philippines – The Supreme Court ordered Malacañang to answer the petition to stop the government from pushing through with the privatization of the Philippine Orthopedic Center (POC).

High Court’s Information Chief Theodore Te said the high court gave Malacañang 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 the privatization violates the constitutionally guaranteed rights to health care and equitable access to health services.

The “Modernization of the Philippine Orthopedic Center” project is under the Public-Private Partnership scheme of the Aquino administration – 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 State’s responsibility to provide and ensure a basic social service “should not be relinquished to a private entity through privatization or commercialization of a government hospital to the prejudice of the poor and underprivileged.”

The POC is a DOH-retained hospital. It is the country‘s only hospital specializing inorthopedic disorders including cases of spinal cord injuries. It is being privatized as part of President Aquino’s Private Public Partnership (PPP) project of funding even social services.

Under the winning bid, the “modernized” POC is allowed to allocate only 70 beds for service (indigent) patients and 420 for sponsored (PhilHealth) patients – 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 Nurses’ Association, Alliance of Health Workers (AHW), Health Alliance for Human Rights (HAHR), People’s Health Movement, Community Medicine  Practitioners and Advocates Association (COMPASS); Head Alliance for Democracy (HEAD), leaders of citizens’ groups Makabayan, Gabriela, Kalipunan ng Damayan ng Mahihirap (KADAMAY), Kilusang Mayo Uno (KMU), and congressmen from Bayan Muna and Kabataan partylist.


Bidding for Fabella hospital canceled

Philippine Daily Inquirer, 18 February 2014

Niña P. Calleja


MANILA, Philippines—The 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.

“We 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 government’s classroom projects. The facility will be built by the private sector then we will pay them over time in tranches,” 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: “They should compel Neda, not us.”

He added: “The secretary or the head of the procuring agency has the right to cancel the bidding for any purpose he sees fit.”

The aging Fabella Hospital, sometimes described as a “baby factory” 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 DOH’s 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,  according to some groups.

“Experience tells us that PPP projects are bound to make the cost of public services higher, further disenfranchising the poor,” said Joms Salvador, secretary general of Gabriela, the militant party-list women’s 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 agency’s case rate allocation. The Philippine Charity Sweepstakes Office has an office there to help indigents. Social welfare assistance is also available.


All 72 DOH-run hospitals candidate for PPP

Philippine Daily Inquirer, 15 February 2014

By Niña P. Calleja


MANILA, Philippines—All 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 country’s 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.

“All 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,” Ona told a media forum.

He stressed that the health department’s recourse to PPP, a flagship program of the Aquino administration, was a broad strategy to modernize the country’s public hospitals.

There are 72 DOH-run hospitals and more than 700 district and provincial hospitals across the country.

Ona defended the government’s 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.

“We 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,” 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.

“We have already studied this based on the experience of others. We have looked into all the gaps and difficulties,” 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.

“If we are going to do this through mere government funds, we would need to borrow money,” Ona said.

Various groups, including the National Orthopedic Hospital Workers’ 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 POC’s 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.


On Mending Broken Bones and the Modernization of the Philippine Orthopedic Center

PPP Center
Featured Article

PPP TALK January-March 2013 Issue (view e-copy)


A child writhers in agony while waiting for her turn to be treated at the jam-packed emergency room. She fell off a makeshift footbridge not far from her home and broke her leg. Amidst the chaos around, a doctor examines her while finishing up the chart of another patient with a head injury. An orderly wheels her out of the trauma room into the children’s orthopedic wing. She will need an open reduction and internal fixation (ORIF) surgery to repair a broken femur fracture.

The next time we see her, the surgeon has placed a rod into the center of her bone to support it until it heals. To stabilize the healing bone, a metal plate is placed next to it and is attached by screws to a frame outside her leg.

She is just one of the many patients that flock to the Philippine Orthopedic Center to heal their broken bones. The same story has been told within the hospital’s walls almost 50 years ago. The familiar tale is said all over again for our public hospitals.


Public Medical Care

In 2009, 60 percent of the licensed hospitals in the Philippines are privately-owned while only 40 percent is government-owned. Despite this proportion, the 2008 National Demographic and Health Survey (NDHS) tells us that 50 percent of the patients who sought medical attention consulted public health facilities, while the remaining half either went to private health facilities or relied on alternative or traditional health care. In addition, recent health statistics show that more than 50 percent of those who sought inpatient care were admitted at public hospitals.

Indeed, the demand for public hospitals in the country is high, especially since majority of Filipinos are from low to middle income households. Practically, we choose public hospitals over private ones, even if the latter will give you better medical attention, because public health services are accessible and more affordable.

In recent years however, budgetary constraints in the health sector have compromised many of our public hospitals leaving them in dire condition. The quality of healthcare service delivery in public hospitals has deteriorated due to lack of resources, particularly in  infrastructure, modern medical facilities and equipment, and medicines. Add to this the continuing decline in the number of healthcare professionals.

The state of our public hospitals somehow mirrors the country’s public health care system. And critical to uplifting and reforming the sector is the modernization and upgrade of public health facilities that service majority of our population, especially the poor.


Engaging Partners for Reform

The Aquino administration has committed to institute reforms in the public health sector. For starters, the Department of Health’s (DOH) budget was increased to Php56.8 billion, which is 24 percent or Php11 billion higher than its 2012 budget of Php45.8 billion. This will fund the maintenance cost of government hospitals including initiatives to attain our Millennium Development Goals on Universal Health Care or Kalusugang Pangkalahatan.

However, government alone cannot solve the problem of our public hospitals. To push its planned modernization projects, DOH has decided to tap private financing for upfront capital investment for the immediate repair, rehabilitation, and construction of selected priority health facilities.

Thus, public-private partnership (PPP) emerged as one of the government’s strategy to accelerate reform for high quality health care and bring forth efficiency and innovation.

First in DOH’s PPP pipeline is the Modernization of the Philippine Orthopedic Center (POC).


World-class Orthopedic Care

Undoubtedly, POC is one of the best hospitals for orthopedic care in the country. This iconic medical institution even houses some of the top medical experts in the field of orthopedic medicine.

But the POC, like many other public hospitals, suffer from a disease that plagues our public health system — poor facility and lack of modern equipment. Since its construction in1963, no major renovation and improvement have taken place because of insufficient funds. Some of the hospital’s facilities and equipment are decades old.

A visit to the POC’s Out-Patient Department (OPD) can be an extreme exercise in patience and ingenuity. A hospital nurse shared that they are already used to this kind of situation. On a regular basis they serve around 400-500 patients daily.

These dire conditions have caused inconvenience and discomfort to POC’s patients, prolonging their recovery.

With the increase in orthopedic and trauma cases in the country, government is prioritizing modernization and upgrading the POC.

In September 2012, the National Economic and Development Authority (NEDA) Board, headed by the President, approved DOH’s project to modernize the POC through a build-operate-and-transfer (BOT) arrangement under the PPP Program.

With the expertise and vast resources of the private sector, DOH will establish a state-of-the-art hospital facility that will be the country’s ‘Leading Tertiary Care Center for Bone and Joint Diseases, Trauma, and Rehabilitation Medicine’. It will be located within the National Kidney and Transplant Institute (NKTI) Compound along East Avenue in Quezon City.

The winning bidder will be responsible for constructing a new hospital facility, as well as that of installing all required medical equipment and technology, giving POC’s clients access to state-of-the-art facilities and world class medical care. The private partner will also provide orthopedic clinical services and allied services in operating and maintaining the super-specialty tertiary facility for a cooperation period of 25 years. Government will monitor the performance of its private sector partner to make sure that it operates the POC with the agreed Minimum Performance and Specifications Standards (MPSS) specified in the contract.

More than 400 beds out of the 700-bed capacity of the POC have been allocated for Philhealth members and most importantly for those patients who live below the poverty line. When modernized, the POC will be better equipped to serve the poorest of the poor.


No one loses job

With the private sector providing world-class amenities and services for the modernized POC, it is expected that changes in management and staff services will be instituted. This, however, does not mean that people, who have been with the POC for decades, providing committed and quality service, will be left without a job.

Health Secretary Enrique Ona was most emphatic when he assured POC’s health workers that not a single person working at the POC will lose his job. With the new POC management eventually taking over, POC heath workers have two options: continue working under the new management as a private health practitioner or remain with government and transfer into another government hospital who will readily welcome their services.

Nobody loses a job as a result of the modernization of the POC.


It’s not privatization

The POC will remain government-owned and will be responsible in making sure that its partner gets the job done as stipulated in the contract to be signed. This arrangement under the PPP is definitely not privatization.

Government remains the owner of the POC, not the private sector. This is the fact.

Instead, government uses PPP as a mechanism to complement all its efforts in expanding access to high quality health service that is at par with other privately-run, world-class medical facilities while ensuring its affordability to the public.

Modernizing the POC is a step towards mending the broken bones of our public healthcare system — one that has been crippled for the longest time.

Change, especially one as extensive and as massive as that of the modernization of the POC, brings with it a debilitating divisiveness that can paralyze government’s campaign for advancement. But beyond the differences and the opposition that break up the POC, the bottom line is that it is still a government hospital and its job is to serve the people. As public servants, it is time that the POC stand up as one to protect and preserve the health of its patients, especially for those who need their help the most.


Cancer center to rise in Iloilo City

Sun Star Iloilo, 17 January 2014

By Lydia C. Pendon


THE first cancer center for Western Visayas will be built at the Western Visayas Medical Center (WVMC) in Mandurriao district, in Iloilo City.

Hospital chief Dr. Jose Mari Fermin said the building costing P63 million is a Public Private Partnership (PPP) and is being evaluated by the National Economic Development Authority (Neda).

The equipment for the center will include a linear accelerator, citiscan, mammography, ultrasound, X-ray and chemotherapy facilities to be aided by private donors and corporations.

Fermin said the Department of Health (DOH) is set to establish cancer centers in different areas of the Philippines.

Bidding for the construction of the Iloilo center is set on February 2014. The said project will have a four-month construction period.

DOH Secretary Enrique Ona had promised the cancer centers to be established in different areas with the collaboration of the private sector.

He added that patients will have to use their PhilHealth membership to avail of the center services.

The PPP hospitals in the country include two in Manila: the Philippine Orthopedic Center and the Jose Fabella Memorial Hospital.

A total of 26 hospitals outside Metro Manila are set to be half-corporate with 70 percent owned by the government and 30 percent by the private sector and this will include the WVMC Cancer Center in Iloilo City.


Megawide finalizing loan deal for hospital PPP venture

Business World, 18 December 2013

By Cliff Harvey C. Venzon


LISTED BUILDER Megawide Construction Corp. is wrapping up a deal for a syndicated loan worth nearly P3 billion that will help bankroll the current administration’s first hospital public-private partnership (PPP) project, a senior company official said yesterday.

  “We are almost done with the financial closure. It’s a syndicated loan. We are raising around P2.9 billion for Philippine Orthopedic,” Chief Financial Officer Oliver Y. Tan told reporters over lunch in Makati City. “The rest would be internal [funding].”

The company has tapped Land Bank of the Philippines as the lead arranger for the syndicated loan from “two to three banks.” Mr. Tan declined to name the lenders.

Megawide’s consortium with World Citi, Inc. last Dec. 11 obtained a notice of award for a P5.7-billion contract to modernize the Philippine Orthopedic Center in Quezon City. The project involves construction of a new 700-bed hospital and a 25-year concession period during which World Citi will manage the hospital.

“We are in the design phase. In the last quarter of next year, we hope to start construction,” Mr. Tan said.

“It will take two years to complete the project, we are looking at the first quarter of 2017 for it to be up and running.”

Last week, Megawide, together with its Indian partner GMR Infrastructure Ltd., tendered the best bid for the P17.5-billion PPP project to expand and operate Mactan-Cebu International Airport, after offering P14.40-billion upfront payment to the government on top of shouldering the construction cost.

The Megawide-GMR bid is still being evaluated by the Transportation department, and a notice of award could be issued on Jan. 6 next year.

Mr. Tan said Megawide could tap existing bank lines if his company bags the project.

“Tapping the equities market has always been an option but we don’t want to be diluted anymore, so we might probably do a stock rights offering,” Mr. Tan said, referring to a share sale wherein existing shareholders could maintain ownership in the company.

“But we are ready without even going to the capital market. Obviously, you don’t go to a war without ammunition.”

The airport project could be the fourth PPP deal to be awarded to Megawide.

The company last October bagged two of the five contracts under the P8.8-billion PPP for School Infrastructure Project (PSIP) Phase II.

Its consortium with Citicore Holdings Investment, Inc. was one of two groups that last year won the P16.42-billion PSIP Phase I.

Megawide recorded a net profit of P983.24 million as of September, up 55.21% from P633.50 million in the same nine months last year. Contract revenues increased 28.70% to P7.22 billion from P5.61 billion, while contract cost rose 26.65% to P5.94 billion from P4.69 billion.

Megawide shares gained 46 centavos or 3.33% to close P14.28 apiece yesterday from P13.82 each last Tuesday.


11 December 2013


Hope springs for both patients and the medical team of the Philippine Orthopedic Center (POC) as the Department of Health finally issued the Notice of Award to the project’s winning consortium Megawide Construction Corporation and World Citi Medical Center who will modernize the POC. This was after the DOH’s Pre-qualifications Bids and Awards Committee for the Modernization of the POC (MPOC) issued Resolution No. 13 last November 28 recommending to Health Secretary Enrique Ona that the contract be awarded to Megawide-World Citi Consortium.

With the modernization of the POC underway, the DOH prepares to step up preparations for the actual implementation of the project. DOH estimates that with the increase in bed capacity from the current 300 beds to 700 beds, the modernized POC will require a total of 1,575 staff from its present 927 staff or a hefty 70% increase in employment.  Health Secretary Enrique Ona said that the projected increase in the number of staff needed is based on a 2.25 staff to bed ratio.

Out of the 700 beds, 70 will be allocated for charity cases and 420 for PHILHEALTH sponsored patients to jumpstart the country’s universal health care program.

Health Undersecretary and Bids and Awards Committee Chair Teodoro Herbosa reiterated that while the project was already awarded to the private sector who will design, build, finance and operate and maintain the facility, government still retains ownership of the POC.

“The POC will remain a government agency but now with access to extensive financial and technologically-advanced resources provided by the private sector. This is the advantage of structuring this project under a PPP arrangement. Government is partnering with Megawide-World Citi Consortium for 25 years which is the agreed concession period. During that time they will maintain and operate the POC.  This gives government more fiscal space to fund other health projects. The DOH will make sure that they will deliver the agreed superior medical services that we asked of them and bring these medical benefits down to the neediest patient,” Herbosa maintained.

With the contract already awarded, construction work on the new POC site at the National Kidney and Transplant Institute (NKTI) Compound in East Avenue is targeted to start on the second half of 2014.

The project is the first health project under the country’s Public-Private Partnership program.


PPP projects for health care still lacking in PHL

Business Mirror, 24 September 2013

By Cai Ordinario


THE Philippines has a huge potential to undertake health-related Public-Private Partnership (PPP) Projects  but the country has yet to embrace this potential having only one full-blown PPP in the health sector.

PPP Center Executive Director Cosette Canilao said that currently, the government only has one PPP project in the health sector which is the P5.7-billion Modernization of the Philippine Orthopedic project.

Canilao said the Department of Health (DOH) recently decided to undertake the P453-million Vaccine Self-Sufficiency Project through the regular procurement system rather than via PPP.

She said that while the DOH has expressed interest in proposing a PPP for digital cancer centers, this PPP may not be able to maximize the potential of a full-blown PPP project.

“The [DOH] said something about digital cancer centers but again they’re thinking of the structures. They will build the structure but it seems it will not be a pure PPP, its not a high-value PPP. It seems it will just be a public-private interaction. It’s not a real PPP [because it will be done through a] service agreement and I dont think you’re harnessing the real power of PPPs through that,” Canilao said.

In a presentation at the Health Care for All forum on Tuesday, Philippine Institute for Development Studies Consultant Josephine Anne Lucero said PPPs is a strategy that will help attain Universal Health Coverage in the country.

She said, however, that PPPs that were reviewed in her study were not long term and most were focused on specific health services. She added that while there were a lot of efforts to address health concerns through PPPs, these efforts were scattered.

“A health public-private partnership should be a long-term contract between the public sector and one or more private sectors, organized as a legal entity, with a common goal to provide a public health service, while sharing substantial financial and operational risk,” Lucero said in her presentation.

Lucero said what is ideal is for the government to undertake not only public-private interactions (PPIs), which is the classification of most PPPs in the country, but Public-Private Investment Partnerships (PPIPs) which are long term at least 10 years and deliver integrated services, among others.

To create PPIPs, Lucero noted that the government must develop an integrated and long-term health plan that contains detailed steps and identifies accountable institutions and agencies.

She added there is a need to “incentivize” local chief executives to participate in PPIP projects. One of the ways by which this can be done is to turn the participation in PPIPs into a competition of best practices among local government units (LGUs).

“The DOH should increase the capacity of all stakeholders-central office officials, LGUs, private sector, health-care workers and civilian groups. [There is also a need for] a more specialized capacity building program for PPPs in health should be fostered by the DOH PPP Center,” Lucero said, among other recommendations.


Sole bidder to bag PPP deal?

25 June 2013, Business World


The Megawide Construction Corp.-World Citi Inc. consortium could soon be declared the winner of a hospital public-private partnership (PPP) deal after its technical and financial proposals were yesterday deemed “compliant” by the Health department.

Health Undersecretary Teodoro J. Herbosa, bids committee chairman, said Megawide and World Citi’s offer for the modernization of the Philippine Orthopedic Center (MPOC) project would now be evaluated by the National Economic Development Authority-Investment Coordination Committee (NEDA-ICC).

A notice of award will be issued if the NEDA-ICC gives its approval, he added.

The consortium bid P5.672 billion for the project, which the government had said would cost P5.7 billion. Megawide and World Citi also asked for an annual subsidy of P600 million for five years, which Mr. Herbosa said would fund services for the poor.

He cited Republic Act (RA) 7718 or the amended build-operate-transfer law, which states that “direct negotiation shall be resorted to when there is only one complying bidder left”.

The Megawide-World Citi consortium was the sole bidder for the MPOC project, which involves the construction, operation and maintenance of a 700-bed facility that will be built inside the National Kidney Transplant Institute compound along East Ave. in Quezon City.

The POC is currently located at Maria Clara corner Banawe streets., also in Quezon City.

The Health department earlier said that nine firms were interested.

Bidding is being conducted under a “one stage, three envelope system” where qualification documents and technical and financial proposals are submitted the same time.

The Megawide-World Citi consortium earlier passed the qualification hurdle and Mr. Herbosa had said a ruling on the technical offer would follow. The financial proposal, meanwhile, was only opened yesterday.

Megawide has already bagged one PPP project, last year securing a contract for one of two phase one segments of the PPP School Infrastructure Project (PSIP). It has also qualified to bid for phase two of the PSIP.

Three PPP projects have so far been awarded:

• the P1.96-billion Daang Hari-South Luzon Expressway Link, bagged by Ayala Corp. in December 2011;

• the P16.42-billion PSIP Phase One granted last year to Citicore Holdings Investment, Inc.-Megawide and BF Corp.-Riverbanks Development Corp. consortiums; and

• the P15.86-billion Ninoy Aquino International Airport Expressway Phase II project awarded last month to San Miguel Corp. unit Optimal Infrastructure Development, Inc.


Eligibility check for orthopedic bid

09 June 2013, Business World


The Health Department is set to announce today if sole participant Megawide Construction Corp.-World Citi, Inc. consortium is eligible to bid for the Philippine Orthopedic Center (MPOC) modernization project, an official said yesterday.

“I’ll know tomorrow [Monday] p.m. [afternoon]. TWG (technical working group] reports to PBAC (Pre-qualification, Bids, and Awards Committee),” Health Undersecretary Teodoro J. Herbosa, MPOC PBAC chairman said by text message when asked if the qualification documents submitted by the Megawide-World Citi consortium is complete and accurate.

The consortium was the lone bidder that showed up last week to submit qualification documents, technical and financial proposals for the Public-Private Partnership (PPP) project.

With an estimated cost of ₱5.70 billion, the project involves the construction, operation and maintenance of a 700-bed facility that will be built inside the National Kidney Transplant Institute compound along East Ave. in Quezon City. The PoC is currently located at Maria Clara st. corner Banawe st., also in Quezon City.

Megawide has bagged one PPP project last year securing a contract for one of two Phase One segments of the PPP School Infrastructure Project (PSIP). It has also qualified to bid for phase two of the PSIP.

Mr. Herbosa last week said PBAC will issue a resolution declaring Megawide-World Citi as eligible to bid once the qualification documents are determined as complete.

The technical proposal will then be reviewed, to be followed by the financial offer. The Health department will then recommend approval of an award by National Economic Development Authority-Investment Coordination Committee if the financial offer “is below or within our ceiling,” Mr. Herbosa said last week.

He said the Health departments expects “20 days to do all of that.”

The bidding is being conducted under a “one stage, three envelope system” where a prospective investor submits its qualification documents and its technical and financial proposals at the same time.

The PPP program was launched in late 2010 by the Aquino administration as a means of addressing the country’s lack of critical infrastructure.

Three PPP projects have so far been awarded: the ₱1.96-billion Daang Hari-South Luzon Expressway Link, bagged by Ayala Corp. in December 2011; the ₱16.42-billion PSIP Phase One granted last year to the Citicore Holdings Investment, Inc., Megawide and BF Corp.-Riverbanks Development Corp. consortiums; and the ₱15.86-billion Ninoy Aquino International Airport Expressway Phase II project given earlier this month to San Miguel Corp. unit Optimal Infrastructure Development, Inc. — KMPT


Orthopedic Center PPP offered to investors

25 November 20012, Business World Online


Another public-private partnership (PPP) project has been rolled out by the government, with the Health department calling for bids to build and operate a new Philippine Orthopedic Center.

The P5.6 billion-project — approved by President Benigno S. C. Aquino III on Sept. 8 — involves a 25-year contract for the construction as well as operations and maintenance of a 700-bed hospital inside the National Kidney and Transplant Institute compound in Quezon City.

Bid documents for the project will be available for P250,000 starting today until Feb. 25 next year, the Health department said. A pre-bid conference will be held on Jan. 25, 2013 and qualified bidders have until March 26 to submit their offers.

Health Undersecretary Teodoro J. Herbosa, officer-in-charge of the department’s PPP projects, had said they were looking to award the contract by May next year.

Prospective bidders are expected to procure, install and manage “modern diagnostics and clinical equipment” as well as “teaching and training facilities for basic and advanced clinical care.” They also need to provide “appropriately qualified staff,” including medical, paramedical, nursing and support personnel.

The Orthopedic Center project joins two other PPP projects — the P60-billion Light Rail Transit-1 extension and the P15.86-billion NAIA Expressway 2 — that are now in the advanced stages of being bid out.

Two PPP projects been awarded since the government unveiled its flagship infrastructure program in 2010. The P1.96-billion Daang Hari-Southern Luzon Expressway link was given to Ayala Corp. last December. The second, a P16.42-billion project to build 9,300 classrooms in Luzon, was won in September by the BF Corp.-Riverbanks Development Corp. and Citicore Investments holdings, Inc.-Megawide Construction Corp., Inc. consortiums.