Over 10,000 health workers could lose jobs due to DOH budget cut – Recto

This concern comes as the Department of Health gears up for the implementation of the Universal Health Care law in 2020

MANILA, Philippines – Over 10,000 health personnel under the Human Resource for Health Deployment Program (HRHDP) could lose their jobs because of the P9.39-billion cut in the budget of the Department of Health (DOH), according to Senator Ralph Recto.

Recto said apart from 7,107 nurses, 202 dentists and 597 medical technologists could also become jobless by in 2020. “This is equivalent to 4 in 10 [health workers], a plague-like 40 percent casualty rate.”

This concern comes as the DOH gears up for the implementation of the Universal Health Care (UHC) law in 2020. (READ: EXPLAINER: What Filipinos can expect from the Universal Health Care law

Recto said that to be able to retain 26,389 health workers in 2020, the HRHDP should be granted a P16-billion budget allocation, which would need adding P6.55 billion to the program’s P9.45 billion indicative budget.

The DOH’s proposed budget for 2020 is P160.15 billion, lower than 2019’s P169.45 billion.

The agency’s HRHDP, the program that strengthens the primary health workforce across the country, will get P2.45 billion under the proposed 2020 budget – a massive cut from the P8.5-billion it received in 2019.

This budget is to be augmented by the Department of Budget and Management’s (DBM) Miscellaneous Personnel Benefits Fund (MPBF). In 2019, P3.8 billion was drawn from said fund. In the proposed 2020 budget, P7 billion will come from the MPBF, which could raise the total HRHDP fund to P9.45 billion.

The release of the additional fund from DBM, however, is “subject to conditions and not automatic,” Recto emphasized.

“The P2.45 billion under the DOH budget will only cover the continued employment of 3,854 nurses, out of the 17,293 deployed this year,” Recto said. “Add the 6,322 nurses to be funded by MPBF and the potential total comes up to 10,186 hired and rehired in 2020, he added.

Recto said increasing the DOH budget is necessary to prevent the country from becoming an “an archipelago of dismissed nurses.”

“We have to do this because the health professional deployment and dispersal program is one of the lynchpins of UHC. Thus, the UHC should be launched with a great leap forward in the number of doctors, nurses, dentists, midwives, medical technologists and other health workers to unserved and underserved, poor and far-flung areas,” the senator said.

The landmark UHC measure was signed into law in February. The DOH signed its implementing rules and regulations (IRR) Thursday, October 10.

Asked about the potential job losses due to the budget cut, Health Secretary Francisco Duque III said nothing is final yet about the budget, and that talks with the DBM are still ongoing.

Quezon province 4th disctrict Representative Angelina Tan, the UHC bill’s principle sponsor in the lower house, said lawmakers are “helping the DOH to regain the cuts in the budget.” Tan also said they are still looking at the proposed budget closely to find allocations that could be channeled to the implementation of the UHC law. Senator Risa Hontiveros, who lobbied for the bill in the Senate, said as much about efforts in the upper house. Duque had said some P257 billion was needed for the first year of UHC’s implementation. But because the amount is beyond their proposed budget for 2020, the DOH said there would be a gradual or “progressive realization” of the rollout of the landmark law.

The law, which mandated the enhancement of primary healthcare, would be implemented in 33 integration sites in 2020.

The health department said, that together with local government units, it could learn from the experience of the first batch of provinces and cities. The goal under the new law is to optimize service delivery, health regulation, health care financing, governance and performance accountability, and health systems development. – Rappler.com

FNU Congress

Nurses from Filipino Nurses United (FNU) and nurses from different public and private hospitals ask for 30,000 salary increase, safe nurse to patient ratio, and quality patient care during a press conference at Ermita Manila on 8 October 2019.  Photo by: Lito Borras/Rappler

Stirring win for nurses; nation’s teachers next

EDITORIAL – MANILA BULLETIN
Published October 23, 2019, 12:05 AM
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The country’s nurses in government hospitals won a stirring victory when the Supreme Court ruled last October 8 that they are entitled to a minimum monthly salary of P30,000 under Republic Act 9173, the Philippine Nursing Act signed by President Gloria M. Arroyo in 2002. But Congress will have to enact the funds needed to implement the law.

Government nurses are among the many government workers who have long been asking for salary adjustments. The national organization of nurses, the Filipino Nurses United (FNU), said they are among the most overworked government workers, each nurse attending to 40 patients in some hospitals, when the ideal ratio is 1:12. The current take-home pay of government nurses is P18,000 to P21,000 a month. It is even lower in private hospitals – P8,000 to P12,000.

This is one reason so many Filipino nurses seek employment abroad. In comparison, the average monthly salary of a nurse in the United States is equivalent to P200,000.

All these years, nurses have not been given the pay provided by RA 9173 because Congress in 2009 approved Joint Resolution No. 4 authorizing the president to modify the compensation and position classification system of government employees. President Arroyo then issued Executive Order 811 setting salary grades for all government workers and that for government nurses was set at Grade 11—P20,754 a month.

Last week, the Supreme Court, acting on a petition filed by the Ang Nars partylist, ruled that a Congress joint resolution and a presidential executive order cannot overturn a law.

In the wake of the court decision, Anak Kalusugan partylist Rep. Michael Defensor called on Congres to now pass a joint resolution putting into effect the increased nurses’ pay. He pointed out that this was how the nation’s soldiers and policemen were able to have their salaries doubled in 2017 by Congress prodded by the newly elected President Duterte.

In response to claims that the government has not been able raise government salaries for lack of funds, FNU President Eleanor Nolasco said that what the government lacks is not funding but political will. When the President wanted money for police salaries, there were funds for it, she pointed out. “They have the money if they want to, but they have a thousand reasons if they don’t want to.”

Now that the Supreme Court has ruled on government nurses’ salaries, it would not look good if President Duterte, who went all-out for military and police pay increases, would continue to leave the problem to Congress. He would open himself to claims that he lacks political will for nurses after what he did for the uniformed services.

Then there is the problem of teachers – a much bigger problem because they are many more than policemen or nurses. The teachers may not have a Supreme Court decision behind them but, perhaps more than any other group in the government service, they deserve much better pay than they are receiving now.

Nurses long deserved wage increase

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Published by : INQUIRER.net
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Congress may pass a supplemental budget to fund the P30,531 minimum monthly salary of government nurses as affirmed by the Supreme Court (SC), House Deputy Minority Leader and Bayan Muna Rep. Carlos Zarate said Thursday.

Filipino Nurses United has been campaigning for wage increase for all nurses.
FNU challenges the legislators to fund the unimplemented Nursing law of 2002 which has deprived the government nurses of long deserved wage increase for 17 years.

Group seeks P30,000 basic pay for nurses By: Jovic Yee – Reporter / @jovicyeeINQ

Philippine Daily Inquirer / 04:57 AM October 09, 2019
PAY HIKE DEMAND Members of the Filipino Nurses United call for a P30,000 entry-level salary for nurses on Tuesday, the start of the organization’s two-day congress in Manila. —EDWIN BACASMAS
MANILA, Philippines — For two years, “Bea” worked as a nurse at one of the country’s most efficient and reliable private hospitals in Metro Manila.
But unlike the top-notch care that patients would receive from the hospital, Bea was left to make do with a meager salary despite working long hours.
When she decided to resign last year, Bea’s basic monthly pay was only about P18,000. It was well below the monthly budget of at least P42,000 that, according to the National Economic and Development Authority, a family of five needed to live above the poverty line in 2018.

This is why the Filipino Nurses United (FNU), a national organization of nurses in government and private hospitals, is calling for a minimum salary of P30,000 for nurses to help ensure that enough of them stay in the hospitals.
“Right now, they wouldn’t bite even if there’s a call for them to stay. Because at the same time, you have [government-to-government programs] to Germany and Japan which offer nurses higher pay,” said FNU national president Eleanor Nolasco.
Data from the Department of Health (DOH) showed that in 2018, the government had under its employ only 13,152 nurses.

Gov’t hospital pay
The current take-home pay of nurses in public hospitals is between P18,000 and P21,000, said Nolasco, citing the findings of her group’s study.
It is even lower in private hospitals, especially in the provinces, at between P8,000 and P12,000.
This is despite the fact that Republic Act No. 9173, or the Philippine Nursing Act of 2002, provides that government nurses receive the minimum Salary Grade 15 (SG15), Nolasco lamented.
Depending on the class of a city or municipality, SG15 ranges from P19,845 to P30,531.
Nolasco admitted that the P30,000 starting salary FNU was seeking was not enough to keep a nurse in the country, especially when she can earn an average monthly salary equivalent to P160,000 in Canada and up to P200,000 in the United States.

‘Reasonable’ demand
“It’s really not enough. But we think that ours is a reasonable appeal. We are not asking beyond what is reasonable,” she said.
On paper, Bea’s shift was supposed to last eight hours, but in reality it could extend up to 12 hours.
While she was given overtime pay, it still was not enough to cover for all the stress she had to go through.
“The nurse-to-patient ratio was fine, but the demands from us nurses were just too much that it was no longer justifiable,” said Bea, who now works as an aesthetic nurse.
“It came to a point that the work was no longer satisfying. I lost my passion there,” she added.
Bea’s experience is not unique. FNU noted that some 200,000 nurses have opted to work in other health-related facilities offering services such as cosmetic procedures.

‘Unsafe’ ratio
Because nurses are discouraged to work in hospitals because of the low salaries, the nurse-to-patient ratio is now “unsafe,” especially in government hospitals, which could be as high as 1:40, according to Nolasco.
She pointed out that given that workload, a nurse could not deliver to patients the quality health care expected of her.
Ideally, the DOH standard is a nurse-to-patient ratio of 1:12.
Nolasco noted that the disparity was even larger in a community, where it was expected that a nurse would ideally have to take care of the needs of 20,000 people.
In Barangay Culiat in Quezon City, for instance, only one nurse is assigned to the community of 101,500 residents.

Polio, measles outbreak
Nolasco said that if only the government had enough nurses on the field, the current outbreaks of measles and polio could have been prevented, especially that this was being linked to low immunization.
“Health education and promotion are part of a nurse’s work. These [outbreaks are a] reflection of the poor public health system. The lack in human and material resources,” she said.
On Tuesday, FNU called on lawmakers to look into the renationalization of health services, especially because the current devolved system in which local governments run their health facilities has led to the “politicization of health.”
“As we see it now, there’s an imbalance. The state must take the bulk of the responsibility especially that health is a basic social service,” Nolasco said.