Catanduanes Forum
CORPORATIZING the Eastern Bicol Medical Center
Public Hearing
A public hearing was conducted last monday, January 25, 2010, 1:30 in the afternoon, at the Provincial Capitol Dome.
Present during the public hearing were Vice Governor Alfred Aquino (Presiding Officer); PBM Ariel Molina (Committee on Enterprise) & PBM Edwin Tanael (Committee on Health) as the proponent of the measure; and the members of the Technical Working Group (TWG) headed by Engr. Luis Surtida (Provincial Administrator), Mrs. Maluo Vargas (Provincial Treasurers Office), Dr. Antonio Romano (provincial consultant on health), and the representatives coming from the different sectors in the province.
Proposed Conversion
An ordinance is pending at the Sangguniang Panlalawigan of Catanduanes for the conversion of the Eastern Bicol Medical Center (a.k.a. Provincial Health Office) into a "Provincial Economic Enterprise".
This is the response of the local government in the national government’s implementation of the devolution of some national government services, including the health sector reform, with the introduction of the RA 7160 known as the Local Government Code of 1991.
The aim of the government for the devolution was to decentralize the management and delivery of health services from the national health department to the Local Government Units (LGU’s).
As a result of the devolution, the quality and coverage of health services deteriorated particularly in the poor provinces.
According to the proposal, the purpose of the conversion is to establish a central point for the delivery of quality medical care – especially accessible to the poor by improving the financial status of public hospitals in order to achieve improved access to quality & equitable health services, and bring down the cost of health making it affordable to the poor.
Under the proposed measure, the Provincial Hospital will be converted into a non-stock and non-profit organization guided by a Board of Trustees as policy making body.
Fiscal Autonomy
Among the identified strategies to be adopted to attain the objectives were the implementation of a Universal PhilHealth Insurance Coverage (PHIC), out-sourcing of services & equipments, capability upgrading of the hospital, and revenue retention & utilization.
A separate budget and appropriation will be created for the EBMC allegedly to be prepared in accordance with the guidelines and policies on budget preparation, authorization and execution issued by proper authorities.
As a result salaries, wages, representation and transportation allowances of officials and employees of this economic enterprise shall not be included in the annual budget of the provincial government.
But aside from the revenue-enhancement program of the hospital, the major source(s) of funds shall come from grants/subsidy from the provincial local government units and other agencies/funding partners.
Withdrawals/disbursement of funds will be duly authorized by the Board with the concurrence of the chief of the hospital, the provincial treasurer, and the approval of the chairman of the Board of Trustees.
Board of Trustees
According to the proposed measure, the Board of Trustees will be composed of the following:
1. Chairman: Provincial Governor
2. Vice Chairman: Vice-Governor
3. Members:
a. Chief, Eastern Bicol Medical Center;
b. Chairman, Sangguniang Panlalawigan Committee on Budget and Appropriation;
c. Chairman, Sangguniang Panlalawigan Committee on Health;
d. Provincial Health Officer;
e. Regional Director of the Department of Health-CHD Region V;
f. President, Philippine Medical Society (PMA)-Catanduanes;
g. President, Federated Association of Barangay Health Workers (BHW);
h. President, Liga ng mga Barangay (ABC) of Catanduanes;
i. Congressman or his representative;
j. President, Federated Association of Senior Citizens; and
k. Representative from the academe.
The powers and functions of the Board of Trustees are the following
1. To formulate policy reforms, programs, and projects/ recommend new legislation to the Sangguniang Panlalawigan(SP) related to better health services delivery;
2. To promulgate its own rules and regulations in the conduct of their own business;
3. To perform the powers and functions enjoined upon by law, resolutions or ordinances, executive orders duly approved by the SP/Governor of the province for the overall management and control of the properties, business and activities of the EBMC; and
4. To formulate, approve and endorse to the proper authorities the total annual performance budget and appropriation of EBMC and execute, monitor and evaluate the same pursuant to existing budgeting, accounting and auditing rules & regulations.
Additional powers and functions of the Board were also identified as follows:
1. Source out funds for any of the purposes of EBMC, accept any fund, donation or gift from local and foreign donors, contribution, endorsement, grants, bequest, and materials of any kind necessary for the enterprise to hold and administer the same as directed by its donors/contributors;
2. Enter, make, perform and carry out or cancel and rescind contracts of every kind and for any lawful purpose with any person, firm, association, corporation, whether domestic or foreign;
3. Delegate to the chief of the EBMC/ other concerned provincial hospital officials such power and functions as it may deem proper, and which it may be entitled by law to delegate; and
4. Act as a Board and collegial body on any related matters for the enterprise.
The Local Government Code
Under the Local Government Code of 1991, local government units (LGU’s) shall endeavour to be self-reliant and shall continue excercising the powers and discharging the duties and functions currently vested upon them.
They shall discharge the functions and responsibilities of national government agencies and offices, such as the Department of Health, devolved to them pursuant to the code.
Local Health Boards are created in every LGU’s to serve the purpose pursuant to the code.
The compositions of the Provincial Local Health Board pursuant to the code are as follows:
1. Chairman: Provincial Governor;
2. Vice Chairman: the Provincial Health Officer;
3. Members:
a. Chairman, Sangguniang Panlalawigan Committee on Health;
b. Representative from the private sector, Philippine Medical Society (PMA)-Catanduanes; and
c. Representative of the Department of Health (DOH) in the province.
Among the key functions of the Provincial Local Health Board are the following:
1. To propose to the sanggunian concerned (SP), in accordance with the standards and criteria set by the DOH, annual budgetary allocations for the operation and maintenance of health facilities & services within the province;
2. To serve as an advisory committee to the sanggunian concerned (SP) on health matters such as, but not limited to, the necessity for, and application of, local appropriation for public health purposes; and
3. Consistent with the technical and administrative standards of the DOH, create committees which shall advice local health agencies on matters such as, but not limited to, personnel selection & promotion, bids & awards, grievances & complaints, personnel discipline, budget review, operations review and similar functions.
Observations
Aside from the lone concurrence of a former member of the Sangguniang Panlalawigan, most of the reactions raised by those present at the public hearing were left pendent.
The question raised by the doctors/ medical practitioners of EBMC (representing the rank & files of the EBMC) and from the personnel coming from the PhilHealth (providing for the health insurance coverage specially for the poor & underprivileged patients) only shows that there was no prior consultations to this sectors which will be the main players for the success of this project.
The creation of the Board of Trustees under the proposed measure will result in duplication of functions as a result of the existence of the Local Health Board under the Local Government Code.
The proposed measure will not guarantee a better health services since it will be subject to the mercy of the politicians save for the inclusion of members most of them if not all are politicians/appointed by politicians.
The creation of the Board of Trustees will neither guarantee an improved delivery of health services since the composition of the Board are always subject to changes according to change in administration as a result of an election.
Statistics reveal that seven (7) out of ten (10) Filipinos die without even seeing a doctor. Nearly 75 percent of Filipinos live below the poverty line, most of them from the rural areas. These are the people who have no access to the most basic services including health care and medical treatment.
At present, the province hosts a couple of private hospitals which caters to the needs of demanding patients, not to mention the private medical clinics all over the island.
The middle & upper class chose to seek medical services either in mainland bicol or in metro manila because they have the money to spend.
What the province need is an honest to goodness, efficient, and consistent medical facility that will cater especially to the majority of the people in the island who mostly belongs to the poor and underprivileged.
My opinion
To arrest the problem of the worsening health services devolved in the local government units, they must compel the local health boards to function and do their job as mandated by the law. Catanduanes must have a fully-functional Provincial Health Board composed of individuals knowledgeable on how hospitals are managed and operated.
To improve the condition of these health facilities, legislations must be passed, through the local sanggunians, to create a separate Trust Fund exclusively for the purpose and encourage the creation of the necessary support programs for the improvement of these health services and facilities.
funeraria business
sisay tabi an gusto mag business partner sakuya? matindog tabi kita ning funeraria business sa kataning kang EBMCorporation ta sigurado akong kadakol na sana kang magakatiligbak dyan ta dae na makapa bullhong ang mga pasyente.
Tama ang sabi kang SPY ko, "for formality sake" lang itong public hearing.
Ta bago pa nag pa hearing, talagang dagos na ang plano na pag privatize kang EBMC. Kaherak man kita. Mapahilot na sana ako kang kurog ning tulak ko.
approved
before noon this wednesday, february 3, 2010, the ordinance converting the IPHO/EBMC into an economic enterprise was approved by the sangguniang panlalawigan of catanduanes...
the money is there i think for a very nice hospital!
but where is the money?i see it!!but not in cash but in form of hunderds of useless streetlights on the pier and on mainstreet, in form of useless big canals in moowalk,in form of concret roads, in form of concret willcome structures and and and...,the first priority must be the hospital and free medicare in my view.the first priority is to care for human life.
there is no other priority in front of that!!!!
its very simple for everybody to understand!!
my suggestion is also it must be a hospital that treat poor and rich tao equal and money and servis must be not a question for everybody,i call that democratie,on 4 all and all 4 one!regards loooping8
Privatization of EBMC (Catanduanes IPHO)
The idea might be good but the circumstances are questionable. Enot na napansin ko ang so called "Technical Working Group". What's surprising is that it doesn't include somebody from EBMC. So I called an "employee" of EBMC and asked about this issue. Guess what? Maski palan sinda dai lamang pigkonsulta kang mga nag isip ka ini. Pina apod lang daa sinda asin pig inform manungod ka ini kang aga mismo bago ang public hearing. Ang nag isip buda nag plano daa kang gabos puro sana mga taga Capitol. Ha???? Anong klaseng Tech Working Group ini na dai lamang naghapot hapot sa mga concerns kang mga mas naka isi kang mga problema ning mga pasyente buda empleyado kang EBMC? Bakong pag ika ma laog sa salong halong, common sense will dictate, na mapa aram ka lamang sa kag halong? Unless of course kalain kang plano mo sa paglaog sa halong or unless dai kang common sense? Maski daa lamang salong kalag ning doctor, nurse, midwife, orderly or utility pati security guard sa EBMC dai lamang pig consulta kang mga taga Capitol. Well of course Mr Antonio Romano is an MD. Pero dai man sya nakaisi kang mga problema ning mga frontliners sa EBMC ta dai man siya ga duty sa EBMC. Ngonyan pa sana ngani maski daa gapas or pang bandage pigasakit pa mag disponer ang kadaklan sa mga pasyente. How much more pag private na?
I was told that more than 70% of EBMCs patients are indigents. Well, kaya ngani siguro pig bale sa plano ang pag enrol daa sa Universal Philhealth kang gabos na mga pamilya dyan sa Catanduanes. Magayon na plano. Pero mas magayon kung ini ang enoton na gibohon kesa ang plano pag privatize na kang EBMC sa March. Enoton nyo ngona na ayuson ang Philhealth kang mga tawo. Enoton nyo ngona na ayuson ang mga gamit buda servicio kang EBMC pati na ang sweldo kang mga empleyado.
But if these "bright minds" in the Capitol are really in a hurry, sige, INOTON NYO NA I-PRIVATIZE ANG CAPITOL!!!
Sampol
nalingawan ko tabi so prenesentar na rates duman sa public hearing. huni tabi:
(Particulars / Cost of Operation / Present Rates / Suggested New Rates)
Room & Board:
Suite Room / 1,487.84 / 1,200.00 / 1,500.00
Aircon / ...................... / 600.00 / 900.00
Electric Fan
Single........... / 743.92 / 400.00 / 600.00
Twin Sharing / .......... / 200.00 / 550.00 per bed
Pakisabot na lang po ta dai ako batid magpost nin table... salamat
Agoy pagkakinurog!!!!
Agoy!!! pagkakinorug arimantak ko sa paghuna-huna na ang EBMC guiguibohon enterprise kan satong mga honorableng o dishonorableng government opisyales...Gulpi na ang atong mga diyos....Gov...kahilaki lamang aki ko ta nabungi sa aksedente may tuho paran kalsada...Vice gov.. kahilaki lamang agom ko ta nakunan ta gulpi karagkadag kan awto grabe paano lubak sa among tinampo...Cong...kahilaki lamang akong mga bata ta malnourish na sa sobrang gutom...kaipuhan na suwero at di ko mabakalan nin bitamina ta sobra barato bandara...Kapitan tabanga lamang ako maoperahan lugad ko na lobo na sa pigsa...napako paano sa pag hingayad ko sa nakaaging bagyo...Grabe magiging mga diyos nin mga ga tius at segurado tabang ang mga diyos basta boto ka sa abot na eleksyon...Huna ng mga diyos na ito sa kila ang pera na gastos ng ospital kaya baad gulpi pa ang kilang ibulsa...agoy lalo ga huto-huto sa kurog arimantak ko...Pero kung totoo ang purpose sa planong ito...gulpi ang makikinabang sa ospital na ang kalidad ay parang St. Luke o Makati Medical Center...
CORPORATIZING the East Bicol Medical Center
I showed this to my husband who thought the new proposals looked very much like the Primary Care Trusts (PCTs) set up under the British National Health Service. An explanation about PCTs can be found in Wikipedia here:
http://en.wikipedia.org/wiki/NHS_primary_care_trust
In UK they are responsible for spending 80% of the nation's healthcare budget. Their value comes in knowing the local areas in which they operate. They can therefore direct funding in the most efficient way. For example it is not worth spending money on lots of premature baby incubators if the majority of your population is elderly. If the PCT operates in a mining area then they will have different challenges than one sited in an area of agriculture.
PCTs can therefore be a more efficient way of delivering healthcare in a community. This all depends upon the quality of management. We would question the need for a committee to be top heavy with politicians and would expect to see a good representation of local doctors, nurses, pharmacists and dentists.
We would welcome affordable healthcare extended to the poorer members of the region. This should be the primary concern. Free care at point of service would be the best one could hope for.
On a different note:
I would like to see an end to the practice of medical staff recommending funeral services to relatives (especially whilst the patient is still alive). Undoubtedly they must be doing so for some consideration from the company concerned.
Doctors should prescribe generic drugs instead of the branded versions of drugs for which they receive commission from drugs company.
These and other shady practices must be identified and firmly stamped out.
INDUSTRIA LA MUERTA FUNERARIA
The proposed business model for the EBMC operational set up is too complicated to understand much more to manage. Kadakor pa nin babahugon na members of the Bored of Mistrusted na kadakran bata nin mga politicos. Syento por syento lalong magkakawendang wendang servicio nin EBMC.
The proposed EBMC business set up will surely benefit only one business sector - FUNERARIA. Is Gov. Boboy diversifying into funeral service business?
mistrusted
Ang dangog ko daw kung asa gobyerno ka dae ka pwd magkapot ning pangduwang position dae kaya magbalga sinda sa provision kang constitution????
Anu kaya ang magiging premyo sa bagiging miembro ning mistrusted “pa-snack” o padulas o sahod ???? Baging masmadakuhlh ang give away kesa ibabakahlh ning oxygen kang gahingalong tapatok ang angug… Pero maski pa-snack dagdag gastos man giraray.
Baging daing trabaho talaga sa capitol ta mahlha si gov., si vice, si pbm CBA chair buda si pbm CH chair pigahanapan pa ning sideline. Isabay pa si ABC pres. Buda si cong anung ribok kaan. Baad maging senado lang ang ebmc pagnagkataon.hehehe
Agugoy!
ano man ini?...gapas nganing pigasakit pa magbakar....
suggestion: expand nyo na lang ang morgue.
Tibaad...
dai ka magsugot tay' ta segun sa bareta kan mga sihungan binaryo na ngani daa an Emergency Room pasiring sa bagong lokasyon kaini sa kanto nin ospital, katampad nin canteen asin harani talaga sa morgue. sabi ngani kan mga gaagrangay na naghehelang... "baging parigsuk" ngaya...
Emergency rm
Aw parigsok man talagang!... sisay man ang nagkuritkugit asin apruba nin planong an ta napunta na duman harani sa canteen ang ER? Dapat ngani kung iriwat duman sya isa-lugar bago sa idang-aran (R-side before the main entrance) tanganing accessible man para sa mga: naputlan nin kinabuhay, nabagsakan nin bubong,tini-ak na angog, mag-aki-on, hinayblad sa kaka brawn-awt,etc... ta iyo yan an pinaka importanteng kwarto nin hosp.
Kung maribong pa so driver baad maideretso pa lugod yan sa morgue este sa canteen...
enterprising ebmc
If the purpose of this is to improve quality of care to patients this is okay, but will the price of services be affordable to our people?
Oky din sana if politians will nt medle with the operations and administration of the hospital...let those who have hospital management experience handle the operation of the hospital, also mas maganda kung before mag enterprise na yan, maimprove muna ang facilities para if you will charge a patient with something hindi naman lugi ang magbabayad...
as for the er issue taypongard, check mo ung American Institute if archeticts Guidleines fr design and constrcution of healthcare facilities...nandon ang design requirements ng ER...hope it will help..if you cant find it send me email address sed kit pdf copy peor ung 1997 version lang
ER issue
dai ta na siguro kaipuhan ang "American Institute of architects Guidelines fr design and constrcution of healthcare facilities" ta
bako man tabing so design requirements nin er ang piga agrangay ko, kundi so er location...
...ta kami po na mga ordinaryong tawo ang pakasabot mi pag piga buag sa hospital "ipaburong", kaya ngani ang mga lokasyon nin er pigasalugar duman: sa nga-nga-an, sa madaring mariparo, sa bakong baradong daran, sa pinakamadaring la-ugan.
...saro pa sa piga agrangay ko kung ngata ta pigahapot ko kung sisay so nagkurit-kugit & apruba nin plano?... ta kung nag refer sya sa "American Institute of architects Guidelines fr design and constrcution of healthcare facilities" dai ito dapat ibugtak harani sa kaunan (canteen), ta dapat saro sa i-kunsiderar nin maga disenyo iyo ang direksyon nin hangin"(windward/Leeward)... kung dai ako nasara: ang maga laog na hangin sa canteen hari sa atubangan na direksyon. Kung ang atubangan nin canteen iyo ang er, gustong sabihon mahahangop nin gakaon sa canteen kung ano ang hangop nin er.
...panduwa sa piga-agrangay ko sa bagong location nin er iyo an "psychological impact" sa pasyente... ta mas lalong mangluluya ang pasyente kung ibuag sa er na mahihiling pa ang (haraning) morgue.[sign of the cross(+)]susmarsep! baad iyo pa an ika-utsan .