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Health workers, patients bear the cost of orthopedic center privatization

Eddie, 61, waits for his wife at the covered walk of the Philippine Orthopedic Center. Photo by MARIA FEONA IMPERIAL
Eddie, 61, waits for his wife at the covered walk of the Philippine Orthopedic Center. Photo by MARIA FEONA IMPERIAL

Text, photos and video by MARIA FEONA IMPERIAL

EDDIE, 61, used to be family chauffeur in Manila. One day last month, he was held and beaten up by a group of young men on Recto Avenue. He lost his legs and has since could barely transport anyone, including himself.

Eddie no longer sits on the driver’s seat but on a hospital bed at the covered walk of the Philippine Orthopedic Center (POC). He said he prefers to stay there than hear the screaming or see the suffering of other patients inside the 70-year-old tertiary hospital.

Until his legs are replaced by surgical implants, he would have to attend regular check-ups at the outpatient department. Doctors have told him that he has to fully recover first before being admitted for his surgical operation.

Most of Eddie’s hospital expenses have so far been covered by PhilHealth and the Pantawid Pamilyang Pilipino Program, of which they are recipients, his wife, Sarah, said.

The benefits, she said, are limited to what public hospital facilities can provide.

Kung meron po sa ospital, libre lang sana ‘yun, (If there are available facilities in the hospital, it is free),” Sarah said. “Kaya lang wala (But there are none).”

The cost of the surgical operation for Eddie, including the surgical implants, is estimated at P98,000, an amount Sarah said the family can’t afford. The couple has six children, only two of whom are working, as sales staff in malls.

Eddie’s family is seeking financial help from the Philippine Charity Sweepstakes Office. But until all the paperwork is done, he would just have to wait on his hospital bed on the covered walk after his check-up.

Eddie belongs to the 90 percent of POC’s patients who are poor and have to endure what Sean Herbert Velchez, head of the hospital’s workers union, describes at “dilapidated infrastructure” and “backward technology” at the state-run hospital.

Patients and their relatives endure long queues in the out-patient department. Photo by MARIA FEONA IMPERIAL
Patients and their relatives endure long queues in the out-patient department. Photo by MARIA FEONA IMPERIAL

“The equipment we use today are still those from the postwar era, which were recycled from military tanks by Dr. Jose V. De los Santos Sr., the father of Philippine orthopedics,” he said.

Seeing the “worsening” condition of the hospital for musculoskeletal injuries and diseases, health workers like Velchez are not opposing the modernization of the POC.

But, they said, the POC should remain “publicly run and publicly funded” to ensure the continuing health services for the poor.

Privatization of the POC and other public healthcare services will endanger this, said Velchez who, along with leaders of hospital unions and progressive groups such as the national Alliance of Health Workers (AHW), continues to stage protest actions to denounce what he said is Aquino administration’s failure to deliver an efficient public health system.

Around 500 public and community health workers from Metro Manila marched along Commonwealth Avenue Monday in time for President Aquino’s sixth and final State of the Nation Address (SONA) to denounce the administration for its failure to deliver an efficient public health system.

Previously, the workers staged a protest in front of the POC on July 1. A week earlier, around 30 Quezon City doctors, nurses and hospital workers held a separate demonstration in front of the Philippine Heart Center.

The Department of Health is modernizing the POC through the help of Megawide Construction Corp. (Megawide) and the World Citi Consortium to which it leased the hospital property for P5.7 billion.

Under the government’s public-private partnership program, Megawide will lead the construction of a 700-bed capacity super-specialty tertiary orthopedic hospital to be located within the National Kidney Transplant Institute (NKTI) compound along East Avenue in Quezon City.

Megawide will design, build, finance, operate and maintain the POC until the end of the concession period, and then transfer the hospital to the DOH after 25 years.

News reports earlier quoted the DOH as saying that the POC will be modernized, not privatized.

According to a statement on the Public Private Partnership Center website, “the government remains the owner of the POC, not the private sector.”

Government only uses the “PPP as a mechanism to complement all its efforts in expanding access to high-quality health services that is at par with other privately-run, world class medical facilities while ensuring its affordability to the public,” the statement read.

Velchez said, however, it is not true that the government does not have enough funds to improve healthcare.

Patients of the POC watch as health workers stage protest. Photo by MARIA FEONA IMPERIAL
Patients of the POC watch as health workers stage protest. Photo by MARIA FEONA IMPERIAL

Even without the intervention of the private sector, the POC could have long been modernized had the government spent the taxes collected from sin tax, he said.

Under Republic Act 10351 or the Sin Tax Reform Act of 2012, increased taxes for tobacco and alcohol products would be earmarked for health programs.

Citing a study by the Philippine College of Physicians, Velchez said about P150 billion worth of sin tax have been unaccounted for.

With the privatization of the POC, “the entire process of healthcare delivery in the Philippines would become a business, disenfranchising especially the poor,” he said.

Eddie expressed his dismay upon seeing for the first time how the POC doctors, nurses and health workers protested at the POC façade.

Katulad ko, isang mahirap, wala akong savings, kung mapapapunta sa ibang tao ito, libo na babayaran ko rito (Like me, who is poor and has no savings, if the hospital would be transferred to private corporations, I will have to pay thousands),” he said.

Besides costlier treatment for patients, Velchez said health workers themselves bear the effects of privatization, including unfair labor standards.

Velchez said last year they received a memorandum from Health Undersecretary Teodoro Herbosa, giving them three options: first, resign from government and reapply to MegaWide as contractual workers; second, early retirement at the age of 40; third, be deployed to other areas with vacant positions for health workers.

“So, if the available job is in Mamasapano District Hospital, you may be transferred there,” he said. In addition, retirement at the age of 40 does not guarantee receiving benefits from the Government Service Insurance System early, he added.

A patient at the Philippine Orthopedic Center waits to be released. Photo by MARIA FEONA IMPERIAL
A patient at the Philippine Orthopedic Center waits to be released. Photo by MARIA FEONA IMPERIAL

Contractual health workers who were hired through job orders, such as emergency-hired nurses, are worse off, Velchez said.

They work like regular hospital workers but do not enjoy benefits such as hazard pay, incentives, and night differential pay, he said.

“Since they are contractual workers, the hospital is not accountable for them because there is no employee-employer relationship,” he said.

He added that since contractual workers are “political accommodations,” they do not join political activities and can be removed from their post anytime.

According to Velchez, the whole issue privatizing public healthcare services is a question of the government’s moral obligation.

“How does (government) regard the present state of the people’s health?” he asked.

(The author is a University of the Philippines student writing for VERA Files as part of her internship.)