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NEWS (September 15– September 21, 2008) Keon presents health sector program in IN DOH limits upgrade of LC hospital By Leilanie G. Adriano Staff Reporters Breaking
his silence and dispelling
speculations regarding the controversial and politicized proposal of the
Laoag city government to upgrade the Laoag City General Hospital (LGGH) into
an at least 100-bed tertiary hospital, Gov. Michael M. Keon called for a
press conference and presented, with the use of PowerPoint, the overview of
the Health Sector Reform Development Program (HSRDP) in Ilocos Norte on
September 17 at the Capitol session hall. The health reform
agenda has been one of the top priorities of Keon’s administration in an
effort to address patients’ woes on the poor delivery of health care system
in the province, where many patients are sometimes confined along the aisles
and corridors of the government hospitals. In 2005, the HSRDP
was established by the DOH, and Ilocos Norte was one of the 16 provinces
selected for its implementation because the province has the capability to
meet all the criteria set by the DOH. Fundamental to the implementation of
these reforms is the formulation of a Rationalization Plan by the province.
Subsequently, the Rationalization Plan of the province, which includes Laoag
city being a component city of the province, was conceptualized through the
participation of all stakeholders for health in the government sector based
on the health needs identified in the health care delivery system in the
province. The HSRDP in the
province is based from two financing scheme programs – the Health Sector Development
Program (HSDP) and Health Sector Policy Support Program (HSPSP). The total
amount covered under the HSDP is about P108.56 million with funds coming from
ADB loan and grant, and PGIN equity; while the HSPSP has an estimated of
about P120 million with funds from the European Commission (EC) grant, DOH
counterpart to EC, DOH regular budget and variable amounts from Philhealth
(PHIC) and the concerned local government units. With these two
programs, at least three government hospitals in the province, which include
the Gov. Roque B. Ablan Sr. Memorial Hospital (provincial hospital) in From a 100-bedroom
capacity, the provincial hospital will be upgraded to 150-bed capacity while Further citing the
DOH’s policies and guidelines on the implementation of the province’s HSRDP,
Keon said that the proposed upgrade of the LCGH into a tertiary level health
care facility is actually limited to a 50-bed capacity with a budget estimate
of not more than P74 million. With his
presentation, Keon clarified that he is not against the development plan of
the city government of Laoag, particularly the upgrade of the city hospital
as alleged by his critics aired over local radio stations here. He stressed,
however, that any “development” must conform to the Rationalization Plan of
the provincial government so as not to create a “negative” impact, such as a
cut-throat competition, on the health sector program of the entire province.
He further emphasized that this is a DOH mandated program, and the PGIN’s
role is to implement this policy. The Laoag city
government is planning to put up a a P350-million medical center through a
possible loan agreement with a financial institution. The Laoag city
council majority had approved a resolution granting authority to Laoag City
Mayor Michael V. Fariñas “to look for and negotiate with any financial
institution for a loan to upgrade the However, the issue
on the proposed improvement of the Laoag City hospital drew several comments
from the public, including some provincial legislators of the province, when
the city council failed to submit the said resolution, which according to the
Sanggunian Panlalawigan (SP) “should be passed for review” by the board because
it pertains to an “investment plan” of the city government. During the press
briefing, which was attended by members of the Sangguniang Panlalawigan,
department heads of the provincial government and some Laoag city councilors,
both Vice Governor Windell Chua, and SP member and Laoag Councilor Vicentito
Lazo said that they believe that the resolution should be submitted to the SP
for review. Lazo said that in
the past when the city council approved to upgrade the city hospital worth P9
million the resolution of this was submitted to the superior SP for review.
He asserted that now with much higher amount of P350 million, the more it
should be submitted for review by the SP, especially if it would be a loan. On his part, Chua
said that to avoid all the confusion, he then suggested that the issue be
brought to the Department of Interior and Local Government which will resolve
it once and for all. Under the local
government code, ordinances or resolutions pertaining to local development
plans and public investment programs of local government units should be
formulated by the local development council and must be submitted for review
by the superior sanggunian, according to Elpidio Ratuita, provincial director
of the DILG, when asked for the DILG’s opinion regarding the issue. Ratuita
was also present during the governor’s presentation and press briefing. Keon said that the
Laoag city government was “unwilling” to turn-over the documents and show the
feasibility study of its proposed hospital project. In an earlier
interview with The Ilocos Times,
the city council’s secretary, Enrico Aurelio, reiterated that the
controversial resolution was “not a part of the local development plan or
investment program of the city government.” With this
development, Keon said that he was prompted to write a letter addressed
to the Department of Health Secretary, Francisco Duque III, and President
Gloria Macapagal-Arroyo, expressing his apprehensions on the upgrading of the
LCGH to a 250-bed tertiary hospital (worth P350 million). On Sept. 1, Mario C.
Villaverde, undersecretary of health of the Policy and Standards Development
Team for Service of the DOH responded to Keon’s letter dated August 12
stating that the proposed upgrading of the Laoag City hospital “is not consistent
with the proposed rationalization plan” of Ilocos Norte’s health care
delivery system. “The proposed
upgrading of the LCGH will definitely lead to inefficiency, maldistribution
of beds and inequity,” said Villaverde in his letter, “because the proposed
upgrading is not included in the approved provincial investment plan for
health.” “I don’t understand
why the city government is not aware of this,” Keon said referring to the
Rationalization Plan of the provincial government’s health care program where
the upgrading of hospitals in Ilocos Norte should “complement” and should not
intend to compete with each other. He is certain that a P350 million loan
that would be requested by the city government from a financial institution,
such as the Development Bank of the Philippines or Land Bank, will be turned
down because the bank will definitely refer to the DOH which allowed an
upgrade to only a 50-bed capacity worth P74 million. The governor
theorized that the city mayor could have been possibly “ill-advised” as to
the Rationalization Plan of the provincial government as he stressed that the
standard set in the plan is “binding” and not “recommendatory.” Provincial
health officer Dr. Walberg Samonte
confirmed this as he stated that bidding for the renovation and extension of
the provincial hospital is already being prepared by the provincial
engineer’s office Based on previous
minutes of the meeting of the city council, Laoag City councilor Francis
Manolito Dacuycuy has been quoted saying the Rationalization “Rat” plan of
the province was merely “recommendatory” in nature, relaying a statement made
by the regional health director of the DOH, Dr. Janairo, when the councilor,
also a doctor, met with him to discuss the proposed upgrade of the LCGH.
In a position paper
made by Dr. Samonte, he reiterated that the city government’s plan to upgrade
the LCGH’s level I to level II or 50-bed capacity is necessary as proposed in
the rationalization plan of the province. However, he said, “the proposed
upgrading of the Laoag hospital to level III does not conform the provincial
health development plan as reflected in the Rat plan and the province-wide
investment program for health.” With the improvement
of 18 hospitals, 8 public and 10 private hospitals in Ilocos Norte, Samonte
said that Ilocos Norte’s 1 bed per 976 population is substantially higher
than the standard 1 bed is to 1,000 population ratio as to the adequacy of
health facilities in a given population. The governor noted
that the establishment of a tertiary hospital in Laoag City does not also
conform to some specific criteria set under the amendments of DOH
administrative order 2006-0004-A which states “the proposed hospital shall be
at least one hour away by the usual means of transportation during most part
of the year from the nearest existing hospital.” The existing
provincial hospital is approximately 15 minutes away from the LCGH and about
30-minutes away from the Asked for his
reaction in an interview with ABS-CBN TV-Patrol Laoag just after the
governor’s presentation, Dacuycuy said that in contravention of the DOH’s
HSRDP in the province he would still push for the proposed P350 million (270
million for the structure and facilities, and 80 million for equipments)
upgrade of the LCGH. As the chief proponent of the proposed project, he
believes that the people of Laoag city and the whole of Ilocos Norte still
need a new well-equipped hospital with better services than the ones
existing. The
Ilocos Times tried to get the reaction
of Fariñas but the mayor was out of the city as of press time. Ilocos Times copyright 2008 |
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