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OFFLINE: PHL healthcare system needs massive overhaul

It’s not exactly big news to learn that the Philippine healthcare system is in the middle of a major manpower crisis. It’s been talked about and reported multiple times in both print and broadcast media. I’ve written about it before.

But it was only very recently that I learned of how serious the problem has become. Actually, critical might be a better word.

I have friends and relatives who work in the healthcare industry, mostly doctors and nurses. I also know a few owners or stockholders of hospitals, big and small.

During the height of the pandemic, a friend – a male nurse – related to me and my partner how he had to give up as he was too burned out to continue. More than the burnout is the low pay he was getting from a private hospital in Manila.

His gross pay, he told us, was less than P20,000. Then there were the usual deductions like withholding tax, SSS, and Pag-IBIG.

For all the hard work he was putting into his job, he was not entitled to overtime pay. During the pandemic, he and his fellow workers were promised additional pay, which they never got. More on this later.

Worst of all, he was witness to a few of his fellow nurses getting infected with COVID-19, and a couple even passed away in the hospital where he was employed.

He told us that he previously liked his job, liked the idea of helping care for the sick and the injured. But too many nights of forced overtime had gotten to him.

One day, he just upped and quit. He was not looking for another nursing job anywhere he told us. After a few weeks of rest, he said he had found an online gig which was so much easier as he could work from home. Best of all, he was earning double what he was getting as an overworked nurse. He learned that many nurses were also working at the call center, and all said there was no turning back.

A doctor-relative whom I ran into during a recent birthday party told me that the hospital where he worked – it’s one of the biggest in the city – was getting desperate for nurses. He even advised me to tell all my friends and relatives who had kids who were soon to enter college to take up nursing, as jobs were plentiful.

As for the pay, private and public hospitals have become so desperate that they were now considering raising the starting pay. But because they cannot possibly double the present salaries, they were thinking of providing non-cash benefits such as free meals, housing, and improved medical coverage to include their relatives.

All this is well and good, but the fact remains that most Filipino nurses would rather work abroad, where their pay is anywhere from five to 10 times what they can make in the country.

My late wife’s best friend became a nurse in the US, and can be considered rich by all accounts. She has two houses, three cars, and money in the bank. She, of course, got promoted in the California hospital where she spent all of three decades, before retiring not too long ago.

She may not be a millionaire by US standards, but is a multi-millionaire by Philippine standards. Her lifestyle told me that she was easily in the upper, upper middle class.

She best exemplifies what’s wrong with the Philippine healthcare system. Its workers are generally badly underpaid with little room for growth. Not just nurses, but technicians and nursing assistants, too. With few exceptions, even doctors do not make big money, especially those who work for the government hospitals and clinics.

A friend who married a Brit and goes to the UK regularly told me something that I heard of long ago, which I found hard to believe.

In merry, old England and the rest of the United Kingdom, healthcare is fully subsidized by the government. Anyone who gets sick or injured and needs hospitalization need never worry, for anything.

That’s right, folks.  The UK healthcare system is one of the best in the world because healthcare is treated as a basic human right.

In comparison, the Philippine healthcare system is nothing more than a big business for the private sector, and a source of corruption in the private sector.

Look at all the big hospitals. Guess who owns them.

The taipans, of course. All the country’s billionaire businessmen found out long ago that hospitals were goldmines.

In recent year, the big players have been gobbling up the small and medium sized hospitals in the provinces, making them part of their healthcare empire.

It can also be said that the taipans all own private schools as education is also a big business. But that’s a topic best discussed for another day.

For now, the new Health secretary has taken cognizance of the crisis the country’s healthcare system is facing.

To partially resolve the manpower crisis, Health Secretary Ted Herbosa is considering hiring nursing graduates who have not yet passed the licensure AKA board exams to serve as regular nurses in government hospitals.

They will get the same pay and benefits, and he is even thinking of funding their review classes so they have better chances of passing the board.

He, however, has no solution to the ongoing exodus of nurses. There have been proposals in the past to block nurses from going abroad until they have served many years in local hospitals.

Such proposals have gone for naught, as preventing anyone from seeking greener pastures seems downright illegal, if not immoral.

The organization of private hospitals has also recognized the need to take drastic action to stem the tide. But so far, no one has come up with a solution that works for all concerned parties.

One suggestion is to shorten the four-year nursing course to three or even two, but this would mean that they would not have earned a valid bachelor’s degree, which is all important to kids’ parents then and now.

They would end up with an associate degree, but this is still – wrongly – looked down upon by parents and even students themselves, who do not see themselves as real nurses.

And sorry, folks, but I do not have an answer. It’s a problem that’s facing the Philippine healthcare system, but it may also be facing other countries.

For now, it’s Secretary Herbosa’s problem and we can only hope that he is up to the very difficult task.