Ona: Take health care out of politicians’ hands

MANILA, Philippines – More than two decades after the delivery of health services was devolved to local government units (LGUs), one thing has not changed: local politics is getting in the way of attending to the actual needs of poor families.

To address this, Health Secretary Enrique Ona is proposing that the Local Government Code be amended to revert to the Department of Health (DOH) the direct supervision of provincial health officers and municipal health officers, away from governors and mayors.

Ona told Rappler in an interview on Tuesday, January, 14, that the DOH is preparing a bill for sponsorship by like-minded lawmakers. The DOH will absorb an initial estimated cost of P1.2 billion to P1.4 billion in salaries of the local health officers.

Since 1992, the DOH had been limited to information dissemination on health campaigns and collating information from the LGUs for setting policy guidelines. The nitty-gritty of service – that is, health reporting and health care – has been the responsibility of the local government units (LGUs).

“The role of the national government through the Department of Health (DOH) is to make sure that this information is right away collated and necessary advice is given to the local government, as well as even assistance, if needed,” Ona said.

But uneven levels of information and capacity hound LGUs.

“You see, the devolution of health is such that the responsibility of public health and even hospital care in a particular province is under the responsibility of the governor, and in a particular town, it is the responsibility of the mayor,” Ona explained.

For him, this is where it gets very political. Unlike DOH, Ona said, some local executives – whether governor or mayor – may not put health as their priority. 

“It commonly is a very political issue because the provincial health officer gets his salary from the governor, and can be changed by the governor every time there is a new governor for that matter. There is no so-called permanency in their job, and that kind of makes things difficult,” he said.

These are observations he had even before becoming health secretary, although he admitted devolution does have its good points. “It puts the local officials direct responsibility and ownership to the result of the health care and health system – there should be that kind of balance.”

Four-point legacy

This year, DOH will enjoy its largest budget increase in history – from P53 billion in 2013 to approximately P84 billion in 2014, or a 58% increase – thanks to the sin tax law.

The signing of the controversial law is, for Ona, the most significant reform in the national health care system of the country. (READ: A year of sin tax: More work ahead)

The increased budget will be alloted for the health insurance coverage of more than 50 million Filipinos as subsidized by the national government.  

But with only two years left in office, the health secretary said there are 4 more areas where he would like to leave his mark:

1. Financial risk protection – to achieve more than 90% coverage for health insurance by the end of 2014
2. Improvement of health facilities
3. Achieving targets for Millennium Development Goals (like maternal mortality)
4. Improvement of IT system 

“I’m very certain that within this year, [or] the next couple of years, we’ll see major changes in the health system of the country,” he said. 

Watch Rappler’s interview with DOH Secretary Enrique Ona here:

– Jee Geronimo/Rappler