Are LGUs to blame for deadly diseases?
Published : Tuesday, January 28, 2014 00:00 in Journal Online (www.journal.com.ph)
As cases of measles rose to epidemic proportions early this month, some people blamed solely the Department of Health for failure to stop the alarming spread of the highly-contagious disease.
Yet little did they know that they were barking up the wrong tree. Contrary to common knowledge that DoH was still primarily responsible for disease prevention, it is local government units that are now supposed to be in the forefront of public health care.
This is due to devolution of the delivery of health services from DoH to LGUs as mandated by the Local Government Code whereby LGUs took over the responsibility, since 1992, of providing public health programs and services, including operation and maintenance of provincial and municipal hospitals, rural health units, and barangay health centers.
Since then, DoH functions have been limited to setting policy guidelines, providing technical assistance on health to LGUs, and mounting public information campaigns on health issues, but retaining control over specialized and tertiary hospitals while exercising regulatory and supervisory functions over LGUs and private healthcare providers.
With decentralization of health services in effect for more than two decades now, people would think our public healthcare system is running smoothly, especially with various reintegration schemes to make devolution work, like creating Inter-Local Health Zones for more coordination and collaboration.
But all still doesn’t seem well. A published report about two weeks ago said Health Sec. Enrique Ona intends to ask Congress to amend the Local Government Code to revert to DoH the direct supervision of provincial and municipal health officers.
Why? Because of local politics. “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 make things difficult,” Ona explained.
He also lamented that some local executives may not even prioritize health services. And Ona’s assertions find support in a research paper authored by Dr. Kenneth Hartigan-Go of the Center for Development Management of the Asian Institute of Management, Marian Theresia Valera, and Mary Kris Visperas.
The paper titled A Framework to Promote Good Governance in Healthcare and released in July, 2013 gives an “overview of the corruption and ethical dilemmas in the Philippine healthcare system” and shows how devolution has become a tool for politics.
“Instances exist where purchase requests for medical supplies have been put on hold if the municipal health officer was not on good terms with the mayor... Cases have also been documented where the hiring and training of health personnel are not based on required skill or need but on nepotism and political considerations,” the paper said.
Yet amid the downside of devolution, its supporters believe the decentralization of devolved services has helped people identify what kind and how much healthcare services they want to get and what programs are attuned to community needs. Devolution has brought about more community participation.
Local executives need to pursue creative and innovative ways for them to be successful economic managers and be able to generate and utilize funds prudently to meet obligations. With devolution, the revenue-raising power of LGUs to find their own funds was expanded to empower them with greater local fiscal autonomy instead of merely relying on their internal revenue allotment to maintain devolved hospitals and the quality of health services.
It’s crucial for LGUs to rise to the various challenges in the delivery of devolved health services, or else millions of poor and underprivileged Filipinos would suffer greatly from the inefficiency of local government executives.
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