DOH, heal thyself
For a country that produces some 80,000 nursing graduates every year on top of its over 10,000 registered nurses, it seems the height of irony that our hospitals and health facilities have remained perennially understaffed.
That’s because the Philippines has deployed at least 25,000 nursing professionals abroad in the last three years as of 2023. In 2019 alone, 18,644 Filipino nurses left for work overseas, according to data compiled by the Philippine Overseas Employment Administration. It’s a record number that underpaid Filipino nurses are desperate to join, as they flock to recruitment missions regularly organized by high-income countries. This, despite the thousands of vacancies for nurses, particularly in rural areas and private hospitals.
The situation has gotten so bad that the Department of Health (DOH) recently appealed for our nurses to stay and help keep the country’s health system afloat. “We need you. We need people who are ready to serve … Many communities still lack access to basic health services because there simply aren’t enough health workers,” Health Secretary Teodoro Herbosa said during a recent job fair as part of the agency’s 127th year celebration.
Earning an average of P23,000 to P30,000 a month, Filipino nurses are among the lowest-paid government workers in the country, with nurses in private hospitals getting even more dismal rates despite working up to 16-hour shifts.
Workforce deficiency
While the DOH has set the standard nurse-to-patient ratio at 1:12, most government hospitals make do with one nurse for every 20 patients to cope with staff shortage.
To fix its own workforce deficiency, rich countries lure Filipino nurses with highly competitive salaries and benefits, attractive settlement packages, and expedited immigration and accreditation processes. A recent recruitment mission from Manitoba, Canada, for instance, offered a monthly pay equivalent to P200,000, or 10 times what most nurses earn locally. A family reunification program sweetened the deal.
Notwithstanding the government’s appeal, a peer-reviewed paper titled “Health workforce issues and recommended practices in the implementation of Universal Health Coverage in the Philippines” by researchers at the Ateneo de Manila University found that many nursing graduates feel “lost and unsupported” as they join the workforce.
The study explained that “the country’s medical and nursing education system is too focused on hospital-based care” which leaves health professionals unequipped to work within communities, government systems, and other health programs.
Overworked nurses
The researchers also noted that many health facilities suffer from restrictive hiring rules and budget ceilings that hinder filling up vacant posts. Local government units must allocate no more than 45 percent of their annual budget to salaries of health professionals, which then “forces overworked nurses to take on multiple roles, often without additional pay,” the Ateneo research noted. Training for health workers remains a problem as well, with claims that they are forced to pay training fees and accreditation on their own, added the research.
The Ateneo study concluded that pursuing a career in health care remains worthwhile, but only if “key reforms are made, including scholarships with return service agreements; better integration of community health in school curricula; less restrictive hiring policies; and stronger support for newly deployed health workers.”
On top of a decent salary upgrade for health workers, these are solid recommendations that the DOH should pursue if it were to seriously woo Filipino nurses to stay. As it is, despite its heartfelt appeal, the agency has lost the trust of many health professionals for its inefficient, even indifferent, handling of the Health Emergency Allowance (HEA) due them for risking their life during the pandemic.
Rigorous housecleaning
Under Republic Act No. 11712, health-care workers are entitled to an allowance of from P3,000 to P9,000 every month. Though the DOH maintains that the allowance had been released, recent rallies by nurses and health workers’ groups indicate incomplete disbursement and conflicting statements on the availability of funds from the Health Department and the Department of Budget and Management. By October of last year, the DOH said, it would have distributed the last tranche worth P29.9 billion.
The agency’s credibility wasn’t helped any by recent information that P20-billion of the controversial P89.9 billion PhilHealth fund transferred to the national treasury went to the government’s HEA budget for health workers.
Such revelation should compel the DOH to embark on a rigorous housecleaning, for its own health and that of stakeholders in the health sector. Because until government seriously considers the welfare of nurses and their families and pursues needed reforms to regain their trust, the DOH appeal will continue to ring hollow, sounding very much like the death rattle of a terminally ill patient.
