Sigue: Who is in charge?

Disruptive mode

THE Covid-19 pandemic has become a real-time, wide-screen litmus test for public health systems of countries around the world, as well for local government units (LGUs) in the Philippines. Why would LGUs be directly accountable for health services? It is because the power to design, finance and operate health service functions and programs have been fully devolved to the LGUs since 1991.

The World Health Organization (WHO) has repeatedly prescribed the presence of a strong public health system as a major success factor in the fight against the pandemic. It has also candidly pointed out how developed countries will always have an advantage in this aspect considering how advanced and well-funded their systems are as compared to developing countries, which has traditionally failed to prioritize health in their national agenda.

It is important for every Filipino to know who is in charge of their health services. This column gives way to contents of the Philippines Health System Review 2018 by the Asia Pacific Observatory on Health Systems and Policies and the European Union.

In the Philippines, health as a basic human right is enshrined in Article II, Section 15 of the 1987 Constitution which states, “the State shall protect and promote the right to health of the people and instill health consciousness among them.”

The Department of Health (DOH) is the national authority on health and has the responsibility to ensure the highest achievable standards of health care, from which LGUs, NGOs, the private sector and other stakeholders anchor their health programs and strategies.

The DOH provides national policy direction and strategic plans, regulatory services, standards and guidelines for health, and highly specialized and specific tertiary-level hospital services. It provides leadership, technical assistance, capacity-building, linkages and coordination with other national government agencies, local government units (LGUs) and private entities in the implementation of national legislation on health.

In the advent of Local Government Code of 1991, the health system of the Philippines was decentralized and health services was devolved to the local government units. LGUs have full autonomy to finance and operate the local health systems.

As mandated by law, provincial governments are tasked with providing primary and secondary hospital care, while city and municipal governments are tasked with providing primary health care, promotive and preventive health programs and basic ambulatory clinical care.

The role of the DOH in this setup is to lay down national policies and plans, develop technical standards, enforce health regulations, and monitor, evaluate and deliver tertiary and specialized hospital services.

With the devolution of health services, the direct provision and management of health services such as public health programs, promotive and preventive health care, and primary and secondary general hospital services were transferred to LGUs.

Under this set-up, the provincial government, headed by the governor, manages the provincial health system (comprising the provincial health office and the provincial and district hospitals). The municipal government, headed by the mayor, manages the municipal health system composed of rural health units and barangay health clinics.

The city government, specifically in highly urbanized and independent cities, manages city hospitals, medical centers, health centers and barangay health stations

In every province, city or municipality, there is a local health board chaired by the local chief executive. Its function is to serve as an advisory body to the local chief executive and the local legislative council (Sanggunian) on health-related matters.

It is very clear under these premises, that the one in charge of health services in Bacolod is the mayor while the one in charge of health policies is the Sanggunian Panlungsod. Under health services, every Bacolodnon should bear in mind the components - health services such as public health programs, promotive and preventive health care, and primary and secondary general hospital services. Every citizen has the right to seek accountability and performance of duty as mandated by law.


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