THE Cebu City Council has asked the Department of Health (DOH) and the Private Hospitals Association of the Philippines to investigate the alleged refusal of Perpetual Succor Hospital to admit and treat the aunt of Councilor Mary Ann de los Santos, which the councilor blamed for her death.

Milagros de los Santos, 91, was taken to Perpetual Succor on September 23 and refused admission because the hospital “had no staff” to attend to her at the time. An Emergency Rescue Unit Foundation (Eruf) ambulance took her back to her home in Barangay Lahug, then, as she was still having difficulty of breathing, ferried her to another hospital in Mandaue City, where she was declared dead on arrival.

Councilor de los Santos, in a privileged speech before the City Council last September 28, asked why Perpetual Succor, “a level 3 hospital, cannot provide emergency service and the community is not informed about it.”

She asked that the hospital be sanctioned criminally, civilly and administratively, the works, for the alleged omission. On criminal liability, she cited Republic Act (RA) No. 8344 of 1997.

DE LOS SANTOS’S COMPLAINT covers Perpetual Succor’s not having enough health workers to respond to the emergency. It’s not known if it has met the staffing requirements of a level-3 hospital and whether at the time, there were other emergency cases that occupied all its available personnel. The inquiry should find out the hospital’s capacity when the incident happened.

Councilor de los Santos said it was the duty of the hospital to inform the public about its deficiency and offer an alternative facility or measure. Whether that is required by regulations, its “mission and vision,” or by plain courtesy is not clear. In some instances during the Covid-19 pandemic, no such announcements were made: news media stories and images of vehicles lining up at hospital roadsides, waiting for room, served as announcement.

How the persons taking de los Santos’s aunt were refused is another matter. Two news accounts, quoting the councilor, said they were “outrightly dismissed.”

WHAT LAW COVERS. Assuming the hospital could validly refuse admission for lack of capacity -- bed space, equipment or health workers -- was it required to administer “necessary emergency treatment and support” so as to “stabilize the patient”?

The said provision is in RA 8344, which Councilor de los Santos cited, to support her call for criminal and other sanctions on the hospital. That 1997 law, along with Pambansa Bilang 702 of 1984, was amended by RA No. 10932 of 2016 and the provision is repeated in the latter law whose purpose was mainly to increase the penalties for violation.

But does it provide for the emergency treatment many of us assume is required by law?

Under existing laws (unless they were further amended without being publicized), the punishable acts include:

(1) Refusal of the hospital or medical clinic to admit or treat patients in emergency or serious cases because of failure to pay a deposit; mere requesting, soliciting, demanding or accepting payment as prerequisite for giving basic emergency care is punishable.

In the case of de los Santos's aunt, the family was ready to pay, a deposit was not asked by Perpetual Succor, and the reason for its refusal was something else, namely lack of personnel.

(2) “Necessary emergency treatment “ shall be administered to the patient before he shall be transferred to another medical facility. The law says “transfer,” covering a situation where the patient is admitted and later has to be moved to another hospital or clinic where he can get the required treatment.

De los Santos’s aunt apparently was not admitted, she was refused admission and reportedly didn’t even get off the ambulance. It is doubtful if her case was one of “transfer” that’s covered by the law. Criminal laws are generally interpreted strictly for the accused.

REMEDIES ASKED. Councilor de los Santos asked for measures to prevent a repetition of the incident.

Similar incidents had occurred before, though under a different setting, the Covid health emergency, but still for one similar reason: not enough health workers. On April 16, 2020, then president Rodrigo Duterte ordered DOH to investigate hospitals refusing to accept Covid patients. One of a few warnings he made, along with the DOH memorandum, saying “that all hospitals are not allowed to refuse patients who need medical assistance.” No hospital or clinic is known to have been

sanctioned following the orders.

MORE SPECIFIC LAW. With the Covid emergency “dissipated,” could a hospital or medical clinic still validly refuse a patient? Does lack of staff justify refusal? The inquiry might clarify that.

And a more specific law from Congress can help. The law must be specific as to the instances the hospital or clinic can validly refuse, and when it can refuse and does refuse, whether it is still required to give emergency treatment to the rejected patient.