Republic of the Philippines
HOUSE OF REPRESENTATIVE:
Quezon City

SIXTEENTH CONGRESS
Second Regular Session

HOUSE BILL No.6 5.14

Introduced by Felix William B. Fuentebella

EXPLANATORY NOTE
‘The Philippine Constitution provides that;

) The State shall protect and promote the right to health of the people and instill health
consciousness among them;

b) The State shall adopt an integrated and comprehensive approach to health development
which shall endeavor to make essential goods, health and other social services available to all
the people at affordable cost; and,

c) The State shall undertake health manpower development that will be responsive to the
health needs of the population,

It is indeed the highest priority of every nation to secure the health and safety of its citizens.
In fact, the United Nation’s 3rd Sustainable Development Goal (SDG) is to “ensure healthy
lives and promote well-being for all at all ages.” Under this goal, the UN has targeted the
substantial increases in health financing and in the recruitment, development, training and
retention of the health workforce in developing countries, especially in least developed
countries and small island developing States.

The international community, through the World Health Organization (WHO) and the
International Labour Organization (ILO) sees the Philippines as a major source of health
professionals that can respond to the health needs of the global population. Currently the
number one supplier of health workers in Southeast Asia, the Philippines plays a significant
role for the international community to attain its health-related sustainable development goals
(SDGs).

The Staff’ Regent of the University of the Philippines (UP)in 2012, Jossel Ebesate pointed out
that sinee 2008, the country has seen an increase in the number of unemployed o:
misemployed nurses. He cited that while government hospitals need a 300 percent increase in
the number of murses to meet at least the 1:12 murse-to-patient ratio, the lack of a


comprehensive health human resource plan aggravates what can be considered as a recurring,
“cyclic oversupply of nurses for a certain period and the depletion of the supply of health
professionals due to out-migration.”

A study made by Fely M. Lorenzo, Kriselle Icamina of the Institute of Health Policy and
Development Studies of the National Institutes of Health (UP-Manila), and Dr. Jaime Galvez
Tan and Lara Javier of the UP College of Medicine pointed out that because of the scarcity of
jobs and the poor working conditions prevailing in facilities where they are employed,
Philippine nurses are forced to find employment overseas. The report also cited that “more
than 9,000 doctors have already left as nurses from 2002-2005, while around 80 percent of
public health physicians have taken up or are enrolled in nursing.”

The following statistics are very disturbin;

Philippine Overseas Employment Administration figures reveal that an average of
16,238 nurses, 9,413 caregivers/caretakers, 1,297 veterinarians/dental and other

medical technicians, 1,199 physiotherapists/occupational therapi
ray technicians, and 221 medical doctors have been deployed over

s, 510 medical x-
seas from 2010-

2014:
Deployment of Health Workers, New Hires: 2010-2014
Category 2010 | 2011 | 2012 | 2013 | 2014 | AVERAGE
1 |Nurses Professional 32,082| 17,236 | 15,655 | 16,404 | 19,815| 16,238,
Veterinarians, Dental Technicians and
2Jother kinds of Medical Technicians 1,280] 1,314 1310] 1377 | 1,204] 1,297
Physiotherapists and Occupational
3) Therapists 896] 1,262] 1,204] 1,624] 1,010| 1,199
4|Technicians Medical X-Ray 475] 544 4s7| 535] so7| 510
[Dental Assistants 38a] 457 375| 308 | 208 | 346
6|Nursing Personnel 349] 186 306] _279| aaa | __246
7|Midwives Professional 266] 162 169 123 ga| 163
Dietitians and Public Health :
8] Nutritionists 185) 89 ag] 107 g3|__8
9|Doctors Medical 176| __ 292 | 2so| _165| 221] 221
10|Pharmaceutical Assistants 126] __18 tos| __96| 196 | __129
12} Dentists toa] 126 a27| 118 2] 11a
12] Optometrists and Opticians 9a 95 85 70 46 78
13] Pharmacists ga] ana 95 86 89 95
14| Midwifery Personnel ay] 18 9 2 4 2
15| Medical Assistants 13 96 ao] a2 83 55
16) acteriologists_and Pharmacologists 10] 2 6 8 10 9
17 | Caregivers and Caretakers 929310101 | 9,128 | 6,466| 42,075 | 913
TOTAL 25,847 [32,222 [29,072 [ 27,820 [ 35,858 | 30,240

‘Source of bot: Philippine Overseas Employment Adrinistration

Since 2003, about “50 percent of nurses employed in specialty hospitals in the
Philippine Heart Center, the National Kidney and Transplant Institute, the Lung
Center of the Philippines and the Philippine Children’s Medical Center went abroad.”
(Ebesate, 2012)


‘© Based on the government’s pay scale, most government physicians are paid about
24,141 ($516.562 USD) to a high of P34,605 ($740.455 USD), which merely
satisfies the monthly cost of living of a family of six, and does not allow for spending
even for health and well-being needs.

Seven (7) out of ten (10) Filipinos die without being seen by health personnel.

fty (50) percent of the population has no access to health care, and only sixty (60)
percent has access to essential drugs. (Ibid)

In 2003-2005, some 200 hospitals completely closed and 800 partially closed for lack
of doctors and nurses. (Galvez-Tan)

While the benefits of overseas employment cannot be ignored, the underemployment of
health professionals in overseas jobs, loss of skilled health workers to support the
development needs of the country, which in tun, jeopardizes the integrity and quality of
health services, and the poor working conditions that are currently borne by the Filipino
public health professionals require a holistic, deliberate and evidence-based health resources
management policy that will guide the overall planning of health services skill production
taking into consideration domestic and international health requirements, and a program that
will establish a database of domestic health needs, provide a registry of all health workers,
provide continuing education for health workers, establish standards of proficiency according
to profession and skill category, and assist returning workers reintegrate into the economy,

To achieve all these, there is a need to institutionalize and maintain an inter-agency
coordinating body to plan, implement and monitor the development and management of
human resources for health in the country while engaging in meaningful partnerships with the
private sector and the international community to provide better opportunities for Filipino
health workers,

The institutionalization of the inter-agency Philippine Human Resource for Health Network
(HRH Network), headed by the Secretary of the Department of Health, as the central
coordinating body for the government, is hereby proposed.

FELIX WILLIA| FUENTEBELLA


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SIXTEENTH CONGRESS
Second Regular Session

HOUSE BILL No, 6514

Introduced by Felix William B. Fuentebella

AN ACT
INSTITUTIONALIZING THE PHILIPPINE HUMAN RESOURCES FOR
HEALTH NETWORK

Be it enacted by the Senate and the House of Representatives of the Philippines in Congress
assembled:

SECTION 1. Short Title — This Act shall be known as the "Philippine Human
Resources for Health Network Act."

SEC. 2. Declaration of Policy — The Philippine Constitution declares that:

a) ‘The State shall protect and promote the right to health of the people and instill
health consciousness among them;

b) The State shall adopt an integrated and comprehensive approach to health
development which shall endeavor to make essential goods, health and other social
services available to all the people at affordable cost; and,

©) The State shall undertake health manpower development that will be responsive to
the health needs of the population

Towards these ends, the State shall institutionalize and maintain an inter-agency
coordinating body to oversee the development and management of human resources for
health in the country through the following strategies:

a) by ensuring that the development of human resources for health (HRH), and the
policy formulation, monitoring and enforcement of such development policies,
including the planning thereof, shall be research-led and evidenced-based, guided
by international standards of health, undertaken with the active participation of the
private sector, integrated into the programs of and coordinated across the
concemed government agencies and imbued with the unequivocal commitment to
the goal of protecting the interest and well-being of Filipino HRH;

1


b) by ensuring that the recruitment, education and training of HRH is linked to
Philippine health system needs that shall be accurately depicted at the provincial
level, in accordance with the data and standards adopted locally and
internationally;

©) by ensuring that the supervision, regulation and oversight of the education and
training of HRH will uphold the ethical practices of a well-motivated workforce
that will effectively contribute to the health system;

4) by engaging in meaningful partnerships with the private sector and the
international community to ensure the beneficial sharing of resources, information
and new technologies in the area of health service delivery;

e) by facilitating the reintegration of health workers into the economy through the
creation of programs that will allow them to continue to be productive, whether
through entrepreneurial activities or through employment in the health sector,
whether they are returning on a temporary or permanent basis;

£) by promoting through government-to-government engagements, the mutual
recognition of work experience, credentials, competencies of health workers as to
facilitate the employment of Filipino HRH in foreign jobsites and to afford them
the same level of social protection received by nationals of their host countries,
and

2) by promoting medical tourism to generate employment, drive local economies to
actively compete in the market and rationalize investments in health facility
improvements.

SEC. 3. Definition of Terms ~ As used in this Act:

a) Philippine HRH Network -refers to a multi-sectoral body composed of different
government agencies and non-government organizations that shall be authorized
to formulate policies and recommend measures that shall address and respond to
HH issues, problems and challenges in the country,

b) Human Resources for Health (HRH) - refers to health care professionals and
health care workers who are respectively educated and appropriately trained
individuals duly licensed under Philippine laws to practice their respective
professions in the field of health services, such as: (1) Physicians, (2) Nurses,
(3) Dentists, (4) Midwives, (5) Pharmacists, (6) Medical Technologists, (7)
Nutritionist-Dietitians, (8) Physical Therapists, (9) Radiologic Technologists, and
(10) X-Ray Technologists. The term likewise includes alternative, traditional and
other health care workers and providers that are not supervised, regulated or
‘overseen by an agency of government, such as community health workers, doulas,
peer wellness specialists, massage therapists, acupressure specialists and personal
health navigators, and such other health care workers and providers that the
Secretary of the Department of Health (DOH) may include in accordance with the
policies enunciated in Section 2 of this Act.

SEC. 4. Creation of the Philippine HRH Network ~ The Philippine HRI Network,
hereinafter referred to as the Network, is hereby created, and shall be the central coordinating
body responsible for recommending evidence-based policies and programs and providing
technical advisory on HRH development and management in the Philippines. The Network

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shall be headed and coordinated directly by the Secretary of the DOH and shall be composed
of the heads of the following agencies:

a) Department of Foreign Affairs (DFA);
b) Department of Trade and Industry (DTD);

c) Department of Education (DepEd)

d) Department of Labor and Employment (DOLE);

¢) Department of the Interior and Local Government (DILG);

4) Department of Budget and Management (DBM);

2) National Economic and Development Authority (NEDA);

h) Philippine Statistics Authority (PSA);

i) Philippine Overseas Employment Administration (POEA);

j) Overseas Workers Welfare Administration (OWWA);

k) Commission on Filipinos Overseas (CFO);

1) Bureau of Immigration (BI);

m) Technical Education and Skills Development Authority (TESDA);
n) Commission on Higher Education (CHED);

0) Professional Regulation Commission (PRC);

p) Civil Service Commission (CSC);
4) University of the Philippines-National Institutes of Health

1) National Reintegration Center for Overseas Foreign Workers - DOLE

The heads of the concerned accredited professional associations shall be invited to the
meetings and consultations of the Network to provide technical inputs and community-based
observations and data, and to ensure the quality of information upon which policy reforms
shall be based,

The recommendations of the Network shall be acted upon by the Secretary of the
DOH who is the approving authority of the Network. The implementation of policies
pertaining to HRH as recommended by the Network and approved by the Secretary of the
DOH as Network head shall be accordingly supervised by the respective departments and
agencies

SEC. 5. Formulation of a Master Plan for HRH Development ~ ‘The Network shall
guide a comprehensive Master Plan that shall address the demand for health worker services
in the country, harmonize all policies pertaining to HRH, including those that promote the
well-being and interest, encourage the continuing improvement of health services through
training and other learning modes especially on new health protocols and technologies and
international standards of health.

. 6. The Technical Working Committees ~ There shall be created four (4)
Technical Working Committees that shall be responsible for translating policy directions of
the HRH Network into operational strategies and oversee the implementation of the
Network's plans and programs,

The Secretary of the DOH as the Chairperson of the Network, shall determine the
composition and membership of the Technical Working Committees. They shall be
composed of permanent representatives or their alternates from each member-agency, with a
rank not lower than Division Chief.

The Technical Working Committees (TWCs) shall oversee the following concerns:


a) The Planning, Standards, Education and Curriculum Committee ~ shall formulate
strategies and recommendations to address the health worker needs of the
population, respond to the health service demands of various local government
units, and shall recommend the appropriate educational training and curricula in
accordance with local and international standards, and the standards to be used in
monitoring and evaluating these training curricula,

b) Recruitment and Training Committee ~ shall formulate strategies to assist health
workers in obtaining gainful employment, recommend the provision of additional
and appropriate trainings, and formulate policies to ensure their protection against
illegal, immoral and unethical practices.

©) The Industry Development and Placement of Workers Committee — shall
formulate strategies to increase the employment opportunities for health workers
locally and internationally, recommend standards for salaries, incentives and
benefits of health workers, including health care insurance coverage, and assist in
the strengthening of employer-employee relationships in the health sector.

d) The Reintegration Committee - shall formulate the strategies and
recommendations to ensure the smooth reintegration of overseas health workers
back into the economy and the local health industry.

The Secretary of the DOH and the Chairperson of the CHED shall serve as co-
Chairpersons of the Planning, Standards, Education and Curriculum Committee. The
Secretary of the DOH and the Chairperson of the PRC shall serve as co-Chairpersons of the
Recruitment and Training Committee. The Secretaries of the DOH, DTI and DOLE shall
serve as co-Chairpersons of the Industry Development and Placement of Workers Committee,
The Secretaries of the DOH and DOLE, and the Executive Director of the UP-National
Institutes of Health shall serve as co-Chairpersons of the Reintegration Committee.

SEC. 7. The Network Secretariat. The Secretary of the DOH and all the member-
agencies of the Network shall provide the support staff to comprise the Secretariat who shall
assist the Network in the performance of its functions as herein provided. The Network
Secretariat shall act as the convening body of the Network and shall perform such functions
as the facilitation of multi-sectoral meetings, consolidation of reports and policy agenda of
the Network, the management of a database and logistics, the management of researches, and
coordination of capacity-building activities. Within thirty (30) days of the effectivity of this

Act, the Network Secretariat composed of technical and administrative staff designated by
member-agencies shall commence the discharge of their tasks under the supervision of an
officer to be designated by the Secretary of the DOH and who shall be responsible for
overseeing the coordination and the monitoring of the implementation of the Network's
programs and projects,

SEC. 8. Development and Maintenance of an Integrated HRH Database ~ The
Network shall develop and maintain an integrated database containing relevant information
on health human resources to be used for evidence-based planning and policy making, As
ch, all concerned government agencies are mandated to provide the Network the necessary
information from their databases and to update such data on a regular basis: Provided, That
such regularity shall be stipulated in the rules and regulations to be issued to implement this
Act.



SEC. 9. Accreditation and Certification of Alternative, Traditional and Other Health
Care Workers and Providers ~ Upon the effectivity of this Act, the Secretary of the DOH
shall issue the list of alternative, traditional and other health occupations. Upon the
recommendation of the Planning, Standards, Education and Curriculum Committee, the
Secretary of the DOH shalll prescribe the standards of proficiency for each occupation. In this
connection, the Network shall establish a training and certification system for each
occupation, taking into consideration existing programs and standards observed by the
DepEd, TESDA and other agencies: Provided, that within one year (1) from the effectivity of
this Act, all training programs for these workers shall be aligned with the standards set by the
Network. The names of all certified alternative, traditional and other health care workers and
hall be included in the HRH Integrated Database.

2, 10, National HRH Network Policy Forum — The National HRH Policy Forum
shall be conducted annually to serve as a venue for the presentation of policy directions,
initiatives, research studies and recommendations, and accomplishments of the HRH. It shall
likewise serve as an advocacy mechanism to promote HRH development in the country.

SEC. 11. Network Capability Building Activities ~ The Network shall continually
conduct trainings, seminars and workshops as may be appropriate to upgrade the aptitudes
and capabilities of health workers and Network Secretariat members.

SEC. 12. Appropriations — The funds necessary for the implementation of this Act
shall be charged against the current budget of the Department of Health and other concerned
agencies. Thereafter, the amount necessary for its continued implementation shall be
included in the annual General Appropriations Act.

SEC. 13. Implementing Rules and Regulations Within a year from the effectivity of
this Act, the Secretary of the DOH, in coordination with the member-agencies of the
‘Network, shall issue the rules and regulations to implement it.

SEC. 14, Separability Clause- If any provision or part hereof, is held invalid or
unconstitutional, the remainder of the law or the provision not otherwise affected shall remain
valid and subsisting,

SEC. 15. Repealing Clause - Any law, presidential decree or issuance, executive
order, letter of instruction, administrative order, rule or regulation contrary to or inconsistent
with the provisions of this Act is hereby repealed, modified or amended accordingly.

SEC. 16, Effectivity Clause - This Act shall take effect fifteen (15) days after its
publication in a least two (2) newspapers of general circulation