Republic of the Philippines
HOUSE OF REPRESENTATIVES

Quezon City
/s” Receven 2
FIFTEENTH CONGRESS Ez Manee ones
it i

Second Regular Session

House BiliNo._SC41.

Introduced by Representatives EMMI A. DE JESUS,
RAFAEL MARIANO, TEDDY CASINO, NER! COLMENARES, ANTONIO TINIO
and RAYMOND PALATINO

EXPLANATORY NOTE

The state is mandated to protect and promote health as a basic human right. But health
as a human right has been influenced by social determinants of health that largely
impact the population. Privatization of health care facilities and services, labor export
policy, contractualization, among others, exacerbate poor people's access to quality
health care. The lack of government funding for government hospitals’ operations and
facilities and the absence of wage increases and benefits for health professionals and
workers have marginalized our medical professionals.

‘As a consequence, basic health care including essential services at the community level
are inaccessible for majority of the marginalized Filipinos. Majority of Filipino people ~
plagued with poverty, hunger and unsafe living conditions do not have access and
cannot afford to seek medical attention. Unhealthy living conditions and lifestyle and
poverty lead to increase non-communicable diseases while preventable diseases remain
constant threats for many Fil

The Registered Nurses for Health Enhancement and Local Service (RNheals) Program of
the Department of Health (DOH) or any other similar government program, also falls
under the broad definition of "exploitation". The Nurse-Trainees are obliged to perform
the functions and assume work load of regular staff nurses in the public health facilities
for a year and are given a measly allowance of P8,000 per month while some get
additional allowance of P2,000.00 from the Local Government Units (LGUs). These
nurse-trainees will also supervise the so-called Community Health Teams organized to



deliver basic health services in the communities such as support to immunization
activities, pregnancy tracking and motivation of pregnant women to avail antenatal care
and delivery in health facilities and other health promotion activities.

Considering that RNheals Trainees only get P10,000 of monthly allowance, these nurses
were actually underpaid, exploited monthly by the government by as low as P7,099 or
as high as P12,688. The present monthly starting salaries now for nurses in the
government is P18,549 for Salary Grade 11 in public hospitals and P24,887 for Salary
Grade 15 in Rural Health Units/City Health Centers and School Nurses under
Department of Education as Nurse II position.

There has been an exodus of health care professionals migrating out of the country such
as doctors and nurses. Present nursing jobs provide little or no security and/or
protection and are characterized by low wages, work overload and poor opportunities
for professional growth.

The state's dismal funding for health services results not only to an unhealthy Filipino
population but also to an unhealthy and exploited working condition and environment
for nurses and other health workers. Our nurses have been poorly compensated,
overworked and threatened of their job security. Our health care system has also been
in dire need of more health workers not only operational and maintenance needs to be
able to deliver comprehensive and proper health care services from the cities to the
communities in the rural areas.

Still, the available nursing manpower is underutilized and untapped. The nurse-patient
ratio in government hospitals and public health system is generally below the standard
for quality nursing care of 1:12 in a hospital ward and 1:20,000 in community health
setting.

In areas where essential health services are not accessible, the government has either
failed to fill up vacant plantilla positions or failed to insist on creating necessary plantilla
positions that would cover the need of the community. This gap makes Filipino nurses
vulnerable to various forms of exploitation. Both government and public hospitals have
been gaining profit in the form of exorbitant fees collected from nurses and also saving
money by not hiring regular Registered Nurses (RN).

According to the Philippine Nurses' Association, the term "volunteer" or “on-the-job
training” has been misused by many hospitals to rationalize these unscrupulous practice
creating confusion and false hopes among the ranks of some 294,809 unemployed
Filipino nurses in the country (as of September 1, 2011) that undergoing this practice
would expedite their hiring process for local and foreign employment. Itis stipulated in
the Article II, Section 2- Declaration of Policy of the Philippine Nursing Act, RA 9173
mandated that “The State hereby guarantees the delivery of quality basic health
services through an adequate nursing personnel system throughout the country”


It is about time that we enact a legislation that strongly signals the state policy on the
protection of nurses and other health workers. Hence, this proposed measure to
prohibit exploitation of nurses in public and private hospitals and health care facilities,

5

(fi — Fart a a (ee
REP. EMMI A. DE JESUS REP. TEDDY CASINO
Gabriela Wamen’s Party / Bayan Muna Partylist

/
REP, YERI COLMENAI eS REP. RAFAEL MARIANO
Bayan Muna Rartylist Anakpawis Partylist

Wa

PP. ANTONIO TINIO REP. pls PALATINO

ACT Teachers Kabataan Partylist



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
Second Regular Session

House BillNo. 5641.

Introduced by Representatives EMMI A. DE JESUS,
RAFAEL MARIANO, TEDDY CASINO, NERI COLMENARES, ANTONIO TINIO
and RAYMOND PALATINO

AN ACT PROHIBITING EXPLOITATIVE “VOLUNTEERISM” OF NURSES
IN THE HEALTH CARE SYSTEM.

SECTION 1. Short Title. — This Act shall also be known as the “AN ACT PROHIBITING
EXPLOITATIVE “VOLUNTEERISM” OF NURSES”.

SECTION 2. Declaration of Policy. ~ The State recognizes the importance of health and of
providing proper and comprehensive health care services to its people. The protection
and promotion of the right to health is an assumed responsibility of the State. Section
15, Article 1! of the Philippine Constitution states, "The State shall protect and promote
the right to health of the people and instil health consciousness among them". The State
also recognizes the important role and the contribution of Filipino nurses both here and
abroad. As such, the State shall protect the dignity of the nursing profession and shall
ensure that Filipino nurses are protected against exploitation.

SECTION 3. Definition of terms:
1. Registered Nurse - is any Filipino nurse who has graduated with a degree in
Bachelor of Science in Nursing and has passed the Philippine Regulatory Commission


(PRC) Board of Nursing exams, and whose registration has not been revoked by the
PRC.

2. Volunteer Registered Nurse -is any Registered Nurse, who, on his/her own
volition, offers his/her services to a hospital, clinic or health facility, for free or
without compensation. Services of a Registered Nurse is considered voluntary when:

a. The Registered Nurse is not burdened with the same duties and
responsibilities of a Registered Nurse employed by the hospital, clinic or
health facility;

b. The Registered Nurse is not required to render full-time service;

c. The Registered Nurse is not the sole Registered Nurse on duty;

d. The Registered Nurse’s service is complimentary to the existing workforce of
the hospital and not intended to fill-up any vacancy for a regular full-time
Registered Nurse employed by the hospital, clinic or health facility; and

e. The Registered Nurse’s services is not rendered solely in exchange for any
type of Certification by the hospital for the Registered Nurse’s application for
employment purposes whether here or abroad;

3. Fee for work experience — is any amount collected in exchange for the issuance
of any certification of employment or work experience as an actual or perceived
requirement for employment application here or abroad

4. Health Care Facility — any infrastructure or facility where medicine is practiced.

5. Clinic—a health care facility for out-patient care.

SECTION 4. Prohibited Acts. — Any of the following acts are considered as exploitation of

nurses and is hereby prohibited:

1. To contract or avail of the services of a Registered Nurse either without salary, for
allowance, for salary below the applicable minimum wage (for nurses deployed in
private health facilities) or below the prescribed salaries under Republic Act 9173 as
amended, (for nurses deployed in government health facilities) whether or not
under the pretext of a training, development program, certification course and/or
any seminar;

2. To collect any fee from a Registered Nurse or from any person or entity in his or her
behalf in exchange for a Registered Nurse’s voluntary services in a hospital, clinic or
any health facility;

3. To require or oblige a Volunteer or Trainee Registered Nurse to do any of the
following:

a. To perform the regular work functions and/or regular work load expected
from a regular Staff Nurse employed by the hospital, clinic or health facility
without proper compensation;

b. To render full-time service as a condition for the continued availment of his /
her volunteer services; and

c. To be the sole Registered Nurse on duty, except during disasters and
calamities.



4, To contract or avail the services of a Volunteer or Trainee Registered Nurse in order
to fill-up a vacant position that requires the hiring of a full-time regular employed
Registered Nurse; and

5. To contract or avail of the Registered Nurse’s services for free in exchange for any
type of Certification by the hospital for the Registered Nurse’s application for
employment purposes whether here or abroad.

6. To contract or avail of the services of a registered nurse, under the pretext of
training or certification course, but requires her/him to render the tasks and
responsibilities expected of a regular staff or community nurse, with the so-called
allowance with or without benefits, which is below the applicable minimum wage
for both private and public institutions.

SECTION 5. Refund and Compensation.

Any Registered Nurse found to have been a victim of any violation of this Act shall be
entitled to: (a) a full refund of all fees illegally collected; and, (b) payment of unpaid
salary which should not be less than the applicable minimum wage for services
rendered.

SECTION 6. Rights and Protection of Volunteer Registered Nurses. — Any person,
hospital, clinic or health care facility that contracts or avails of the services of a
volunteer Registered Nurse is required to:

1, Provide health, sanitary and safety equipment to the volunteer Registered Nurse;

2. Free medical care, laboratory and hospitalization for any injury, sickness or disease
that may be contracted by the volunteer Registered Nurse in the course of his/her
volunteer service;

3. Allow volunteer Registered Nurse to participate in any capacity-building and/or skills
enhancement training offered by the hospital, clinic or health care facility;

SECTION 7. Penalty Clause:

Any person found guilty of committing Section 4 of this Act shall suffer the penalty of
imprisonment of not less than six (6) months and not more than one (1) year and a fine
of not less than one hundred thousand pesos (P100,000) but not more than five
hundred thousand pesos (500,000).

Any hospital, clinic or health care facility found violating Section 6 of this Act shall, on
the first offense, be given a period of fifteen (15) days from notice of violation to
comply. On its second offense, the hospital, clinic or health care facility shall be fined
with not less than One Hundred Thousand Pesos (P100,000). On its third offense, the
hospital, clinic or health care facility, shall, in addition to a fine of One Hundred
Thousand Pesos (P100,000), be banned from availing of the services of a volunteer
Registered Nurse. In any case, the hospital, clinic or health care facility shall be held
liable for damages and all medical expenses incurred by a volunteer Registered Nurse



for any injury, sickness or disease contracted in the course of delivering volunteer
service.

If the offender is an association, corporation, or any other juridical person, the penalty
above-stated shall be imposed upon the president, treasurer, owner or any other
person responsible for the violation. In addition, a warning shall be issued to the
hospital for its first offense, suspension of its license to operate for a period of not less
than one (1) month and not less than six (6) months shall be imposed on for its second
offense and cancellation of its license to operate shall be meted out for its third offense.

If the offender is a government facility under a national government agency, local
government unit or government owned and controlled corporation, the penalty above-
stated shall be imposed upon the concerned Department Secretary, Local Chief
Executive, Chairman of the Board and the Hospital Director, Chief of Hospital,
Provincial/City/Municipal Health Officer or head of concerned health facility, whichever
is applicable.

If the offender is a foreigner, he/she shall be deported immediately after service of the
sentence and be barred permanently from entering the country.

SECTION 8. Implementing Agencies. - The Department of Health is hereby designated as
the agency tasked with monitoring the compliance with and implementations of the
provisions of this Act by public hospitals or health care facilities while the Department of
Labor and Employment is similarly designated as the agency tasked with monitoring the
compliance with and implementations of the provisions of this Act by private hospitals
or health care facilities.

SECTION 9. Repealing Clause. All laws, executive orders, presidential decrees,
presidential proclamations, rules and regulations or parts thereof inconsistent with the
provisions of this Act are hereby repealed or modified accordingly.

SECTION 10. Effectivity Clause. This Act shall take effect fifteen (15) days after its
complete publication in the Official Gazette or in a newspaper of general circulation.