Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL NO.3922

Introduced by
BAYAN MUNA Party-List Representatives FERDINAND R. GAITE,
‘CARLOS ISAGANI T. ZARATE, and EUFEMIA C. CULLAMAT

AN ACT
REVERTING TO THE NATIONAL GOVERNMENT THE DISCHARGE OF BASIC
HEALTH SERVICES DEVOLVED TO LOCAL GOVERNMENT UNITS (LGUs),
AMENDING FOR THE PURPOSE REPUBLIC ACT NO. 7160, OTHERWISE
KNOWN AS THE LOCAL GOVERNMENT CODE OF 1991, APPROPRIATING
FUNDS THEREFOR, AND FOR OTHER PURPOSES

EXPLANATORY NOTE

This Bill seeks to bolster the government’s delivery of health services to the Filipino people
and improve access to quality healthcare by returning to the national government the health
care delivery system currently devolved to the local. government units (LGUs)..

Article I. Section 15 of the 1987 Constitution states clearly that the State shall protect and
promote the right to health of the people and instill health consciousness among them. The
collective health of the people affects and hyper-extends the success or failure of government
in attaining human and socio-economic development.

Further, the World Health Organization (WHO) Alma Ata Declaration in 1978, of which the
Philippine government is a signatory, reiterates that health is a fundamental human right and
explicitly states that “the attainment of the highest possible level of health is a most important
world-wide social goal”,

‘The devolution of government’s health care delivery system via Republic Act No. 7160,
otherwise known Local Government Code of 1991, has given rise to various problems,
especially in terms of access to quality healthcare.

A review of the Local Government Code in 2014 published by Health Perspectives Inc have
shown that devolution have resulted to a highly fragmented health system. The DOH has no
direct control over the LGUs who are the implementers of health program, the LGUs on the
other hand develop health plans without regard for the larger health agenda,


Local officials also lack the capacity to effectively manage the health services, while many
health personnel could not adequately deal with local officials. Health is not a priority of
most LGU officials, LGUs have unequal capacities to sustain health services. The gap
between different class of municipalities widened, as urbanized and developed municipalities
tend to have more finds for health care than those in the 4" - 6 class municipalities.

Independent research group IBON Foundation, in its paper Devolution of Health Services in
2010, documented further deterioration of public health facilities, lack of health personnel
‘and demoralization of devolved health personnel due to low salaries and benefits compared to
their national counterparts.

Based on the data from IBON, the budget for health, nutrition and population contro! have
alarmingly decreased since devolution. In provinces, the share of the said item in 2001 stood
‘at 20% of their total income and expenditures but went to 14% of total income and 16% of
total expenditures in 2008. In municipalities, the share of the said item in total income and
expenditures went down by 23% and 15%, respectively.

Even the Department of Health recognized the problems created by devolution of health care,
as former DOH Secretary Enrique Ona in 2014 proposed that the Local Government Code be
amended to revert the direct supervision of provincial officers and municipal health officers
to the DOH.

‘There is an urgent need to address the problems created by devolution of health services.
Health care must be made accessible, affordable, and appropriate to the needs of the people
especially at the grassroots level. The public health care delivery system must be
strengthened down to the barangay level. Preventive health care and public health must be
given emphasis.

Ultimately, collective action and political will remain vital in bringing about meaningful
social changes that will redound to the people’s benefit. Your earnest support to this endeavor
can, ina very literal sense, save lives.

This bill has been filed since the 15" Congress by Bayan Muna Party-List. It is a major step
to address the fatal flaws of the decentralization of health services. In order to have a
comprehensive and integrated health care delivery system as mandated by the Constitution of
the Republic of the Philippines the urgent approval of this bill is earnestly recommended.

Approved,


'P. FERDINAND R. GAITE,
BAYAN MUNA Partylist

—

pm ait
REP. CART! At REP. EUFE! C. CULLAMAT
BAYAN MUNA tylist BAYAN MUNA Partylist


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS,
First Regular Session

HOUSE BILL NO. ne

Introduced by
BAYAN MUNA Party-List Rep. FERDINAND R. GAITE, Rep.
CARLOS ISAGANI T. ZARATE and Rep. EUFEMIA C. CULLAMAT,

AN ACT
REVERTING TO THE NATIONAL GOVERNMENT THE DISCHARGE OF BASIC
HEALTH SERVICES DEVOLVED TO LOCAL GOVERNMENT UNITS (LGUs),
AMENDING FOR THE PURPOSE REPUBLIC ACT NO. 7160, OTHERWISE
KNOWN AS THE LOCAL GOVERNMENT CODE OF 1991, APPROPRIATING
FUNDS THEREFOR, AND FOR OTHER PURPOSES

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

SECTION 1. Title. This act shall be known as the “Renationalization of Health Services
and Facilities Act of 2019”.

SECTION 2. Declaration of Policy. It is the declared policy of the State that it shall protect
‘and promote the right to health of the people and instill health consciousness among them.
Further, the State shall endeavor to make essential goods, health and other services available
to all the people at affordable cost.

SECTION 3. Objectives. The objectives of this Act are:

4) to prevent the further deterioration of government health services and facilities and reverse
the negative trend brought about by devolution;

b) to provide all essential health services to the people, especially the sick, the poor and
marginalized sectors of society; and

c) to improve and uplift the morale, social, and economic ‘well-being of health workers.

SECTION 4. Renationalization. All health services and facilities devolved to the local
government units are hereby renationalized or retumed to the auspices of the national

4


government. Renationalization for the purpose of this Act shall mean the reversion to the
national government of the discharge of basic health services devolved to local government
units (LGUs), Which shall include the control, supervision, management and maintenance of
health facilities, personnel and health services.

For this purpose, the following provision of the Local Government Code of 1991 (RA7160),
are hereby deleted, repealed and declared no longer enforceable and effective:

Section 17 (b) paragraph (1) (ii), paragraph (2) (iii), paragraph (3) (iv), and (4) for health

services only:
Section 102 (a) (1), (2), (3), (0) (1), @), and (3);
Section 103 (a) and (b); Section 104;

Section 105; and

Other related provisions of the Local Government Code that pertain to devolved health
services and facilities.

‘TRANSITORY PROVISIONS

SECTION 5. Appropriations. - The amount necessary for the initial implementation of this
Act shall be Php 60 billion and added to the appropriations of the Department of Health.

Thereafter, such sums as may be needed for its continued implementation shall be included in
the Annual General Appropriations Act, specifically five (5) percent of the country’s
projected Gross National Product (GNP), as recommended by the World Health Organization
(WHO), are allocated for the continued operation and maintenance of all the government
hospitals at the national, regional, provincial, district, city, and municipality levels and shall
be included in the annual budget of the Department of the Health in the General
Appropriations Act of every year.

FINAL PROVISIONS

SECTION 6. Separability Clause. The provisions of this Act are hereby declared to be
separable and, in the event of any such provisions are declared unconstitutional, the other
provisions which are not affected thereby shall remain in force and effect.

SECTION 7. Repealing Clause, All provisions in laws, decrees, memoranda, circulars,
orders and other rules and regulations inconsistent with this Act shall be deemed amended or
repealed if the inconsistency is irreconcilable.

SECTION 8. Implementing Rules and Regulations. The implementing rules and
regulations (IRR) of this Act shall be promulgated by the Department of Health (DOH) with
representatives from the local government units, the relevant professional health associations
and health sector organizations and shall be drawn up within three months after the approval
of this Act. Failure of the DOH to promulgate the IRR within the period required in this Act
shall subject the Secretary of Health to administrative sanction.



SECTION 9. Effectivity. This Act shall take effect fifteen days (15) days after publication
in the Official Gazette or in a national newspaper of general circulation.

Approved,