Philippine health workforce in trouble

Immediate solutions needed— PCP, DOH, Health advocates

A health crisis is now unfolding in the Philippines— and at the center of this crisis lies the deplorable state of the country’s healthcare workforce.

On February 11, health advocates led by the Philippine Society of General Internal Medicine (PSGIM) and the Philippine College of Physicians (PCP), sounded the alarm on the extreme shortage of Philippine healthcare workforce, and its impact on the nation’s drive for achieving universal healthcare.

“The Philippines is now suffering a tremendous lack of health workers. Doctors and health workers are those who drive forward the healthcare system, yet according to Philippine Regulatory Commission data, we only have an average of 7 doctors to service every 10,000 Filipinos,” said Department of Health Undersecretary Teodoro Herbosa.

According to the Professional Regulation Commission, there were only 70,000 doctors registered in the country as of 2014, even as the Philippines’ population hit the 100-million mark in 2013. Based on DOH figures, however, the ratio goes even lower, with 3.5 doctors for every 10,000 persons.

Even worse, this shortage of doctors and health workers is even more pronounced in rural as compared to urban regions. In areas served mainly by public doctors, the average doctor-to-population ratio declines to an abysmal 3 doctors for every 100,000 Filipinos.

“The crisis of the Philippine healthcare workforce is not only that of a shortage of workers, but also of serious inequity in the ability of the rich and poor to access doctors,” said Representative Leah Paquiz of Ang Nars Party-list. “There is a huge discrepancy in the quantity and quality of health care services received by the poor and the rich, which at its extreme, are world class for millionaires, while insufficient for the poor and marginalized groups.”

“Even President Aquino acknowledged in his first SONA that 60 percent of Filipinos die without being attended by a health professional. Health is a human right, yet what we are seeing is really scarcity of health workers and services in the midst of plenty,” Paquiz added.

According to the health advocates, the chronic deficit and inequity of health professionals is a complex, systemic problem, whose driving factors include, but are not limited to:

•     The cross-country migration of Philippine health workers to more developed areas such as the United States, Europe, and the Middle East (“Brain drain”)

•     The intensity of urbanization and rural-to-urban migration, which has led to a disproportionate concentration of health professionals in urban centers such as Metro Manila (“Maldistribution”)

•     The lack of incentives that encourage doctors to over-specialize, and to seek employment in the private sector while the public health sector  remains understaffed (“Malallocation”)

•     The growing concern over the lack of priority of health and the state of the healthcare workforce in public policy, which has remained despite the devolution of heathcare to local government units

“With increased funds for health which has been secured by the passage of the Sin Tax Law, poor Filipinos can now be assured of coverage by the National Health Insurance System and the upgrading of healthcare facilities,” said Dr. Antonio Dans, president of PSGIM. “The question now is: is the Philippines’ healthcare workforce ready to handle the healthcare needs of these millions of Filipinos?”

“The problems of healthcare workforce are in need to long-term, system-wide solutions, if we are to overcome the nation’s health crisis. Not only do we need to recruit more health workers and retain them within our shores, but we also must better regulate the workforce, retrain them, redistribute their deployments, and reassess the direction of present health policy,” Dans said.

 The PCP Health Forum on the Philippine Healthcare Workforce in Crisis is only the first of a series of media forums that the organization will be arranging on the state of Philippine healthcare, to celebrate its 60th anniversary.