This is one of the many popular nursery rhymes that I used to amuse myself with when I was still of pre-school age. I sang this to ease my fear upon sight of doctors whom I associated with painful injections. Now older and much wiser, the same nursery rhyme about doctors has evolved into a new meaning, especially for us Filipinos.
The brain drain of Filipino professionals like doctors and nurses leaving the country for better-paying jobs abroad has painfully affected us all. But our health officials appear unperturbed by this sad reality since no less than the government itself inflicts its misplaced priorities on our medical services.
A case in point is the dislocation of 30 government doctors, 18 nurses, 14 dentists, three medical technologists, 11 nursing aides and other medical workers in the Malacañang Clinic. They will be transferred to the Department of Health (DOH) under the "rationalization" program, or RAT for short, mandated by President Arroyo under Executive Order (EO) 366.
A fresh medicine board qualifier gets a monthly salary of P12,000 as a government doctor. This is a measly sum if you compare it with the salary of a janitor in government who gets P8,000 a month. Despite low pay, many of these government doctors work out of love to serve the poor sick people who can’t afford medical and health care that have become so expensive.
One of them is my good friend, Dr. Rolando Deduyo, director of the Malacanang Clinic. Deduyo, who rose from the ranks to become chief of the Malacañang Clinic, says this is not the first time that such a transfer was considered. There have been attempts by the past administrations to transfer the entire medical personnel of the Malacanang Clinic to the DOH. But these plans fell through for one reason or the other.
This time, the reason being cited for the revival of the planned transfer is due to the alleged use of the Malacanang Clinic "for politics." Naturally, medical services rendered to the public by the Palace Clinic will always smacked of politics because it is the first-line of public servants deployed for the medical missions of the President and/or his spouse. But this is politics that heals.
For example, it was during the term of former President Joseph Estrada whose wife, former First Lady, now Senator, Dr. Loi Ejercito secured 10 dialysis machines for the Malacañang Clinic. Indigent patients requiring this very expensive medical assistance got it free at the Clinic on orders of Estrada. Fortunately, this noble project is continued up to now by Mrs.Arroyo’s husband, First Gentleman Jose Miguel Arroyo who was able to procure five additional dialysis machines now in service at the Clinic.
The Malacañang Clinic under the Office of the President (OP) and operates independently from DOH. Under its charter, the Clinic provides medical services not just to Malacanang employees and the residents of the communities around the Palace but also for indigent patients who seek presidential assistance for their medical needs.
While he has no objection to the transfer, Dr.Deduyo, however, recalled that former DOH Secretary now Senator Juan Flavier said the planned transfer was impractical. Flavier, who was the first DOH Secretary to set foot in the Malacañang Clinic, recognized the need to maintain the status quo. This is because the former mandate of the DOH to provide primary care such as health care centers had been devolved to the local government units (LGUs). The mandate retained with the DOH supervision and regulatory powers over government hospitals and specialized hospitals like the Heart Center of the Philippines.
The RAT program actually is a government-wide directive, which, among other things, seeks to trim off excess fat from the bloated bureaucracy due to many duplication of functions. Rough estimates place government workers at 1.2 million, the bulk of whom, or close to 400,000 are public school teachers, and more than 200,000 are in the police and military establishments.
As per EO 366, the RAT should have been implemented starting Dec.4 but this has been put on hold due to the sheer number of government workers who will be laid off under the various schemes that include voluntary early retirement. In fairness, the objective of RAT is commendable in trying to improve efficiency of public service and generate savings and ease the perennial problem of fiscal deficit because half of the annual budget goes to salaries and wages of government personnel.
I think President Arroyo’s newly appointed presidential adviser on job creation, former Agriculture Secretary Arthur Yap will have his hands full in dealing with the prospects of the government adding to the rising unemployment problem in the country once the RAT program gets underway early next year.
Mrs.Arroyo gave Yap this Cabinet post which was formerly headed in concurrent capacity by outgoing Presidential Management Staff (PMS) Secretary Rigoberto Tiglao who last week hurdled his confirmation at the Commission on Appointments as new ambassador of the Philippines to Greece and Cyprus. Tiglao’s buddy, Philippine Information Agency director-general Rene Velasco takes over as new PMS head.
While the country is having serious unemployment problems, Yap is so apprehensive about his new job title that he would rather be a presidential adviser on agriculture and livelihood where he believes he can give more substantive contributions than as a mere monitor of jobs being generated or lost. By the way, Yap’s immediate predecessor, Secretary Luis Lorenzo Jr. also used to be the President's presidential adviser on job creation prior to his posting to the Agriculture Department.
There will be more changes in the Cabinet of President Arroyo by year-end and early next year. Consequently, even if people leave the government service, new ones come in for sure. So do you think the RAT program will ever be implemented?