The 1st Privilege Speech of Cong. Leah S. Paquiz, ANG NARS Party-list Mr.

Speaker, I stand here today to talk about HEALTH CARE and the majority of th e health work force called NURSES . I would like to start with a short description of our health care system as docu mented by the University of the Philippines National Institute of Health (UPNIH) Universal Health Care study group:and I quote within the country, there are glar ing disparities in health status among regions and income groups. This disparity in health status results from the INEQUITIES in society in general and, WITHIN THE HEALTH SYSTEM, from the inequity in access to health service. This inequity in access results from a health system characterized by : inappropriate governan ce within the health system, antiquated and inadequate health information system , ineffective regulation of health goods and services, fragmentation of health s ervice delivery, a dysfunctional health work force, and unfair, unjust, and inad equate health care financing . Recently, the Universal Health Care Program was approved by the President. Unive rsal Health Care is defined as the provision to every Filipino of the highest qu ality of health care but this program is entirely geared to gathering more membe rship to Phil Health as a basis to help provide for health care services. The en tirety of this scheme is illness oriented to the neglect of health promotion and prevention of diseases activities. What ails the present Philippine health care system? 1. A HUGE DISCREPANCY in the quantity and quality of health care services receiv ed by the poor and the rich at its extremes, INSUFFICIENT for the poor and margi nalized groups, and WORLD CLASS for the millionaires billionaires. In our countr y, given the same disease, THE RICH WILL SURVIVE and the POOR WILL DIE. For exam ple, consultation fee of a medical specialist is PHP1,000.00. What are the chanc es for the poor to get to a medical specialist? Virtually, NONE. 2. The DEVOLUTION of health care services has SEVERED not only QUALITY CARE but also DELETION of the many important national, regional, provincial, and local he alth activities and services. Severely affected is the inadequate, if not, missi ng monitoring, regulation, and evaluation of health care services at the primary level. 3. PUBLIC HEALTH SERVICES have DWINDLED down so much (unlike the decades 50 s, 60 s, up to mid 70 s) that HEALTH PROMOTION AND PREVENTION OF DISEASES has just come ab out to nearly disappear. Almost gone are the primary health care services that w as developed by DOH in the late 70 s. Those primary health care services were attu ned to community health needs and were accessible, available and affordable by a ll. The absence of a system at the community level needs to be addressed so that communities can easily avail of services akin to their needs. 4. Yet, many present illnesses such as diabetes, cardiovascular diseases, cancer , HIV, and behavioural problems can be prevented with GOOD PREVENTIVE HEALTH CAR E SERVICES. 5. The planned privatization of 29 hospitals of the Department of Health (DOH) w ill aggravate the ACCESS AND AFFORDABILITY of health care services for the POOR AND MARGINALIZED GROUPS. The DOH has started the bidding as part of the Public-P rivate-Partnership (PPP) program the government-owned Philippine Orthopaedic Hos pital. Under this PPP program, the DOH invited the bidders to undertake the PHP5 .6 Billion project which involves the construction of a modern 12 storey buildin g. There seems to be so much interest on the PPP plans for this hospitals as I h ave heard there are many buyers lining up to acquire and invest in them. And wha t does investment means? To one who invests, there must be a related profit.

Mr. Speaker, Allow me now to FOCUS ON THE NURSING WORK FORCE S, THE SILENT HEROES OF THE HEALTH CARE SYSTEM Where are the nurses? 1. They are in hospitals where most of the nurses work:

THE CARE SPECIALIST

Who renders 24/7 care services?? . THE NURSES!!! Who does all the necessary procedures for health care??.... THE NURSES!!! Who are called when patients ask for assistance?? .. THE NURSES!!! Who coordinates the CARE SERVICES in hospitals??.... THE NURSES!!!! Just like THE DOCTORS who are the CURE SPECIALISTS, THE CARE SPECIALISTS ARE THE NURSES!!! Yet, many hospitals are under staffed with professional nurses, nurse ratios are generally 1:20 or 1:30. QUALITY CARE IS COMPROMISED. Indeed, SCARCITY in the mi dst of PLENTY. Many nurses are employed as contractuals, job orders and when exp osed to dismal conditions in hospitals they are DISMISSED ARBITRARILY. 2. Nurses in the hundreds and thousands (more than 200,000 in 2012) are unemploy ed or under-employed and those who want to seek hospital experience serve as FAL SE VOLUNTEERS, FALSE TRAINEES AND CHARGED WITH EXORBITANT FEES. Because of the sheer volume of Nurses who wish to work, they became vulnerable t o exploitation and became pawns in the world of precarious working conditions. H apless Nurses take on false volunteer programs in dire exchange for training or employment certificates which is not given them. Some even pay the hospitals for these training. Some Nurses gladly volunteer and take on the work of a staff Nu rse without pay just so they can practice as a hospital nurse. These Nurses do n ot have Employer-Employee relationship. Thus are not protected from the risks an d hazards in the performance of their duties. They can be terminated without due process. We have Nurses working in hospitals as contractual for more than two y ears but they have yet to become Regular Employees. They do not receive basic be nefits allowed by Law like Pagibig, SSS/GSIS, Philhealth, or 13th month pay. Section 32 of Republic Ac No. 9173 entitled, s Mr. Speaker that: Philippine Nursing Act of 2002. State

In order to enhance the general welfare, commitment to service and professionali sm of Nurses the minimum base pay of Nurses working in public health institution s shall not be lower than salary grade 15 Salary Grade 15 has a monetary equivalent of P24, 887.00. To the dismay of these nurses, the present Salary Grade implemented is SG 11 or roughly P18, 549. Aski ng for the implementation of SG 15 is not too much. It is a decent amount for a Nurse to provide for his or her family, as he or she performs her duties to prov ide quality healthcare. You have just heard my descriptions of the poor working conditions besetting our nurses where they are employed and the inequitable provisions of their work situ ations. While in the past, the Philippines can boast of good nursing education p rograms and services, SADLY, it is only our country in the ASEAN region that has no CHIEF NURSE POSITION in the DOH. What a pity that during the early years, nu rses from other ASEAN countries were coming to study in our schools and to make observational field visits to our health units. That was a glorious past and now , we are behind in every indicator of development. Ironically, despite the severe need for nursing services here in our country, ou r nurses are forced to leave the country in search of better opportunities abroa d.

Today, our profession mourns as we lose a colleague. I want you to meet Mr.Erano Santos. He was a man who dreamed of big dreams. He would have been content to s tay in his town in Angeles, Pampanga where he worked as a Clinical Instructor in Holy Angel University. He was an orphan and was forced to support his siblings. He waited for seven years for his papers to be processed for migration to US. H e chose to migrate to Ohio, and later on moved to Tenessee. On the fateful day o f July 20, 2013, after coming from work, Mr.Erano Santos was shot and killed fol lowing an altercation. The perpetrator of the crime did not only kill him, he to ok his car as well. His life ended on the pavement of the parking lot. His dream s of a better life for his family forever shattered. Locally, where do the unemployed nurses try to seek jobs? In CALL CENTERS, BEAUT Y CLINICS, GYMS, SPAS, HOTELS, DRUG COMPANIES and as CREWS in FAST FOOD CHAINS a nd RESTAURANTS. 3. WHERE ARE THE PUBLIC HEALTH NURSES who used to make home visits to families a nd gave health lectures to mothers on healthy family living and care of the very young, young, adolescents, adults, and elderly as well as pregnant and post-nat al mothers? 4. When you really come to think of it, it is really CARING FROM WOMB TO TOMB. CAN WE IMAGINE A WORLD WITHOUT NURSES (OR CARE)? Mr. Speaker, we believe that a strong nation begins with healthy constituents. O ur vision is to make the nursing sector an effective partner of the government t owards building a strong and healthy nation. It is our primary thrust to equip e very barangay health center and public school clinic with a nurse to deliver qua lity primary healthcare for the promotion of health and prevention of sickness. If this happens then we wouldn t see thousands of our nurses leave the country. I would like to put forward for us all that health is the be all in our lives. As more and more longevity of life is expected due to discoveries and inventions in modern technology and medicine, the nurses will be in much greater need to care for the elderly. In fact, this is what is happening to our Filipino nurses and care-givers who are out-sourced for care of the aged and elderly in the develope d countries. I submit to you all that there is a big need to look at our present health care system and undertake reforms to meet the Universal Health Care goal. Given the i nequity that operates in our present health care system, can we help in the achi evement of better equity? What combinations of legislation and health policies c an improve health in our country? Equity is fundamental to the achievement of th e goal of universal health care.