DOH Secretary Franciso Duque (left) and former Covid-19 National Task Force adviser Dr. Tony Leachon (right).

(First of a Series of Two)

Let’s not quibble here. After all, changing gears in the midstream is just a cliché.

Don’t get me wrong, the President and only the President has the right and power to appoint or disappoint (sic) any in his official family. He is the chief executive of the government. 

But why President Rodrigo Roa Duterte has not fired Secretary Francisco Duque III but has allowed National Task Force adviser Dr. Tony Leachon to resign means politics is getting the better hand in managing our health affairs.

My strongest issue against Health Secretary Francisco Duque III is not just how he bungled supervising the government response to the Covid-19 crisis or destroyed public trust on the government’s immunization program with his suspicious behavior in favor of Sanofi and the giant pharma industry during the Dengvaxia controversy.

Four years in office, Duque still doesn’t get the point.

Decrepit profile of healthcare system

While Duterte and Duque enjoys mutual patronage for some yet undetermined affinity, data from the DOH shows that there are 1,236 hospitals in the country as of 2017, and of these, 2/3 are private hospitals.

Despite the WHO standard is 20 beds per 10,000 population, the Philippines has never reached the recommended ratio.

This indicator even worsened from 14.4 beds per 10,000 population in 1990 to only 9.9 beds per population in 2014, according to the Philippine Statistics Authority (PSA).  

Of the 1/3 that are government hospitals, most are in despicable state ever since they were devolved to the local governments who could hardly sustain enough funding for them to meet basic operational standards.

I have a grandchild who despite being born normal at a Pontevedra Municipal Hospital in Capiz last month, died within 36 hours from birth due to the negligence and carelessness of its nursing staff.

These government hospitals are under the supervision of the Department of Health.

And when it comes to community health services, only 47% of barangays had barangay health stations in 2018.

There is also a significant shortage of health personnel in the country.

The PSA reported a ratio of one government physician to 33,000 Filipinos, which is far from the WHO recommended 1:1,000 doctor to population ratio.

When President Duterte assumed office, the DOH said that the country is in need of 15,000 doctors to meet the healthcare needs of Filipinos each year.

The number of public health nurses is also dismal at a ratio of 1 to 50,000 Filipinos.

Philippine Overseas Employment Administration (POEA) data show that despite the scarcity of government health workers, the country has been exporting nurses for decades, which is worsening the brain drain of the health sector.  

The Philippines deployed 19,551 nurses in 2016 or 53 nurses per day. In 2013, the Department of Labor and Employment (DOLE) advised nurses to find work in business process outsourcing (BPO) as medical transcriptionists, billers, and health care secretaries since they can no longer be accommodated in government hospitals.

These shortages in medical facilities and personnel are due to government’s low prioritization of the health sector as seen in the national budget.

While it seems good that the health sector budget has increased from Php177.7 billion in 2019 to Php185.5 billion in 2020, its overall share in the national budget has fallen from 4.9% to 4.5 percent.

The Php7.8 billion or 4.4% increase in the health sector budget is even eaten up by inflation.  

Situation Zero

The cuts to much-needed health programs that could help the country better cope with the ongoing pandemic already reeked of serious lack of vision and gross mismanagement.

For instance, the budget for Health Systems Strengthening Program was cut by Php6 billion in 2020. The program is used for ensuring a wide range of human health resources such as doctors, nurses, midwives, community health workers, and other health care providers.

The budget for the Epidemiology and Surveillance Program which monitors, investigates, and analyzes disease outbreaks was cut by more than half. It was reduced from Php262.9 million in 2019 to Php115.5 million in 2020.

This is the Situation Zero, when Covid-19 entered the picture this year.

Only God’s grace save our country from the contagion and its curse of death.

Message from Mindanao

One of Duterte’s staunchest supporters in the Davao press has asked for the head of Duque. Serafin Ledesma Jr., writing for Sun-Star Daily Davao wrote:

 “The President’s patience maybe thinning out.

“The putrid smell from the dead rat eventually reached the doorsteps of Malacanang. President Duterte questioned why DOH insists on buying PPEs from what Duque described as “exclusive” distributor and said to his face he hates people taking advantage of the crisis and people’s misery.

“He needs a dynamic team who can work and last with him up to the wee hours. It is about time to retire an old horse with blinders. Mr. President there are too many to choose from in the stable.”

Senate resolution

At least 14 senators crossed party lines calling for Duque’s resignation for his “failure of leadership, negligence, lack of foresight, and inefficiency in performance.” This, they said, led to “poor planning, delayed response, lack of transparency, and misguided and flip-flopping polices and measures” in addressing the pandemic.

The multi-partisan signatories to the resolution were: Senate President Vicente Sotto III, Senate Majority Leader Juan Miguel Zubiri, Sonny Angara, Nancy Binay, Grace Poe, Joel Villanueva, Francis Tolentino, Imee Marcos, Manny Pacquiao, Sherwin Gatchalian, Ronald dela Rosa, Ramon Revilla Jr., Lito Lapid and Panfilo Lacson. Senate President Pro-Tempore Ralph Recto was supposed to be among the signatories to the resolution but he was not able to send his e-signature on time.

The senate position was influenced by an association composed of 744 private hospitals asking for the replacement of Duque, with “someone who can deliver better in addressing the health concerns of the country.”

Former men in uniform

A West Pointer, a former infantry and intelligence officer in the Army, Siegfred Mison writing on his column at the Business Mirror said Dr. Tony Leachon, in his capacity as Special Adviser to National Task Force implementer Charlie Galvez, simply posted on social media a respectful yet opinionated note: “I think DOH has lost focus in everything. Risk communication, priorities, data management, and execution of all plans.”

It takes audacity, not aggression, to speak the truth and show how to align to one’s true worth. Whenever we speak, let’s not be intimidated by the world we live in. Some might feel subtly castrated by human norms or by government policies, both of which were crafted to legitimately minimize aggression, Mison added.

Another former man in uniform, Interior Secretary Eduardo Año on Thursday expressed regret over the removal of Dr. Leachon, “I think he did that (with) good intentions. He does not want to malign anyone. He wants to emphasize some reports, sometimes he is very emotional.”

Año acknowledged the huge role the doctor played as adviser of the task force prior to his being asked to resign. He is sort of what you call a critical thinker. “Even in my actions, he was a big help,” he said.  Nonetheless, Año said he will stay in touch with Leachon even after the latter left his post.

So the question persists, did the President fire the wrong man?

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