Thursday, October 9, 2008

Governor ATEs Keynote Speech Pangasinan Health Summit (Sept 25-27, 2008) Oxford Hotel, Clark Economic Zone, Angeles City


His Excellency EC Ambassador Alistair Macdonald, EC Team Leader Dr. Jose Cardona, DOH Regional Director Eduardo Janairo, Ms. Marichi De Sagun-Deputy Chief, Office of Health, USAID, Dr. Aye Aye Thwin-Chief of Health, USAID, Vice-Governor Marlyn Primicias-Agabas, and the members of the Sangguniang Panlalawigan, League of Municipalities National President Ramon N. Guico, Jr. and our city and municipal mayors, vice-mayors, sangguniang bayan members, municipal health officers, provincial department heads, our friends and partners from the EC-F1 program, the USAID, the DOH, NGOs, friends, ladies and gentlemen:

Permit me, first of all, to thank all of you for being here to grace, and to take part in this provincial health summit for the province of Pangasinan.

I am genuinely overwhelmed. I guess your valuable presence underscores the crucial importance of this particular affair.

This important event has been made possible because of the generosity of the European Community (through its Health Sector Policy Support Program), the USAID (through its HealthGov, TB LINC, PRISM, A2Z, and HealthPRO Programs), and the Department of Health.

These three indispensable partners/donor agencies, also paved the way for Pangasinan to be included as one of only 16 beneficiary provinces that are now pursuing aggressive strategic directions in health, and implementing relevant interventions, under the FOURmula One for Health Strategy.

FOURmula One stands on the four pillars of health program implementation, namely: services delivery, financing, regulation, and good governance

On top of sustained USAID technical assistance, the EC and the DOH will invest some P140 million grant for Pangasinan for five years up to 2010.

So far, Pangasinan has received P17.7million cash from the program, part of which has been spent for local trainings, and part will be used to upgrade our hospital and other public health facilities.

What can be more important than the life, the health, and the total well-being of our people?

The people are our reason for being. And their health and well-being deserve our utmost priority.

But that is precisely the problem. It appears that health ranks very low in our order of priorities.

Over the last 5 years, the average share of health in the annual budget of LGUs in Pangasinan is 21.74% for the province, and only 7.5% for municipalities/cities.

It is, therefore, not surprising that one year ago, the Regional Center for Health Development ranked Pangasinan number two from the bottom in health program implementation in Region I.

It is evident that we have not performed well enough during the past few years. Thus, we need to work hard to catch up, and to keep in pace, with the rest of the region.

But first, we must accept that health care is everybody’s concern. It is a collective responsibility, where each of us has an important role to play.

And if you do not do your part, you would leave a big gap in the overall effort to promote good health, and miss the privilege to promote the quality of life and the quality of our people.

For my part, I have put the provincial health program as the ultimate measure of my success as a governor. This is based on my firm belief that the most destitute person in our province is the poor man who is sick.

If the government is not capable of providing quality and adequate health care for the poor, then who would take care of them?

It is even worse if the government refuses to take care of the poor, even if it has the resources, and the capability (no matter how limited) to do so.

It is the job of the government to take care of the poor.

In the case of health and medical care, the government is the equalizing factor.

Unless the government deliberately makes way for the poor, adequate and quality health care will remain a virtual monopoly of the rich and those who have the personal capability to afford it.

Today, there are positive factors already in place that make it easier for LGUs to do their part in the overall effort for health promotion and care.

For one, medical insurance comes very handy and affordable through the national health insurance program. Through the capitation fund, Philhealth multiplies the limited capability of LGUs to provide health care to the poor.

There is, therefore, no reason why health and medical care should remain inaccessible to the poor in our midst.

Our dream is that the poor head of family in Pangasinan will have no fear for himself, or any member of his family, getting sick, fully confident that he and his entire family can get the best and adequate medical care in our RHUs, and in our provincial hospitals, through Philhealth insurance.

Over the last 15 months, the provincial government has exerted earnest efforts to achieve a universal enrollment of indigent families in Philhealth.

At yearend in 2007, the province had enrolled 26,096 indigent families. As of September 22, 2008, the total number of certified indigent families enrolled solely by the provincial government has reached 84,088 (and still counting), or 34,088 families from the 4th to 5th class municipalities, and 50,000 families from the cities and 1st to 3rd class municipalities.

The sole basis for Philhealth provincial sponsorship is the living standards survey or LSS, an instrument developed by the USAID to determine the economic status of families.

In short, only certified indigent families are enrolled by the province, regardless of their political color, or party affiliation.

For us in the provincial government of Pangasinan, health care is a non-partisan concern.

This is not the place to play politics. On the contrary, this is one perfect venue and opportunity for good governance.

After all, good governance leads to good health. Good health is good governance.

Combined with those sponsored by our congressmen, some LGUs, and NGOs, we now have a cumulative total of 129,149 families (out of about 151,000 indigent families in Pangasinan) now enjoying Philhealth insurance.

That means about 85% coverage for the poorest 25% of the population, as of last count a few days ago.

If you multiply that figure by an average of 5 members per family, this means a total of at least 645,745 individual Pangasinenses eligible for paid health and medical care in our government health facilities.

It is, therefore, crucial for our health care facilities, starting with our RHUs, and the province’s 7 community hospitals, 6 district hospitals, and 1 provincial hospital, to be properly accredited with Philhealth, physically fit, properly equipped and adequately manned to attend to all these prospect paying patients.

Unfortunately, out of the 68 RHUs in Pangasinan, only 38 are accredited for Out Patient Benefits, only 28 are accredited for TB DOTS, and none at all for Maternity Care.

If the private hospitals and clinics in the province are up to it, and we in government are not prepared, the main bulk of the financial benefits of the national health insurance program will simply go to private health care providers, and we in local governments will miss the opportunity to increase our financial and organizational capability to provide quality health and medical care to the people.

For our part in the provincial government, all our 14 hospitals are now in various stages of rehabilitation and improvement.

Each of them will have a separate birthing or neo-natal care facility, a better-equipped laboratory, an ultrasound unit, an ECG, a functional X-ray machine, among others.

All wards, whether for pay, or for charity, will be air-conditioned. Who said that it is only the rich that deserve air-conditioned accommodations?

Our ultimate goal, among others, is to make sure that no pregnant woman will be left to deliver her baby at home, but instead will invariably receive competent care and attention in a government birthing facility.

We will institute a system of communications and referrals to enable the barangay to inform the nearest provincial government hospital to pick up every woman due for delivery by ambulance.

Right now, all of our hospitals are being re-arranged to ensure work efficiency and the logical flow in hospital procedures, and to make them comfortable and convenient both for our hospital staff and the patients.

To underscore the prime importance that we place on health in the provincial order of priorities, I have personally met with our doctors and chiefs of hospital more that 30 times over a period of 15 months. I have met each of the other groups and offices at an average of 5 times only over the same period.

As reward for our efforts, our hospital chiefs have now come to realize that they are not just medical specialists attending to patients, but more than anything they are hospital managers whose main responsibility is to attend to the smooth operation of their respective hospitals.

It is our dream to make the provincial hospital in San Carlos City the benchmark for hospital operations in Pangasinan, even for the best private hospital in the province.

But on top of hospital and curative health care, we also need to strengthen our capability to promote good health, and healthy lifestyles and practices, and to invest more in disease prevention through an aggressive public health program.

I have often said that we have no business designing and pursuing very complicated and fancy health programs, if we are not yet able to provide the most basic things such as disease immunization, adequate potable water sources, sanitary toilets, drainage canals, waste disposal systems, and other environmental sanitation needs, and if we have not yet succeeded in teaching our people basic personal hygiene practices like washing their hands before eating, or regularly brushing their teeth, and to practice proper nutrition, which should be affordable and does not have to be expensive.

The aim is to promote personal good health among our people so that our hospitals and public health care facilities will have less and less sick people to treat.

I believe it is the moral obligation of every LGU to strengthen its public health promotion and disease prevention capability.

It should not be very difficult to craft a good public health program. All you have to do is to visit the poorest community in town.

The state of the people, and the physical environment thereat should give you a good idea on how to improve the health conditions of our people.

And it looks like we are now doing okay, and moving in the right direction.

The latest evaluation across the country reveals that Pangasinan ranks number two, along with Eastern Samar, in the overall implementation of the FOURmula One for Health Program.

Today, the small province of Capiz is number one. Tomorrow, it will be Pangasinan. And that’s not just an empty threat. It’s a promise.

I wish to emphasize that it is very important for the local chief executive, the local sanggunian, the municipal health officer, and the mayor’s key staff to have an adequate working knowledge of the overall health situation in their locality.

These local officials should be able to guide not just themselves, but also the other partners in health such as the DOH, the province, the NGOs, and donor institutions like the EC and the USAID on local health priorities.

It is a sad and embarrassing story, if the local government officials, instead of leading the way, have to depend more on the dictates and prescriptions of other external health partners, because the LGU officials themselves are not aware of their own situation, and consequently, do not actually know what’s good for their respective constituencies.

Indeed, the challenge for LGUs looks quite overwhelming.

But if we sincerely wish to give the best kind of care and service to our people, and if only we put our minds to it, we would soon have in Pangasinan the healthiest group of Filipinos that ever lived in this country.

I must be dreaming again. But isn’t that why we are all here today, because we have big dreams for our people, because we have that bold vision of Pangasinan as the best place to live, to work, to invest, and to raise a family.

Why not? Let us all go ahead and dream big.

And guided by our dreams, let us move forward, and together conquer new ground, and reach greater heights of progress and prosperity for our people, and our beloved Pangasinan.

Good afternoon.

I really hope we will have a fruitful two-day interaction in this second Health Summit for the province of Pangasinan.

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