July 31, 2019 — The full implementation of Republic Act No. 11223 or the Universal Health Care (UHC) Act will not take effect until 2029 since public consultations are still being held and the Implementing Rules and Regulations (IRR) need consolidation. The Department of Health is hoping to finalize the IRR by August and is still open for further comments. Once consolidated, the Congress and Senate will have to approve the IRR. However, there will be a pilot implementation of the UHC in 33 provinces and highly urbanized cities.
In line with the UHC Act that automatically enrols all Filipinos in the National Health Insurance Program and prescribes complementary health system reforms, the Philippine General Hospital held forums to discuss the role of PGH in the UHC implementation.
“We as a hospital should lead in crafting or suggesting ways to make universal health care more meaningful to our patients and easier to implement. The topic caused us to think about what we do here. We realized that our education in UP is community medical-oriented, but when we get to PGH, we orient ourselves with the highest specialty that we can, forgetting our community orientation. This made us realize that maybe, it’s about time we renew the way we train our residents in line with Universal Health Care,” PGH Director Gerardo Legaspi stated.
The first forum entitled “Training Doctors for Universal Health Care: The Role of UPCM and PGH” was held on 18 July 2019 with Professor Emeritus Dr. Zorayda Leopando of the PGH Department of Family and Community Medicine as speaker. “We anticipate that the UHC law will be the game changer in terms of health care and not just medical education but all health professions education,” she stated.
Dr. Leopando identified the needed reforms in medical education to strengthen UHC implementation as follows:
1) Education should focus on the attainment of the Sustainable Development Goals (SDG) that include targets for health and well-being;
2) Training should be aligned with Transformative Education, giving emphasis on the country’s health needs and social determinants of health;
3) Health literacy should be increased with focus on reducing non-communicable diseases and implementation of population-wide health promotion programs and activities across the social determinants of health;
4) Improvement of health communication;
5) Development of a culture of quality care and patient safety through appropriate use of clinical practice guidelines/clinical pathways;
6) Adoption of an appropriate referral and back referral system and participation in quality circles.
“Health professionals must be part of a health care provider network. We need to know the roles of professionals and the mandates and governing laws because we are working as a team,” Dr. Leopando affirmed.
CM Associate Dean for Academic Development Dr. Coralie Dimacali concurred. “We can work together harmoniously in the delivery of healthcare; and good collaboration is one of the key components for successful UHC implementation. Interprofessional health care teams should be created in hospitals similar to the interprofessional practice of medical interns with other UP Manila colleges in their Community Health Development Program trainings in barangays.” She added that the university should develop in medical students analytical and organizational skills which are also essential under universal health care.
PGH Coordinator for Training Dr. Stella Marie Jose urged PGH to form linkages with primary health facilities acting as catch areas to provide primary health care to patients and refer complicated patients to PGH. “PGH should assist in the training and certification of the primary health care physicians by offering courses and review classes.”
World Health Organization Consultant for Health Systems Strengthening Dr. Albert Francis Domingo maintained that PGH should forge formal agreements with primary care providers and provincial hospitals in terms of referrals and transfer of health records.
In closing, Dr. Leopando emphasized the need to inspire medical graduates to take primary care as a lifelong career and to know by heart the definition of primary care and services provided. “Make all doctors realize that they are not only doctors of the sick but are doctors for health. They should help improve the health literacy of Filipinos, thereby enhancing health promotion and maintenance.”
Charmaine Lingdas | Published in UP Manila Healthscape July – August 2019
