Pay disparity a disincentive for rural-based doctors

Published June 20, 2020, 12:00 AM

by manilabulletin_admin

By Vanne Terrazola

The disparity between the wages and benefits given by the national government and local government units (LGUs) has been discouraging Filipino doctors to serve in rural and low-income areas on the Philippines, officials said on Friday.

Department of Health (DOH) Undersecretary for Administration and Financial Management Roger Tong-An said as of this year, over 100 sixth-class municipalities in the country do not even have doctors.

“As of June 2020, 38.46 per cent of 6th class municipalities are doctor-less,” Tong-An bared during the hearing of the Senate local government committee Friday, June 19.

“The Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) has 36 doctor-less municipalities out of the 103 other doctorless municipalities,” he added.

The DOH official said a doctor hired by a sixth-class municipality receives only 65 percent of the salary received by doctors working in national government hospitals.

He said the national government currently compensates public health doctors P85,074 per month, aside from the the benefits they receive under existing laws, such as the Magna Carta for Public Health Workers Act (RA No. 7305).

“This has discouraged doctors to serve in low-income class municipalities or the geographically-isolated disadvantaged areas,” Tong-An said.

According to him, LGUs “find themselves limited in paying their doctors” because of the Local Government Code, which caps the total appropriation of LGUs for personal services at 45 to 55 percent and limits their appropriation for hiring more doctors and the grant of their benefits.

He also attributed the problem to the Compensation and Position Classification Act of 1989 (RA No. 6758), which defines the pay rates in LGUs depending on their class and financial capability.

At present, 372 doctors are deployed to rural areas of country under the DOH’s “Doctors to the Barrio” Program (DTBP), 53 percent of them in fourth to sixth-class municipalities.

Only a few of them, however, opt to work for local government units.

Director for Human Resource Development Ruth Politico said based on their study, retention rate is only at 18 percent. A total 1,342 doctors were deployed under the DTBP since 1993, she said.

Quoting the doctors, Politico said that the low absorption rate was due to the low salaries offered by the LGUs. She said some LGUs also do not have the financial capacity to provide the doctors other benefits, noting the Magna Carta provides that such are “subject to availability of funds.”

In reaction, League of Provinces chairman and Quirino Governor Dakila Cua said LGUs find it difficult to compete with the national government in compensating the doctors.

“Sweldo ng (The wages in) national government hospitals or DOH hospitals are much higher than the salaries that are prescribed under the LGU. Kaya ‘yong doctors and nurses, ‘pag nagtaas ang sweldo ang DOH, ayan na, nahahatak nila ‘yong mga doctor, ‘yong mga nurses (That’s why when the DOH raises the salary rate, they tend to attract the doctors and nurses from local hospitals),” Cua said.

“Hindi naman namin sinasabi na ‘wag kayong magtaas, pero siguro, kung pwede niyo kaming matulungan din dahil hindi po kaya ng mga LGU na makipagsabayan sa national government kapag nagtaasan na ng sahod (We are not saying that you don’t increase wages, but maybe, you can help us because LGUs cannot compete with the national government when salaries are increased),” he added.

Dr. Clemencia Bondoc, Iloilo municipal officer and national president of Association of Municipal Health Officers of the Philippines, echoed this concern, saying the pay raise and benefits provided by laws are “just promises, dreams and never a reality.”

She said rural health workers currently receive P50,000 and below. Most of them also do not receive their hazard pay and other allowances, and “not given enough protection” amid the coronavirus pandemic.

“When this is over, we’re afraid, we will be losing a lot of doctors. So many will retire and a lot more will leave the service especially our doctors to the barrios,” Bondoc said.

“Public health is not a place to spend your career as a doctor. Paano kasi, [you spent] eight years studying medicine, one year internship, and three years in training, yet you are not even given the dignity and respect of being a doctor,” she said.

Senator Francis Tolentino suggested that the national government instead delegate the funds to the LGUs, so that salaries given to local doctors will be at par with what it gives. Cua agreed with the proposal.

The Senate local committee was tackling, among others, the Senate Bill No. 446 filed by Sen. Ramon Revilla Jr. The measure sought to grant incentives and other benefits to doctors in rural areas of the country.

Meanwhile, Tong-An said there is no need to craft a new law granting rural health workers more benefits. He instead called for the proper implementation and review of existing laws related to the health workers’ benefits.