Taking care of HCWs

Thousands of Filipino health workers, particularly nurses, leave for jobs overseas annually to seek the proverbial greener pastures. Here at home, the so-called heroes of the COVID-19 pandemic endure low salaries, poor working conditions, and delays in their allowances— reasons why many of them choose to leave their families and country. To stop this brain drain, the three-member Makabayan bloc filed House Bill No. 6132 or the Magna Carta of Private Health Workers last Nov. 15 to encourage health care workers (HCWs) in the private sector to stay and serve in the Philippines by providing for their rights, welfare, and benefits. Private HCWs are not covered by Republic Act No. 7305 or the Magna Carta of Public Health Workers—a 30-year-old law that also needs to be revisited.

HB 6132 wants to “reduce, if not eliminate the disparities between the health workers in the public and private sector under the principle of equality and non-discrimination.” Among the disparities it seeks to address are benefits like hazard pay, subsistence allowance, laundry allowance, security of tenure, and longevity pay. It also prescribes a maximum of eight hours of work a day, or 40 hours a week, but paid seven days a week or a total of 56 hours a week, as well as compensation for overtime work.

The bill also proposes a P50,000 entry level salary for nurses, while that for other HCWs is set at P1,100 per day. Filipino nurses, according to the Philippine Nurses Association, are among the lowest paid with a monthly salary of $687 (about P40,000), compared with their peers in other Southeast Asian countries. A 2020 study by iPrice Group showed that nurses in Vietnam are paid $1,083 and those in Singapore get $4,058 monthly.

But the paper, “When the ‘heroes’ ‘don’t feel cared for’: The migration and resignation of Philippine nurses amidst the COVID-19 pandemic,” published last May in the National Library of Medicine website pegged the entry-level salary for a nurse in private hospitals at as low as $160 or P9,000, not even enough to cover their cost of living especially in this era of inflationary prices. The paper further noted that in October last year, 5 to 10 percent of nurses working in private hospitals have resigned—some choosing to leave their profession or leave the country for those who were lucky to make the quota. This migration of medical professionals has continued as the COVID-19 situation started to plateau.

Health reform advocate Dr. Tony Leachon warned in a tweet last Oct. 23: “Our biggest health care problem is not the pandemic ... but the continuous migration of our health care workers, particularly the nurses. This would affect our [Universal Health Care] plans and delivery of efficient services to our patients.”

Before the COVID-19 pandemic, about 17,000 nurses would leave for abroad annually. In November 2020, the government imposed a 5,000 cap to ensure that the country will not run out of HCWs at such a critical time. The government later raised the cap to 7,500—a move that was opposed by nurses’ groups and labor unions as unconstitutional and inhumane, especially amid complaints of poor working conditions and delayed allowances, while other countries had better job offers. Last September, as the Department of Health (DOH) reported a nursing shortfall of more than 100,000, President Marcos Jr. mulled increasing the current cap but said that the government needed to improve local opportunities.

At the height of the pandemic, HCWs complained of burnout, an ironic situation for frontliners who were taking care of the sick but were not getting the appropriate care and attention from the government. Even until today, HCWs are still waiting for their unpaid COVID-19 benefits covering the periods July-December 2021, and July 2022 to the present. The DOH has requested for an additional P27 billion to pay over 2.1 million eligible public and private HCWs. But the Department of Budget and Management has asked for documentation from the DOH, including certification of the claims and the list of eligible HCWs.

The government should begin the President’s directive of improving local opportunities by paying out what the state owes HCWs—the fact that the allowances due them have been delayed for over a year is unconscionable when they have been at the frontlines of the pandemic, risking their and their families’ lives to honor their oath. They do not even have to beg for allowances that they have been promised and for services they have already rendered, and the government must ensure that their welfare is taken cared of even after the pandemic.

Aside from passing a new law to protect the rights of private health workers, policymakers must also revisit RA 7305 and make sure that its provisions remain relevant and responsive to the times. HCWs are the backbone of the health system—and it will collapse if their work is not valued, their rights not protected, and their issues not addressed. Let us take care of our health care workers.