The Heath Policy Network, a group comprised of healthcare stakeholders said the government and the Department of Health (DoH) should focus on improving the healthcare facilities in depressed areas and in the rural areas as well as develop a pooled procurement program with the help of local governments to fund healthcare essentials such as medicines, medical equipment and supplies among others. Also, the group recommended the development of a social health insurance program.

In its recent media forum, members of the network criticized the devolution of healthcare services for the poor state of the Philippine healthcare system.

Healthcare service was officially devolved in 1991 with the passing of the local govenrment code. It was implemented in 1992 and gave local governments autonomy on raising money to sustain their healthcare expenditures.

"Ever since the government devolved healthcare services to the LGUs, the performance of the country's healthcare system has been far from excellent," the network said.

The group cited a research entitled "Overview of the Devolution of Healthcare Services in the Philippines" by J. Grundy, L. Gorgolon and E. Sandig for the International electric journal of rural and remote health research education, Practice and Policy of the Deakin University in Australia.

"Fundamentally, the paper asserts that there was no strategic plan on how to properly execute the transition from central health regulation to devolution. While the DoH created the Local Government Assistance and Monitoring Services (LGAMS) to assist and support DoH representatives in the provincial level this was considered an ad hoc body with limited resources and inadequately prepared staff," Asian Institute of Management professor Emmanuel E. Leyco, Executive director of the network and a senior health policy consultant said in his presentation.

"Basically, the paper indicated that 'all concerned and affected by the devolution were insufficiently prepared to cope with the wide sweeping changes it brought," he added.

The group noted that while the DoH managed the effects of the devolution through streamlining its functions up until 2000, there is still unequal distribution and delivery of health care services, lack of health facilities, limited medical insurance coverage, high cost of medicines, and insufficient efforts to improve treatment of non-communicable diseases. Adding insult to the injury is the decreasing number of doctors and nurses especially in the rural areas.

The researchers noted that after a year of devolution, there was a decreased hospital occupancy and health center utilization rates, untimely or decreased procurement of drugs, medicines and supplies by LGU supplies, decreased maintenance and operating expenses for health facilities, loss of managerial and fiscal control of hospitals by hospital administration, resignation of key personnel and low staff morale.

The health policy network also said that there was little increase in the number of hospitals since 1999 to 2005 and this has also brought problems in the healthcare system.

In 2005, there were a total of 1,838 hospitals with 38 percent of them as public hospitals and 62 percent, private. In 2007, the number of government-run hospitals decreased from 702 to 359 while private hospitals also dropped from 1,136 to 595, health policy network noted.

Likewise, majority of these hospitals are operating in Luzon, particularly in 'economically thriving provinces and cities.' Only a few can be found in poorer areas such as the Autonomous Region of Muslim Mindanao, CARAGA and Southern Mindanao, the group added.

As a result, diagnosis has remained poor and medicines and supplies became inferior and rarely available.

"A more holistic approach or strategy to address the ills plaguing the Philippine healthcare system should be undertaken. This approach should focus on addressing the geographic and socio-economic conditions prevailing in the regions in the country," the group recommended.