(First of two parts)
Government hospitals, especially tertiary or specialty hospitals, were built complete with laboratory and other diagnostic facilities and pharmacies.
Every year, the national government allots a budget for the salaries of staff and operation and maintenance of these medical facilities to make healthcare more affordable to the poor as mandated by the Constitution.
But for so long now, many, if not all, of these government hospitals—whether owned by local government units or under the direct supervision of the Department of Health (DOH)—have been outsourcing laboratory and pharmacy services to smaller, private providers.
Patients needing blood analysis (a requirement for disease outbreaks like dengue and leptospirosis) usually go to these private lab facilities after being told by a hospital that its own units are not functioning or need to be upgraded. The private labs do not offer discounts or credit and won’t allow laboratory services to be charged against the bill of patients confined in the hospital. Even basic intravenous tubes and fluids, tubes/bottles for blood, urine or fecal tests and basic anesthesia or pain killers can’t be found in the hospital pharmacies, when a budget has been allocated for such purposes. The usual excuse a patient or his attendant hears from the staff at the hospital pharmacy is that the item is “out of stock” or “limited volume available only.”
The particular item, however, is available in the private botica just outside the hospital.
The state of state hospital services has gone from bad to worse, and even the best specialty facilities like the Philippine Heart Center, Lung Center, National Kidney and Transplant Institute and the Philippine Children’s Medical Center are not spared.
At one point, the Aquino administration even thought of putting these medical facilities on the auction block, if only to reduce government expenditure. But the move was staunchly opposed by the Network Opposed to Privatization, which accused the administration of turning its back on the poor.
It is easy to understand the proliferation of laboratory and pharmaceutical stores around state hospitals. Government hospitals attract more patients because their services are far cheaper than that of private hospitals.
The enterprising lab or pharmacy owner need only to convince doctors and nurses to refer patients to their stores.
To keep the symbiotic relation going smoothly, labs and boticas sometimes offer a retainer’s fee, pay a rebate for every patient referred to them, or they hire the doctors or nurses as “consultants.”
In some instances, the doctors or hospital staff themselves own private labs and pharmacies, and make a huge profit from the set-up.
In the Code of Ethics of the Philippine Medical Association “the primary objective of this practice is service to mankind” and “financial reward or gain is just a subordinate consideration.”
Section 5 of the Code on the Duties of Physicians stipulate: “A physician shall not commercially endorse any medical or health product or service.”
It further states: “A physician shall not receive any commission for referring patients to a colleague, third person or institution. However, nominal gifts during occasions may be received.”
(To be concluded)