Senate committee on health & demography holds hearing — July 28, 2026

[0:00] Senator Soto. Can I make my sponsorship speech? Thank you. Honorable Chair again. Senator Rizan Teveros, Senator Soto, distinguished members of this committee, my fellow legislators, resource persons, ladies and gentlemen, good morning. [0:21] I would also like to acknowledge representatives from the City of Mutuan. We have here Attorney Ayan Sabado, City Administrator, City Councilor Theodore Gabriel Salcedo, Chair Committee on Health, Sangguniang Panlunsod, Mr. J.M. Alviar, Health City Consultant, and former Councilor Jeremy Busa, Health City Councilor. [0:53] Former Councilor and Health City Consultant. Allow me to express, Madam Chair, my gratitude to the committee for taking up House Bill 8470, proposing the renationalization and upgrading of Mutuan Medical Center into a Level 3 facility. [1:14] Upgrading the Mutuan Medical Center will increase its bed capacity from 150 to 300, transferring its direct supervision and funding to the Department of Health, which primarily aims to resolve persistent overcrowding and local financial constraints. [1:40] Moreover, this would support with the requirement of a tie-up of Level 3 hospital for the newly established College of Medicine in Caraga State University, a first in Caraga region. [1:58] Ultimately, this bill ensures sustainable modernization and accessible, specialized healthcare, not only for the residents of Mutuan City, but the entire of Caraga region. [2:16] With this, Madam Chair, Senator Soto, this representation seeks your full support for the passage of this important House Bill. Thank you and good morning. [2:31] Thank you, Madam Chair. [2:35] Thank you, Rep. Joe Boy. [2:36] And now, 4th District Bukidnon Representative La'arney Roque. [2:42] Good morning, Senator. [2:46] Good morning. [2:47] Is this the time to do the... [2:48] Later, Naya. [2:50] I think we're just introducing ourselves. [2:53] I'm just a congresswoman of the 4th District of Bukidnon, San Tito, and then San Risa. [3:01] It is a pleasure to be here. [3:03] And I am here for the hospital bill for the first ever DOH hospital in the whole province. [3:08] Thank you, Pa. [3:09] Thank you, Pa. [3:10] Good. [3:11] Now, oh, my Kasimanwa from Capi's representative, Baby Jane Castro. [3:17] Yes, Jane Castro. [3:19] Good morning. [3:21] I am Jane Castro of the 2nd District of Capi's. [3:25] I'm here for the re-nationalization of House Bill 8474. [3:30] Thank you. [3:31] Thank you, man. [3:33] Present online from Sambales representative, Jay Kong Hun. [3:40] Rep Kong Hun. [3:41] Rep Kong Hun, gusto nyo bang mag-opening statement about your bill? [3:46] Magandang umaga po, Senator Risa, Senator Tito Soto. [3:50] Good morning po. [3:51] Later na lang po, pag i-discuss na po yung aking bill, magkakaroon po ako ng opening statement. [3:56] Thank you po. [3:58] Okay, thank you. [3:59] From Capi's, also Rep. [4:05] Howard Gintu. [4:08] Good morning, Senator Risa and Senator Tito Soto. [4:12] I'm here representing the 1st District of Capi's in support of our bill regarding the re-nationalization of our provincial hospital. [4:22] Thank you. [4:24] Thank you, ma'am. [4:25] Thank you, ma'am. [4:26] From Kalinga, Representative Caroline Aguiao. [4:30] Thank you, Madam Chair, Sen Tito Soto. [4:37] I'm here to represent the province of Kalinga for the re-nationalization of the Kalinga Provincial Hospital. [4:45] Thank you so much. [4:46] Yeah, ma'am. [4:47] Ma'am. [4:48] Rep. Marlesa Hofer-Hassim, 2nd District, Samuanga-Cibugay. [4:53] Good morning, Senator Risa and Senator Tito Soto. [4:56] I'm Ana Marlesa Hofer-Hassim, the representative of Samuanga-Cibugay 2nd District, here to defend House Bill No. 8471, establishing the first ever DOH hospital in our province. [5:11] Thank you. [5:12] Thank you, ma'am. [5:13] And last but not the least, from the 3rd District of Bukidnon, Rep. Audrey Subiri. [5:18] Good morning. [5:21] Thank you very much, Senator Risa Hantiveros, and to Senator Tito Soto. [5:25] I would like to thank you for your gracious and kind invitation to all of us, and we are all happy to be here. [5:31] We all share the same goal of bringing more medical care to our fellow Filipinos, especially those who need it the most. [5:38] And I am here together with Representative Roque, because in the province of Bukidnon, as she mentioned, there is absolutely no DOH hospital yet. [5:46] And we are both hoping that we can create one in each of our districts. [5:50] And so I am here for the upgrade of the Bukidnon provincial hospital in the municipality of Maramag. [5:56] I have a bill, HB 230, that will convert it into a tertiary level 3 general hospital to be put under the management and supervision of the Department of Health. [6:06] Thank you very much. [6:07] Thank you very much. [6:08] Thank you very much. [6:09] Thank you very much. [6:10] Thank you very much. [6:11] Thank you very much. [6:12] Thank you very much. [6:13] Okay, so yes, Senator Tito Soto. [6:14] Thank you. [6:15] Thank you for that. [6:16] First of all, well, at the outset, what I would want to do is to thank you, our chairperson, for calling and convening this committee for these local bills. [6:29] And even one, two Senate bills. [6:36] So thank you very much. [6:37] Because what I would want to do and to say this morning is to endorse all these local bills. [6:45] And if I can be, if I can be made a co-sponsor when you do the sponsorship, Madam Chairperson. [6:58] Thank you very much. [6:59] Thank you very much. [7:00] Thank you so much, SP Pro Temp. [7:04] Walang mas masaya pa kung hindi co-sponsor kayo sa mga bills ng Committee on Health and Demography. [7:11] Maraming salamat po. [7:12] So first crack, Department of Health. [7:18] Lalo na dahil kayo po yung pangunahing implementer sa ilalim ng inaprobohan na ng Senado na hospital bed capacity and service capacity rationalization law bill namin. [7:34] So, unang tanong po, Dr. Maria Bitwin, anong service gaps at anong catchment populations ang magja-justify sa bawat proposed hospital na tinatalakay natin ngayong umaga? [7:50] Magandang umaga po, Madam Chair, and to our esteemed colleagues here and the Senators and Congresswomen. [8:14] First of all, we'd like to acknowledge the intent of all the proposed measures. [8:19] We recognize that the Philippines has yet to reach the intended bed capacities for the entire country. [8:26] Um, we recognize that these bills are spanning key provinces as well. [8:31] This is Capiz, Zamboanga, Cebuga, Bukidnon, Davao de Oro, Zambales, Kalinga, Agusan del Norte, South Cotabato, and Romlon. [8:39] Um, which are all experiencing long-standing infrastructure and health service shortages across the regions. [8:46] Um, if I may share the bed gaps for each province that I mentioned, Capiz currently faces a regional, [8:56] uh, they have a provincial bed gap of 1,100 level 1 beds and over 2,300 level 3 beds. [9:04] So when we talk about level 3 beds, um, this is a, the, the expanse it covers is supposed to be for the entire region. [9:11] So when I mentioned po kung ano yung mga bed gaps natin, [9:15] Provincia po ang pinag-uusapan kapag level 1 at 2, and then pag level 3 po, um, dapat po, shared po ito sa buong region. [9:23] Um, so for Capiz, that is our number. [9:26] Zamboanga, Cebuga, on the other half, we have 900 level 1 beds. [9:30] And since the recommendation is for level 3 beds, it's, uh, 3,800, uh, beds, uh, currently. [9:38] For Bukidnon, uh, for level 1, we are talking about 2,200 level 1 beds. [9:44] Uh, for level 3, it's 3,100. [9:49] For Zamboanga, um, we are talking about level 1, 942 beds, um, 178 level 2, and 9,558 level 3 beds. [10:03] Um, for Kalinga, level 1 is 156, uh, bed gap, uh, level 2, 154 level 3, uh, 978 for car. [10:13] Uh, Davao de Oro, on the other hand, is level 1, 987 level 2, uh, 562, and for level 3, it is 3,269 beds. [10:23] Agusan del Norte is looking at level 1 gaps at 666, um, 267 for level 2, and 2,280 for level 3 for the entire region 13. [10:38] Uh, South Cotabato, on the other hand, has, since this is already our, uh, hospital, we, Soxargen Regional Hospital, uh, General Hospital on the other hand. [10:47] For level 3, we are looking at 4, uh, 277 bed gap. [10:53] For Romblon, it's level 1, 367, level 2, 199, and level 3, 3,061 beds. [11:02] So we will submit the tabulated form so that it is easier for you to have reference for this. [11:08] Thank you, Madam Chair. [11:09] Thank you. Very helpful. [11:11] Ah, ah, kung ano yung bed gap na kailangan talagang i-close sa mga bills na to na may kinalaman sa provincial hospitals. [11:22] At I have to check if any of them are for a regional hospital, kung ah, paano ishi-share sa ibang mga probinsya sa kanikanyang region [11:31] para maklose yung level 3, ah, regional, ah, bed gaps. Thank you so much. [11:36] Yes, of course, Senator Tito. [11:37] Madam Chairperson, just, ah, out of curiosity, your opening statement, you said, [11:42] we have not reached the, or do we, there is an ideal bed capacity for the country? [11:48] Ah, ah, ah, how much is that? Or how many? What would be the total ideal bed capacity? [11:56] So right now, our target bed capacity is really at 2.7 beds per 1,000 population, 7 beds. [12:07] So it is a moving target, ah, based on our increasing population. [12:12] Ngayon, ah, this is in total for the entire country. [12:15] 2.7 beds per? [12:17] 1,000 population po. [12:19] 1,000, okay. [12:20] Yes. [12:21] What is the current bed capacity? [12:24] 1.01. [12:28] That is the average across the nation. However, we have disparities as of the moment. [12:34] We can submit the specific bed to population ratios per province, per region, and then that is our average as of the moment. [12:44] So in other words, we're 50% of the ideal bed capacity. [12:50] Less than, Mr. Jeff. [12:51] Less than 50%. [12:52] Less than 50%. [12:53] Because 2.7 po yung. [12:54] Okay, thank you. [12:55] Thank you. [12:57] Thank you. [12:58] Yung catchment population, meron din po ba kayong data per proposed hospital na pinag-uusapan natin ngayon? [13:07] For the proposed hospitals po, the catchment populations we look at, again, is the province-wide. [13:13] So that is, if we're looking at a level 1 and 2, and we do not limit ourselves to that if we're talking about a level 3. [13:20] Since majority of these are level 3 hospitals, they are being proposed to increase in or upgrade po sa kanilang service capability. [13:29] Ang level 3 po, sa ngayon po pagmamapa po namin, ang ginagamit nga po namin is travel time. [13:36] Because ang pinapansin po natin, it's not distance. [13:39] There will be areas that will have better road networks, hence, mas malayo po yung kaya pong ma-reach or catchment na available po. [13:47] So, on the other hand, yung distance po, very limiting yun eh. At nagko-cross boundaries din po kami kung mas malapit po sa kabilang probinsya. [13:57] So, for that one po, we did not limit ourselves to it. However, if I may just give some general guideline po. [14:05] So, all DOH hospitals are generally envisioned to become regional hospitals or at least regional catchments, especially if they are level 3 hospitals. [14:15] Hence, we are talking about a minimum of 3 hours catchment po dapat. [14:20] So, in the analysis of these facilities that were being proposed to us, when we did the analysis, we limited first to one hour. [14:28] Because we recognize that the healthcare provider network of some of these provinces have not yet been fully established. [14:35] So, alam din po namin na sa mga ibang probinsya po, ang tatlong oras meaning 700, I mean 100 kilometers away na po yun. [14:46] So, if we are looking at an emergency, if we could lessen that amount of time, we would prefer it as well. [14:53] So, the PHFDP or the Philippine Health Facility Development Plan, ang target po talaga niya is lahat ng Pilipino may access sa isang hospital within one hour. [15:05] Whether it is a private facility, a government facility, as long as it is a hospital. [15:11] So, that is the bare minimum that we started looking at po. [15:19] Thank you, Dr. Maria. [15:22] Between, pakishare din yung data na yun tungkol sa catchment populations para sa lahat ng bills na ito. [15:35] Because maghahanda ang committee report individually, pero magandang makita natin yung relationship ng isa't isa kung mayroon. [15:46] Especially in the context of yung referral systems na pinag-uusapan din natin provincially and of course regionally as well. [15:54] Anong initial bed capacities, initial service capabilities at staffing complements ang nirekomenda niyo sa bawat facility na pinag-uusapan natin na yun? [16:08] We will also make an omnibus po for this. [16:11] So, for those that are being renationalized, of course, it is a maintain and increase. [16:16] But for the facilities that are intended for establishment, ang minimum po namin right now is 50 beds level 1. [16:25] Mababa po ang tunog niya. [16:27] Pero based on our experience, it is better to as soon as we are able to accommodate patients, magsimula na po kami kaagad imbis na maghintay po na maitaas ang servisyo. [16:38] And also, outside of publicity or marketing of these facilities, we also recognize po na may mga pagkakataon po na ang establishments. [16:50] Hindi pa po sanay ang mga tao na pumunta or nag-build up din po kami ng demand kahit na po DOH po ang facility. [16:58] So, napansin po namin na magsisimula po kaming mababa, nasasanay po ang behavior din po ng mga tao dun sa catchment na ay, meron na po dito. [17:08] So, it is also easier for us to ease in, one, the staff, two, the budgeting, and three, the infrastructure. [17:15] So, we're able to make it operate earlier, and then while we do a phased approach, increasing in all aspects po. [17:22] So, that's the HRH, our infrastructure, and even the capacity of our management side. [17:30] Kasi po, madalas po either nanggagaling din po tayo dun sa area na kukuha ng mga managers ng ating facility, [17:40] or kukuha po tayo wherever we have some expertise from our current existing facilities, meron pa rin pong learning curve dun. [17:49] So, we don't want to limit the facility na ay magpapatakbo lamang tayo kapag level 2 na. [17:56] Hindi po, we do not waste the time po. [17:58] And kung tama yung na-take ko na notes kanina, ewan ko ba ako binabanatan for taking notes, [18:09] useful naman kahit sa year instead. [18:20] Aside lang yun. [18:21] Kung tama yung notes na nakuha ko, anim sa Shumna province ang pinag-uusapan natin ang bills nila sa ngayon. [18:28] Ang bed gap sa level 1, hindi ko lang nasulat yung level 2, ay nasa hundreds. [18:34] And then tatlo yung nasa level ng thousands na ang bed gap. [18:38] So, well, I thought, sasabihin nyo po na ang minimum na gusto nyo sanang ma-establish kung construction ng bagong hospital ay 50 beds. [18:47] I thought you would say kahit 100. [18:49] Pero para sa parehong magnitude, dun sa anim na probinsya. [18:53] But okay, 50 is more than zero. [18:56] And sabi nyo nga na i-phase in nyo yung higher bed and service capacities per hospital. [19:03] At importante yung building up demand on the side ng mga members ng health system natin. [19:09] So, tayong lahat ng mga Pilipino. [19:11] And the matter of the learning curve. [19:13] Napansin po namin yun at the outset na gusto natin may complementation, not competition or duplication. [19:21] So, nabanggit nyo na po kanina yung referral network. [19:38] But kung meron kayong gustong idagdag, [19:40] paano nakikita ng department mag-fit in itong bawat na hospital na pinag-uusapan natin dun sa provincial and even regional referral networks? [19:50] Thank you Madam Chair for that question. [19:53] So, the referral network or the healthcare provider network po natin ay nagsisimula po yan sa primary care and then our level 1. [20:02] And then level 2 or 3 to provide the tertiary care services. [20:07] So, yun po yung healthcare provider network. [20:09] We usually, kapag level 3 na po ang facility na DOH owned, lumalabas po siya dun sa mismong box natin ng referral network. [20:21] Because they are accepting of even beyond or multiple healthcare provider networks po. [20:30] So, we can also share that with the committee po yung visualization po namin of that one. [20:35] Because it's much easier to understand. [20:38] Yun po yung tinatawag po namin na end referral o kaya apex hospital po. [20:43] So, yung mga apex po natin bilang may mga servisyo po silang na ibibigay na mas mataas ang antas. [20:49] So, kahit po sa malayong healthcare provider network nang galing ang isang pasyente, [21:04] provider network that we are physically adjacent to. [21:07] So, pagdating po dito sa mga hospital natin ngayon, [21:10] So, if I may be honest po, ang mas concern po namin is, [21:14] for some of the renationalizations, [21:16] baka po, ano ba, mapuputol po namin yung healthcare provider network nila [21:23] bilang yung isa pong hospital ay lalabas kapag naging DOH hospital po siya. [21:28] Bagamat hindi naman po ganun kabilis maging level 3 din, [21:32] may pagkakataon pa rin po na they will serve, of course, the network that they are around. [21:39] But it is preferred that a complete service delivery design po sa healthcare provider network [21:47] is under the LGU is one level 1 and at least one level 2 or 3. [21:54] So, they are not compelled naman po na maging level 3 yung hospital po nila [21:58] dahil alam din po namin na mas mahal din po itong ipatakbo. [22:01] Kaya po, inaako na po ito ng Department of Health [22:05] na yun po yung maging hospital na idedevelop po ng Department. [22:11] So, yun lang po yung major concern po namin doon. [22:14] But all the rest, wala pong concern dun sa, [22:18] parang hindi po ba tatanggap, wala pong ganun. [22:23] So, the Department of Health, health facilities will accept any and all from any catchment actually po. [22:31] And we will, and it is also part of the hospital operations that we do now. [22:37] But we encourage actual MOAS with different healthcare provider networks. [22:43] There are some po na specific to service. [22:45] There are some na in general po. [22:47] So, yun po yung placement po ng mga DOH hospitals in the system. [22:52] Thank you, Madam Chair. [22:54] Thank you, Director Maria Bituin. [22:58] So, anyway, for sure, mag-TTWG tayo. [23:12] At doon, importante, with yung context din, at least sa amin sa Senate, yung DOH bed capacity [23:23] and service capacity rationalization bill, [23:27] i-match yung plano ng DOH for the whole country [23:31] sa mga plano ng bawat district, province for their area and constituents [23:40] para mabuo yung universal healthcare system natin. [23:43] Lalo na yung pillar na yun na binanggit nyo, yung service delivery network. [23:48] And it's reassuring to hear na most of the bills mukhang walang problema [23:54] in terms of the referral network. [23:56] So, sa TWG na pabubuhuin din po namin ang komite sa COMSEC, [24:01] we will really need the department's advice kung paano yung mga bills natin [24:07] on renationalization ay pwedeng marationalize pa rin, [24:13] mapasok pa rin sa service delivery network. [24:17] Something I learned just now and I think very helpful na [24:32] ang vision ng department ay at least isang level 1 or isang level 2 [24:38] plus at least isang level 3. [24:41] Sorry, I got it wrong. [24:44] Kahit nandunotake ako. [24:45] Pakiulit yung tama. [24:46] If I may, isang level 1 and then isa pong level 2 or 3. [24:52] Okay. [24:56] So, paano natin bubuuin yan primarily with the help of these bills [25:03] na kinoconsider natin. [25:05] And salamat din sa binanggit nyo na nage-encourage ko yung mga MOA [25:09] sa mga iba't ibang health service provider. [25:12] So, sa TWG, tignan natin kung paano noon yung mga ganong MOA [25:17] makukomplement din itong bills natin. [25:19] And pag binangga natin doon sa plano ng DOH for the whole country, [25:25] salamat po. [25:26] Now, ito, four provinces na may tigalawang proposed hospitals [25:34] dito sa mga bills natin. [25:36] Those are sa Buanga, Sibugay, Kapis, at saka Bukidnon. [25:40] Anong payo ng DOH para maiwasan yung duplication of services [25:45] at maiwasan din yung competition para sa mga limited health personnel? [25:50] Thank you both, Madam Chair, for those. [26:02] As mentioned earlier, our aim is really to align with the [26:06] Philippine Health Facility Development Plan guidelines. [26:10] So, ito po yung one-hour access. [26:13] Opo. [26:14] So, we have done some mapping as well. [26:17] But, siyempre, limited po yung view po namin on that. [26:20] Maps can only tell you so much as compared to getting to know [26:25] the people as well and the service demand. [26:27] So, medyo mababaw po yung, for me, [26:31] we can do something deeper for those. [26:34] However, we also recognize that there's major limitation in HRH. [26:38] So, we really do not want to be duplicating the same services. [26:41] So, if there are opportunities for us to, for example, [26:45] have integration of services that is being proposed, that is preferred. [26:49] If we are looking at a already stable healthcare provider network, [27:00] tapos mag-re-renationalization po ng isa, [27:03] pwede po namin kunin yung existing na isa instead na magpatayo po ng bago. [27:09] So, because it also moves faster. [27:12] Madalas po ang difficulties namin with some of the establishments is yung readiness po of the land. [27:19] But, among other things. [27:21] So, yun po yung general guidelines ko po for this part. [27:27] We can further discuss it later on when we go through the bills. [27:30] Thank you po. [27:31] Thank you. [27:32] Thank you. [27:33] And of course, malaking tulong yung PHFDP ng department to help us achieve our national dream [27:40] with very realistic and responsive provincial and district parts. [27:46] Opo. [27:47] Through these bills. [27:48] So, yung integration na sinasabi nyo. [27:50] And it gives me an idea yung mangyayari sa TWG na yung isang mode na sinabi nyo na posibleng [27:58] among the renationalization bills na kunin nyo nga yung isa sa halip-halimbawa ng magpatayo. [28:04] So, there could also be different modes sa mga bills natin. [28:09] And speaking of, so, for the hospitals na pinopropose i-renationalize, paano yung mga personnel, assets, liabilities, records, contracts, pati funds, [28:25] maililipat na hindi madidisrupt yung existing operations? [28:36] Thank you po, Madam Chair. [28:37] So, we have experienced this as well in the past naman po. [28:40] So, the transition governance, we usually build or develop a transition committee [28:47] which is specific to that facility that is being renationalized [28:51] in recognition din po of the various stakeholders that are involved. [28:55] So, iba-iba din po sila, hindi po one-size-fits-all yung nangyayari po din sa amin. [29:01] So, this is usually under the DOH oversight. [29:04] We do, and it's supported by our Center for Health Development. [29:09] Kung meron po kaming regional hospital or may apex hospital na dun, kasama din po sila madalas dun sa transition period [29:18] because they do a, like, parang mentoring din po dun sa transition because DOH operates the facilities very differently. [29:27] We have standardized metrics for our facilities. [29:31] That is something that might not be familiar to the, kasi iba nga po yung metrics na sinusunod namin [29:37] versus the facility that might be owned by an LGU or somebody else. [29:42] For the transfer of assets and liabilities, ang first step po namin lagi dito ay we do an audit. [29:48] We do a comprehensive audit of what is there, what is available. [29:52] So, aalamin po namin kung ano yung mga kontrata, liabilities, existing operational assets, even the personnel. [29:59] So, we do a complete listing of all of that. [30:01] And we have to make sure po that in the audit all have to be resolved prior to donations or whatever tigal instruments that have to be done for the full transfer po. [30:15] So, madalas po ang nangyayari sa amin, minimum of one year. [30:20] And we do, may mga moa din po kami minsan, lalo na po kapag pumasa ang batas na nasa pagitan ng budget cycle [30:30] at hindi po namin mapondohan ang facility in terms of MOOE. [30:35] Pag ganun po, meron po kaming agreements with the previous owner of the facility na sila muna ang magpapatakbo or magpupondo. [30:44] Pero itutuloy pa rin po yung management and supervision na components na paglipat po. [30:51] And then, hanggang sa panahon po na mabigyan po namin, which is usually immediate naman po. [30:57] As soon as the next budget cycle is available to us to provide the MOOE and the PS. [31:04] As for the PS po, this is the DOH follows a standardized staffing pattern for all of our facilities. [31:13] So, usually this is where the conflict might lie because the staffing patterns of some of the LGU-owned facilities do not match in completeness. [31:24] So, baka po iba yung bilang nila versus yung sa amin, iba yung qualification standards and positions that we hold. [31:33] So, usually our recommendation is, bago pa po pumasa o kaya yung malapit na pumasa ang bill, [31:40] we recommend that the current plantilla holders already prepare themselves as well. [31:49] So, yung QS po kailangan mamit nila if there are additional trainings that have to be done. [31:55] Because hindi po automatic yung paglipat po nila. [32:02] They have to really apply for those positions as soon as they are released to us by the DBM. [32:09] So, they will go through the CSC. [32:12] So, hindi rin naman po sila pwedeng i-separate ng biglaan. [32:29] So, there are those transitory provisions that we go through to ensure that the services continue, [32:35] but also that we ensure yung tenure din po nung mga employed under the re-nationalization, [32:44] re-nationalized hospital. [32:46] Thank you po, madam. [32:47] Thank you po, Dr. Maria Bituin. [32:49] So, it's good to know may transition committee under DOH oversight [32:54] and particularly yung CHD. [32:59] Minimum of one year pala yung audit ng assets and liabilities. [33:04] So, okay lang. In a way, it gives us time talaga for the proponents of each bill, each hospital [33:12] na mag-participate optimally, maximally in setting up yung that new or re-imagined part [33:20] ng service delivery network dun sa district or province nila. [33:25] And it was so interesting for me yung binanggit nyo na yung provisions you make sa transition [33:31] kapag pumasay yung bawat batas in the middle of the budget cycle. [33:36] So, siyempre yung house magkakaroon ng first crack ulit sa GAB [33:39] and then bago dumating sa amin for us to work on as the NEP towards sa GAB. [33:46] So, nakakatawa, it gives me, the committee, and siguro our colleagues sa house yung ganyang notice [33:55] na we also have to work with DOH in making provisions dito sa budget [34:02] given kung nasa anong stage na ng transition ang bawat hospital. [34:06] And salamat dun sa sharing nyo paano nyo ginagawa ng paraan yung mga MOOE, yung mga PS, [34:14] kung in-between cycles nga, at yung mode din na posible ng arrangements with the previous owners [34:19] while DOH is stepping up dun sa supervision and management. [34:23] In-imagine ko na talaga comsec yung PWG. Magiging interesante ito. Very, very concrete. [34:32] So, and speaking of yung ganyang mga budget classes, [34:38] ano yung, kung meron na po ang department, ano po yung mga estimated na PS, MOOE, CO requirements [34:48] sa bawat hospital. Kung meron na, sa mga bills natin, during establishment, [34:55] yung phased implementation, isama na yung phased transition, [35:00] tapos full annual operation, kung meron na, para ma-imagine na namin yung mga susunod na... [35:12] Madam Chair, for initial bed capacity of level 150 beds, [35:18] ang PS po namin na estimated is around 73 million per annum, [35:25] and then the MOOE is a minimum of 40 to 85, depending on... [35:30] Because we are patient load-based po when we do our budgeting, [35:34] this is not a per-bed-based budgeting po. [35:38] For the intermediate upgrades that we were looking at yung mga level 2 po natin, [35:42] we were looking at the PS of around 160 to 200 million per annum, [35:48] and then the MOOE of around 155 to 244. [35:53] So, these numbers po are based on DOH hospitals when they were at that level. [36:01] So, we anticipate the similar demand and patient load that will be given to these facilities [36:08] once we re-nationalize or establish. [36:11] For capital outlay, if I may, Madam Chair, if I may defer to our colleague from the HPF. [36:16] Thank you. Architect Molina, please. [36:20] Good afternoon, Madam Chair. [36:22] For the infrastructure requirements of a level 1 hospital, [36:27] the estimated infrastructure cost together with the medical equipment is around 4.04 million per bed. [36:34] For a level 2 hospital, it has 4.37 million per bed. [36:42] And for a level 3, it is 4.66 million per bed. [36:47] So, more or less, if we are going to establish a 50-bed capacity hospital for a level 1, [36:54] it's around more or less 200 million. [36:56] And for a level 2, around 250 million. [37:02] And for a level 3, more or less 300 million. [37:07] So, that is the capital outlay requirement for each level, service level capacity hospitals. [37:13] Thank you, Madam Chair. [37:14] Thank you to Architect Molina. [37:16] So, at least, may mga idea kami when DOH hospitals were at those levels, [37:22] ito yung kailangang ma-appropriate ng Kongreso for the capital outlay at the outset. [37:29] Tapos, year on year, ito yung pwede namin i-anticipate na kakailanganin budgetan din [37:35] for the PS and for the MOOE. [37:39] At current prices pa po yun. [37:40] Siyempre, mag-appreciate. [37:41] But, I mean, all of us around the table are UHC advocates. [37:45] So, alam natin na every peso spent for primary care is saving of 3 or so sa tertiary. [37:52] So, money well spent po. [37:55] Ang huling tanong ko sa ngayon sa DOH, [37:59] before I ask all our other stakeholders sa inyong comments, recommendations, [38:03] and although usually, alam nyo naman, [38:06] kasi nag-share din po kayo ng mga committees nyo, [38:09] usually, we don't allow the resource persons to question each other, [38:14] pero nakakatawang isipin, [38:15] comsec, parang pre-TWDG na to, [38:18] and sana pre-BICOM, di ba? [38:20] I would welcome if yung ating mga good resource persons from the house [38:34] would also like to seek advice from DOH [38:36] or kanilang comments, recommendations about your particular bills po. [38:41] But for now, sa DOH, [38:43] sa ngayon, sa pag-survey nyo po sa mga bills na pinag-uusapan natin, [38:48] aling bills ang handa na para sa immediate implementation [38:52] at alin ay mga ngailangan pa, [38:55] halimbawa, simula sa ating TWG, [38:58] mga ngailangan pa ng mga dagdag na pagpaplano, [39:01] pagpopondo, at posibleng pag-amienda bilang bills po. [39:20] Thank you, Madam Chair. [39:22] May bias po kami dito dahil may SOC Surgeon General Hospital po. [39:28] Yun po, siguradong sigurado po kaming kakayanin po namin [39:32] mag-face approach sa kanyang expansion. [39:35] As for the others, [39:38] I think we are still waiting for availabilities of, [39:42] kung masisecure po na deeds of donation for land, [39:46] or yung assurance po that the provincial government [39:51] or who owns the facility is going to support po. [39:55] Because as of the moment, even if they are, [39:57] the bill is passed or has reached the Senate, [40:01] there are times when there are still certain concerns [40:04] to be reached on those matters. [40:06] Thank you, Madam Chair. [40:10] Thank you rin po, Dr. Maria Bituin. [40:12] And fair enough, and perfect segue [40:14] sa ating mga house authors. [40:16] I'm sure they will also touch on [40:22] yung mga concerns, [40:25] whether yung sa deeds of donation, [40:27] sa mga lupa, [40:29] yung kahandaan ng provincial governments nila, [40:32] aside from Romblon, of course, [40:33] na supportahan itong mga bills. [40:35] So, I guess I'll open the floor to, [40:40] oh, yes, [40:43] panay mga taga-districts and province naman tayo rito, [40:46] so I don't need to ask other resource persons for their input. [40:49] So, I'll open the floor, [40:51] maybe a freer-flowing discussion [40:53] sa mga gustong mag-salita pa about your individual bills [40:57] and or mag-tanong o humingi ng payo sa DOH. [41:01] I think, Rep Jogboy, okay? [41:02] Yes, Madam Chair, may I request that our consultants [41:08] and the City Administrator of the Butuan City Government [41:18] be given speaking rights for their manifestation, Madam Chair. [41:24] Sure po, Rep Jogboy. [41:26] So, it will be, is it Attorney Sabado? [41:29] Yes. [41:31] Take note lang tayo mga kauban, no? [41:33] Mga kasama, we have 45 minutes more or less [41:35] till the end of the hearing, [41:36] so, let's use the time wisely [41:38] para yung iba pa na maaaring gusto mag-salita, makapag-salita. [41:41] Attorney, please proceed. [41:42] This will be very brief, Madam Chair. [41:45] Distinguished members of the committee [41:48] and other members of the House, good morning. [41:51] On behalf of the City Government, [41:52] I respectfully express our full support [41:54] and manifestation for the proposed measure [41:59] to rationalize or convert into level 3 national government hospital [42:05] the existing Butuan Medical Center. [42:07] Butuan City, Madam Chair, serves not only its residents [42:10] but also functions as the regional center of Caraga. [42:13] Every day, Butuan Medical Center attends to patients [42:16] from the provinces of Agusan del Norte, Agusan del Sur, Surigao del Norte, Surigao del Sur, [42:22] and Dinagat Islands, as well as neighboring localities, Madam Chair. [42:26] The hospital has long outgrown its original mandate and capacity. [42:30] Increasing patient admissions, the growing complexity of medical cases, [42:34] and the demands of a rapidly expanding regional population [42:37] require greater institutional capacity [42:40] that what can reasonably be sustained [42:42] under the local government resources alone [42:44] that cannot be, Madam Chair. [42:46] The city government has consistently invested [42:49] through the able and active support [42:51] of our very good congressman [42:53] in hospital through infrastructures, equipment, [42:56] personal support, and operational subsidies, Madam Chair. [42:59] While we remain committed to strengthening public health care, [43:04] the realities of healthcare financing, specialized medical services, [43:08] and modern hospital operations [43:10] necessitate greater participation [43:12] by the national government, Madam Chair. [43:15] The renationalization of the BMC [43:17] into a Level 3 national government hospital [43:19] will produce tangible public benefits. [43:22] It will facilitate increased national appropriations [43:25] for infrastructure and modern medical equipment, [43:27] enable the hiring of more specialists, [43:30] nurses, and allied health professionals, [43:32] and expand specialized services for the entire Carragha. [43:35] This proposal is an investment in the health security [43:39] of more than 2 million people throughout the Carragha region. [43:42] As the region's administrative commercial healthcare hub, [43:45] but one must possess a tertiary referral hospital [43:49] commensurate to its regional role. [43:51] The city government likewise commits its continued partnership, Madam Chair. [43:56] We have allocated already a lot. [43:59] The problem is an area. [44:01] We have allocated a lot, Madam Chair, for this expansion, [44:04] and we are very willing to talk to DOH [44:07] to donate most of these lots, Madam Chair. [44:12] We therefore respectfully request the Senate [44:16] to approve the proposed legislation [44:18] converting and rationalizing the Butuan Medical Center [44:23] into a Level 3 national-governed hospital. [44:26] Such measure to us, Madam Chair, [44:28] will significantly strengthen the healthcare system of Carragha [44:31] and improve access to quality medical services, [44:34] and ultimately, Madam Chair, save the lives of our people. [44:38] Thank you very much. [44:39] Thank you very much. [44:41] By any chance, DOH, [44:42] do you have a question to the city admin of Butuan [44:45] about the proposed hospital? [44:48] Madam Chair, may we ask the estimate lot size for this? [44:55] Very practical. [44:56] Very practical, Attorney Sabado. [44:59] We have around, Madam Chair, 2 hectares. [45:04] Estimate, Madam Chair. [45:05] Ah, thumbs up. [45:09] Sabi ni Dr. Maria Bituin. [45:12] So estimated 2 hectares. [45:14] Okay, salamat po. [45:15] Anyone else who would like to... [45:18] Yes, Representative Laarney. [45:20] That's all, Madam Chair. [45:27] Thank you so much. [45:28] Salamat po, Rep Choboy. [45:31] Madam Chair, Honorable Senator Rizal Hantiveros, [45:35] my distinguished colleagues in the House of Representatives [45:40] and our resource experts present today in this morning's meeting. [45:44] Every single day, Madam Chair, [45:46] millions of Filipino farmers rise before dawn to sustain our nation. [45:52] They step into fields fraught with unseen risks [45:56] from extreme heat and toxic chemicals [45:59] to tropical illnesses and severe occupational injuries. [46:03] They nourish our homes, our communities, and our economy. [46:07] Yet, when illness strikes, they are all too often left to bear the burden alone. [46:14] Traveling along distances for care or enduring pain [46:18] simply because treatment is out of reach. [46:22] It is an injustice that we can no longer accept. [46:25] The very hands that feed the Philippines [46:28] deserve our highest standard of care, protection, and respect. [46:32] House Bill number 8622 represents a historic turning point. [46:39] By creating the Bukidnon Farmers Research and Medical Center, [46:43] or BFRMC in Valencia City, Bukidnon, [46:46] we are establishing the country's first-ever specialty research hospital [46:52] dedicated specifically to the health, unique illnesses, and occupational hazards [46:58] of our agricultural workers. [47:01] While local general hospitals exist elsewhere, [47:04] no facility in the Philippines currently combines multi-specialty care [47:10] with targeted research on tropical medicine, [47:13] agricultural toxicology, acute trauma care, and life-saving anti-venom treatment. [47:20] This landmark measures accomplishes two vital goals. [47:26] Immediate healthcare access. [47:28] It delivers crucial general and emergency care to Bukidnon and surrounding provinces, [47:33] filling a severe gap where no government hospital currently stands. [47:38] Specialized innovation. [47:40] In partnership with DOH and RITM, [47:44] it establishes a national center of excellence to research, [47:48] treat, and prevent the unique health hazards [47:51] faced by those in the agricultural sector. [47:54] Currently, Bukidnon has about 1.6 million residents, [47:59] and this bill will be able to serve Bukidnon's seven indigenous tribes, [48:04] which underscores the measure's commitment to healthcare equity, [48:09] social justice, and inclusive development. [48:12] There are no DOH-retained hospitals in the entire province of Bukidnon. [48:17] The nearest DOH hospitals would be about 130 to 150 kilometers away, [48:23] which are in Cagayan de Oro City in the north, or Davao City in the south of Bukidnon. [48:29] Madam Chair, our farmers have spent generations sacrificing their health to feed our country. [48:36] It is time we give them a sanctuary worthy of their sacrifice. [48:41] I respectfully ask for your leadership and the committee's favorable endorsement [48:46] of House Bill number 8622. [48:50] May Iong Buntag, Madam Chair. [48:52] May Iong Buntag, Pud. [48:54] Oga, salamat ka ayo. [48:56] I was thinking we could invite also RITM to the TWG kung sakali. [49:01] But initially, may points ba gustong i-bring into the conversation ng DOH in terms of the feasibility? [49:08] Around the table, alam natin yung pangangailangan for each of these hospitals. [49:13] Any thoughts or questions about feasibility? [49:18] Madam Chair, if I may already speak about both Bukidnon proposals, is that okay po? [49:26] Kung ganun, let's hear first from Rep. Audrey. [49:29] Thank you very much, Madam Chair. [49:32] Good morning to Madam Chair, my colleagues in Congress, as well as of course my very dear friend from Bukidnon as well. [49:40] It's so nice that we're here together. [49:42] Congresswoman Laarni Roque, and of course our distinguished guests from the DOH. [49:47] First of all, Madam Chair, I would like to express my sincere thanks and gratitude to you for allowing us to be here today and to speak about this very urgent issue. [49:57] Thank you for being here. [49:58] Thank you. [49:59] All of you. [50:00] Of course, we're very happy to be here. [50:02] Now, the renovation and upgrading of the Bukidnon Provincial Hospital in Maramag into a Department of Health managed Level 3 General Hospital is a direct response to the growing healthcare needs of the people of Bukidnon. [50:15] Madam Chair, I fully agree with you on your points earlier when you mentioned that we must not ensure that we are wasting the taxpayers' money. [50:23] In many places around the country, there are more than enough, well, not more than enough, there are already DOH hospitals. [50:29] But we in Bukidnon, Madam Chair, we are one of the 40 provinces left that has not even a single DOH province. [50:36] And we are not a small speck of dust. As the first lady of our province said, we have 1.6 million people there, and we don't have a single Level 3 hospital. [50:49] And so really considering this number, it behooves us to act swiftly for the sake of our people. [50:55] And I can assure you, Madam Chair, that a Level 3 tertiary hospital in Bukidnon would not be a mere checkmark on the piece of paper. [51:02] And two DOH hospitals in Bukidnon, there is no competition whatsoever on which district should get one. [51:08] But rather, this would be fully complimentary as it would be serving both north and south parts of our province. [51:14] We are very proud of Bukidnon and how amazing and beautiful it is. [51:18] And I think everyone here should know, though, that the reason why we have such beautiful landscapes is because it is so expansive. [51:28] And this makes it, I was actually very happy to hear from our friends and DOH that what we are looking at is not merely the number of kilometers, but the travel time. [51:37] Because this is precisely our biggest problem. [51:40] You know, Madam Chair, to cross from one end of Bukidnon to the other, yung straight line lang ha. [51:46] It will easily take you four to six hours depending on, you know, if there are no landslides, if there is no road that is now blocked. [51:55] Our problem is Bukidnon is not just north to south, we're also east to west. [51:59] And even in my own district alone, sometimes I have to travel five hours to get to another barangay in my own district. [52:07] And so at present, Madam Chair, the Bukidnon provincial hospital, so as I said, this is fully complimentary. [52:13] This is not in competition at all. [52:16] At present, the BPH in Maramag as a level two hospital is operating well beyond its authorized 130 bed capacity. [52:34] We have an average bed occupancy rate of 182 percent, which means translated into numbers, we are looking at 237 people coming in every day to use only 130 beds. [52:47] And if I'm not mistaken, a tertiary three hospital would have a minimum of 200. [52:52] But even that, it's still missing for us because, yung nga, gaya ng sabi ko, 237. [52:57] And this is just today. [52:58] Syempre, we want to build to accommodate the needs of the future. [53:02] And so, and of course, I was also very surprised to hear the ratio of 2.7 beds per person, per 1,000 people. [53:13] Madam Chair, baka magulat po kayo dahil a very simple math, I'm not a math genius, but a very simple one, [53:20] showed me that we are currently servicing 1,126 people per bed in Bukidnon. [53:27] This is, and these are not just, I mean, these may look like just numbers to everybody. [53:33] But let me tell you, just last June, these numbers meant that I had a 12-year-old child pass away [53:41] because he was caught in a fire in his barangay and his injuries were so severe [53:47] that before they could even make it down the town, I regret that the child passed away. [53:54] He never made it to the hospital. [53:56] A doctor never got to see him. [53:58] And these are the realities we face in Bukidnon. [54:01] As Ms. Congresswoman Rocky mentioned, Bukidnon is home to the seven tribes, and we have a lot of indigenous. [54:09] And more importantly, as I said, our people who are living in the highlands, the ones who are not access, [54:16] who have no access to the hospitals, these are our farmers, and these are the most vulnerable in our society. [54:21] More often than not, these are the IPs. They really do truly need this kind of healthcare. [54:26] And so, as I said, as we all know, the closest level three hospital accessible to many of our constituents [54:33] is in Northern Mindanao Medical Center in Cagayan de Oro City. [54:36] It says here three to four hours away, but again, that is if you are going to maybe the municipio, which is, of course, by the main highway, [54:45] but if you are coming from the barangays in the inland, this three to four hours away does not apply at all. [54:52] And for individuals requiring emergency or specialized care, this distance can mean the difference between life. [54:59] No, we have seen it become the difference between life and death. [55:04] And these realities clearly demonstrate the urgent need to expand the capacity of Bukidnon Provincial Hospital [55:10] and upgrade our facilities and services, both in Valencia and in Maramag. [55:16] By enacting our measures, we can bring quality and specialized healthcare closer to our people, [55:22] sparing them the burden of traveling long distances to receive the treatment that they need. [55:27] At this point, of course, I will turn this over to our friends at the DOH because I would very much also like to hear your advice. [55:34] I feel, I know we're all on the same page. I know we're all working towards the same goals [55:39] and I'm excited because I know we will find a way to make this work. [55:42] So thank you very much, Madam Chair. I sincerely thank you for your leadership [55:46] and your continued support to the province of Bukidnon and, of course, to my dear colleagues. [55:51] Thank you very much, Dr. Maria Bituyan. [55:57] So, back to you, Dr. Maria Bituyan. [55:59] So, ano yung nakikita nyong feasible na moving forward, taking the two bills into consideration? [56:09] Thank you, Madam Chair. So, we mapped both facilities and they were both strategically placed. [56:16] the proposed areas where they were assumed to be included or situated except for BPH [56:23] because we know the exact point where it is at. Both will serve access. [56:28] Yun nga po, nakikita din po namin na maganda po siya nasa gitna po siyang banda ng probinsya. [56:33] Nasa paglitan din po siya ng dalawang LGU-owned facilities na iba pa, na level 1 at isang level 2. [56:39] So, ang napansin po namin doon is, in practical terms po, no, since meron pong maiiwan dun sa service delivery design, [56:49] mas madali po para sa amin na mag-renationalize ng isang facility na hindi po masisira ang service delivery design, [56:56] which is yung BPH Maramag. [56:58] Ang sa akin lamang po ay naiintindihan din po namin yung intent na magkaroon po ng specialized services [57:04] or yung nakaayon po dun sa specialty centers po natin. [57:08] So, meron po tayong Regional Specialty Centers Act. [57:11] Kasama po doon ang infectious disease and tropical medicine. [57:15] Kasama din po doon ang toxicology at trauma care. [57:18] Yun po yung nakita namin dun sa panukala, no. [57:21] Itong mga SES na ito ay meron din po sa NMMC or yung Northern Mindanao Medical Center, [57:28] pero hindi po namin sinasabi na bawal po magkaroon po. [57:32] On the other hand, we are encouraging po na if we are able to develop the BPH Maramag into a level 3 facility, [57:40] kakayanin din po niya na magkaroon po ng specialty centers. [57:44] Ang recommendation lang po namin is, baka po hindi namin ililimita dun sa tatlo, [57:50] kasi depende po dun sa magiging pangangailangan po ng probinsya yung mga specialty centers na idedesignate. [57:57] Which is usually po sa loob po ng Department of Health. [58:00] It is a designation according to a department order and it does not need legislation [58:06] because we are already attached to the Regional Specialty Centers Act. [58:10] Yung limitation lang po, ayoko pong tuldukan. Yun po. [58:14] However, we do not also limit na possible yung magkaroon siya ng research component that is specific to farmers. [58:22] But in general, the recommendation is BPH Maramag as a general hospital na level 3 [58:30] with provision for possible specialty centers. [58:34] So, we will meet both needs that is recognized by our congresswomen who are here. [58:40] Sila po din ang nakakaalam dun sa pangangailangan ng kanilang probinsya. [58:44] Maliban po dun, sa amin naman, ang phased approach po na ginagawa namin, [58:49] developmental po ito, there might be in the future other SCs that may be more appropriate [58:55] or maybe added on for this facility. [58:58] So, yun lang po yung recommendation namin. Thank you. [59:02] Thank you. [59:03] So, at least parang nagsisimula na nga dito yung mangyayaring mga proseso sa PWG [59:10] given the department's initial recommendation. [59:14] And thank you for pointing out yung developmental na approach natin [59:20] in terms of a longer time horizon than just this one year. [59:24] So, I'm sure Bukidnon already appreciates yung partnership with DOH [59:31] and please continue to make your inputs through that partnership in the years ahead, [59:38] not just in the next year, using this developmental approach. [59:55] Salamat. [59:56] Salamat. [59:57] Yes. [59:58] Oh, sorry. [59:59] Yes, okay. [1:00:00] Yes, please. [1:00:06] For Romblon, Governor Trina. [1:00:09] Magandang hapon po sa ating lahat. [1:00:11] To our esteemed Chair, Senator Lisa Honteveros, [1:00:14] to the members of the House of Representatives, [1:00:16] to our resource persons from the DOH, [1:00:18] and to all present here today. [1:00:20] We respectfully convey our full support for SBN 2061, [1:00:25] which provides for the renationalization of the Romblon Provincial Hospital [1:00:29] for the following reasons. [1:00:30] First, almost half of the annual budget of the provincial government [1:00:34] goes to the operations of our eight hospitals. [1:00:36] Romblon Provincial Hospital alone utilizes almost 15% of the total annual provincial budget, [1:00:42] which is around 235 million pesos for 2026. [1:00:46] This is not counting indirect expenditures coming from the Office of the Governor, [1:00:51] PSWDO, and other agencies. [1:00:53] Renationalizing the Romblon Provincial Hospital would allow us to divert this considerable allocation [1:00:59] to further support the upgrading of our other hospitals, [1:01:02] as well as other programs for our constituents. [1:01:04] So of our eight hospitals, two are level one hospitals, [1:01:08] while six are infirmary level status. [1:01:10] Secondly, due to our geographical location, [1:01:14] we have difficulty in recruiting, adequately compensating, [1:01:17] and retaining medical specialists for the provincial hospital. [1:01:20] Taking into account the medical complexity of some of the cases, [1:01:24] we are confident that the DOH is well equipped to tap into their network and pool of specialists [1:01:29] to provide much needed specialized and sub-specialized expertise that would benefit our patients. [1:01:34] This would also allow for a more considerable budget for infrastructure and equipment. [1:01:38] This is important at this point in time, as we are currently in the process of establishing an intensive care unit. [1:01:45] This would also facilitate upgrading towards becoming a level two hospital. [1:01:50] Third, in consonance with PBBM's policy of zero balance billing in DOH hospitals, [1:01:55] this would maximize resources to further support the right of indigent patients to receive free healthcare. [1:02:01] At the moment, we do not yet have a DOH-administered hospital in Romblon Province. [1:02:05] Fourth, re-nationalizing the Romblon Provincial Hospital would allow for a more efficient and smoother referral network. [1:02:12] As we need to refer some patients to secondary and tertiary level hospitals outside of the province, [1:02:18] most of these are DOH-administered hospitals, so we believe that referrals would be easier and faster. [1:02:23] Just to give an example, if we are to refer to a secondary or tertiary level hospital, [1:02:30] most cases, this is Batangas or Metro Manila, our patients need to board a boat which would take 10 to 12 hours, [1:02:39] not counting the land transportation. [1:02:41] Because we are a series of islands, if, for example, [1:02:44] yung IP po namin sa Cebuyan Island, they would have to travel the hours to get down to the lowland [1:02:51] and then cross one or two islands to receive specialized medical care. [1:02:55] So, ganun po ka importante na ma-renationalize ang Romblon Provincial Hospital. [1:03:01] Our gratitude to Senator Camille Villarar for her sponsorship of SBN 2061, [1:03:06] and to Congressman Eleandro Jesus Madrona for his sponsorship of a parallel bill in Congress. [1:03:11] And, of course, to this committee chaired by Senator Risa Hantiveros for providing the avenue to discuss [1:03:17] and possibly endorse this bill. [1:03:19] Our greetings also to Senator Lauren Legarda. [1:03:22] Our chief of hospital, Dr. Christian Ke, is also online to provide his support. [1:03:27] So, in conclusion, while the province is adequately able to operate our public hospitals, [1:03:32] renationalizing Romblon Provincial Hospital would mobilize more resources [1:03:36] and engender a strategic and more sustainable partnership between the province and the DOH [1:03:41] towards better healthcare and quality of life for our citizens in Romblon. [1:03:45] The provincial government commits its full support for the process [1:03:48] and to ensure a smooth transition. [1:03:51] Thank you very much. [1:03:53] Thank you very much, Gov Trina. [1:03:56] Your capital is already spending a little higher than DOH's average MOOE per year. [1:04:06] Sabi nila kanina 200 million and you're almost halfway to yung level 2 MOOE nila na 250 million at your 235 million. [1:04:20] And so, before I ask DOH for their comments on the bill, [1:04:28] Chair would like to recognize the presence of Senator Lauren Legarda. [1:04:31] Thank you so much for joining us and Lauren. [1:04:33] Yes. [1:04:34] Thank you very much, Chair Risa, Senator Risa, and welcome to our counterparts, our friends, colleagues from the House of Representatives and local government and from the DOH and the other members of the executive. [1:04:48] I know that you've had this hearing for a couple of hours, but I came from out of town from Batanga State University for, and I was trying to monitor online from my staff. [1:04:58] I was wondering whether you had discussed already with the local governments and the congressional representatives as well the problem of the zero balance billing. [1:05:09] As this has been discussed, or we are discussing measures. [1:05:15] But I think this impacts on the problems that you face every day. [1:05:19] Because in last year's SONA, the ZBB was highlighted. [1:05:23] Yesterday, I believe it was also mentioned. [1:05:26] But actually, and to be honest, we know that the zero balance billing does not work. [1:05:33] Why do I say that? [1:05:34] Because it only applies to the wards and DOH, correct me if I'm wrong, of ward basic accommodations in DOH retained hospitals. [1:05:47] In provinces like Antique, I hope I'm wrong, but I think, can you check with a provincial health officer, we don't have a DOH retained hospital. [1:05:59] And the local governments do not have sufficient resources to fund, not just the structure. [1:06:08] We're talking about accommodating our indigenous people from the mountains, our farmers and fisher folks. [1:06:17] They have to ask maip, maifip, that's what we call it now. [1:06:21] But somehow, there are sectors, and rightly so, want to outlaw or ban maifip. [1:06:28] And they say it's so politicized, trapo daw, epal daw. [1:06:33] But what do you do? [1:06:34] If the ZBB only applies to the DOH retained hospital, if local governments don't have enough resources to fund their constituents' medical and health needs, [1:06:47] what do you do? [1:06:48] What do you do? [1:06:49] You're a senator, you represent a region. [1:06:51] We're from the same region, my dear. [1:06:53] That's why I guess Capiz is here. [1:06:55] And Antique, I'm sure this problem is everywhere. [1:07:02] So, maaari kayang sagutin, before DOH, I know you're discussing another measure. [1:07:07] Can you answer, please? [1:07:09] My first question is, how do we extend the zero balance billing beyond the DOH retained hospitals? [1:07:18] I hope this was discussed earlier and expand to the LGU, whether province or municipal or city hospitals. [1:07:37] Because the ideal would be, ang funds talaga, nasa PhilHealth na. [1:07:42] Sa pagpasok ng pasyente, ay hindi na hihingi eh, guarantee letter kay Kong, yung mayor hihingi kay Sen. Ano ba? [1:07:52] Yun nga, kaya nagiging patronage. [1:07:54] But how can it not be patronage if there are no resources? [1:07:58] So, DOH, can you please answer? [1:08:01] Which brings me, Madam Chair, to my second question. [1:08:04] I hope this was discussed, but maybe not. [1:08:07] Yung utang ng national government sa sektor na pangkalusugan through PhilHealth, [1:08:23] over 200 billion, tama ba ko? [1:08:28] Ang utang pa. [1:08:30] Ito ba'y nasa NEP? [1:08:31] Sasagutin ba ito ng PhilHealth or ng DOH? [1:08:34] Sabihin nyo, ay hindi, iba yung budget ng PhilHealth. [1:08:37] Dapat alam nyo yan. [1:08:38] Kasi, nag-i-impact yan sa inyo. [1:08:41] Pag hindi na concentrated ang ma-IFIP sa DOH, [1:08:45] ibig sabihin, lahat ng pondo na pangkalusugan ay nasa PhilHealth. [1:08:50] Dapat talaga ideally ganun. [1:08:53] Kung ayaw nyo ng EPAL, ng politika, ng trapo, ng GL, lahat yan. [1:08:59] Lahat ibigay na sa PhilHealth. [1:09:01] Pagpasok sa ospital, covered lahat. [1:09:08] Di ba? [1:09:09] Madam Chair, ikaw ang eksperto sa health, [1:09:12] and you were with PhilHealth before. [1:09:14] Do I not make sense? [1:09:15] And I'm certain you agree, because we've stood on the floor many times [1:09:19] how the PhilHealth funds were illegally deleted, taken out from PhilHealth, [1:09:31] placed in unprogrammed appropriations, and utilized for other matters other than health. [1:09:38] You agree with me, right? [1:09:39] We know that. [1:09:40] We've discussed it on the floor along with Senator Pia and others. [1:09:43] So those are my two questions. [1:09:45] Zero balance billing. [1:09:46] Up to what extent is DOH covering ZBB? [1:09:50] And second, is the full augmentation of the health funds through PhilHealth [1:09:57] already in the National Expenditure Program under PhilHealth? [1:10:01] Can DOH please answer? [1:10:02] Thank you. [1:10:03] Thank you. [1:10:04] Thank you, Senator Loren. [1:10:07] We did not invite PhilHealth to this hearing, [1:10:10] because we are focusing on the 12 bills from the nine provinces. [1:10:18] So we have our representatives and governors. [1:10:21] So if I could just ask, I'm going to call next the representatives from the four other provinces [1:10:29] before calling again DOH. [1:10:31] So if it's part of your presentation, please do include the observations [1:10:38] about the current IFE program and the current performance of PhilHealth in your district and province. [1:10:51] Perhaps Madam Chair, the presenters can answer whether the ZBB actually exists in their districts or provinces. [1:10:58] Like in my province, there is no DOH retained. [1:11:01] So if there is no DOH retained, then there is no ZBB. [1:11:05] How do we go? [1:11:06] How many hours are we going to Iloilo? [1:11:09] Where is that? [1:11:10] Where is that? [1:11:11] We will die. [1:11:12] That's why it's not realistic. [1:11:26] Or how do we do that? [1:11:27] That's why we should put the government into PhilHealth. [1:11:31] So my questions are very relevant and I hope it can be answered by DOH even if PhilHealth is not here. [1:11:37] But the question they can answer and what local governments can also answer would be, [1:11:42] is the ZBB working in your areas? [1:11:45] Thank you, Madam Chair. [1:11:46] Thank you, Senator Loren. [1:11:54] So maybe DOH you can hold your thoughts about the bill for Romblon unless you're ready to present them already. [1:12:07] And then I'll call the four other representatives about their bills. [1:12:11] Ready na ba kayo, Dr. Maria Bituin? [1:12:13] Kasi nag-express ang kapitolyo ng Romblon, yung provincial support. [1:12:16] Are there any other thoughts from DOH initially about the feasibility of the bill? [1:12:21] Kasi kanina nga, we said around the table, alam natin the needs being addressed by these bills. [1:12:26] Feasibility sa Romblon kung meron ang points ang DOH. [1:12:31] Yes. [1:12:33] Before we move on to next, Samboanga, si Bugay, our two representatives. [1:12:37] Thank you, Madam Chair. [1:12:38] Thank you, Madam Chair. [1:12:39] In terms of the Romblon, sorry, Romblon Provincial Hospital for Renationalization. [1:12:51] If we are able to get the physical side, we are very much open to the renationalization that we will have relative to the existing health facilities in the province. [1:13:05] Thank you, Madam Chair. [1:13:06] Thank you, Dr. Maria Bituin. [1:13:08] So, Gov3na, siguro kahit sa TWG, unless you have the answer now about the land, I'm sure your representative will take advantage of that openness expressed by DOH about the bill. [1:13:20] Madam Chair, to our DOH representative, we have around 1.5 hectares of land. [1:13:25] And although this is presently occupied by many buildings, there is still space for expansion. [1:13:31] Thank you. [1:13:32] Thank you, Gov3na. [1:13:33] So, let's hear from our representatives. [1:13:38] First, Rep. Hofer, Asim. [1:13:41] Yes, Rep. Marlesa. [1:13:43] Madam Chairperson, Senator Risa Honteveros, Senator Lauren Legarda, my colleagues from the House, representatives of DOH, ladies and gentlemen, Maayong Buntag sa Tanan. [1:14:00] It is my distinct honor and privilege to appear before this distinguished committee to express my full and equivocal support for House Bill No. 8471, [1:14:10] which seeks to establish the Samuanga-Cibugay Medical Center, a level 3 general hospital in the municipality of Ipil, province of Samuanga-Cibugay. [1:14:21] This proposed measure is not merely about constructing another government hospital. [1:14:25] It is about fulfilling the fundamental right of every Filipino to accessible, quality, and timely healthcare. [1:14:32] It is an investment in the lives, dignity, and future of the people of Samuanga-Cibugay. [1:14:38] The need for this measure is both urgent and well supported by data. [1:14:44] According to DOH, Health Facility Development Bureau, based on the Philippine Statistics Authority 2025, estimated provincial population of 715,886,000. [1:14:57] Samuanga-Cibugay has a hospital bed to population ratio of only one bed for every 2,983 persons, almost 3,000, Madam Chair. [1:15:08] This clearly illustrates the limited capacity of our existing healthcare system to meet the growing healthcare needs of our people. [1:15:18] The Philippine Health Facility Development Plan of 2020 to 2040 likewise projects a shortage of 1,761 level 1 hospital beds and 752 level 2 hospital beds in the province. [1:15:33] Moreover, under the Universal Healthcare Act and the Philippine Health Facility Development Plan, [1:15:40] every province is expected to have an appropriate referral hospital within its healthcare provider network. [1:15:47] Regrettably, Samuanga-Cibugay, like all the provinces who are here today, remains one of the few provinces in the country without a level 2 or level 3 government hospital. [1:15:58] Because of this, patients requiring specialized medical care have no choice but to travel to Samuanga City or Pagadian City, [1:16:08] both of which are approximately four hours away from the provincial capital of Itil. [1:16:14] For countless families, this journey means delayed treatment, additional transportation, and hospitalization expenses. [1:16:24] And in many emergency cases, the difference between life and death. [1:16:29] The municipality of Itil is the logical and strategic location for this facility. [1:16:35] As the provincial capital and administrative center, it is well positioned to serve not only the residents of Itil but also of the 16 municipalities. [1:16:48] A level 3 general hospital in Itil will serve as the primary referral center for Samuanga-Cibugay and significantly improve healthcare delivery throughout the province. [1:16:58] I also want to say that Itil is also the center of Samuanga Peninsula. [1:17:05] Aside from that, it is also the center. It can support the regional centers of Samuanga City and Pagadian City. [1:17:13] The establishment of the Samuanga-Cibugay Medical Center will expand access to specialized and tertiary medical services, [1:17:21] strengthen emergency and referral systems, reduce the burden on hospitals in neighboring cities, [1:17:27] and bring quality healthcare closer to the communities that need it most. [1:17:31] Equally important, it will fulfill the national government's commitment under the Universal Health Care Act [1:17:38] to ensure that every province has adequate government-managed healthcare facilities capable of meeting the needs of its people. [1:17:47] While we respectfully seek the approval of House Bill No. 8471, [1:17:51] I likewise take this opportunity to earnestly request the support of this distinguished committee for two other measures that are equally vital to the long-term development of our province. [1:18:02] First, House Bill No. 172, which seeks to establish the Zamuanga-Cibugay State College. [1:18:08] This will expand access to quality higher education and provide greater opportunities for the youth of our province to pursue their academic aspirations without having to leave their communities. [1:18:19] I propose this bill so that we can also provide graduates of the allied medical health services. [1:18:27] Another bill, House Bill No. 7071, which proposes the establishment of the Mindanao State University, [1:18:35] Zamuanga-Cibugay College of Medicine, which will help address the persistent shortage of physicians not only in Zamuanga-Cibugay, [1:18:42] but throughout Region 9 by producing competent, community-oriented doctors who are more likely to serve in underserved areas. [1:18:52] Taken together, these three measures represent a comprehensive investment in the future of Zamuanga-Cibugay. [1:18:59] A modern tertiary hospital would provide quality healthcare. [1:19:04] A state college and college of medicine will cultivate the next generation of healthcare professionals. [1:19:10] These initiatives are interconnected and will collectively improve the quality of life, strengthen human capital, and promote inclusive and sustainable development in our province. [1:19:21] For these reasons, I most respectfully urge this distinguished committee to extend its full support to House Bill No. 8471, 172, and 7071, and to provide the necessary funding for these implementations. [1:19:37] Your favorable action on these measures will accomplish far more than the establishment of new institutions. [1:19:44] It will save lives, educate future generations, and produce much-needed healthcare professionals. [1:19:51] It will also stimulate economic growth and create lasting opportunities for the people of Zamuanga-Cibugay. [1:19:58] When sickness strikes, it often becomes a major crisis for families in my district. [1:20:05] We very, very, very badly need this hospital. [1:20:09] On behalf of the people of our province, I sincerely thank you. [1:20:12] Thank this committee for your time, your consideration, and your unwavering commitment to improving the lives of every Filipino. [1:20:19] Mga ang buntag sa inyong hangtanan. [1:20:23] So I would assume wala rin silang DOH Retained Hospital? [1:20:27] Wala din po. We only have a provincial managed hospital which is at present only at level 1. [1:20:33] Yes, okay. [1:20:35] Thank you. [1:20:36] Thank you. [1:20:37] Thank you, Rep. Marles. [1:20:38] Thank you, Rep. Marles. [1:20:39] Thank you, Rep. Marles. [1:20:40] Thank you, Rep. Marles. [1:20:41] It's a great package of bills. [1:20:42] It's like a lead back. [1:20:43] And I'm sure the two other bills that you mentioned will also be tackled with the same great interest by the Senate Committee on Higher Education. [1:20:52] So could we hear now also for Samuanga Sibugay from Arep Bangkoro? [1:20:58] Thank you, Madam Chair. [1:21:00] To our Chairperson, Honorable Risa Honteberos. [1:21:03] To Senator Loren de Garda. [1:21:06] My dear colleagues here in attendance. [1:21:10] Governor Fabi, Representative from the DOH. [1:21:15] Maying hapon sa tanan. [1:21:16] It is both an honor and privilege to appear before this distinguished committee to sponsor House Bill No. 8473 entitled, [1:21:27] An Act Establishing in the Municipality of Malangas, Province of Sambuanga Sibugay, a Level 3 General Hospital to be known as Malangas Medical Center and appropriating funds, therefore. [1:21:40] Madam Chair, this measure is not merely about constructing another government hospital. [1:21:48] It is about correcting a long-standing disparity in healthcare access in the province of Sambuanga Sibugay. [1:21:57] Today, the entire first district of Sambuanga Sibugay has no Level 1 government or private hospital of its own. [1:22:08] This reality has placed thousands of our constituents a significant disadvantage. [1:22:14] Whenever they require hospitalization, emergency treatment, surgery or specialized medical care, they are compelled to travel outside the district. [1:22:26] Most patients are referred to the provincial capital which belongs to the second legislative district. [1:22:36] Others have no choice but to seek treatment in neighboring provinces such as Sambuanga del Sur, Sambuanga City or Misamis Occidental. [1:22:46] For many families, this means traveling several hours while carrying critically ill patients. [1:22:56] It means additional transportation expenses, higher medical costs, lost income and unnecessary delays in receiving life-saving treatment. [1:23:08] During medical emergencies, every minute matters and these delays can mean the difference between life and death. [1:23:18] This is precisely why the establishment of Malangas Medical Center as Level 3 General Hospital is both urgent and necessary. [1:23:26] Strategically located, the municipality of Malangas can effectively serve not only its own residents but also the municipalities or the first district and nearby communities in Sambuanga del Sur that currently lack adequate access to advanced medical services. [1:23:46] As a Level 3 General Hospital, the Malangas Medical Center will provide comprehensive medical and surgical services, specialty care, modern diagnostic facilities, intensive care units, emergency services and advanced healthcare capabilities that are presently unavailable within the district. [1:24:10] More importantly, it will significantly reduce patients' referrals outside the district, [1:24:17] decongest existing provincial and regional hospitals, improve emergency response and bring quality healthcare closer to our people. [1:24:28] Madam Chair, this proposal enjoys the full support of our local governments. [1:24:33] The provincial government of Sambunga, Sibugay has formally endorsed this measure through Sangguniang Panlalawigan Resolution No. 2025-10225, [1:24:46] while the municipality of Malangas has likewise expressed its unwavering support through Sangguniang Bayan Resolution 2025-407, [1:24:56] which includes the donation of 10 hectares for the proposed medical facility. [1:25:05] These resolutions demonstrate the unified commitment of our provincial and municipal leaders to address one of the most pressing needs of our constituents. [1:25:14] The establishment of Namlangas Medical Center is likewise consistent with the objectives of the Universal Health Care Act, [1:25:25] which to make quality healthcare accessible to every Filipino regardless of geographic location or economic status. [1:25:35] Madam Chair, distinguished members of the committee, this measure is ultimately about dignity. [1:25:40] It's about ensuring that no mother in labor has to travel hours before reaching a hospital. [1:25:47] It's about ensuring that accidents, victims receive immediate emergency care. [1:25:54] It's about giving every child, every senior citizen and every family in the first district of Sambunga, Sibugay, access to the healthcare they deserve. [1:26:04] For these reasons, I most respectfully appeal for the favorable consideration and approval of House Bill No. 8473 together. [1:26:19] Let us bring health quality healthcare closer to our people and finally provide the first district of Sambunga, Sibugay with its own government hospital. [1:26:30] Thank you very much. [1:26:31] Thank you very much. [1:26:32] May God bless us all. [1:26:34] God bless you too, Rep Bancoro. [1:26:36] So, mamaya DOH after the five other speakers from the different districts, [1:26:42] makicomment on both the Sambunga, Sibugay bills within their province. [1:26:50] But note, there is an endorsement of the provincial government and then pending donation of 10 hectares. [1:26:59] Sen, Lauren, then I'll call on Rep J Konghun from Sambalit. [1:27:06] Most of the bills, if not all, correct me if I'm wrong, were created by the local governments, right? [1:27:17] Either through Congressional initiative funding from GAAA or through local government funds. [1:27:27] Is it all, Madam Chair, all are congressional initiatives funded from the national government GAAA but run by the local governments? [1:27:38] No? [1:27:39] Different. [1:27:41] But there is no DOH retained hospital. [1:27:45] And that's why the aspiration, the ask is to make it under the direct supervision of the Department of Health. [1:27:53] It's not a provincial hospital. [1:27:55] Ah, the provincial hospitals. [1:27:56] So, these are the first nine of 32 provinces sa bansa na wala pang. [1:28:02] So, halos one-third ng mga probinsya natin wala pang provincial hospitals. [1:28:07] Yes. [1:28:08] We're not yet there. Okay. [1:28:09] They want to be under the direct supervision of the Department of Health. Is that it? [1:28:14] They want to establish, yes, the provincial hospitals. [1:28:16] So, that means you want it back to the national? Renationalization? [1:28:21] Yung ilan po, for renationalization. [1:28:24] Only some, not all? [1:28:25] Yes. [1:28:26] Okay. And so, maybe the debate of whether we should renationalize all, are we actually changing or amending the law way back that decentralized healthcare? [1:28:46] Or would it be dependent on the region, the province, and the district, or the locality? [1:28:53] We are not amending the universal healthcare law here. [1:29:01] Or rather, we're not amending the local government code. [1:29:03] Opo. [1:29:04] But in the context of LGC and the UHC law, we are hearing 12 of the bills of nine provinces, one represented here by the Capitolio and the others represented by their district representatives, to either establish or upgrade or renationalize their hospitals, para lahat nung siyam magkaroon ng provincial hospital. [1:29:31] So, the renationalization is not the renationalization. [1:29:33] So, the renationalization is not the ask of all. [1:29:36] No, it's the ask of some. [1:29:38] Of some which are already on the provincial level. [1:29:41] And that is because, right? [1:29:44] None of the provinces represented by their reps and by their governor already have provincial hospitals. [1:29:51] Correct. [1:29:52] So, they are taking different routes to establish provincial hospitals. [1:29:55] So, they want a provincial hospital, but they want the provincial hospital to be under the direct supervision of the Department of Health. [1:30:02] And that's why the DOH is commenting on each of their bills. [1:30:05] Yes. [1:30:06] No, not necessarily because I see who don't know. [1:30:08] You just simply want to increase the level, to elevate the level. [1:30:11] None at all. [1:30:14] Okay. [1:30:15] But the others want to go back to the national government. [1:30:18] So, it would be different needs for every district. [1:30:22] But for those who don't have, may I just know, how many have DOH retained hospitals in your districts or provinces? [1:30:29] None. [1:30:30] So, that means the zero balance billing does not apply to us. [1:30:36] Pati kami, wala. [1:30:37] So, when they say, ah, zero balance billing na, ah, libre na ang healthcare. [1:30:44] That's why we look at each other. [1:30:46] Hindi eh. [1:30:47] We're on the ground eh. [1:30:48] Nakikita natin. [1:30:49] Nagihirap pa. [1:30:50] So, pag sabi nilang, tanggalin na ang mga IFIP. [1:30:53] Hindi na dapat tumadaan sa congressman, sa senators. [1:30:57] Kailangan eh. [1:30:58] Paano na tayo o yung mga constituents nyo? [1:31:02] Diba? [1:31:03] Until such time that the national government has presence through your DOH retained hospitals [1:31:10] with hospitals, specialty hospitals na pwedeng mag-ZBB because sapat ang pondo nila, [1:31:17] that's the only time that we can really delete the MAIFIP that they say is very politicized. [1:31:26] But in the meantime, it's needed, right? [1:31:28] And in the meantime that the field health cannot answer for all the health needs of our constituents, [1:31:34] we need the MAIFIP. [1:31:36] Okay. [1:31:38] Very clear. [1:31:39] Thank you. [1:31:40] Thank you. [1:31:41] Okay. [1:31:42] Marami akong tanong. [1:31:43] Thank you, Senator. [1:31:45] Thank you, Senator Lauren. [1:31:47] So, we will tackle those matters of Universal Healthcare Medical Assistance Program [1:31:56] and continue to engage field health in other hearings of the Senate Committee on Health. [1:32:02] So, online, we have Zambales Representative Jay Conghun. [1:32:22] Would you like to speak on your bill, Rep. Jay? [1:32:27] Maraming maraming salamat po, Sen. Rizzo Tiveros at Sen. Lauren Ligarda. [1:32:37] Bago po ang lahat, [1:32:38] Lais ko muna ipaubot ang aking taus-pusong pasasalamat sa Committee on Health. [1:32:43] Maraming maraming salamat po sa inyong suporta at pakikiisa sa hangarin naming mga sambalenyo [1:32:50] na mas malapit at mas maging mahusay ang servisyong pangkalusugan. [1:32:55] Ang pagtatag ng Subic General Hospital ay hindi lamang tukol sa pagkakaroon ng isang ospital. [1:33:01] Ito ay tukol sa paglalapit ng dekalidad at kumpletong servisyong medikal sa bawat pamilyang sambalenyo. [1:33:08] Sa kasalukuyan, wala pong DOH hospital sa buong lalawigan sa Bales. [1:33:16] Ang pinakabalapit ay nasa San Fernando, Mapaga, [1:33:19] bagit isang daag kilometro o layo. [1:33:21] Para sa ating mga kababayang nangangailaga na agarang gamutan [1:33:25] o mas mataas na antas ng medical care, [1:33:28] napakalaking bagay ng bawat kilometrong hindi nila kangailangan lakpayin. [1:33:33] Ang magandang balita, [1:33:35] Mayroon na tayong first class hospital building sa Subic na maaaring gamitin. [1:33:40] Nariyan ng imprestruktura. [1:33:43] Ang kailangan natin ay bigyan ito ng buong kakayahan [1:33:47] mga doktor, espesyalista, nurses, modernong kagamitan, [1:33:51] sapat na podo at mga servisyong maaasahan ng ating mga kababayan. [1:33:56] Ito ang dahilan kung bakit napakahalaga [1:33:59] ng pagtatag ng Subic General Hospital [1:34:03] bilang kaoda-odahang DOH Hospital [1:34:05] sa buong lalawigan ng Sambales at lungsot ng Olongapo. [1:34:09] Dahil kapag may emergency, [1:34:11] bawat minuto ay mahalaga. [1:34:13] Hindi lamang ospital ang ating binubuo. [1:34:15] Naglalabid tayo ng pag-asa, kaligtasan, [1:34:18] at servisyong pag-asugad sa bawat pabilang sambaleno. [1:34:23] At ito ang ating hagarin. [1:34:25] Ang servisyong medikal ng DOH hindi nakailakang bayuhin [1:34:29] dahil ilalapit ito mismo sa ating mga kababayan dito sa Sambales. [1:34:33] Maraming salamat po, Chair. [1:34:35] Maraming salamat din po, Rep J. [1:34:42] Next, we just have four more resource persons, dear friends, [1:34:46] and I know it's past one o'clock, [1:34:54] but if you can stay, [1:34:56] Salapis, Representative Jane, please. [1:35:00] Good afternoon, Madam Chair Ontivero, [1:35:07] Senator Lauren Legarda, [1:35:09] and to my fellow public servants, [1:35:11] and also to the resource speakers, [1:35:14] a pleasant good afternoon. [1:35:16] So, House Bill number 8474 [1:35:19] is an act upgrading the Rojas Memorial Provincial Hospital [1:35:23] situated in Barangay Langot City of Rojas, [1:35:26] province of Capiz, [1:35:28] into a level 3 general hospital [1:35:32] to be known as Capiz Medical Center [1:35:36] and appropriating funds, therefore. [1:35:38] So, the bill wants to create a new and modern hospital [1:35:44] in Rojas City called Capiz Medical Center. [1:35:49] So, Rojas Medical Provincial Hospital [1:35:52] is the sole provincial hospital in Capiz, [1:35:56] and it is always in its full capacity [1:35:59] because it serves not only the people of Capiz [1:36:01] but also neighboring areas like Southern Aklan, [1:36:05] Northern Ilo'i, [1:36:06] also the island solved the problem of congestion. [1:36:16] The provincial government of Capiz [1:36:20] started building its new hospital in 2010, [1:36:24] and it's now 2026, [1:36:25] so it's 16 years in the making. [1:36:27] It has a 298 bed capacity [1:36:30] and at present it has outpatient department [1:36:35] like, for example, [1:36:36] the newborn continuity clinic, [1:36:40] dialysis centers, [1:36:42] and also eye care. [1:36:44] However, the provincial government of Capiz [1:36:47] does not really have adequate resources [1:36:51] to finish the hospital. [1:36:56] And also, not only that, [1:37:01] we cannot pay for the equipment [1:37:06] and for the staff that is required [1:37:09] to run the hospital properly. [1:37:11] And also, we have five hospitals in Capiz [1:37:18] which are funded by the provincial government, [1:37:20] like, for example, [1:37:22] the Tapas District Hospital, [1:37:24] in the past, [1:37:25] it increased about 60 million pesos a year [1:37:30] in its expenses. [1:37:31] And also, the Senator Gerardo Rojas, [1:37:36] in Maria Hospital, in Dao, [1:37:37] about 80 million, Mambuso District Hospital, [1:37:41] 80 million, [1:37:42] and the Bailan District Hospital, [1:37:44] which is in Ponte Vedra, [1:37:46] first district, [1:37:47] about 100 million. [1:37:49] And for, in the city itself, [1:37:51] the Rojas Memorial Provincial Hospital, [1:37:54] it increased about 400 million. [1:37:57] 400 million. [1:37:58] So, the funds, [1:38:08] the provincial government, [1:38:09] in general, [1:38:10] is the development, [1:38:14] or, [1:38:15] to, [1:38:22] or, [1:38:29] to, [1:38:33] so, [1:38:34] this is the, [1:38:35] the detail, [1:38:36] and, [1:38:38] additional medical staff. [1:38:42] So, once, [1:38:43] this, [1:38:44] capital, [1:38:45] Kapiz Medical Center, [1:38:46] is, [1:38:47] completed, [1:38:49] and taken over, [1:38:50] or managed by the DOH, [1:38:51] it will have advanced, [1:38:53] medical services, [1:38:55] and will have more beds. [1:38:57] And also, [1:38:58] we can offer new services, [1:38:59] like the training of doctors, [1:39:01] in the specialist fields, [1:39:03] like, [1:39:04] ENT, [1:39:05] surgery, [1:39:06] internal med, [1:39:07] and also, [1:39:08] we can, [1:39:09] serve more the people, [1:39:11] in the neighboring areas, [1:39:13] like in, [1:39:14] Batad, [1:39:15] Balasan, [1:39:16] Carles, [1:39:17] or also, [1:39:18] in, [1:39:19] Romblon, [1:39:20] as I've said, [1:39:21] Romblon, [1:39:22] and Masbate, [1:39:23] and southern, [1:39:24] Aquan also. [1:39:25] And, [1:39:26] and also, [1:39:27] once it becomes a, [1:39:29] Kapiz Medical Center, [1:39:31] they're also, [1:39:32] pushing, [1:39:33] or planning to, [1:39:34] have this, [1:39:35] interventional cardiology, [1:39:38] also, [1:39:39] the oncology specialist, [1:39:40] specialty center, [1:39:42] because, [1:39:43] there are, [1:39:44] cancer patients there. [1:39:45] And, [1:39:46] sometimes, [1:39:47] they have to seek, [1:39:48] medical, [1:39:49] medical care, [1:39:50] in Iloilo, [1:39:51] or in Manila, [1:39:53] and, [1:39:54] causing a delay, [1:39:55] in the treatment, [1:39:56] and also, [1:39:57] in caring, [1:39:59] or, [1:40:00] there's a considerable, [1:40:01] burden, [1:40:03] no, [1:40:04] additional, [1:40:05] additional, [1:40:06] financial, [1:40:07] strains, [1:40:08] on the, [1:40:09] affected families, [1:40:10] and also, [1:40:11] this burden, [1:40:12] diseases, [1:40:13] no, [1:40:14] like, [1:40:15] the cardiovascular diseases, [1:40:16] and, [1:40:17] this cancer, [1:40:18] thing, [1:40:19] they, [1:40:20] usually, [1:40:21] require, [1:40:22] specialized, [1:40:23] and, [1:40:24] prolonged, [1:40:25] chemotherapy. [1:40:26] There's also, [1:40:27] this, [1:40:28] catheterization, [1:40:29] also, [1:40:30] surgery, [1:40:31] and, [1:40:32] prolonged, [1:40:33] medication. [1:40:34] So, [1:40:35] it really, [1:40:36] will drain the, [1:40:37] the families, [1:40:38] who will be affected, [1:40:39] or, [1:40:40] who will be, [1:40:41] will bear this responsibility. [1:40:43] And, [1:40:44] also, [1:40:45] the interventional cardiology, [1:40:46] because, [1:40:47] there is a rising incidence of, [1:40:49] cardiovascular diseases in the region. [1:40:52] So, [1:40:53] and also cancer. [1:40:54] So, [1:40:55] this will pose, [1:40:56] a serious, [1:40:57] public health concern. [1:40:58] And, [1:40:59] also, [1:41:00] we also don't have, [1:41:01] IDOH, [1:41:02] retained, [1:41:03] hospital. [1:41:04] Well, [1:41:05] there's four. [1:41:06] In Uloilo, [1:41:07] there's, [1:41:08] Santa Barbara, [1:41:10] I mean, [1:41:11] Sanitarium Hospital in Santa Barbara. [1:41:13] There's Western Visayas State University Hospital in La Paz. [1:41:18] They're also in Western Visayas Medical Center in, [1:41:21] Manduriao, [1:41:22] and there's also in Barotac Nuevo. [1:41:24] But, [1:41:25] none in Capi. [1:41:26] So, [1:41:27] we hope that, [1:41:28] the Capi's Medical Center will become an apex hospital. [1:41:32] And, [1:41:33] furthermore, [1:41:34] no, [1:41:35] no more. [1:41:36] It's already past one o'clock. [1:41:39] Anyway, [1:41:40] we hope that, [1:41:42] we are, [1:41:43] really hoping for the full support, [1:41:45] you know, [1:41:46] in this bill, [1:41:47] or this endeavor, [1:41:48] because it will be, [1:41:50] create a milestone, [1:41:52] and for the public health care in Capi's, [1:41:55] and also the neighboring, [1:41:57] also the region itself. [1:41:59] So, [1:42:00] this bill is very crucial, [1:42:01] important, [1:42:02] in order to assure the people of Capi's, [1:42:05] and also the neighboring areas, [1:42:07] that they can get excellent health care. [1:42:09] Thank you, Madam Chair. [1:42:11] Thank you. [1:42:12] Thank you. [1:42:13] Thank you, Rep. Jane. [1:42:14] Thank you. [1:42:15] Thank you. [1:42:16] Thank you. [1:42:17] Thank you. [1:42:18] So now, also for Capi's, [1:42:19] could we hear from Rep. Guintu? [1:42:21] Madam Chair Pearson, [1:42:25] my fellow Capistons, [1:42:26] Senator Risa, [1:42:27] my fellow colleagues from the House of Press Representative, [1:42:30] and to Governor Fabic, [1:42:33] and ating mga Kapwa Pilipino, [1:42:35] na nakasubaybay sa committee hearing, [1:42:37] maayong hapon. [1:42:38] I'm here to support the passage of House Bill 8474, [1:42:46] which is upgrading our provincial hospital into a level 3 hospital [1:42:50] to be known as the Capi's Medical Center. [1:42:52] By way of information, [1:42:54] we also have proposed in the House of Representatives, [1:42:57] the establishment of a level 3 hospital in the first district of Capi's. [1:43:00] While every representative wishes to have a level 3 hospital in their district, [1:43:05] so as we may be assured that our constituents are provided proper medical care, [1:43:10] I have asked to defer discussion on my proposal [1:43:14] to prioritize and focus on the establishment of the Capi's Medical Center. [1:43:18] I submitted the wisdom of the committee on how to proceed with my proposal, [1:43:24] House Bill 8475, [1:43:26] as this will also help in addressing the health concerns of the first district of Capi's [1:43:31] and the surrounding LGUs. [1:43:33] With that, Madam Chair, [1:43:35] please allow me to give my insights as to why House Bill 8474, [1:43:41] or the upgrading of the Ross Memorial Hospital, [1:43:45] should be prioritized by this committee. [1:43:49] As mentioned earlier, our hospital, Ross Memorial Hospital, [1:43:54] not just serves our fellow Capisnons. [1:43:58] We are also serving patients coming from Masbate, Romblon, Northern Iloilo, Aklan. [1:44:05] And right now, we could not accommodate any more patients. [1:44:12] We are operating on more than double our capacity, actually almost triple our capacity. [1:44:19] We have also, because of the lack of facilities, [1:44:27] most of our patients that need specialty services, [1:44:32] need to transfer or to travel to Iloilo just to avail of these services. [1:44:39] And aside from which, we also need to have special medical services [1:44:46] and ease the burden on other hospitals. [1:44:49] As mentioned by Congresswoman Jane, there are other hospitals within our district, [1:44:54] but because of the lack of facility, they are all transferred to RMTH. [1:45:01] For example, this hospital in Mambusaw, Tapas, when the case is no longer treatable in these hospitals, [1:45:13] they are transferred to RMTH or Ross Memorial Hospital. [1:45:18] And then at RMTH, it is operated on full capacity. [1:45:21] Then we have to transfer them as far as Iloilo. [1:45:24] So with that, Madam Chair, I humbly urge this committee to favorably endorse House Bill 8474 [1:45:31] and for plenary consideration and approval by the Senate. [1:45:35] Thank you, Madam Chair. [1:45:36] I forgot. [1:45:37] Yes, Rep. Jane. [1:45:38] And salamat good to Rep. Jane too. [1:45:41] Yes, Rep. Jane. [1:45:42] I forgot. [1:45:43] Once this will become a Kapis Medical Center, they are also planning to put a neurological clinic. [1:45:55] You know, this disease called dystonia. [1:46:00] Mountain chair? [1:46:01] Dystonia. [1:46:03] Yeah, it's endemic only in Kapis. [1:46:07] No, the chromosomal aberration is transferred from the mother to the son, only to her male offspring. [1:46:15] And so there is this, it's called lubag. [1:46:20] No, parang yung washing clothes you're trying to wring. [1:46:27] Yeah. [1:46:28] So this one is a painful contortion. [1:46:30] Just imagine the mouth, the tongue hanging, not only for a day, for a month, for a year, but for years. [1:46:37] So horrible. [1:46:38] And the current modality here is DBS, not DBS. [1:46:45] It's a deep brain stimulation where this procedure cronyotomy is done. [1:46:53] And then there's a chip placed in there or implanted in there in order to limit the involuntary movements. [1:47:00] And this is, of course, and this is only being done in big hospitals like in Medical City and PGA. [1:47:07] So I hope that this bill will have a favorable result. [1:47:13] Thank you. [1:47:14] Thank you, Saliwat. [1:47:16] And Saliwat, salamat gid to Rep Gintu for that acts of solidarity with the other bill coming out from our home province. [1:47:26] Yung pong deferment ng consideration ng bill ninyo. [1:47:31] I take note of that. [1:47:33] The committee takes note. [1:47:34] Pero i-await po namin yung action muna ng house before we can take a similar action. [1:47:39] Thank you, Madam Chairperson, for that. [1:47:41] Salamat man. [1:47:42] Okay. [1:47:43] I know na may lalakbay pa yung mga kasama hanggang sa house. [1:47:48] We just have two more speakers for those who can still stay. [1:47:52] Rep Agyao, Rep Caroline for Apaya. [1:47:59] I'm so sorry. [1:48:00] For Kalinga. [1:48:01] For Kalinga. [1:48:02] Before we go back lastly to DOH. [1:48:05] Thank you, Madam Chair. [1:48:07] To our Honorable Chairperson, Sen. Teresa. [1:48:12] To our distinguished members of the Senate Committee on Health. [1:48:16] And to my colleagues. [1:48:18] And to all the advocates of quality healthcare. [1:48:21] Na imbag na malim tayamin. [1:48:25] This representation, respectfully secure support, favorable consideration of House Bill 8621. [1:48:33] With seek to upgrade the Kalinga Provincial Hospital into a level 3 regional hospital to be known as the Northern Cordillera Regional Medical Center under the supervision of the Department of Health. [1:48:46] This measure is a long-standing aspiration of the people of Kalinga and neighboring provinces in the Cordillera region. [1:48:53] Particularly, of course, some parts of Abra, Apayao, and Mountain Province. [1:49:03] That can also be catered to the Kalinga Provincial Hospital. [1:49:10] And then other municipalities of Isabela and Cagayan. [1:49:13] With this response to the growing demand for quality, accessible, and specialized healthcare services that our people urgently need. [1:49:22] During the deliberation of this measure in the House of Representatives, the provincial government of Kalinga expressly manifested its full support for the proposed upgrading and re-nationalization of the Kalinga Provincial Hospital. [1:49:35] For the reason that they could not anymore support the hospital due to its limited funds. [1:49:42] The governor texted me a while ago that almost their PS and MOOE, it's almost 355 million. [1:49:55] That is almost 22% of their NTA. [1:50:00] So, they have also, they're also focusing on the three, six district hospitals, which are the infirmary hospitals, level one in the province. [1:50:13] All of which require a continuous funding, upgrading of the equipments, and the healthcare personnel to address the medical needs of their respective communities. [1:50:23] With these responsibilities, the provincial government can no longer sufficiently shoulder the growing financial and operational requirements of the provincial government, of the provincial hospital. [1:50:37] And the governor also noted that it's almost 3.8 hectares with buildings already. [1:50:48] And then, they're willing to transfer to the national government with all the buildings. [1:50:55] And then, this Kalinga Provincial Hospital is level one. [1:51:01] And then, it's ongoing for the level two. [1:51:05] And then, Honorable Chair, it is also important to highlight that the Department of Health has expressed its support for this measure. [1:51:17] Subsequently, the Department formally submitted its written position to the House. [1:51:22] And then, importantly, Kalinga is very far. [1:51:27] And then, it's almost 98% of which people who are in Kalinga are in the IPs. [1:51:36] So, karamihan po, they're all, ah, siyempre doon sa mga iba kanina, malalayo, ah, nasa mountainous areas, po may upland and then the low, low land po sa Kalinga. [1:51:49] So, with this, at present, the patients requiring an advanced medical intervention are often referred from the Kalinga Provincial Hospital to the Apex Hospital, which is the Baguio General Hospital, which is almost 10 hours drive from Kalinga. [1:52:09] And then, ah, we have also a near hospital, it's a Calgayan Valley Medical Center, but, ah, it's almost two hours. [1:52:18] But then, ah, I know, ah, Cagayan is catering the Cagayan, the CBMC is catering the Cagayan constituents. [1:52:28] So, for us, maybe, ah, it's not, ah, it's less priority, of course, for the Kalinga people. [1:52:35] Ah, reaching all these facilities requires almost, especially in Manila, for, ah, if they want to go to a heart center, ah, it takes a 12 hours drive. [1:52:49] So, malalayo po ito, ah, so, ah, sa accessibility, para din ma-de-decongest, ma-decongest yung Baguio General Hospital, ah, sana po ma-approve po itong bill. [1:53:01] Well, ah, through the approval of the House Bill 8621, we can bring specialized medical services closer to our communities and ensure that no patients will suffer and delay in receiving the care they urgently need. [1:53:16] So, ah, pag, ah, let's say, there are patients that, ah, we transfer to, ah, Cagayan Medical Center, karamihan po namamatay. [1:53:26] So, ah, especially those, ah, needs surgery. [1:53:31] So, mga, karamihan sa mga yon is yung mga, ah, nababanga, yung mga gunshot wounds. [1:53:37] And especially, siyempre, pag nagagaling pa sila sa mga bundok, ah, from Tabuk kasi it takes, ah, other, other municipalities, ah, takes four hours drive to Tabuk City. [1:53:49] So, with this, ah, ah, ah, Madam Chair, ah, it is, ah, the clamor of the people of Kalinga and I, the officialdom of the province of Kalinga, earnestly appeal to your benevolent, ah, hearts for the approval of this bill. [1:54:07] Thank you so much, ah, thank you so much. [1:54:11] Nagyama na, Crep Caroline. [1:54:13] So, DOH, ah, take note yung sinabing full support ng provincial government and then yung willingness ilipat ang 3.8-hectare lot with the buildings, ah, to the national government. [1:54:26] Ah, ah, puno ang plato nyo ngayon. You are the last speaker. So, ah, the committee would appreciate and I'm sure the representatives, ah, would appreciate, ah, again, around the table, alam natin yung pangangailangan talaga per district as per province. [1:54:42] So, comments po ninyo on the feasibility. Kaugnay po ng dalawang bills sa Sambuanga, Sibugay, kaugnay po ng Sambales, kaugnay ng dalawang, oh, well, ah, sa ngayon isang bill muna, ah, sa Capis, and kaugnay po ng, ah, Kalinga. [1:54:59] So, Dr. Maria Bituin, ah, and or Architect Molina. Yes, ma'am. [1:55:05] Thank you, Madam Chair. So, I will start off po with Sambuanga, Sibugay. For both facilities, they are for establishment, ah, [1:55:13] since they are on equal footing in that matter. Um, we're also recognizing the need or the, um, other subsequent house bills that are related to our, um, Malangas, ah, sorry, our EPIL, ah, proposal, ah, facility. [1:55:31] However, when we were, again, um, I put in the caveat of our analysis that we are limited to access and we are looking at, um, um, EPIL has one, ah, facility, a hospital that is level one that is already in that area. Um, limit. [1:55:49] So, if we wanted to expand the access of hospitals, we would prefer actually, um, Malangas. [1:55:55] Because Malangas currently, even in the subsequent, um, or surrounding, ah, municipalities around it, ah, does not yet have a hospital. [1:56:05] They are, they have infirmaries, ah, but then we also know that the level of care that is provided by our infirmaries is not, it's not equal to a hospital. [1:56:15] Um, um, us being limited to this type of, ah, assessment only, we would prefer Malangas, ah, over, um, the EPIL, ah, proposal. [1:56:26] However, we are open to the wisdom of Congress, um, since both are for establishment and will take the same amount of, more or less the same amount of time. [1:56:36] So, um, um, for this one, it is not as definitive as the others in terms of our recommendation. [1:56:42] But, um, from the view of our, ah, technical assessment as of the moment, it is Malangas Medical Center that is preferred. [1:56:51] Ah, do I move on? [1:56:53] Yes, please. [1:56:54] Just to say at this point, ah, sana as we move into the technical working group, ah, DOH could give special attention to the two, ah, provinces, [1:57:04] two districts each ang may proposed bills, how you can help, how you could advise them and, ah, advise the, yung counterparts nila dito sa amin, sa Senate Committee on Health, [1:57:15] paano ma-realize yung universal healthcare within, ah, their provinces. [1:57:19] It's like a mini, ah, UHC, but it's the highest level of UHC after the national. [1:57:25] So, paano pwedeng mag-complement yung mga bills nila, um, given possible amendments and complementation to realize a UHC within each of their provinces. [1:57:50] So, that's both for Bukidnon and Samuanga, Sibugay. [1:57:53] Please proceed. [1:57:54] Thank you, Madam Chair. [1:57:55] As I move on to the Zambales, um, the Zambales proposal, we recognize that there is currently no, ah, government facility as well in that area, um, in the province of, ah, sorry, in, currently in Subic. [1:58:13] So, the nearest one is already in Olongapo city. [1:58:16] So, um, ideally, we would also prefer that it be at least one hour away from the James L. Gordon, um, general hospital. [1:58:24] Um, however, we are very much open since we do not have a facility yet in, in that province. [1:58:31] So, I think they've already mentioned that there are some provisions already that are available to that and we are open to accepting that donation. [1:58:39] Um, I will move on, um, to Capiz since, um, since we are still obliged to give our, our, our assessment, um, relative to both bills, even if this was deferred. [1:58:50] Um, for the province of Capiz, the preference is still the renationalization of the Rojas Memorial Provincial Hospital, uh, in recognition of, uh, conversion to a level three would be much faster from our end. [1:59:04] Um, um, our only concern is that there will no longer be a level two government hospital in the facility. [1:59:10] Um, as a blanket statement, I would like to also, uh, recognize all of the provinces here who are maintaining, uh, their level one hospitals and infirmaries, uh, outside of the facilities that we intend to establish and or renationalize. [1:59:27] So, um, so, thank you so much for, uh, for the rest of our province, uh, so, for our end, Capiz, uh, it's the Rojas Memorial Provincial Hospital to be known as Capiz Medical Center. [1:59:46] For the, uh, just a quick note, Dr. Maria, before you move on, so, kung yung concern, particularly for Capiz is wala nang matitirang level two hospital, I don't know if there will be an opening in the TWG given the provisions of the two bills, uh, to either, uh, fill that or at least lay some groundwork for future filling up through future bills coming from the Capiz representatives. [2:00:15] Please proceed. [2:00:16] For, uh, the Kalinga, um, proposal, uh, we are in full, we are in support of this renationalization. [2:00:30] We are actually already supporting in terms of the HPEP as well. [2:00:35] Um, I just wanted to also clarify that, uh, our DOH hospitals do not prioritize the, the province that they are in. [2:00:47] If the patients are coming in po, kasi na-mention po ni Congresswoman na baka po hindi daw sila ang priority ng Cagayan Valley Medical Center, I would like to clarify that we do not, um, prioritize based on where you are coming from. [2:01:01] Um, the DOH hospitals serve all Filipinos, um, and they are tiered according to urgency. [2:01:09] So, triaging po tayo dyan. [2:01:12] However, we also recognize na mas mahirap po kasing ma-access. [2:01:15] So, yun din po ang practicality po na pinag-uusapan natin dito. [2:01:20] So, kung madadagdagan po natin ng access natin sa mga health facilities, um, yun po ang isusulong din po namin. [2:01:27] So, that is all for me. [2:01:29] Thank you so much, uh, to Dr. Maria Bituin and Architect Molina from DOH. [2:01:37] Saasahan po namin yung patuloy na participation nyo kasama ng committee namin at yung ating mga, uh, house authors as we, uh, move into the, uh, TWG. [2:01:50] Just one, one quick follow-up question sa ngayon. [2:01:52] Uh, Dr. Maria Bituin, tama po ba na dalawang location ngayon sa ngayon ang Rojas, uh, Memorial Hospital sa Capiz? [2:02:01] At kung tama po yun, alin dun, uh, ang i-re-renationalize or alin dun yung i-re-rename? [2:02:07] Thank you, Madam Chair, for that question. [2:02:11] So, um, of course, we gathered information relative to this. [2:02:16] There are currently two, um, structures. [2:02:19] The first structure or the old structure is still functioning as of the moment. [2:02:24] Um, that is the one that is functioning as a hospital. [2:02:27] Um, please do correct me if I am wrong, but from our understanding, there is no room for expansion in that site. [2:02:33] Um, they have also already built in a second, uh, site around eight kilometers away from the previous site. [2:02:43] Um, and this is currently with a license to operate as a pre-standing dialysis pa lang po. [2:02:50] So it is not a hospital yet. [2:02:53] Um, from our understanding, it is the new site that will be provided to the Department of Health. [2:03:00] Please. [2:03:01] Okay. [2:03:02] We are getting an affirmative to that. [2:03:04] Correct. [2:03:05] Uh, Senri, so basically, uh, we have, uh, uh, hospital right now in the, uh, Boulevard. [2:03:12] That is what, uh, is catering to the patients. [2:03:14] Then we have another one in Lanot that is, um, only acting as more of a, um, OPD right now. [2:03:23] Uh, but it's already constructed, but it's not yet finished. [2:03:26] That is what the bill is, uh, seeking for an assistance to complete the building and also as upgrade the current, the building that is in Barangay Lanot. [2:03:36] Both of these are within Roja City. [2:03:41] Oh, damo nga salamat for that, uh, corroboration and then additional, uh, important, um, information. [2:03:48] So, uh, again, no, maraming salamat kina Dr. Maria Bituin and, uh, Architect Molina. [2:03:55] Also, lastly, for expressing the, uh, recognition and appreciation to the different provinces and the different, uh, districts for sustaining their, maintaining their Level 1 hospitals. [2:04:09] It's really a, uh, uh, it's really a reflection nung pagpapahalaga na binibigay natin lahat around the table sa primary healthcare. [2:04:18] Uh, so, uh, at this point, uh, uh, again, again, maraming maraming salamat sa ating mga resource persons at lahat pa nang, uh, nagbigay ng, uh, kanilang mga pagsusumite at saka rekomendasyon. [2:04:34] Uh, uh, malinaw sa pagdinig na ito na kailangan natin palawakin ang access sa mga ospital. [2:04:40] Lalo na sa mga lalawigan na kulang o walang, uh, DOH-run facility. [2:04:46] Uh, pero malinaw rin, and, uh, I'm glad we're, um, leveled off around the table, uh, na di rin sapat ang pagtatag ng ospital sa batas lamang. [2:05:07] Kailangan may malinaw na pangangailangan check sa patapondo. [2:05:13] Kailangan natin i-check yun in the following years. [2:05:15] Tamang staffing, maayos na transition. [2:05:18] So DOH will be leading that with CHD, uh, at malinaw na papel sa referral network. [2:05:25] Kaya inaatasan, uh, natin ang committee secretary, uh, magconvene ang technical working group upang pagtibay ng mga panukala at ihanda ang kinakailangang committee reports. [2:05:37] Ah, dapat matukoy ng TWG kung aling mga panukala ang suportado ng malinaw na health service need. Ah, alin ang dapat itatag, i-upgrade, o i-renationalize. [2:05:50] Anong mga amendment ang kailangan sa transition, again, led by DOH, staffing, funding, at implementation. [2:05:57] Kung paano i-re-rationalize o i-differentiate ang magkakapares na ospital. [2:06:04] Kung alin ang dapat ipatupad ng phased. Ah, so there's a one-year transition, may phasing posible or desirable. [2:06:11] And may phased din tayong suporta sa budgets year on year moving forward. [2:06:24] At kung aling mga panukala ang handa na para sa committee approval. [2:06:28] So ang layuni natin ay hindi ospital sa papel, kundi ospital na may tao, pondo, kagamitan at kakayahang magligtas ng buhay. [2:06:38] Maraming maraming salamat, dear, dear colleagues, for your wonderful bills and your super-appreciated na partisipasyon ngayong araw. [2:06:48] The hearing, oh yes, Rep La'arney. Last but not the least. [2:06:53] Pasensya po, Senator Riza. Considering that we will be having a technical working group for this bill, [2:07:01] May I suggest that you also please invite the Department of Agriculture and of course RITM representative. [2:07:14] Kasi hindi lang naman po, hospital ang hinihingi namin. [2:07:18] It's more of the specialized research center for all our farmers. [2:07:23] For all the, alam niyo na po, yung mga sakit na indigenous lang talaga sa mga farmers. [2:07:29] Kasama na lang po doon yung hospital. [2:07:42] It's more of a research facility. [2:07:44] So it was medyo worrisome for me when I heard na uunahin yung hospital. [2:07:50] Tapos hindi musasabayan ng research center mamaya pa pag na-establish na yung hospital. [2:07:54] It was technically, specifically, more of a research center. [2:07:58] Kasama lang talaga yung hospital in cases of may mga emergencies. [2:08:03] Kasi kahit po, Madam Chair, kahit bahay ko po napupuntahan po ng ahas. [2:08:08] Hindi po yan parang rare. It's a normal thing for households. [2:08:13] So we do need that research center kasi we are already in the middle of a place na makikita mo yung kung saan ang gagaling lahat ng mga sakit ng mga farmers po. [2:08:24] Yun naman po talaga yung pinaka-gist. Hindi naman po makikikompete sa hospital na gusto nila sa third level. [2:08:41] Pero may I request for an audience with also DA po aside from the RITM. [2:08:47] Salamat po, Madam Chair. [2:08:49] Salamat po, Drepla Arnie. So we will seek the inputs also even now kahit bago ng TWG sa RITM at sa DA din. [2:08:58] Madam Chair, may I also suggest that we invite the regional director of DOH sa TWG natin para to discuss the issue of affecting the whole region. Thank you. [2:09:11] Salamat. Salamat ka, Ayo. So we will also invite the regional director either in person or at least online para makuha yung inputs nila. [2:09:23] Okay. So muli, maraming salamat po sa bawat isa, sa lahat. And ingat po and see you again. Okay, this hearing is adjourned. [2:09:33] Sa araw na ito, kami magsisikap na maging mabuti para sa sarili, sa kapwa at sa bayan. Isang mapagpalang umaga sa ating lahat. [2:10:39] Sa dami nang nangyayari sa bansa, pagaanin natin ang diskusyon dyan. [2:10:44] Nagpagas na ba ang lahat? [2:10:46] Ano man ang opinion mo? [2:10:47] Kalma, kalma. [2:10:49] Pag-usapan natin yan. [2:10:50] Tingnan natin, anong kanilang salo din dyan? [2:10:53] Kasama si na Sandro Otona. [2:10:55] Easy ka naman dyan. [2:10:56] At maan bakapagal kung anong take mo? [2:10:59] Lunes hanggang biyernes. [2:11:01] Alas 4.30 ng hapon sa DZMM Radio Patrol.