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A major issue in devolved health facilities, e.g, devolved hospitals and Rural Health Units (RHUs),  concerns the personal services (PS) limitation being applied to them pursuant to Section 325 (a) of R.A 7160, otherwise known as the Local Government Code of 1991.   This is invoked by majority of budget officers from the local government units (LGUs), thereby likewise limiting the capability of the local government units, in terms of health manpower requirements, to serve the health needs of constituents. Also, it is seemingly supported by some circular issued by Department of Budget and Management, e.g, Local Budget Circular no. 98, issued last October 14, 2011, which is a 180 degrees turn-around stand on the matter, in view of the previous favorable issuance, e.g, concerning public health workers (PHW) benefits under RA 7305, otherwise known as the Magna Carta for Public Health Workers, which exempts local health personnel from its coverage.

Thus, instead, of empowering the LGUs based on the basic autonomy or devolution principle, operationally, by way of strict interpretation of the letter of the law regarding PS limitation,  which is, incidentally, contrary to the spirit of the same law, the LGUs are rendered inutile, at most, to do their tasks, as provided under Section 17 (a), thereof, which states:

 Section 17. Basic Services and Facilities. –

(a) Local government units shall endeavor to be self-reliant and shall continue exercising the powers and discharging the duties and functions currently vested upon them. They shall also discharge the functions and responsibilities of national agencies and offices devolved to them pursuant to this Code. Local government units shall likewise exercise such other powers and discharge such other functions and responsibilities as are necessary, appropriate, or incidental to efficient and effective provisions of the basic services and facilities enumerated herein.

Also, the self-reliance principle, which is stated in the provision, is likewise impaired, as LGUs, due to literal adverse interpretation of the law on PS limitation, are compelled to perpetually seek manpower augmentation from the Department of Health  or from the private sector, which defeats the said principle. In short, LGUs are over-dependent on external manpower support, as they can not comply with the health manpower requirements, by themselves, which is very ironic, because they are being limited by their own adverse opinion or use of said opinion to hammer their own heads with the very law that allegedly empower them to better serve the community.

Further, the DOH health manpower standards ratio to population is cumulatively adversely affected by yearly increase of population, which requires additional manpower, in order to effectively serve the community. Hence, the PS limitation in health services, does not only limit the health manpower but, also,  manifestly, a very backward arrangement, in so far as health services are concerned.

Are the hospitals and rural health units (RHUs) exempt from personal services (PS) limitation?

Legally speaking, Yes.This is supported by the spirit of RA 7160 itself, which also defines the nature of devolved health facilities, by international commitments and by the basic rule in statutory construction, which is applicable in case of conflicts of two or more laws.

Section 325. General Limitations. – The use of the provincial, city, and municipal funds shall be subject to the following limitations:

(a) The total appropriations, whether annual or supplemental, for personal services of a local government unit for one (1) fiscal year shall not exceed forty-five percent (45%) in the case of first to third class provinces, cities and municipalities, and fifty-five percent (55%) in the case of fourth class or lower, of the total annual income from regular sources realized in the next preceding fiscal year. The appropriations for salaries, wages, representation and transportation allowances of officials and employees of the public utilities and economic enterprises owned, operated, and maintained by the local government unit concerned shall not be included in the annual budget or in the computation of the maximum amount for personal services. The appropriations for the personal services of such economic enterprises shall be charged to their respective budgets;

Whereas, Republic Act No. 4226 or the  “Hospital Licensure Act” provides:

Sec. 15. Rules and Regulations. – The Bureau of Medical Services acting as a licensing agency and subject to the approval of the Secretary of Health, shall promulgate rules and regulations to implement the provisions of this Act.

Sec. 16. Classification of Hospitals. – The licensing agency shall study and adopt a system of classifying in the Philippines as to (1) general or special; (2) hospital service capabilities; (3) size or bed capacity; and (4) class of hospital whether training or not.

In support of R.A 4226, the Department of Health and Department of Budget and Management jointly issued Joint Circulars no. 2013-1 last September 23, 2013, which prescribe the standard manpower complements of hospitals.

In addition thereto, PS limitation in R.A 7160 is in conflict with the international commitments or WHO commitments pertaining to public health, which became part of the law of the land pursuant to the principle in Section 2 of Article II of the 1987 Philippine Constitution. The WHO commitments require ample health staff to carry into effect the agreement. Accordingly, the Department of Health adopted a policy of 1:20,000 ratio of  doctor to population, 1:20,000 ratio of nurse to population, 1:20,000 ratio of dentist to population and 1:3,000 ratio of midwife to population.

Section 2 of Article II of the 1987 Philippine Constitution, states:

SECTION 2. The Philippines renounces war as an instrument of national policy, adopts the generally accepted principles of international law as part of the law of the land and adheres to the policy of peace, equality, justice, freedom, cooperation, and amity with all nations.

In short, the fixed PS limitation that is prescribed under R.A 7160 is in conflict with the dynamic or flexible provision under Republic Act 4226 pertaining to manpower complement of LGU hospitals. Also, it violates the principle laid down in the Constitution, specifically pertaining to the international commitments on health, e.g Millennium Development Goals (MDGs) launched in 2000, and the present Sustainable Development Goals (SDGs), as it erroneously deprived the LGUs of adequate health mapower.

Hence, by applying the principle in statutory construction, where special law prevails over the general law, the Local Government Code of 1991 has to be prevailed upon by Republic Act 4226, and since, PS limitation has also to give way to the international commitments in public health, such PS limitation would not apply to devolved health services.

Attachments:

• Local Budget Circular no. 98 dated October 14, 2011
• DBM-DOH Joint Circular No. 2013-1 dated September 23, 2013
• Republic Act 4226

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