Privatizing the Philippine Orthopedic Center

In 1998, the centennial year of Philippine independence from Spain, I was assigned to do a Sunday Inquirer Magazine cover story on centenarians (“Lives of the Century,” 6/7/98). One of them was Dr. Jose de los Santos, then 100 years old. He agreed to be interviewed at the family-owned hospital named after him. When we met he was wearing a crisp white doctor’s jacket and a broad smile on his face.

Not many know that the doctor was a war hero and one of the founders of the iconic National Orthopedic Hospital, now the Philippine Orthopedic Center (POC) and to be renamed Center for Bone and Joint Disease, Trauma and Rehabilitation Medicine when it is privatized under the Aquino administration’s public-private partnership (PPP) program. Called the “Father of Philippine Orthopedics,” De los Santos was the hospital’s founder and first head, and the founder and first president of the Philippine Orthopedic Association.

De los Santos’ story (excerpts below) came to mind when I learned about the impending privatization of POC and the protests by health, church and advocacy groups who find the move detrimental to the hospital’s poor patients and employees. The 700-bed POC is the only specialized orthopedic government hospital in the country. Located in Quezon City, it has 940 employees. In 2010 it attended to 5,347 service patients and 1,266 paying patients. It serves poor patients with bone and joint injuries and diseases for free—and free does not mean low-quality. Despite a challenged budget, it has some of the best bone doctors and other health personnel.

The Coalition Against the Privatization of POC questions the move to turn the hospital into “the country’s first health project under the PPP program.” This is part of the Aquino administration’s Kalusugan Pangkalahatan (universal health care) that promises increased affordability and accessibility to health care.

The POC is among several government hospitals in the PPP offering, among which are the Research Institute for Tropical Medicine, San Lazaro Hospital, Dr. Jose Fabella Memorial Medical Center, and Jose R. Reyes Memorial Centers.

Here is a briefer from the coalition: The P5.7-billion project approved by President Aquino on Sept. 8, 2012, involves a 25-year contract for the construction, operation and maintenance of a 700-bed hospital inside the National Kidney and Transplant Institute compound in Quezon City. Nine big corporations offered bids but later reportedly backed out. In the end, only one bidder, Megawide Construction Corp., was left. Construction starts in 2014; expected completion is 2016.

The coalition accuses the government of turning health into profitable business and asks: Where will poor patients go? On a given day, 450-500 poor outpatients come for free services; 80-90 percent of inpatients depend on free procedures, medicines and supplies. The hospital stay of trauma patients may take two months and many poor families have to solicit money for expensive metal screws and implants. With its dwindling budget, the POC had to raise rates in radiology and lab procedures. It can no longer offer totally free services.

Credit goes to the ICM sisters in the adjacent convent who minister to and even offer dwelling to poor patients.

In the “modernized” POC under private investors, 420 beds will be for PhilHealth members, 70 for the poor whose expenses will be sponsored by the private operator, and 210 for paying patients. Therapy and metal prostheses will be shouldered by patients. If the 70 beds for the poor are filled, poor patients will be transferred to other facilities of the Department of Health.

And what about the 940 POC workers? Health Secretary Enrique Ona was quoted as saying that no one will lose a job as a result of the POC’s modernization. But the coalition says that in the bid documents, the DOH shall offer the POC staff the options of early retirement, severance/termination of employment, and applying to the project proponent, which will have “the freedom to select employees who wish to transfer” and which is “not under obligation to recognize the existing union.”

The coalition emphasizes that people’s health should not be left entirely in the hands of private investors and that the government, if it is indeed sincere in improving people’s health, should allot adequate funds and invest in public health services.

Here are excerpts from my 1998 article on the Father of Philippine Orthopedics:

There is a well-documented story in the 1945-1946 issue of the USA Catholic Digest that tells of the heroism of Dr. De los Santos, the orthopedic surgeon who blazed a trail for bone and joint surgery in the Philippines. It was written by Blake Clark, an American who witnessed how the brave “little doctor of Mandaluyong” used every scrap available, every drop, every morsel of anything in order to save lives…

The doctor’s creativity was likewise put to the test. He and his assistants made improvised pulleys and weights for the patients. They turned empty crates into support instruments for injured legs and backs, they turned lead wires into brackets and parachute shroudlines into traction lines. Discarded beer cans were filled with sand and used as weights. From wrecked planes, they salvaged aluminum that was turned into braces…

When you hear about the great things they do at the government orthopedic hospital that De los Santos founded, you would not at once realize that these had their beginnings in the ruins of the war, in the midst of twisted steel and smoldering iron bars, among people with mangled limbs and flesh that had been ripped apart, among the wounded, the dying and the dead…. ( I will post the entire article in my blogsite.)

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