Wednesday, April 30, 2014

PNP Reforms (A continuing article). Part 4b – Deactivation or Reorganization of Outdated NSUs (Health Service)

The following is an article from a PNP Health Service publication:
  
PNP General Hospital: Then and Now (Excerpt from A Capite, Ad Calcem - HS 17th Anniversary Edition)

In 1950, an Infirmary was built with a twenty-five (25) capacity as a support unit to the Philippine Constabulary Command, located in Camp Panopio, P Tuazon, Quezon City.  It served as an extension facility of the Victorino Luna General Hospital.  It ws named the Constabulary Station Hospital with a fifty (50) bed capacity on MArch 1, 1955, later it would be renamed as the MPF-CAPCOM Hospital.

In 1972 a 100-bed hospital building was inagurated housing the whole Constabulary Station Hospital, located in Camp Crame, Santolan Quezon City.  In 1989,, it was renamed as the PC-INP General Hospital with one hundred fifty (150) bed capacity.

With the enactment of RA 6975, also known as the Department of the Interior and Local Government Act of 1990, and becasue of the increasing number of patients, the Camp Panopio Hospital (formerly known as MPF-CAPCOM Hospital) and the Camp Crame Hospital (formerly known as PC-INP General Hospital) were merged to become the PNP General Hospital Main, at Camp Crame.  The PNPGH Annex at Camp Panopio housed the surgical facilities of the hospital.  In 2002, the PNPGH Leadership decided to transfer the different sections that were housed at the PNPGH Annex at Camp Panopio to the PNPGH Main at Camp Crame in ordr to provide a more efficient health care system to PNP personnel both uniformed and non-uniformed and their dependents and pther aithorized civilian patients who seek consultation and admission in PNPGH.  This paved the way to several changes in the physical planning and management of the hospital.

The Out-patient Department which caught fire sometime in 1998 had to be renovated and reorganized so as to facilitate a more convenient flow of patients and make room for a new Dialysis Center, an Ultrasound Section in the radiology service, a minor operating for the OPD Surgery Section and for new pharmacy.  The ECG Section also housed in the same building become roomier to accommodate a stress test or tread mill machine.  At present, this ECG Section been renamed as the Heart Station for it has now the capability of also doing a 2Decho cardiogram.  To adhere to the requirements of a Tertiary level hospital, the PNPGH Laboratory Service has added very recently to its services a Bacteriology Section which does culture and sensitivity test and a Blood Bank Station which stores blood for transfusion.  So if before, blood specimen for culture and sensitivity had to be spent out now no more.  Other services of the laboratory were enhanced with modern equipment like the hematology, microscopy, serolgy and clinical chemistry services.

The Emergency room which was first relocated at the center of the hospital ground became bigger and modernized to accommodate more patients.  But years later the then Director of the Health Service, PCSUPT  FEDERICO G DAMATAC and then chief, PNPGH PSSUPT FRANCISCO P ALTAREJOS agreed to transfer the ER to its present location near the entrance of the hospital premises for visibility and easy access of emergency cases. Today, the emergenecy room is more spacious, more equipped and manned by specialty trained medical officers, nurses and other allied personnel

(copied through cut and paste, thus all errors are from the original post.)

However the PNP Health Service paint themselves with the rosiest of pictures, I have negative personal experiences in the unit that I believe that it is time that the unit is removed as a support unit of the PNP and restructured as a PNP-owned profit earning corporation.  But setting aside my personal opinions which many may brand as bias, I still have arguments for the deactivation of the PNPHS.  Here are my reasons:

The concept of a medical corps as a regular unit in the military was borne out by the necessities of war.  Today, many of those reasons are gone, especially in the police.  In the military, doctors and hospitals in the frontlines are necessary as battles are usually located in remote locations far from the reaches of medical facilities.  Moreover, war related cases are usually emergency life and death trauma situations and medical intervention usually requires surgery with minutes to spare, thus necessitating dedicated medical personnel for the situation.

But modern day policing environment, especially for the PNP, has no such need anymore.  In this operational condition, the PNPHS was rendered irrelevant and unnecessary.  Moreover, the local government units, that are by law working in partnership with the PNP, are far better equipped than the PNPHS.  Against this backdrop, the PNPHS is reduced to being a white elephant that there was once a time that a sizable number of its doctors and nurses went abroad and for a long time, they were not even missed.  When the racket was uncovered, two line officers who were both PMAyers were assigned to the HS purposely to account for these “missing in action” doctors.

In its website, the PNPHS vision states: "A modern Health Service rendering optimum health care at par with other well known Health institutions in Asia by 20126."  Its mission statement is: "To provide timely, comprehensive and quality health services to PNP personnel, their dependents, and authorized civilians."  So will they be better than the best hospital that the Philippine hospital industry can come up with?  Looking at these statements, the PNPHS betrays the fact that it they themselves do not know that they had lost their relevance.  Health services to policemen nowadays is best dispensed at the numerous public and private hospitals dotting the country as compared to the PNPHS whose main hospital inside Camp Crame is nothing more than a glorified clinic. 

The irrelevance of the PNPHS was further amplified by another factor:  the PNP rank system that gives great weight to length of service in determining seniority.  This leads to the situation that nurses with higher PNP ranks, boss around doctors who have just joined the service.  At the surface, this may not be an issue but talking to the doctors themselves, it is undeniable that efficiency and effectiveness is very much affected.

 

In page 36 of the 2013 PNP Annual Accomplishment Report, the PNP boasts that a total of 653 personnel were given P 41,550,345.43 as hospital reimbursements.  And I thought that the PNPHS claims to be always right there to serve the PNP?  Using my pulis mateks mateks again, this translates into an average of more than P63K for each of these policemen beneficiaries.  



 

What do I advocate for the PNP health care system?

1.    First:  Let us put to task the PSMBFI who had made the MANDATORY MONTHLY DEDUCTIONS for the police to look for an HMO partner who will assure payment of hospital bills incurred by PNP personnel all over the Philippines.  Instead of making pakitang tao of donating equipment to the PNP such as computers, PSMBFI management should instead return excess/profit money to the members in the form of health care benefits.  After all, it is the money of the members.  Let the PNP take care of its procurement.  There is more than enough money for that, as Napoles succintly demonstrated.

Actually better than partnering with an HMO, the PSMBI can create a division in its organization specifically for this purpose.

2.    Now that the PNP personnel is out of the way of PNPHS, the unit should be converted into a regular hospital owned by the PNP and operated for profit and ran like a regular hospitals staffed by regular civilian employees.  Thus the stupidity of having an HS Director, DDA, DDO, and CDS running the current hospital is corrected.  For what do you need all these generals and senior superintendents to maintain the health of personnel?

Converting the hospital into a for-profit outfit serves another purpose:  the pay and allowances of its employees can be taken from the earnings of the unit.  This again serves a three-fold purpose:  first, the burden of having the pay and allowances of its personnel in the PNP budget is removed; second, the hospital will be forced to improve its services and compete with other hospitals to ensure its continued operations and financial survival, and third, the profits that the hospital will generate can be used to pay the HMO premium or returned to the PNP to be used in other healthcare needs.

3.    The second reason above is very relevant.  In any service organization, it is always safe to equate efficiency and effectiveness with the trust and confidence of its clientele.  In other words, the more efficient and effective organization commands more trust and confidence from its clientele, right?  Now ask around:  how many PNP personnel will actually bet their life and health to the PNPHS?  Obviously, those 653 personnel who were granted that P41 million refund are not among them!

For why should I trust my life on them?  I have personally seen how one “striker” (errand boy/utility boy) afflicted with dengue and initially brought to the PNPGH almost died after 3 days of neglect in their ward!  If not transferred to San Lazaro Hospital in Manila, the kid died.  The doctors in SLH were in equal parts, aghast, amused, angry, and what have you, when the kid narrated to them the medical intervention he received in the PNPGH.

I have also seen a PCO die in the ER of the PNPHS.  The PCO was hit in the back during an encounter in Cubao one afternoon.  He was immediately rushed to the ER and was promptly pronounced dead on arrival by the doctor on duty using a stethoscope to check for a heartbeat.  Upon the prodding of the companions of the officer who requested the doctor not to easily give up, the doctor half heartedly started cardio resuscitation by pumping the chest of the officer.  For every pump, I can actually see the blood squirt out of the two bullet holes in the back of the patient.  It was found out that his lungs were pierced by the bullets.  I am not a doctor but I have a feeling that the officer did not receive the appropriate emergency care.

I have also received a very substandard dental service in the PNP Dental Service.  For a simple and routine procedure, I ended up nakanganga for almost three hours because they do not have the dental bur long enough to do the job.  Up to this day, I have a funny feeling in my mouth and can almost feel the pain that the procedure inflicted on me.  When I researched how much is a dental burr, I was aghast to find out that it only cost less than a thousand pesos.  If they had only told me beforehand, I could have bought one—or went to another dentist altogether.

There was also a time that I sought advice regarding a condition I am feeling.  The answer I got?  Go see a civilian specialist and a name was actually given to me.  I personally know many personnel in the PNPHS including doctors, nurses, dentists, administrative support staff and many of them I can consider as friends.  But I have to call a spade a spade.

Of course, there are competent doctors in the PNPHS but they cannot shine nor reach their potential in such a highly structured and restrictive environment where seniority is usually based on the length of service.  But undoubtedly, the PNPHS also has its share of a confirmed neurotic doctor in the person of then PCI Renato Poscablo who shot his boss and hurled a grenade ironically during the 13th Anniversary Celebration of the PNPHS at the Multi Purpose Hall of Camp Crame.

Though admittedly I cannot cite empirical data to support my claim that the PNPHS does not enjoy the support and confidence of its clientele, a simple random survey of personnel will show that I am not alone or in the minority with this feeling.  Actually, a simple question will highlight the stark reality:  who is the general or any senior officer that you know who went to the PNPGH for treatment of a condition that required hospital admission?  Name one.  I cannot for I never knew one. 

Even its Director, PCSUPT Federico Damatac was rushed to St. Luke's Hospital in E Rodriguez Avenue, a good 5 kilometers away and in Manila's traffic, not less than 30 minutes of travel when he was shot by Poscablo, in the Multi Purpose Hall of Camp Crame, a stones throw away from the PNPGH.  Ironically, Poscablo the criminal was treated at the PNPGH--and both of them have the same injuries:  gunshots.
(read here the story:  http://www.philstar.com/headlines/372650/cop-killed-protecting-others-crame-rampage)

If the Health Service Director himself would not trust his life to his biggest hospital, how much more the other policemen?

(This article is still in draft.  Please place your inputs in the comment section below)

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