Highlights of RH Bill Debates, May 9
Continuation of interpellations on Senate Bill No.2865
Reproductive Health (RH) Bill
Senate Session, 9 May 2012
Sponsor: Senator Pia S. Cayetano (SPSC)
Interpellator: Senator Aquilino ‘Koko’ Pimentel III (SAKP)
On RH as a human right
Sen. Aquilino ‘Koko’ Pimentel III (SAKP): Section 2 on State Policies mentions the concept of human rights. How is RH connected to human rights? Isn’t this already stretching the concept of human rights too far?
Senator Pia S. Cayetano (SPSC): In the sponsorship speech of Sen. Miriam Santiago, she argues that RH is connected to human rights. I refer to her papers on this.
[Refers to Sen. Santiago’s speech] Article 12.1 of the Convention on the Elimination of Discrimination against Women (CEDAW) refers to equality of men and women including the right to decide freely and responsibly the number and spacing of children. It further mandates that the State shall enable women to have access to health care.
The principle of non-discrimination in international law also applies to this and has become part of our domestic laws. It is linked to reproductive and sexual rights as part of the right to health.
Also, our failure to enact an RH law violates the law on the role of women in nation-building as equal partners of men in development. Access to information and services empowers women to fulfill their potential.
SAKP: Can we connect RH rights to the Universal Declaration of Human Rights? Is there a statement there that says RH rights are human rights?
SPSC: Article 25 of the UDHR says that everyone has a right to a standard of living, including access to health care.
SAKP: Are there some obligations we are not complying with which this bill will help us fulfill?
SPSC: Yes. Not because this bill identifies the loopholes in our health practices, but because our approach to RH care has not been consistent because of different policies. It will address the gaps not simply because we are under pressure, but I personally believe that with or without a commitment to these international agreements, we should provide RH care. We should do that because of our own decision.
SAKP: But when we sign these documents, we are also bound to fulfill these commitments.
SPSC: Of course.
SAKP: Are you aware of some major infractions of our country with regard to RH?
SPSC: Yes, there are a lot. If we look at reduction of maternal and infant mortality from a general perspective, and if we look at the health budget, we are not spending enough money for health facilities, including maternal health facilities. Most clinics are not equipped to attend to difficult cases. There are violations from the national to the local levels.
SAKP: Are we obligated to allocate a specific percentage of our budget?
SPSC: These [obligations] don’t specify amounts but it is up to us to determine what amount is appropriate. Also there are local governments who refuse to provide some methods of family planning. There must be a full range of methods available.
SAKP: This law will make it mandatory to allocate budget for RH, and is there penalty for failure to provide?
SPSC: As it stands now, there is no law to address failure to provide RH services. If we look at the Magna Carta of Women (MCW), it mandates the legislative department to look into gaps in our laws and provide for what is missing.
Innovations under the RH Bill
SAKP: You mentioned before that there are many laws or policies providing for RH care, is this RH Bill an attempt to codify all of these?
SPSC: Yes, some are executive orders. To some extent, yes, and also to improve on these policies.
SAKP: What are the new features of the RH Bill which are not found in already existing programs?
SPSC: There is a requirement in the RH Bill that there is a maternal death review. It is necessary for documentation purposes. This is condition that really needs to be done. Sec. 8 provides that the DOH will set specific guidelines for this.
Another is the minimum ratio of one full-time health professional for every 150 deliveries. This specifies that we have to have 1 midwife per 150 deliveries.
SAKP: The expense involved in paying for the salaries of these professionals will come from LGUs? It says it will be borne by the LGUs with assistance from DOH.
SPSC: We intend that those municipalities and cities who can’t afford will be helped by the national government. For instance, DOH has a program on deploying health professionals to far-flung areas.
SAKP: This makes it look like the more deliveries, the more expenses for LGU. This bill makes it mandatory?
SPSC: But this is very true. The bigger the population, the bigger the demand for health care, etc. Any additional birth is an additional expense for the family and the government. But it is just right that the government provides for this. We also have geographical factors to consider. The 1:150 [midwife : health deliveries] ratio is a standard of WHO and DOH.
[Continues explanation on RH Bill innovations] The provision for comprehensive and basic emergency obstetric care is also new in this bill.
Sec. 7 also says all accredited facilities shall provide a full range of family planning methods. I am not aware if there has been any government policy on this.
SAKP: As of today, are there hospitals that don’t offer the full range for family planning methods?
SPSC: At present, it is only the DOH-retained hospitals which are mandated to do this. There are also LGU hospitals and private hospitals which have no mandate.
SAKP: Sec. 7 also says no person shall be denied access to information and services on RH. Is this new? We have no law on this?
SPSC: No, but this is not really codified here. We can cite international agreements but without a specific domestic law, it is really difficult. So this is really the first time that we are doing this.
Sec. 9 provides for family planning supplies as essential medicines. Some of these drugs are already part of the National Drug Formulary. But we need to document it so it will not be subject to political pressure.
SAKP: This bill will make it mandatory for these drugs to be included in the National Drug Formulary?
SPSC: We are not intervening with the work of the National Drug Formulary Board to determine what is safe and legal. We are only codifying it. We also want to have a list that includes other family planning supplies that are not drugs because some of them are not medicines. Maybe this will be part of another list in addition the list of essential medicines.
SAKP: I have a big problem accepting contraceptives as medicines. As supplies, probably, but if you take something for preventing pregnancy, that makes pregnancy an illness.
SPSC: The inclusion of these in the formulary is not new. This list which includes contraceptives already exists, even in other countries, as prescribed by the WHO. We have in Asia: Bangladesh, Indonesia, Nepal, Malaysia, East Timor, India and Sri Lanka. This is part of their essential medicines list.
To summarize, the innovations are: The procurement and distribution of supplies (DOH will spearhead this distribution among LGUs; there is no law that specifies this though this is being done in the present); [Provision of] PhilHealth benefits for serious and life-threatening RH conditions (PhilHealth Law doesn’t refer to these conditions); Mobile health care services (facility needed in many disadvantaged and isolated areas); Age- and development-appropriate RH and sexuality education; and Capacity-building of barangay health workers on family planning and RH needs. #
Photo: RH Bill sponsor Senator Pia S. Cayetano answers questions from Sen. Aquilino Pimentel III (inset).