Highlights of RH debates, March 6

Highlights of RH debates, March 6
Senate Plenary Session
6 March 2012

Note: Main points that were raised from Tuesday’s (Feb.21) floor deliberations on Senate Bill No.2865, the Reproductive Health or RH Bill. Not to be treated as a transcript of the proceedings.

Sen. Antonio Trillanes IV (SAT, Interpellator): On Section 5 on hiring of skilled health professionals and skilled birth attendance, it says we would be hiring a number of skilled professionals for maternal health care. How many are specifically needed to fulfill this provision?

Sen. Miriam Defensor-Santiago (SMDS, Sponsor): The ideal is one [skilled health professional] for every 150 deliveries. The attitude is to allow the DOH to determine the precise number required by the population.

SAT: For purposes of approximating the budget [for hiring skilled health professionals under the RH], can we have the current number of midwives employed in LGUs?
SMDS: 12,500 is allotted for birth attendants.

SAT: This will be on top of what we are already employing?
SMDS: No, it’s the total.

SAT: Would we be employing additional nurses for this section? Because I’ve been going around the country and most hospital administrators are complaining of lack of nurses. If we could employ midwives, can we also employ nurses?
SMDS: Yes, we can do that.

SAT: What does ‘life saving drugs’ mean?
SMDS: That will be according to the guidelines set by the Department of Health. Nurses and midwives administering life saving drugs will have to be up to the guidelines set by DOH.

SAT: Right now they are not allowed to administer life saving drugs all around the country.
SMDS: There’s a new EO that empowers them to do so.

SAT: On Sec. 7, in the final sentence, it states no person shall be denied information and access to FP (family planning) services. Can we qualify the word ‘person’?
SMDS: We take it in the context of the Constitution in such that no ‘person’ is denied liberty, equality and property. We should take it (the term ‘person’) to include all human beings, including adolescents.

SAT: Including children?
SMDS: Yes.

SAT: On Mobile Health Care Service (MHCS), can this representation be enlightened on the relevance of this section?
SMDS: This is an important provision because it gives access to those who are otherwise unable to access the services especially in coastal and mountainous areas.

SAT: I agree with the benefits. But I hope it will not only cater to RH services?
SMDS: No. It will include such areas as general health care services. It will also provide information to those who need information on RH.

SAT: I agree with the importance of this section, but not necessarily to be confined to just this provision of the bill. Would it be possible that the DOH to avail of it now, to request additional funding for this, for purposes other than what the bill states?
SMDS: What would be the difference between the section on MHCS and what you’re proposing?

SAT: So that the DOH can already provide services to the people.
SMDS: The provision is to ensure that people in geographically disadvantaged areas will be able to access services, because people in these areas are more prone to maternal and infant health challenges. These mobile clinics will be for FP, prenatal care, treatment of STIs, HIV & AIDS prevention.

SAT: I agree that such services will be beneficial. That’s why I am suggesting that this could be very well incorporated in the GAA as soon as possible. Is this one-time procurement?
SMDS: We need a law so that the MHCS will not be changed by succeeding government officials. Further, MHCS may be used for other services but RH services will be prioritized as these vans are specifically procured for these services. So instead of making the MHCS vans available for sundry purposes, what we propose is that there should be MHCS for RH and other emergency services, and there should be MHCS for other purposes.

SAT: Does the DOH already have a prototype for this? How much?
SMDS: Yes. [Makes an estimate based on the selling price of a Toyota Innova at P1.2 million.]

SAT: So it’s not customized?
SMDS: It depends on whatever will be cheaper. We will submit the specifications of the DOH prototype in the next hearing.

SAT: On Sec. 13 [Age- and development-appropriate sexuality and RH education]. Is this mandatory? And at what grade level would it start?
SMDS: Yes. Grade 5.

SAT: The curriculum for this would be designed by what department? Do they have a curriculum already?
SMDS: DepEd. There’s a pilot program. We will submit the curriculum next hearing.

SAT: Would graphic representations of sexual intercourse be depicted? Because they do it in other countries and parents have complained.
SMDS: No. That will not work in this predominantly Catholic country.

SAT: Will we have a say in the designing of the curriculum?
SMDS: DepEd will be in a better position to know whether the material will be beneficial to students.

SAT: Can we have oversight functions on this?
SMDS: Yes, that will be better.

SAT: Can we qualify ‘adequately trained teachers’?
SMDS: They are the teachers who have knowledge and correct attitudes in the sense that they will teach this topic in the same manner that they teach social studies or sciences. They would have undergone training from DepEd or DepEd-accredited trainers.

SAT: On Sec. 18-a(2), it says any health care provider who shall refuse to provide service on lack of third party consent, and in emergency cases, the patient will have a final say whether she is a minor or not…shall be penalized.
I have a problem with this because we’re going to charge a worker for refusing a medical health procedure requested by a minor, even under the assumption that the social worker knows what’s best for the patient.
SMDS: The very first right of the person is the right to life. If this is the reason, that justifies otherwise overriding concerns. I submit that this section does not violate the freedom of religion of service provider. If he or she is in a situation where loss of life is present, he or she needs to provide the service. The concept of having freedom of religion is having freedom to believe, which is absolute, and the freedom to act, which is subject to state regulation. The State can regulate this in situations when one’s freedom to act poses danger to the general public.

The health care service provider who refuses to provide services under emergency will also be subject to the rules of the medical profession.

SAT: So a pregnant minor who goes into a center asks for dilation and curettage and a health worker denies a service, the worker will be penalized?
SMDS: No. That is not possible. Because in that case, the procedure would be similar to abortion, and that will never be feasible under this provision

SAT: On penalizing a public officer for refusing to provide for services, what are the thresholds in allocation, approval or release? Example: if a public official offers just P1 or P10 for implementation, would he be exempt from penalty?
SMDS: No, because the law demands full compliance. It will depend on how much will be allocated in the budget.

SAT: On Sec. 21, what’s the ballpark figure for the implementation of the RH law?
SMDS: P2.1 billion.

SAT: Does that include the hiring of midwives and procurement of MHCS and training of teachers?
SMDS: No. But whether we add them all up later, it will not exceed what we have allocated to CCT [Conditional Cash Transfer program], which draws criticisms for failing to achieve its purposes. We will not even get near to the amount allocated for CCT.

DOH has always received little budget compared to other agencies. It doesn’t even amount to 3% of the total budget of the government or the budget of other government agencies for other services. Next to education, health, particularly RH, should be prioritized in the national budget.

SAT: So RH over general health?
SMDS: No. Not necessarily. But RH is an indispensable component of health. #

Sen. Antonio Trillanes IV at Tuesday’s plenary debate on the Reproductive Health Bill (SBN 2865).

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