Healthcare delivery

Published 27 January 2023, The Daily Tribune

Enacted in 2019, Republic Act 11223, otherwise known as the Universal Health Care Act, aims to revolutionize the delivery of healthcare to the Filipino masses. It strives to effect an integrated and comprehensive healthcare model that is cost-effective, accessible, and holistic. The vehicle from which this vision is to be realized is the Primary Care Facility or PCF.

When asked, an ordinary Filipino citizen is often dissuaded from accessing healthcare services because of affordability, distance, and lack of knowledge. While some areas have Barangay Health Stations, their services are often limited to vaccines, basic medicines, and consultations. Oftentimes, these consultations are not consistent or routinely scheduled. When the medical concern raised is too great or severe for the Barangay Health Station, a person is often at a loss on how to access further medical care.

This gap is what the Universal Healthcare Act wishes to bridge with PCFs. It envisions a healthcare delivery system where healthcare providers are integrated into a single network capable of providing healthcare at all stages.

A step up from the Barangay Health Stations, PCFs are licensed by the Department of Health to provide primary care services. Primary Care refers to initial-contact, accessible, continuous, comprehensive, and coordinated care that is accessible at the time of need, including a range of services for all presenting conditions, and the ability to coordinate referrals to other healthcare providers in the healthcare delivery system, when necessary. It is the first touch-base point where all healthcare services will be endorsed and delivered. It can be government-owned or privately owned.

The Universal Health Care Act mandates a government-owned PCF in every rural and urban unit in the Philippines. It prioritizes the establishment of PCFs in geographically isolated and disadvantageous areas so that Filipinos can have ready access to healthcare. For government-owned PCFs, it must provide both individual and population-based services set by the DoH and PhilHealth.

Individual-based services refer to the provision of medical services to one specific individual with limited effect at a population level, whereas population-based services refer to interventions such as health promotion, disease surveillance, and vector control, which have population groups as recipients. As a minimum requirement, PCFs must provide medical consultations and minor surgical services within their premises. By having the capacity to perform surgical services, PCFs can alleviate the logistic struggle of accessing healthcare services and can help decongest government hospitals.

PCFs can also provide ancillary services like clinical laboratories, diagnostic radiologic services, pharmacy, birthing services, dental services, and ambulance services. These ancillary services may be outsourced and may be located either within the PCF itself or in a location outside thereof. All medical services provided by the PCF must comply with DoH and Food and Drug Administration licensing requirements.

When the medical concern is outside the service capacity of the PCF, it then endorses the concern to the appropriate healthcare facility within its network. Ideally, this is within the same geographic region to prevent any admission issues. In all hospitals, a public health unit shall be established to provide coordination with PCFs and to act as a hub for patient navigation of a given healthcare system.

All healthcare providers within the network shall be accredited with PhilHealth to ensure the quality of service and access to affordable healthcare.

With PCFs, the government intends to bring healthcare services closer to the Filipino people.

For more of Dean Nilo Divina’s legal tidbits, please visit www.divinalaw.com. For comments and questions, please send an email to cabdo@divinalaw.com.