Transcript of Sen. Pia Cayetano's Opening statement
DOH and attached agencies Budget Hearing
October 8, 2024

Okay, we'll start. Settle in, please. Welcome everyone to the hearing of our Subcommittee on the Committee on Finance. I'd like to greet all our resource persons, starting with the Secretary of Health, Dr. Secretary Ted Herbosa; PhilHealth President and CEO Emmanual Ledesma; our National Nutrition Council Executive Director, Azucena Dayanghirang; PITAHC Director General, Ma. Theresa Co-Iñigo; Philippine National Aids Council (PNAC) Executive Director, Joselito R. Feliciano; Lung Center of the Philippines (LCP) Executive Director, Vincent Balanag, Jr.; Philippine Children's Medical Center (PCMC) Executive Director, Sonia Gonzales; National Kidney and Transplant Institute (NKTI) Executive Director, Rose Marie Liquete; and Philippine Heart Center (PHC) Executive Director, Avelino Aventura.

On our agenda today are the proposed budgets under the Fiscal Year (FY) 2025 of the National Expenditure Program (NEP) of the DOH and its attached agencies and corporations.

For DOH - Office of the Secretary, we have new appropriations of Php 217, 388, 398, 000; For National Nutrition Council, our total is Php 313, 093, 000; Philippine National AIDS Council, total of Php 50, 284, 000; Lung Center of the Philippines, Php 711, 335, 000; for National Kidney and Transplant Institute, Php 1, 486, 886, 000; for Philippine Children's Medical Center, Php 1, 397, 216, 000; for Philippine Heart Center, Php 2, 212, 920, 000; for Philippine Institute for Traditional and Alternative Health Care, Php 154, 726, 000; and for Philippine Health Insurance Corporation, Php 74, 431, 930, 000.

Before we start the presentations, I'll just make a short opening statement, since my colleagues are not here yet. I want to tie this into the SDGs, the Sustainable Development Goals. SDG 3 is on good health and wellbeing, seeking to ensure healthy lives and promote wellbeing for all ages. And then I tie this into the WHO statement, that is, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

I'd like us to be mindful. I chaired the Committee on Health in 2004 for 9 years, since 2004. And then I've chaired this budget, the Department of Health and attached agencies, for 5 years. Although I do not have any professional degree in any medical field, I have done the research, I have talked to a lot of you, the experts, and I do believe that there's more that we can do, not just in the budgetary process, but in the area of information campaign. And also in the area of promoting health and wellbeing. I think we can actually move away from the urgent and immediate solutions, because we are not in the same place we were when I first became chairman in 2004. Medyo may economic crisis tayo, kulang na kulang yung budget. Because of the laws that we have passed, billions of pesos are now available to healthcare. They are available to the health agencies and to the infrastructure programs, to the health professionals. So hindi na pwedeng ang programs natin are just immediate stopgap interventions. Kumbaga sa natural calamity, hindi na pwede yung biglang last minute nagse-save lang tayo ng lives. This is already parang, kumbaga nga in that field, it's disaster risk management and prevention.

I'd really like to hear what your interventions are. Because they are embedded in your programs. But really on promoting a healthy lifestyle. Because we all know, and I've said this since day one, I am not the health professional, I am the legislator, and now I am the person in charge of your budget. But are we doing enough to help more people enter their senior years in a healthy state of mind and body? Hindi yung nadadagdagan lang ang pang-dialysis, nadadagdagan ang budget pang-maintenance medicines... And then ang increase ng budget for wheelchairs... Importante yun, don't get me wrong. Importante yun. And I know I am preaching to the choir. But I'd like to empower you to think beyond that. I know. Pipilahan din naman ako. Lahat ng mga senators, governors, pipilahan kami for assistance pambili ng gamot, assistance sa na-stroke, pambili ng wheelcare, financial assistance para magpa-therapy. Pero yung tanong ko, enough ba yung ginagawa natin so that while they are kids, while they are teenagers, while they are young people, you are educating them so that they enter their senior years in the prime of health. And that is very possible. With the digital age that we live in, and bahala na kayo, kanya-kanya na kayo, but I can give you my phone, I pass it around, and you look at my Instagram, yung pumapasok ng feed sa akin, it's all about healthy living, nutrition, mga 90 years old na sumasali ng mga marathon, because yun yung interest ko. So ganoon din sana yung pino-promote ko na interest ng mga kababayan natin. Wala namang problema kung mahilig ka sa makeup, mahilig ka mag-shopping, pero sana tulungan natin sila to make health sexy for them, to make health something that they look forward to, to make being healthy an amazing lifestyle, something you want to do after work, instead of going out for a drink.

Anyway, as I said, I'm preaching to the choir, but I'm trying to inspire all of you to help. So with every intervention you make on the operating table, with your budget officers, do the same sana, effort and time, to really see what kind of promotional campaigns you can do, to really change the way we look at not just aging, but living a healthy life.

And I'll end with this. I'm sure you already know this. You look at the Nordic countries, that's how they raise their kids. Yung mga bata pa lang nagtatatakbo. Yung mga bata pa lang pinapakain, ang pagkain nila is prutas, sufficient amount of proteins. Hindi yung sa atin paglabas mo, nagbebenta ng, I don't know how much, five pesos or whatever, na puro asukal, puro coloring. Yun yung snack ng mga bata. But if you go back to the earlier days where ang mga pagkain nila is saging, saging na saba, okay naman diba? Pero kung mapapalitan yan ng napakaraming processed food.

Really, I'd like to focus on that, not necessarily in today's hearing, but in the future budgets and in the time and energy you all spend. There is enough data to tell us that when you live this kind of life, you'll need to put less, we can use the budget. Yung health budget niyo nga, if you ask me dapat kayo din nagpapatayo ng track oval, not necessarily track oval, walking paths, kayo dapat nagpapatayo niyan. Hindi niyo dapat inaasa lang yan sa Philippine Sports. I'm not asking that all people should become marathoners, but they should become walkers. You should be pushing for the budget of... Sa init sa Pilipinas, walking path but also shaded walkways, diba? Para mas ganahan naman sila maglakad.

Anyway, that's my little piece and I hope to say less. I will give the floor to all of you in a few minutes. Just a few issues that I want to ensure that you clarify when I give you the floor.

For DOH, let's clarify the budget for health emergency allowance. Because I was of the impression, and so was my whole team, that the amounts that we were allocating over the last few years were already the total amount needed for the HEA. And then now, we're told there's another Php4.7 billion being requested as of the moment, tapos madadagdagan pa. May deadline naman ito, it can't naman be forever processing these requirements. Medyo nakakagulat lang it. So kindly clarify this.

And then I need an explanation on the low utilization rates for our Health Facility Enhancement Programs and other major programs. This is a perennial problem with DOH. I'd like also an update on infant immunization programs and the hiring of vaccinators. Where are we now? I know we've made some progress, but I'd like to know, I'd like to get more details.

And then the healthcare workers gap. In the previous hearings that I chaired, I already had a hearing on the budget of the Department of Education and the Commission on Higher Education and the state universities and colleges. I take pride in telling them that I'm in a unique position to help those two education agencies tie up with the Department of Health and your health needs. Because hindi naman kayo miraculously makaka-produce ng shortage natin of health workers in certain fields like whether it's the doctors, physical therapists, radiologist, and so on and so forth. We won't be able to fill those gaps if you're not working very closely with CHED on enhancing or increasing the program offerings to the students. It's not going to happen overnight. I don't know how much coordination is happening. So I expect a report on that as well.

And then for PhilHealth, as you all know, the Senate has had hearings on the issue of the transfer of PhilHealth funds to the Bureau of Treasury. And this is very relevant to the budget because for the last five years, as I said, humihingi sa akin, most of the years, except only for last year. PhilHealth has been asking for additional budget and then suddenly namigay ng pera. I understand that hearings have been held, but in this forum, the budget, you need to explain to me what has happened in the last few years and now, why suddenly after every year asking for additional budget, biglang, hindi pala namin kailangan, ito na, binibigay niyo na ang pera para sa ibang paggagamitan ng gobyerno. I want to understand that because I've been the recipient of all the requests, and then suddenly, hindi na nagre-request, nagbibigay pa ng pera. I want to understand that better.

Also for PhilHealth, I think there's just a need to clarify the principle of universal health coverage for all, because something in your presentations refers to an increase in coverage. What does that mean? Because technically, we are covering every Filipino. So just clarify that later on. And then talk about the benefits package, it's very important for people to know the improvement in the benefit packages. And then also the increase in the case rates.

And finally, sana may good news kayo sa Konsulta kasi ilang taon ako nag-aantay ng rollout ito. Ilang taon na rin ako nasasabihan na... at first, the program was still being prepared and then for how many years, it's in the pilot stage. I'm waiting for that to happen. And you all know, I don't need to tell you, you all know that that is an integral component of basic healthcare, preventive healthcare, the Konsulta Package.

We'll start with Secretary Herbosa. You have about 10 minutes. And then PhilHealth will also have 10 minutes. And then by that time, I'm assuming the other colleagues will be here and they will be able to propound their questions after that. I'm assuming the staff of the other senators who are attending are already present. Kindly inform your principal that if they arrive in the middle of the presentation, I'd like the presentations to be presented without our asking questions yet and then I will give the floor after the presentations. Anyway, there are just two major presentations. And 10 minutes will be allotted to the senators, and then we can do a second round if that's not enough. Okay.

Administrative reminders, in this hearing, supposedly in the entire Senate, we practice sustainability. So we have pages going around. If you need water, you'll also be given food. But we don't use PET bottles and we discourage that you have PET bottles. I hope in our notices, we remind our resource persons to bring their own reusable containers. But we have glasses and you'll be given water. Anytime you need to stand up, you want to stretch your legs, you're more than welcome. As long as you're not the one speaking. If you're speaking, then that's the only time I require that you're seated. If you want to stand while you're speaking, that's also fine. But otherwise, you're welcome to stand up, stretch, and go to the restroom. You don't need my permission for that. Okay, so we are ready to start. Secretary, you have the floor.