Almost 40 percent of the “6^th class” rural areas in the Philippines have no doctors because new graduates of schools of medicine refuse to serve in the provinces after their required work experience in the rural areas, primarily citing low salaries being offered.

A shortage of doctors, nurses and other medical workers has been a problem in Philippine rural areas for several decades due to insufficient government funds.

Medical professionals would prefer working abroad due to a very significant high salary being offered always.

Because of this, people living in the country’s rural areas will always continue to face insufficient medical attention due to the lack of medical professionals attending to their needs, an official of the Department of Health said.

This is on top of lack of medical supplies and equipment in the rural areas.

Department of Health (DOH) Undersecretary Roger Tong-an said doctors, including new graduates, “refuse to serve permanently in the countryside”  after serving in the “doctors to the barrios” program.

The “doctors to the barrios program”  was introduced by the DOH in 1993, requiring new graduates to serve rural areas for two years.

Tong-an, who spoke at  the joint hearing of the Senate Committees on Local Government and Basic Education, Tourism, Health and Women, stressed that  most doctors who served in the program “refuse to return”, citing “low pay outside Metro Manila.”

Tong-an said local government units (LGUs), especially in the provinces, are bound by certain laws that set a ceiling on compensation, which include limiting the number of doctors that can be hired by each municipality based on the Local Government Code.

The Compensation Act defines rates of compensation depending on how an area is classified.

“A doctor hired by the LGU of a 6th class municipality is entitled to receive only 65 percent of what an equivalent doctor working for the national government receives. This has discouraged doctors to serve in low-income class municipalities or the geographically isolated and disadvantaged areas,” Tong-an said.

Because of this, 38.46 percent of sixth-class municipalities are tagged as “doctor-less” as of June 2020, according to Tong-an.

Of the 103 doctor-less municipalities in the country, 36 are from the Bangsamoro Autonomous Region, he added.

Tong-an said the DOH would appreciate if all the medical professionals, such as nurses, midwives, sanitary inspectors, barangay health workers, would be covered by Senate Bill 446, which seeks to provide incentives and other benefits to rural doctors.

The DOH urged for a standardized rate for all doctors and other medical professionals, said Tong-an.

Tong-an stressed that the department’s position is doctors, regardless of their area of service, must receive a salary of P85,074 a month plus benefits, such as hazard, subsistence, night differential and non-financial (housing and leaves).

But Dr. Mary Ruth Politico, DOH’s director for human resources, said that the hiring medical professionals in the countryside depends on the LGU’s funds.

“LGU na po ang magpapasuweldo ’pag na-hire,” Politico said.

Sen. Francis Tolentino said the idea to mandate the DOH or the national government to standardize the salary of all health workers.

“Since the ‘doctor to the barrios’ program is not being fully implemented, they would just rather have the Department of Health download the funds to the LGUs where doctors to the barrios are enrolled. And at the same time, maintain this in the salaries at par, as what the DOH is giving,” Tolentino said./Stacy Ang