Wednesday, September 10, 2014

[Vital Signs Column] Why Filipino nurses won't get the pay they deserve

Photo source: Carl Balita
Vital Signs Column
Nurse's Notes
September 2014 Issue

Filipino nurses are world-class professional health care provider, extremely hardworking, and the world's most caring professionals but at the same time one of the most overworked, underpaid, and under-appreciated workers in the Philippines.

Recently the Department of Budget and Management responded to an inquiry from Ang Nars Partylist regarding the non-implementation of Republic Act 9173 otherwise known as "The Philippine Nursing Act of 2002" mandating the government to provide a base pay of nurses to at least Salary Grade 15 (approximately PhP 25,718, Step 4). The DBM through Assistant Director Edgardo Macaranas responded last May 26, 2014 and a response which is not shocking, but expected - the national government cannot implement the 2002 Nursing Law's provision on SG 15.
DBM and the Filipino Nurses
According to DBM, Section 34 of the National Budget Circular No. 521 implementing Congress Joint Resolution No. 4 s. 2009 that certain medical and allied medical positions requiring PRC examination were re-allocated to positions which have substantially equal qualifications, skills, effort and responsibility under similar conditions shall be paid similar salaries. DBM continued that in particular, the entry level for nurses in government service was worth SG 11 (even though they mentioned that it was recently upgraded from SG 10).

By this, DBM would mean that every licensed Filipino nurse's qualifications, skills, effort and responsibility under similar conditions shall only be paid around PhP 19,111 (on Step 4) instead of what the law requires of about P 25,718. Would that mean, that is how lowly our government sees the qualifications, skills, and efforts of our nurses? I don't know with you but that is how it translated to me. It may be the phrasing or what, but it was just so bitter in the mouth.

Truths in the nurses' salaries
The following paragraph then goes with the lines "while the [Nursing] law expressly provides for SG-15 as the entry level for nurses, its implementation would distort the hierarchical relationships of medical and allied positions, as well as other positions in the bureaucracy." Well, there are two truths in these lines: first is that the Philippines still see the conservative hierarchical view of the health team where the doctor would always be the leader and the rest are just members, and where nurses are viewed as assistants to the doctors; and second is that it is not only the nurses who are suffering for being given a salary grade so much lower than what their law provides, but as my memory serves me right even our physicians are not getting what they are supposed to receive perhaps a few grades lower than Salary Grade 27 under Republic Act 6758. The entry level salary for government physicians in the national government receives about PhP 15,841 while in the local government it could go even lower to PhP 12,546. The second truth I believe, is not only felt by nurses and physicians, but other health professionals working in the government as well. 

A lawyer friend once told me that the Salary Standardization by virtue of Joint Resolution No. 4 series of 2009 repeals all laws, orders, circulars, and memoranda inconsistent with the SSL are repealed. The Nursing Law of 2002 is a special law that governs the nursing practice in the Philippines, the Joint Resolution No. 4 of the 14th Congress in 2009 repealed the provision of SG-15 in R.A. 9173 and upgraded SG-10 to SG-11 of the current compensation and position classification of nurses in government service. This would mean that after the SSL and Joint Resolution No. 4 s. 2009 was passed and enacted, there is no SG-15 for entry-level nurses in the Philippines but SG-11.

We aren't talking about the benefits due to every public health care professional should receive under the Magna Carta of Public Health Workers. That in itself is another horror story.

Tipping the balance
The letter also mentioned that upgrading the 4,787 entry-level nurses (Nurse I) would entail around PhP 438 million per year and would further strain government funds. The DBM stressed that should it approves increase in the salaries of nurses, it expects that the other professions would do the same, expressing demands to increase their own salary grades. And that would be the end of the government coffers. 

DBM now somehow tells the nurses, there is no remedy for this unfortunate and bitter case as this bottleneck is so tight, it wouldn't let our health professionals breathe fresh air. VP Jejomar Binay last April urged Congress to revisit the provisions of the SSL and asked them to update it as it many government employees' salaries were so behind compared to their private counterparts. The Vice President also proposed that to include Barangay officials and workers part in the roster of regular government employees and receive regular salaries. 

The only way around it is to actually revisit the SSL and update the grading system. It should however increase if not revert to what each profession's governing law requires (SG-15 for entry-level nurses for example). Others, like former Kabataan Partylist representative Mong Palatino filed bills that "increases" the entry-level salaries of nurses from SG-11 to SG-15. Those workarounds are somehow the only ways I think to solve this situation, unless DBM shows other solutions otherwise.

The 'White Movement'
Several groups of nurses have been mobilizing both in online and offline and have been calling the attention of the government to respond to the needs of the nurses especially in upholding nurses' welfare and providing decent work with decent pay (and that means not giving SG-11 as a meager pay for such a highly hazardous work). A partylist of nurses, Ang Nars Partylist, for one is pushing for further reforms in policies governing and affecting Filipino nurses and other health care providers. Carl Balita, a known nursing reviewer launched his own social media campaign group "Nurses for Change Movement" encouraging netizens to help nurses in their struggle for a more decent work, pay, and treatment as it also encourage nurses to wear black, do candle-lighting, and changing their Facebook profile photos as sign of their protests.

As a former National President of a nursing organization, we have done similar activities and campaigns like these such as the "Nurses' Black-Out Campaign" when we rallied our nurse colleagues who are online to change their profile photos to black to express their support in our call for the government to respond to the welfare of nurses. Luminaries such as former Health Secretaries Alberto Romualdez, Jaime Galvez-Tan, writer Isagani Cruz, celebrities and several others who aren't nurses joined the cause. In January 2011, the last month of the campaign - Senator Pia Cayetano called a committee hearing on the case of nurses who are exploited in different hospitals as paying volunteers in exchange for certifications to use for their applications for work overseas. These movements by nurses later would land a seat in the House of Representatives by partylist group, Ang Nars. 

We may be far from the things Filipino nurses are fighting for and still may be a bit far in attaining them, but movements like these give me hope and strength to continue fighting a good fight not just for nurses' rights and welfare but for the entire health human workforce, which until now remains a striking challenge for the government. 

We won't get the pay we deserve while we work for and in the government NOW, but as we continue our vigilance and continue our partnership with the our government leaders, I am optimistic we will find solutions to these ongoing crisis in health human resources.  

1 comment:

  1. Very well said sir...

    "The letter also mentioned that upgrading the 4,787 entry-level nurses (Nurse I) would entail around PhP 438 million per year and would further strain government funds." - I think sobra sobra pa nga eh, kaya binubulsa nalang ng iba.