Dr. Ignacio Moreno, PHO chief, confirmed this on Sunday during the inauguration and turn-over ceremony of the P20-million Misamis Oriental Provincial Hospital-Balingasag.

The doctors were Dr. Juanita Notarte, [...]]]> AT LEAST four doctors from the J.R. Borja Memorial City Hospital (JRBMCH) transferred to two municipal hospitals in Misamis Oriental, top official from the Provincial Health Office (PHO) said.

Dr. Ignacio Moreno, PHO chief, confirmed this on Sunday during the inauguration and turn-over ceremony of the P20-million Misamis Oriental Provincial Hospital-Balingasag.

The doctors were Dr. Juanita Notarte, former internal medicine head of J.R. Borja General Hospital (JRBMCH); Dr. Dina Factura, Dr. Tim Ibana, and one Dr. Adejado.

It was learned that Dr. Ann Perez, who is now the acting chief of hospital of Claveria District Hospital, was also from JRBMCH.

“Pero dugay na si Dr. Perez sa Claveria. Ang bag-o lang nadawat dire sa Balingasag mao sila si Dr. Notarte, Dr. Factura, Dr. Ibana and Dr. Adejado, pero dugay na gyud sila nag-apply,” Moreno told Sun.Star Cagayan de Oro.

Moreno, however, declined to give any more comment on the doctors’ reason to work at Misamis Oriental Provincial Hospital-Balingasag.

Mayor Constantino Jaraula had said the resignations of some 18 physicians recently can’t be blamed in the supposed low pay and poor working conditions at the secondary-grade hospital.

Jaraula said it was normal for practicing physicians to gain “experience” at government-run hospitals as a stepping stone for “promotion” or employment in municipal health care facilities.

Several of the doctors who spoke to Sun.Star on condition of anonymity said they left J.R. Borja General Hospital because of low pay, delayed salaries and poor working conditions. Some said the inadequate facilities at the hospital had impeded them from performing their jobs properly.

Cagayan de Oro second district Representative Rufus Rodriguez had called the resignations “principled.”

“The doctors were resigning not for greener pastures but as a protest, knowing that their services cannot be properly maximized because the hospital has no decent facility,” Rodriguez said.

“I believe our doctors had really wanted to serve the people; they were willing to render their services. I don’t believe it when they say that those who resigned are a bunch of selfish people who are demanding perks and such,” Rodriguez added. (Annabelle L. Ricalde)

The unfinished three-storey hospital building for over a decade now. Photo by Jessica

Pro-administration Councilor Dante Pajo said [...]]]> A CITY official Monday brushed aside allegations that “politics” was behind the troubles besetting JR Borja General Hospital, even as he denied claims that City Hall has blocked donations made by political rivals to the city-run medical facility.

The unfinished three-storey hospital building for over a decade now. Photo by Jessica

Pro-administration Councilor Dante Pajo said City Hall was eager to receive the 10 dialysis machines earlier pledged by 1st district Rep. Rolando Uy, who belongs to the local political opposition. Councilor Pajo said the donation includes a building that will house the equipment.

“I’ve talked to the Mayor [Constantino Jaraula] and he said he’s okay with the donation,” said Pajo, chairman of the health committee.

Last year, Rep. Uy’s office lamented that City Hall had spurned a similar effort by the lawmaker, who chose to donate the hospital equipment instead to the nationally-run Northern Mindanao Medical Center. The donation was funded from the congressman’s pork barrel.

The city-run hospital is no stranger to being deprived with much-needed diagnostic apparatus and other life-saving equipment simply because these are offered by politicians who don’t play footsies with the incumbents.

Dr. Vincent Tiro, a retired chief of hospital at JR Borja, said the practice became common during the Emano administration.

The physician recalled that at one point during the first term of then Mayor Vicente Emano — now a vice mayor — the latter castigated him for receiving the P2 million worth of medicines from Sen. Aquilino Pimentel, a native of Cagayan de Oro. Starting out as allies, Sen. Pimentel has been Emano’s political nemesis for years now.

“I received it with all gratefulness as then the chief of the hospital as it would mean more service for the sick and needy. I never thought I would be chided for doing what is right,” Dr. Tiro said.

“Politics is very well entrenched at the hospital, from the appointment and removal of personnel, up to the distribution of medicines to barangays,” he said.

Not once did Emano castigate him for handing out medicines to barangay officials deemed outcast to the former mayor’s political circle.

“He [Emano] once told me to ‘Ikaw na lang mag-mayor’ when I reasoned with him on the equitable distribution of medicines,” Tiro said.

During his watch, Tiro said Pimentel also donated a CT scan, which he said was “very much needed” in any hospital to help diagnose various medical conditions. Poor patients, he added, need not go to private hospitals and spend P3,000 for a CT scan.

Tiro said the equipment went to the NMCC instead because Emano would not want it in the city-run hospital.

Weeks later, Tiro said he was fired as chief of the hospital and detailed to another department until he retired in early 2000.

The former JR Borja chief said the P10 million hospital building donated by Pimentel in late 90s suffered the same fate, as the Emano administration had refused to shell out money as counterpart. The building, he said, was left to deteriorate for over a decade now.

However, Pajo said the three-storey building may finally be completed within this year. The after Department of Health (DOH), he said, has offered to finish the project.

“DOH-10 (Northern Mindanao) has already started the bidding phase of the project last June 8. Of the six bidders who signified interest in undertaking the project, five bidders qualified,” the councilor said.

Another view ot the unfinished three-storey hospital building.

The city-run hospital has lately been rocked with controversies, heightened by resignations of several doctors late last month. The physicians–numbering 18 out of the hospital’s 35 doctors–complained of low pay and poor working conditions.

They also lamented the hospital’s inability to give adequate health services to poor patients because the facility lacks even the basic medical equipment.

The hospital management had earlier suspended its weekend consultations.

Pajo said the Saturday and Sunday consultations have been resumed since last week. He said City Hall is already hiring doctors to replace those who resigned. He also denied the resignations had crippling effect on the hospital’s services, describing the doctors’ exodus as a “minor setback.” By Cong B. Corrales Sun.Star Cagayan de Oro

In 2006, the city hospital enjoyed its biggest budget in six years — P123 million — but this amount would dramatically be reduced to around P60 million the following year, [...]]]> THE city-run JR Borja General Hospital hasn’t had a stable budget in recent years, its appropriations rising and falling to resemble that of an erratic curve.

In 2006, the city hospital enjoyed its biggest budget in six years — P123 million — but this amount would dramatically be reduced to around P60 million the following year, or a cut of over P62 million.

On its face, the hospital’s general budget cycle — not counting the exceptional downward spiral in 2007 — has seen a steady growth, rising from over P56 million in 2004 to around P70 million in 2005. From 2007, the funding climbed to over P78 million in 2008, increasing to P83 million this year.

But these increases have largely been driven by inflation and the local government’s administrative obligations to the hospital personnel.

Funds allocated for medicines and life-saving apparatus — lumped under the maintenance, overhead, and operating expense (MOEE) — have remained disproportionate to Cagayan de Oro’s population over the years, and followed the erratic pattern in the general budget.

For example, the MOOE in 2005 saw an increase of over half the amount compared to the previous year — at around P24 million. This amount would only grow by P2 million in 2006, and dropping by a whooping P6.9 million in the succeeding year.

In 2008, the MOEE would again rise to P13 million, or an appropriation of over P32 million.

The additional money for MOEE this year? A meager P215,353.

Specifically, a budget of P4.6 million out of the P32.9 million MOOE for 2009 is allocated for medicines, patient’s subsistence, and medical supplies such as X-ray films, medical oxygen, and nitrogen oxide.

As of August 1, 2007, the National Statistical Coordination Board (NSCB) placed the city’s total population at 553,966.

What that means is that at any one time, the local government only sets aside a miniscule P8.30 on medicines and other life-saving apparatus for any patient admitted to the city-run hospital.

To compare, the P123 million budget in 2006 allocated around P23.4 million for medicines and medical supplies.

Noticeably, however, bulk of that budget went to the construction of an additional building amounting to P50 million. The rest was appropriated to hospital equipment such as one unit of operating room table that cost P1.3 million, five units of fire extinguisher that cost P79,550, a unit of ultrasound machine at P4 million, two computer sets at P120,000, a unit of anesthesia machine at P2.3 million, and two ECG machines at P300,000.

Sun.Star Cagayan de Oro’s analysis of the budget is based on the approved appropriations in the last six years obtained by this paper.

The hospital’s budget has come under scrutiny after several doctors resigned lately, complaining of low pay and poor working conditions. They also lamented the lack of crucial life-saving devices at the hospital, which they said has contributed to its deteriorating services.

Corruption has also tainted the management of the hospital.

In 2007, several employees accused the then hospital chief, Dr. Jerie Calingasan, of graft and corruption. A graft case against Dr. Calingasan is pending at the Ombudsman.

Calingasan, who was stripped of his position at the hospital and reassigned back to the City Health Office, has denied the allegation.

Aided by their lawyer, Manuel Ravanera, the employees alleged that Calingasan made “emergency purchases” that were not actually “emergency” in character. Among the hospital “purchases” was a repair of a Toyota Tamaraw FX and a Kia Besta Ambulance, which amounted to P131,200. Calingasan reimbursed the amount because it supposedly came from his pocket.

There were also purchases of hospital supplies, among others, eight kilos of detergent powder at a price of P11,500.00 or an amount of P1,437.50 per kilo.

In 2006 and 2007, Calingasan was reimbursed the amount P855,939 purportedly due to the “advances” he made to the hospital.

During that period, the complainants alleged that the hospital purchased an overpriced X-ray machine, which cost P6.5 million but supposedly had an actual market price of P3 million. A surgical table that is unbranded and costing P400,000 allegedly purchased at P1.2 million.

These and other irregular transactions were approved by then mayor Vicente Emano, the complaint said.

Last year, a state auditor said in a report that P15 million worth of drugs and medicines at the city-run hospital cannot be accounted.

“What happened now to the JR Borja hospital is that there is mismanagement, and our good medical professionals who [...]]]> With doctors’ exodus, hospital is nearing paralysis, says Rep. Rodriguez

CITY Hall is to blame for the series of resignations of doctors at the city-run JR Borja General Hospital, Cagayan de Oro 2nd district Rep. Rufus Rodriguez said.

“What happened now to the JR Borja hospital is that there is mismanagement, and our good medical professionals who have offered their services there can’t work effectively as they would want to because they lacked support from the City Government,” Rep. Rodriguez told Sun.Star Cagayan de Oro in a phone interview.

Rep. Rodriguez authored the bill that would have increased funding for the dilapidated hospital by placing it under the better-equipped Northern Mindanao Medical Center.

Officials had earlier confirmed the resignations of at least 13 doctors, nearly half of the hospital’s regular resident physicians. Three more were set to leave late last week, a hospital insider told Sun.Star Cagayan de Oro.

If the situation worsens, the City Hall-operated hospital may be heading for paralysis, crippling its already deteriorating services as a result.
Already, the hospital has cut its consultation to cope up with personnel losses, reducing in effect the volume of patients that can be accommodated in a day.

Poor pay and poor working conditions are among the reasons cited by the doctors in tendering their resignations, said the Sun.Star source, who is also a physician.

What cemented the physicians’ decision to leave the hospital was when City Hall blocked Rodriguez’s bill, the source said.

The bill would have helped the hospital in terms of better facilities and higher compensation for the medical staff, the physician said.
Rodriguez said the resignations were a

“wake up call for our City Government. Had they not objected the bill, the salary grades of nurses and doctors would have increased dramatically because they would be paid by the National Government.

Under the salary grade in the national level, the lawmaker said nurses would receive P18,000 per month and P25,000 to P28,000 for doctors.
Rodriguez also clarified earlier reports that he already dropped the bill.

He said the proposed measure is now pending at the Senate health committee because Mayor Constantino Jaraula had earlier written the then committee chairman, Sen. Pia Cayetano, expressing City Hall’s objection to the bill.

“Medyo na-divide karon ang Senate because of Mayor Jaraula’s objection,” Rodriguez said. “But I already passed around 18 resolutions signed by 18 barangay officials who expressed their intention favoring the annexation of the City Hospital to the NMMC.

The bill being parochial in nature, he said some senators are hesitant to support it because of the local government’s opposition.

Rodriguez said the ball is now in the hands of the City Hall, saying the bill may be revived again if Jaraula reconsiders the administration’s position on the matter. by Annabelle L. Ricalde of Sun.Star Cagayan de Oro

Emergency Room, J.R. Borja General Hospital

A city hospital physician, who spoke on condition of anonymity, said the doctors resigned as a group as a statement to City Hall [...]]]> LOW pay and poor working conditions have forced most doctors of the government owned JR Borja Memorial City Hospital to tender their resignations, a hospital insider said.

Emergency Room, J.R. Borja General Hospital

A city hospital physician, who spoke on condition of anonymity, said the doctors resigned as a group as a statement to City Hall that they had lost confidence on the way things are going at the hospital.

Already saddled with patient overload, JR Borja doctors have to contend with lack of medicines and adequate facilities.

Doctors are also inadequately paid compared to other public hospitals, the source said, but clarified that this was not the main reason for the exodus.

The last straw came when City Hall itself scuttled the planned annexation of the City Hospital to the Northern Mindanao Medical Center (NMMC).

Had the plan been realized, it would have would have placed the smaller city-run hospital under the national government, increasing its funding along with the salary of the personnel.

“After that nawad-an na sila og gana. Ingon sila wala gyuy mahitabo ini nga ospital(They just lost hope after that. They said nothing good would come out if they stay in the hospital),” the doctor said.

The source said other doctors like him had also planned to quit, but opted to stay hoping “things will change so soon.” Foremost, the physician said he and his colleagues are hoping that City Hall will reconsider its position on the hospital’s conversion into a national medical facility.

A number of City Hall officials confirmed Monday’s resignations of at least 13 doctors. The City Hospital has 31 doctors in its plantilla.

However, officials could not agree what made the doctors quit.

Cagayan de Oro Councilor Dante Pajo, chair of the committee on health and social service, attributed the doctors’ exodus to “conflict of scheduling in their duty hours.”

Most the doctors who resigned had wanted to work for two straight days to cover the mandated 40 or so duty hours and then avail of five days off, Pajo said.

“Nangbalhin ang mga doctors kay nangita’g more lenient working hours siguro. They are all good doctors but we can’t prevent them from transferring,” Pajo said.

But the councilor said the government hospitals can’t bend work schedules to give doctors “lenient schedules.”

“Doctors are obliged to work eight-hour shifts every day. That’s the way government hospitals work because we are in public health service,” he said.

However, City Information Officer Erwin Culanag said most of those who tendered their resignations had said they wanted to “seek greener pastures.”

“Ang sweldo daw ang rason, ubos ra daw para sa ila,” Culanag told Sun.Star, citing his conversation with Dr. Philip Medalle, acting chief of hospital.

Pajo said doctors from the City Health Office (CHO) had been ordered to temporarily cover the night shifts to cover the staff shortage.

Human Resource Department Head Adriano Lumagsao, Jr. said his office had yet to receive copies of the names of the doctors who resigned.

The staff shortage has taken a toll on the services of the hospital, which already has shortened its consultation hours.

City Hall had earlier rejected a bill authored by 2nd district Rep. Rufus Rodriguez seeking the integration of the rundown JR Borja Memorial City Hospital to the better-equipped NMMC.

House Bill 239 provides “for the upgrade and modernization of the J.R. Borja City Memorial Hospital as an extension hospital of the Northern Mindanao Medical Center in Cagayan de Oro and appropriating funds therefore.”

The bill is co-authored by 1st district Rep. Rolando Uy.

After the initial examination in the emergency room, Labaon was admitted in the hospital. But with the ward full and with no other available room, Labaon was directed to a metal hospital bed in [...]]]> FORTY-eight-year-old Tony Labaon of Dansolihon village was rushed to the city-run J.R. Borja Memorial Hospital after experiencing chest pains three days ago.

After the initial examination in the emergency room, Labaon was admitted in the hospital. But with the ward full and with no other available room, Labaon was directed to a metal hospital bed in the lobby where two other patients, with the hustle and bustle of human traffic around them, are lying.

“Lisod magsakit kun wala’y kwarta. Si mayor (Jaraula) mihatag og P150 para sa tambal ug P60 gikan kang Congressman Uy. Dako gyud akong pasalamat kanila kay lisod gyud ko ‘run,” Labaon told Sun.Star Cagayan de Oro.

The nurses at the nearby nursing station said the five metal beds at the lobby were set up long ago and are regularly assigned to patients. But all these may change for the better if the bill authored by Congressman Rufus Rodriguez (Cagayan de Oro City, 2nd District) becomes law.

House Bill 239 providing for “the upgrade and modernization of the J.R. Borja City Memorial Hospital as an extension hospital of the Northern Mindanao Medical Center (NMMC) in Cagayan de Oro and appropriating funds therefore” was passed and approved during the 14th Congress and is now pending for a 3rd and final public hearing in the Senate.

“This bill was already approved in the lower house and is now pending in the Senate’s committee on health. If this is passed into law, the national government through the DOH will be funding for the construction of additional buildings, the purchase of medical equipment and even the procurement of medicines,” Rodriguez told Sun.Star Cagayan de Oro.

Rodriguez said he is aware of the daunting financial requirements of the city-run hospital but knows that the facility has had to compete with other equally important programs of the city, its sole benefactor.

The Department of Health (DOH) has assessed the 100-bed hospital as a secondary level hospital. As of August 1, 2007, the National Statistical Coordination Board (NSCB) placed the city’s total population at 553,966. Meanwhile the city for 2008 allocated P32,699,647.00 for the maintenance and other operating expenses (MOOE) of the hospital (in its 2009 executive budget proposal, City Hall appropriated an increase of P215,353 to the hospital’s MOOE). What this means is that at any one time, Cagayan de Oro only sets aside a total of P59.028 for any patient admitted to the city-run hospital.

The hospital is ran by a total of 204 personnel. This includes 29 doctors, 52 nurses and seven job-orders assigned as either in-house security guards or janitors. For its medical equipment the hospital employs an old x-ray machine and an ultrasound equipment.

The new “old” building, old because it was initially funded by Sen. Aquilino Pimentel, Jr.’s pork barrel in 1994, would increase the hospital’s capacity to 200 beds. But this portion has been under construction since then City Mayor Pablo Magtajas’ time and, until now, is yet to be finished.

German Doctors

In comparison, the Community Health Care Center (CHCC) located at the back of Xavier University, more popularly known as “German Doctors,” serves about 400 patients a day–roughly 80,000 each year.

CHCC has seven consultation rooms, a laboratory unit, x-ray facilities, electrocardiographic equipment, ultrasonographic machines, a pharmacy, a dental clinic, a reproductive health clinic with a minor operating room, a Tuberculosis DOTS clinic, an immunization office, an operating room with recovery room and 50 hospital beds for confinement.

City hospital employees amenable to bill

But most of the 29 doctors of the said the city-run hospital are amenable to the Rodriguez-sponsored bill saying that it will hasten improvement and development of the said hospital.

“Mas maayo man gud tong national government ang mag administer ug mag maintain kay menos politika. Biktima man gud ni sa pamolitika busa hinay kaayo ang paglambo,” one of the doctors, who requested anonymity, told this paper.

Rodriguez, in an interview with Sun.Star Cagayan de Oro, said all present employees of the hospital will be absorbed under the new administration of the DOH and their salaries and benefits will be shouldered by the national government.

But the bill explicitly states that in the full integration of the said hospital to the NMMC, “the Department of Health shall promulgate the necessary rules and regulations for the effective implementation of this Act,” subsequently stripping the city government of its administrative function on the said hospital.

The bill, however, mandates the city government to continue in providing funding for the hospital until such time that the same is integrated as an extension hospital of NMMC and its funding will be included in the annual General Appropriations Act.

Retention of City’s control

But the Rodriguez bill has been meeting opposition from some quarters. City Councilor Dante Pajo, chair of committee on health and social services, told this paper recently that he was not in favor of the bill saying that the city would ultimately lose its control over the hospital.

“I do not favor the move (HB 239) because the city will lose control of the hospital. The city can manage the hospital ug mawala ang identity as city hospital,” Pajo said.

“If they really want to help, let them appropriate funds for the improvement of the hospital in terms of facilities and equipment,” Pajo added.

Although he was clear that he has in favor of the said bill, Councilor Ian Mark Nacaya told this paper that only under certain provision that the administrative function should remain in the hands of the city government.

“I am in favor of the bill because this will relieve the city of the financial burden. The city has been the sole fund source of the hospital. But the city should maintain administrative function so that it could have two sources of funds, the city and national government,” Nacaya said.

City knows best

But Rodriguez said that even though the city government will lose its control over the hospital it will still service the constituents of the city saying that what is important is the welfare of the people of city.

“If majority of the City Council will not agree with the bill, then I will move to withdraw the bill in spite of the advantages of the bill. I don’t want to be in conflict with the city because they know what’s best for the city. This bill has already been approved in the House of Representatives but I can still move for its withdrawal if the city government does not agree with the bill,” Rodriguez said.

For her part, Hospital Chief Dr. Dures Fe Tagayuna, in a texted message to this paper said: “J.R. Borja Hospital seeks avenues to enhance services and develop its full potentials as a government health facility even as it maintains its identity as the city hospital of Cagayan de Oro.” (COC)