Francisco Duque III, Secretary of Health: Interview

Interview: Francisco Duque III

How can the UHC Act provide quality services without straining the budget?

FRANCISCO DUQUE III: The UHC Act aims to transform the current system towards primary health care, which entails prioritising preventive care, improving health literacy and treating patients at the earliest possible stage. These measures will not only improve Filipinos’ quality of life, but also facilitate the system’s sustainability.

The Philippine Health Security Corporation (PHSC) will be designated as the national purchaser for individual-based health services. As such, it will pool funds from various government sources – namely, from general taxes, the Philippine Amusement and Gaming Corporation and the Philippine Charity Sweepstakes Office. The Department of Health (DOH) actively supports tax hikes on tobacco and alcohol products to provide added revenue to fund various reform initiatives.

Health technology assessments will also be used to decide which health products and services are most cost-effective and, thus, which must be financed by public funds. Lastly, a price negotiation committee will be set up to determine the appropriate amount that the country will pay for these products and services.

Where is there room for public and private service providers to successfully collaborate on UHC?

DUQUE: The private sector has a significant role to play in UHC. In fact, 65% of the country’s health care services are currently rendered by private providers. We recognise the role of the private sector, and have accordingly strengthened PHSC to facilitate engagement of both public and private providers to provide quality and affordable health care services. With the UHC Act in place, PHSC will move towards contracting provider networks that can be purely public, purely private or mixed. Public-private cooperation can expand frontline health services, particularly for primary care, but also for back-end services related to HR, IT, and the management of supply chains and logistics. Payments to health care providers will also eventually shift towards lump-sum, advance payments, so there will be sufficient incentives for the private sector to participate in UHC reforms.

The DOH has already received proposals for five public-private partnership projects worth a total of P13bn ($242m), which will continue to prioritise technology development, infrastructure improvements and medical equipment updates.

To what extent has the Health Facilities Enhancement Programme (HFEP) addressed medical infrastructure gaps and supported inclusive growth?

DUQUE: The HFEP has been crucial to developing infrastructure and promoting growth. Over the last nine years the HFEP has been allocated a budget of approximately P141bn ($2.6bn). Of that, some 76% was allocated to infrastructure, 21% to medical equipment and the remainder to transportation and land outlays. To date, the programme has facilitated the hiring of least 5080 health personnel and 62,900 construction workers. The HFEP has also increased productivity and created opportunities for health care suppliers.

What tools and strategies does the Food and Drug Administration (FDA) use to monitor and enforce quality standards across the board?

DUQUE: The FDA regulatory framework controls the licensing of establishments, manages the registration of health products and oversees post-marketing surveillance. All of these responsibilities are carried out through risk-based assessments of specific pharmaceutical products. In order to strengthen the enforcement of the regulation, the FDA works in partnership with the Philippine National Police to combat the proliferation of counterfeit products. Digitalisation and data analysis also play a fundamental role in the process, and a memorandum of understanding between the FDA and mClinica enhances the utilisation of IT solutions.