- 13 hours ago
What is the current state of Cebu Province’s hospitals, and what improvements can residents expect in the coming years?
From the condition of provincial hospitals to ongoing improvements in healthcare services and plans for the future, how is the provincial government working to address the healthcare needs of Cebuanos?
Join us on Beyond the Headlines as we speak with Dr. Elisee Nicole Catalan, Cebu Province Health Consultant, to discuss the current situation of provincial hospitals, the improvements being pursued, and what lies ahead for public healthcare in Cebu.
What changes should Cebuanos expect, and what challenges still need to be addressed?
Watch and join the conversation.
Look Deeper. Think Better.
From the condition of provincial hospitals to ongoing improvements in healthcare services and plans for the future, how is the provincial government working to address the healthcare needs of Cebuanos?
Join us on Beyond the Headlines as we speak with Dr. Elisee Nicole Catalan, Cebu Province Health Consultant, to discuss the current situation of provincial hospitals, the improvements being pursued, and what lies ahead for public healthcare in Cebu.
What changes should Cebuanos expect, and what challenges still need to be addressed?
Watch and join the conversation.
Look Deeper. Think Better.
Category
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NewsTranscript
00:18It starts with a fresh shot of espresso. Bold, rich, bold, just right.
00:27Then comes the milk. Steamed smooth, creamy, and balanced. The perfect latte is not brushed. It is crafted. One cup
00:38at a time. Your perfect latte is ready. Coffee first, then everything else.
00:46When a Cebuano gets sick, where should they go? And after more than a year of reforms in the Cebu
00:53province healthcare system, how much has actually changed?
00:58Good afternoon and welcome to Beyond the Headlines. I'm DJ Moises. And today's conversation is brought to us by Coffee
01:04First.
01:05Over the past year, Cebu province has reported improvements in hospital staffing, service capacity, and healthcare coordination.
01:17But what do these changes mean for everyday Cebuano? Let's look deeper and think better.
01:24Joining us today is Consultant for Health and Hospital Development, Cebu Provincial Government, Dr. Nikki Catalan.
01:32Hello, Dr. Nikki. Welcome back to Beyond the Headlines.
01:34Thank you, DJ. Thank you so much for the invitation. It's been a year since I was last year. So
01:40thank you, Kaayu.
01:41I remember you were in Filipino costume.
01:43Yeah.
01:43Oh, not costume. Get out.
01:44It was a Monday and I went straight here. That's why.
01:48Yes.
01:48So because it's been a year and the purpose of my first question is actually in the context of baselining.
01:56So when you first assumed the role, at least for the viewers to refresh, what was the condition of the
02:04overall healthcare system of Cebu Provincial Government and what were the areas you thought should be prioritized?
02:12Yeah. So I mentioned the last time I was here, it was like unraveling a very messy ball of yarn.
02:19So it still feels that way, but we're seeing some improvements already. So just as baseline, and I think that's
02:26a very fair question. The baseline really was a lot of dilapidated facilities. The manpower was a lot of the
02:35places were understaffed and there was a lack of supplies and medication. So that was really what we saw in
02:42the first few weeks.
02:43And then I remembered you also mentioned that it seemed, at least in the past, the system is fragmented. What
02:53did you mean about that again?
02:56Fragmented being there was not very good communication, collaboration between the hospitals. So for the viewers, if you're not aware,
03:06the Cebu Province actually holds the most number of provincial hospitals.
03:09We have 16 other provinces in Luzon, in Mindanao, mostly five or six were really the largest. So getting that
03:19cohesiveness and collaboration was quite important within the hospitals and also moreover outside.
03:26So the linkages and relationships with the tertiary hospitals, both government and private, and also working well with the RHUs
03:36and the healthcare units. So it's really a huge, huge undertaking to pull them all together.
03:42And we're still working on that. We're not, we're still getting there.
03:46And when you said that it's a huge undertaking, that also, undertaking, that also brought me back when I was
03:55also curious about the strategy, you know, that you thought would be best to approach it.
04:02So because I clearly remembered, and personally, that was also the part of the interview back then that I was
04:08impressed because it did not sound to me like some random band aid initiatives.
04:14So what was the strategy that you used to untangle?
04:20Yes, we're still in the process of untangling.
04:23So the, how we looked at it, it's such a huge problem.
04:29So we looked at it like the Maslow's hierarchy of needs. I think I explained that before, but in more
04:35detail, we really worked on the lowest hanging fruits and the most immediate needs.
04:42And those were the medication and supplies and also the equipment.
04:46equipment, although equipment in a government setting is very hard to process and it's a very long process, which also
04:54has its safeguards to protect the government.
04:56But anyway, that takes time.
04:57But our most immediate things that we worked on was medication, equipment and supplies.
05:04And the next tier of it was more of the manpower and infrastructure.
05:09Manpower, when we found was very, they're very deficient.
05:12And there were not enough nurses, there were not enough doctors and support staff.
05:17So a very funny story.
05:18In Oslo, if I'm not mistaken, the cashier, the one who does the PhilHealth and the one who does the
05:25record keep, all were the same person.
05:28So you can imagine the challenge and the delay that comes with it.
05:31And the morale also.
05:32Yes, and the morale.
05:33And I might be getting ahead of myself, but there's a cook in Balamban who was there for 18 years.
05:41And she was the lone cook.
05:43So we were adding more support staff for her.
05:46But those are one of the manpower stories I have.
05:49And above that are really the digitalization.
05:52So getting the data.
05:54We want to make evidence-based decisions.
05:57So that's why data is very important to integration.
05:59I'm very proud that we have an ambulance tracker.
06:02It didn't get much attention, but we do have that.
06:06And it's one way for us to monitor where the referrals are going.
06:10If our drivers are going back to the hospitals on time and where they are, that was part of an
06:15issue before also that we're also monitoring.
06:18And above that are more of the aspirational things of having residency programs and other things that could help our
06:28hospitals run better.
06:29So I think that's how we were looking at it.
06:31But we do have concurrent programs from within the pyramid.
06:38So we're working on manpower as well as the infrastructure at the same time.
06:42And some bits in digitalization and also with the manpower, the healthcare resourcing whereby we provide a practice-based residency
06:54program.
06:55And also, so that's happening all at once.
07:00Repity is not a talent of mine.
07:03So I'm very sorry.
07:04No, no, because that also speaks or that demonstrates that there clearly were so many priorities that you had to
07:13balance and implement.
07:15And I could also tell that there were so many also that you and your team were able to accomplish.
07:23Now, among the things that also caught my attention was the reality back then that the Provincial Health Board was
07:31not convened for six years.
07:33That's true.
07:34If I remember it clearly.
07:35And that affected the coordination among the, I mean, within the healthcare system in the province.
07:41That's very true.
07:41So how is it now?
07:43We're very happy.
07:44I think we've had our seventh or eighth Provincial Health Board.
07:47And this board, we have so many people who want to become part of it.
07:51So we had to see who the regular members and the expanded members were.
07:55But we're as inclusive as we could possibly be.
07:58And in this health board, just to give everybody an image or what happens is we have the DOH, we
08:08have DILG sitting in there, we have the League of Municipalities, the mayors are represented.
08:14We also have the private sector, our chiefs of hospitals, of the provincial hospitals are there.
08:20We have Red Cross, RAFI.
08:22So there are so many people sitting on the table.
08:24And we're looking at problems not just by ourselves, but multiple perspectives.
08:29And that's the advantage also of having multi-sectoral composition.
08:36Because all bases are an expertise.
08:39They're covered.
08:40So among the many changes that happened within the healthcare system of Cebu province, which of these you consider to
08:51be the most significant?
08:54That eventually translated to patient experience.
09:00So one challenge we have now, and a good problem we have, is a high census.
09:06So you have more people coming inside our hospitals.
09:10That actually led us to why we have linens now that are, I can talk about that later.
09:15But because our laundry department cannot keep up to the number of people coming in every day.
09:21So I'll set that aside.
09:23But a very good problem to have, the census is higher.
09:26And we've been monitoring patients' feedback.
09:29We've been very sensitive about that.
09:32And if there are any complaints as well, we address them as best we can.
09:36And if I remember, if I recall the pyramid, I think next to the foundation is the staffing.
09:43Yes, the staffing.
09:43And I've seen quite a number of photos also since then about doctors and medical professionals that are also joining
09:53the system.
09:54So can you also tell us more about this?
09:57The doctors were one of the key hires that we had.
10:01The majority of them are MO3s or they're general physicians.
10:05We're still actively looking for specialists.
10:08Specialists are needed for hospital upgrades.
10:11Because at basic, you need to have a pediatrician, obstetrician, internal medicine, and a general surgeon to have that.
10:21Also, we had a lot of hires for the nurses to make sure they're not understaffed.
10:26And as well as the support staff.
10:2944% of the current staff now are new hires within this administration.
10:35And you know, Sir DJ, we had a very milestone for us.
10:40Because first time in Balamban, we had an oath outside of capital.
10:46The reason being, if we had them come to the capital, no, the operations would be disrupted.
10:54And so we just had to go, the GOV had to go to Balamban and oath about 100 plus of
11:02the staff there.
11:03Including other, from other hospitals as well.
11:05They just had to go to Balamban.
11:07So we've done that for BOGO.
11:10And the coming week, this weekend, we'll be in Komotes.
11:13Another oath for 80 plus.
11:15And I mentioned Komotes because the islands are really one of our big challenges to address and to look after.
11:23So it's already been prioritized.
11:27And the reason why I also brought that up, because on a personal note, if our viewers have seen the
11:35pyramid, the reason why I liked it is because you started with the equipment.
11:39Because what is a person there for, if there's nothing to use or nothing to administer.
11:46And then you took care also of the staffing eventually.
11:48So that the two would be working together.
11:52So the other thing also, which I heard, and maybe you can elaborate more on that, is on the medical
12:00technology coverage.
12:01Because that used to be a reason that people had to go to the city for them to be able
12:07to get those tests.
12:08Correct. So the medical technologists only four or started off baseline.
12:15And then now, 16 of 16 have coverage 24-7.
12:19So this matters because if a patient comes in, they don't have to wait for the morning to have their
12:24tests taken or blood taken.
12:26So that's very key for us.
12:29And what about, because I knew that part of the opportunity area also, areas now at that time, were the
12:37operating room and the surgical capacity.
12:40So how is the situation now?
12:41So it's very key.
12:43When I talk about this, it's very important to sort of segment which operating rooms are there.
12:50So of the 16 hospitals, there are two that are level 2 hospitals and they have fully functional ORs.
12:57The level 1 hospitals also have operating rooms, whereas the 10 that are infirmaries don't have operating rooms.
13:05And a lot of this education has to go to the public also because they don't understand, oh, there's a
13:11hospital there.
13:12But they're only allowed to or given the license to operate to a certain level.
13:19So the ones with operating rooms and ones we're actively fixing are the Cebu Provincial Hospitals, which are Balamban, Bugo,
13:28Karkar, and Danao.
13:29They're the big ones.
13:32Kamotes and Balamban also has operating rooms.
13:36And then the infirmaries don't have operating rooms.
13:39So if I captured it correctly, it sounded like there's one in the north, one in the south.
13:46The islands have…
13:48Islands and then Balamban, sorry, is that west?
13:50West.
13:51Because I associate it at south because we passed through Balamban.
13:55So they are strategically located.
13:59Now you've mentioned, Mangud, about infirmary level 1, level 2, level 3, level 4.
14:03Can you refresh me?
14:05Sure.
14:05I'm very, very happy to talk about that because there's so many misconceptions or like, oh, you're fixing the hospitals.
14:13How come Malabuyok or Oslo still needs to refer?
14:19So the way it's set up, if we can step back a little bit about the devolution of healthcare.
14:25So the devolution of healthcare started in 1991 with Republic Act 7160.
14:32So it's the beginning of the devolution and the full devolution was around 2010.
14:37So a lot of these hospitals, before it was centralized, national government or DOH.
14:42Now, the hospitals are either LGU run.
14:47That's why there's also DOH retained, meaning retained by national government, by the DOH.
14:53There's run by the province.
14:55There's run by the city.
14:57And also the levels are different.
15:00So your infirmary is very basic.
15:02It's like they can see and treat patients, very cough colds, GI symptoms.
15:10But when there's a head injury, trauma, or something in that nature, they have to go to a higher level
15:17facility,
15:18which could either be level 1, level 2, or maybe an apex hospital that has a brain surgeon, a neurosurgeon.
15:25So an infirmary does not have those.
15:29Ayo mong level 1 would have more departments na, which basic departments are internal medicine, general surgery, obstetrics, and pediatrics.
15:41So, makasya nila o or makasya nila o or makasya nila mga sakit sa bata na dili kay kinang, not
15:47very severe.
15:48But the level 2 hospitals would be the ones with special services, your incubators, ICUs, yes, precisely.
15:59Level 1s also have ICUs, but mas kuani.
16:02And then the apex hospitals, your tertiary hospitals, are the ones with subspecialists.
16:08So that's where you find the critical care, your neurosurgeons, and all that.
16:13So muna siya ang murag, ang levels of care said.
16:18So, for example, if we go for a particular case, like there's a road accident, and then to avoid the
16:28gory details, there's blood.
16:30So what would be the usual step that doctors or people around would do to get that person into the
16:40healthcare system?
16:41Yeah, so the closest facility, or even if it's an infirmary, they're brought there.
16:49Immediate first aid, your ABCs, your airway, breathing, circulation, are the priorities.
16:55And then afterwards, they get moved to a higher level facility, appropriate to that.
17:00But usually if it's trauma, they really get moved to an apex.
17:04That's where you find the trauma surgeons.
17:06And as a fact, there are very few of them.
17:09So they're only in select hospitals, select apex hospitals.
17:13And correct me if I'm wrong, but as of this time, the apex hospitals are the private hospitals?
17:20We have Vicente Soto, and we also have Cebu South now.
17:24So recently, an apex.
17:26So there are two places that can be brought there, and the private hospitals also are considered your tertiary hospitals
17:34with your higher level subspecialist care.
17:37And then you mentioned, Manong, that there are hospitals that are governed by the province.
17:44And I think, I hope the viewers have captured this map earlier, this 16, no?
17:47But some of the government hospitals, to your point, are also managed by the LGU, outside Kanang 16, and then
17:55are also managed by DOH, no?
17:58Such as Vicente Soto, correct?
17:59Yes, it's an apex hospital.
18:01So because we're very visible online and in media, people associate us with all the hospitals.
18:07So we had to do some education that CCMC is Cebu City, Toledo has their own, and how it's set
18:17up really is beyond the provincial government.
18:21So we're also following by the specific jurisdictions.
18:26And now it makes more sense to me why there is the board, you know, and DOH is sitting there
18:32for better coordination.
18:34Correct. And another said, Sir DJ, like you were talking about trauma, the problem said now because the hospitals, the
18:43infirmaries, and level ones weren't trusted so much before.
18:48Everybody would go straight to the apex.
18:51I heard about that a lot.
18:53And then they sort of robbed the beds of more high equity cases.
18:58So we're trying to educate and we're trying to regain the trust now for cases like pneumonia.
19:05It can be treated in a level one hospital.
19:07You don't need to go directly to an apex hospital.
19:10You can give way to more severe cases.
19:14And the other thing I remembered the first time we had this conversation in Beyond the Headlines is the realization
19:22that Cebu also has islands.
19:25Yes.
19:25And you mentioned Camotes.
19:27Yeah, you're a guida.
19:28You're geographically isolated.
19:30Correct.
19:30And with my interview also, I think last week, with a group of experts or doctors, among my takeaway there
19:39was the golden hour.
19:41Yes.
19:41And in the case of trauma, if I remember correctly, it's one hour.
19:44So how are you also improving the coordination, especially for those who are located in islands, for them to also
19:54be able to not hopefully exceed the golden hour?
19:57Yeah, so there's usually like an hour or 90 minutes for certain emergencies or even heart attacks and brain bleeds.
20:06It's the availability of the ambulances and the transport's very key.
20:11And also coordination because there's some things you can do in first aid that can really help in the treatment.
20:18And we've really been thankful that things have cleared up.
20:22So hopefully, our sea utility vessel will be available before end of the year.
20:29So that's the hope, which will help link the islands especially.
20:33That's the key.
20:35And personally, I find that development positive.
20:41Yes.
20:42Because while they cost more, but we don't have a choice.
20:49That's true.
20:50Because they're located in an island.
20:52That's very true.
20:53And it's sad because the other provinces already have that existing facility.
20:59So it's about time that we have our own.
21:02And we've done a lot of conversations.
21:04And for this to be operational, it's also a multi-sectorial conversation because you have to have Coast Guard.
21:13You have to have the CPA.
21:14You have to have all these working and working well together.
21:18Now, you've covered it in the previous conversation, but at least it's going to be all integrated into just one
21:24question now.
21:25So what can you tell, because you mentioned that you need to, I mean, the system needs to regain the
21:32trust that they have in level one hospital.
21:33So what can you tell those families or parents who would still prefer to rush even cases that could be
21:43handled by levels one and two to apex hospitals?
21:46Yeah.
21:46So the assurance we give is we have more doctors and we have more staff there.
21:51And there's really medications.
21:52I think in our periodic updates, we try to show that they're stocked for as long as they're in the
21:57national infirmary list, we can procure them.
22:03And it's really to show them that we're capable, the facilities are there, and that they can trust.
22:08And beyond that, we wanted to show that, you know, the linens and the amenity kits, we want to give
22:16dignity and care also.
22:19That's not usual for a government hospital.
22:22We wanted to extend that.
22:25And while you were talking about the linens, you mentioned that earlier, and then you mentioned it now.
22:30And I'm just reminded by one particular coffee company.
22:34And they actually used the overall store appearance to communicate to their customers implicitly that this is like the third
22:48place.
22:49Yes.
22:49And the linens actually communicates readiness.
22:53And they can bring it home and they can treat it as a souvenir.
22:57And food was one of the things we were working on that when they're inpatient, the food is nutritious and
23:04substantial enough for them to enjoy also.
23:07So those are the soft touches that we wanted to communicate.
23:12And then the other one is, I think this will bring us back to the pyramid.
23:17Yes.
23:17Because, and this happens to every leader, and that's management of resource.
23:24So resources.
23:25So how would you normally or your team with balance, there's one thing that requires huge investment, but it's necessary.
23:35And then versus something also that's not that huge, but immediate.
23:40So there are those things like cortina versus ambulance.
23:44Yes.
23:44Very true.
23:45Okay.
23:46And for things that should have been done before, where do we start and how do we prioritize?
23:51So really go by what impacts most number of people and what gives safety also.
23:59Most benefit.
23:59Yeah.
24:00And what really saves lives.
24:02That's the number one thing.
24:03We want to prevent, you know, preventable deaths and prolong lives as best possible.
24:09So that's really the North Star we have there.
24:12Ako, I go home and I sleep happy when I know somebody is better taken care of now or natabangan.
24:19So that's a motivation.
24:21I'm very blessed.
24:22We have a very good PHO team.
24:24And one thing that's not said about enough was we really had to overhaul the provincial health office.
24:32So there's a certain structure to it where you have a PHO2, the department head, and two PHO1s and the
24:39restructuring of the programs.
24:41Because what's not seen and communicated also is beyond the hospital, you also have the public health programs.
24:47The ones in the grassroots and in the barangays, which are partly the LGUs, a majority of the LGUs.
24:55But the province also goes and helps.
24:58And if I, and I hope I remember this correctly, but there is one part that I think what was
25:05also discussed the first time you were here.
25:08Because the moment the new administration came in, there were quite a number of medical missions.
25:16And if I remember it correctly, you said that you appreciate that people coming and getting together.
25:22But you're hoping that eventually, yes, we are.
25:25Okay, can you tell us more about that?
25:26Thank you for reminding me about that.
25:28We're still doing that now.
25:30And thousands already have benefited from it.
25:34But it's a stopgap solution.
25:36And it's one way for the new administration to show that care is coming and we're here.
25:42And it's tangible to them.
25:45But the hope really is we don't need to do that in the long term.
25:48But we're very happy because it's another indicator that the private sector, the private hospitals are very supportive.
25:56And I can tell you during these missions, there's no exchange of money.
26:00It's really their people coming to our provincial hospitals and doing the surgeries for free.
26:07And if I'm allowed to share this with last year, for example, in Danao, we brought Chongwa over there.
26:15They brought their own lap towers for the laparoscopic surgeries.
26:20And this year, they didn't have to bring any because we already procured.
26:25So I was very proud about that.
26:26Oh, doc, you don't need to bring your…
26:28Because we already have it.
26:30We just need your people to help us, the surgeons to help us do the surgeries.
26:33And then among the things also, and you've mentioned this earlier, is the collaboration with DOH Central Visayas, field health,
26:42private hospitals, professional societies, and academic institutions.
26:47Just in case our viewers were not able to capture it earlier, but what does this partnership also…
26:55How does this translate to everyday Sabuano experience?
26:58Yes, so we're very fortunate that our DOH Central Visayas, field health, are very, very proactive.
27:06And that alone, their dedication and proactiveness benefits you.
27:11So for example, DOH has many facets, and one of which is your licensing, regulatory licensing division.
27:19So they're the ones looking after, telling us the deficiencies.
27:22And basically, when we started, their list of deficiencies were what we started off with, and we're still working on
27:29those.
27:30It's like a checklist, no?
27:30Correct.
27:31And then for PhilHealth, they tell us what programs to go after.
27:37They help us with registration.
27:38They help us, this is something new.
27:41There's a new circular about this, and then we have to implement it.
27:44So they're proactive, and they help us a lot with, and like, for example, DOH has free training.
27:53So we make use of that.
27:56PhilHealth, Dr. Beverly Hall was here about three weeks ago.
27:59We sat her down, and trauma dumped all our problems.
28:03And can you help us move through with this and think about this?
28:06And they're very open.
28:07And that translates to us being able to give services, and more services, and reach out to more patients.
28:14And I captured also earlier that you mentioned data-driven decisions.
28:19And then, I'm able to tie it with what I read somewhere that you are also prioritizing improving PhilHealth claims
28:28and reducing denied claims.
28:31Can you tell us more about that?
28:32I might not have the exact numbers, but our claims from 2024 to 2025 alone, it's increased significantly.
28:41So one key thing there was also the hiring of the clerks, so that they can file the reimbursements timely,
28:49and also the training of them.
28:51And another part of it was, we're reducing the denied claims.
28:56It's money supposedly there, but we're not accessing it.
29:02And then, by the way, even if you probably have mentioned it in the previous interview, the first time you
29:10were here,
29:11But today, I'm able to capture that Cebu province, after all, has the biggest number of provincial hospitals compared to
29:24other provinces.
29:26And you also discussed that Central Visayas e-referral system and the need to have a consolidated view of all
29:33these 16 hospitals.
29:35How does that work?
29:35I'm very happy you mentioned that.
29:38So the e-referral, to be clear, is a project by DOH.
29:42And it's a landmark project here.
29:46And the province is participating in it, and we're the ones following it.
29:52Because the idea, Sir DJ, for that was to make sure patients don't show up in an Apex hospital unknown.
30:01So the idea between e-referral is, if you're sending a patient out to a higher-level facility, I already
30:07know that's DJ this age.
30:09I've done this, that.
30:11And he's safe to transfer, and when you receive him, this is his state, then you know, because what happened
30:19before…
30:19Instead of going through the interview again, no?
30:21Yeah, or what happened before is, actually, patients would die waiting outside the emergency room.
30:27And that's what they wanted to prevent.
30:29But that's the whole concept between e-referral and following through the real levels of care.
30:36So going back to having a unified view.
30:41So we found out the province does not have a singular view of all 16.
30:47So per hospital had their view of what was spending.
30:50What we're working on is a dashboard of seeing who's spending where, and maybe we can help in the barriers
30:59or whatever was blocking or delaying the transfer.
31:03So that's currently what we're working on as well.
31:06Well, I can imagine how it would look like in the command center.
31:09Yeah, it's just taking a little time because of data privacy.
31:14These are patient data.
31:16The people looking at the data also need to have a certain patient data privacy training and everything.
31:25So that's the part that's taking us…
31:28The more people involved, the more risk there will be.
31:30That's why you're also managing it.
31:32For data privacy.
31:33Correct.
31:34But all systems are ready.
31:36There's only a portion of waiting.
31:38Well, I used to work in a bank.
31:40Oh, I can imagine.
31:42I can imagine the work that needs to be done.
31:45Now, the other thing is, how do you also intend to eventually integrate the rest of the hospitals outside the
31:5216 that are managed by the province?
31:56So this is where universal healthcare is very key.
32:00And it brings me back to many points, which we're working on, this universal healthcare inter-LGU memorandum of agreement.
32:09It fulfills many things.
32:11The integration with PhilHealth that we're ready and our structure is moving as one.
32:20For DOH also means there's cooperation and collaboration between all levels.
32:25Because universal healthcare covers your Barangay Health Center, your RH Rural Health Unit to your infirmaries level ones.
32:34So that's the point.
32:34Even if it's devolved, it's one way to bring it together.
32:39Correct.
32:40Yeah.
32:41So that's really the main point of connecting it outside of the system, the system of 16 hospitals.
32:49Which is very tricky because the jurisdiction really of the Cebu province are the 16.
32:54And when you talk about the RHUs and the city health, they're under their respective mayors.
33:00And having the inter-LGU MOA also gives a general understanding of what the expectations and the responsibilities are of
33:09each of these LGUs.
33:11A lot of MOAs, no?
33:12Yes.
33:13So imagine there are 44 municipalities in six cities.
33:21But we're very happy.
33:22September 4th was it.
33:24We had them all in one room.
33:25Ah.
33:26In Social Hall in the capital.
33:29So we called UH, we called PhilHealth, and we let them speak.
33:33And then it was an education also to the mayors and the municipal health officer that what this integration means
33:41and what it looks like to those respective agencies.
33:46So personally, I'm actually glad because since our last conversation and we were talking about the pyramid and at least
33:54from this conversation or even those that I have also read from other sources, a lot has already happened.
34:00But you also mentioned that there are still other things also that still needs to happen, although you've mentioned a
34:07couple of them already.
34:09So given all these improvements in just a span of over a year, no?
34:14Yeah, a little over a year.
34:15A little over a year.
34:16And then 2028 is already close, no?
34:20So what are you working or prioritizing also to get, I don't want to call that home run, but anyway,
34:27the final stretch.
34:30So I think our North Star really is to keep people safe.
34:33So it's not politically motivated.
34:35And for us, for GovPam and myself personally, any life save is good already for us.
34:43But in terms of institutionalizing that change and keeping that change, one example are the regularization of our healthcare workers
34:52to make sure that nothing happens to them.
34:54Because before SRDJ, the job orders had to be renewed every three months.
35:00We changed that to every six months because the three-month period is too short to process all that papers.
35:05That's why there are delay in payroll because there's so many things that go around.
35:10So we moved that to six months.
35:12And moreover, those that deserve to be regularized, we have been working to make them regular.
35:19And that's one way to institutionalize the healthcare changes we're doing and for infrastructure.
35:24So a lot of people don't know this, but we keep talking about upgrading hospitals.
35:30What does it mean to upgrade a hospital?
35:32So it means having a proper waste disposal area to have from a cadaver holding to a full morgue.
35:38There are things like that that need to happen behind the scenes.
35:42Your sewage treatment plant has to be in place that was not there before.
35:46So very unsexy, very dirty things that we have to deal with.
35:51But they're all requirements to upgrade.
35:53So that's another way also we're institutionalizing that change.
35:56So if these service areas are ready and they're in place and they can be up for level one, there's
36:02no way, there's no excuse that they cannot be upgraded.
36:06So that's the major things we're working on.
36:08And it's really coming from a private sector and coming from overseas, seeing how things move with procurement and infra
36:19and all that, it's a bit too slow for my liking.
36:22But I know there are processes in place for a reason.
36:24So that's what we're really pushing, that all these infra changes would be in timely.
36:31And by the way, you already answered what would have been my second to the last question.
36:36But I'm also glad with what you shared that there's an effort to institutionalize it.
36:44Because this to me is not, at least from my observation, not the usual pattern.
36:51And when a term ends and another term begins, a lot of what would have been done very well are
37:00discontinued.
37:01And we've seen that happen already.
37:04And we don't want that to happen again.
37:05So in as much things we can put in place, we will do our best to make that, you know,
37:13what's this?
37:14Permanent changes.
37:15Correct.
37:16Permanent positive.
37:17Regardless, yes.
37:18Regardless of what whoever and whatever the positive changes they stay.
37:23Correct.
37:23And the people really deserve care that would be there for them reliably.
37:27So that's really the motivation there.
37:31And this one is now the final question.
37:34You've mentioned about your north.
37:36North star.
37:39What gives you so much hope that in spite of the, because no system is perfect wherever we go.
37:48In spite of the roadblocks that you face, no, or the setbacks that you see, no, what gives you hope
37:56that the vision eventually of achieving your north star will happen?
38:02The vision will become a reality.
38:04Yeah.
38:05It's the people.
38:06So I've seen it every day in our hospitals.
38:11They really want this change.
38:14And they went into health care for a reason.
38:17It's very hard to become a nurse.
38:19It's very hard to become a doctor.
38:21But there's a reason there within them.
38:23They really want to help people.
38:24And that's innate in most, if not all, of the people in our health care system now.
38:31And our job really is to take out all those roadblocks and make things happen for them.
38:37And I see that because they're very enthusiastic to work.
38:40For example, this Pink October activities.
38:43I'm so happy to see them do their own Zumba, their own wellness.
38:47It's always been inside them.
38:50And empowering that, for me, gives hope that change will continue for as long as the budget is there, the
38:56support is there, and the feeling that they're heard and supported will continue to be there.
39:01I'm sure they'll do great things in their hospitals because up to our level, we're just in the policy.
39:07We're up in the hands, arms, the heart to it.
39:13So that's what gives me hope, really.
39:16So thank you very much, Doc, for making time for today's conversation.
39:21And among the many, it's also a reminder for me, because among the leaders I follow, he also cited a
39:31very good point about we just don't provide a system or a set of rules.
39:40But we also need to provide the right environment.
39:43So that it makes following the rules and making the system work easy for them.
39:50Yes, correct.
39:51So thank you very much.
39:52Thank you, Sir Dij.
39:53So at the end of the day, healthcare is about a person who needs treatment, a child who needs immediate
40:00care, or a family hoping that help is within reach.
40:05Strengthening Cebu's healthcare system means making that journey easy, ensuring that patients are guided to the care.
40:13They need.
40:13So I'm DJ Moises.
40:15This is Beyond the Headlines.
40:16Thank you for joining us this afternoon.
40:18And let's continue to look deeper and think better.
40:27It starts with a fresh shot of espresso.
40:32Bold, rich, old, just right.
40:37Then comes the milk, steamed, sweet, creamy, and balanced.
40:43The perfect latte is not brushed.
40:45It is crafted.
40:47One cup at a time.
40:49Your perfect latte is ready.
40:51Coffee first.
40:53Then, everything else.
40:59So close.
41:12Here.
41:14Bye.
41:14Bye.
41:17Bye.