THE DECENTRALIZATION of public healthcare services has been ineffective due to a mismatch in the financial capacity and devolved functions of local governments, according to a study of the Philippine Institute for Development Studies (PIDS).

In a statement released Monday, the state think tank said the result of the first study conducted by PIDS Supervising Research Specialist Janet Cuenca showed a decline in level of hospital inpatient services between 2006 and 2013 due to the inadequate budget of local government units (LGUs) to maintain and upgrade their health facilities.

The study examined the effect of health devolution on hospital inpatient services in 54 provinces. Health services are devolved to LGUs under the Local Government Code of 1991, mandating them to operate and maintain health facilities in their areas. “Health devolution was supposed to increase LGU spending on healthcare delivery services to achieve better health outcomes.

However, this has not been the case in most LGUs in the country,” PIDS said. It also said that the health fund in the LGUs’ internal revenue allotment (IRA), or their share from the national budget, have been insufficient to finance the operations of devolved hospitals, pay the salaries of health workers, and procure hospital beds and other health supplies.

Ms. Cuenca also noted in a second study the “mismatch in the fiscal capacity of LGUs and the devolved mandates” as well as the unclear expenditure assignments between the local and national levels which “led to inefficiencies in the delivery of health services in LGUs.” PIDS recommended the review and amendment of taxing powers of provinces, and the IRA formula.

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