Policy and purpose: right to health
- The State protects and promotes the right to health of the people and instills health consciousness by making health services available, accessible, and affordable for all.
- The State adopts an integrated and comprehensive approach to health development by providing specialized health services to the general public.
- The State achieves this approach by establishing and institutionalizing specialty healthcare centers in all regions of the Philippines.
Definitions of key terms
- Advanced Comprehensive Specialty Center (ACSC) serves a full range of specialty and subspecialty clinical services at the subnational level, and has capacity to conduct and provide specialty and subspecialty clinical, public health, and operations research, and training.
- Basic Comprehensive Special Center (BCSC) serves a full range of specialty clinical services at the regional level, and has capacity to conduct and provide specialty clinical, operational, and public health research, and training.
- DOH Hospitals are hospitals under the direct supervision and control of the Department of Health (DOH).
- Government-Owned or-Controlled Corporation (GOCC) Specialty Hospitals specialize in a particular organ or group of organs, or type of patients, as mandated under their respective charters, and are attached to the DOH, including but not limited to the Philippine Heart Center, National Kidney and Transplant Institute, Lung Center of the Philippines, and Philippine Children’s Medical Center.
- National Specialty Center (NSC) is the specialty center with the highest level of expertise in clinical services, teaching, training, and research, and also refers to DOH designations to specialty centers, DOH hospitals mandated by law to provide specialized care in a certain specialty, and GOCC Specialty Hospitals.
- Specialty Center is a unit or department in a hospital that offers specialized care addressing particular conditions, providing specific procedures and management of cases requiring specialized training and equipment on a specific specialty.
Scope: where specialty centers must be established
- The DOH must establish specialty centers in DOH hospitals in every region of the country.
- The DOH must also establish specialty centers in GOCC specialty hospitals pursuant to their respective mandates.
- The establishment covers specialty centers that the DOH categorizes as NSCs, ACSCs, or BCSCs, consistent with the Philippine Health Facility Development Plan.
- Specialty centers are organized around particular specialties, with cancer care, cardiovascular care, lung care, renal care and kidney transplant, brain and spine care, trauma care, burn care, orthopedic care, physical rehabilitation medicine, infectious disease and tropical medicine, toxicology, mental health, geriatric care, neonatal care, dermatology, eye care, and ear, nose and throat care prioritized.
Establishment, categorization, equipment, and staffing sustainability
- The DOH must prioritize establishing specialty centers for the listed specialty areas, including cancer care, cardiovascular care, lung care, and kidney transplant.
- The DOH must categorize the level of service capability of specialty centers as NSCs, ACSCs, and BCSCs in accordance with the Philippine Health Facility Development Plan.
- The DOH must provide appropriate specialist equipment and prioritize funding for capital outlay investment for specialty centers through the Health Facilities Enhancement Program and other fund sources.
- Specialty Centers (or any part thereof) established in separate premises and operated under the same management of a DOH hospital do not require a separate license.
- The DOH, in collaboration with NSCs, DOH hospitals, the Professional Regulation Commission, the Department of Budget and Management (DBM), the Civil Service Commission, concerned accredited professional organizations and specialty/subspecialty associations, and other relevant stakeholders, must ensure staffing sustainability through plans, policies, strategies, and programs for the production, recruitment, training, and retention of medical specialists and expert personnel.
- The DOH must determine the organizational structure and staffing pattern of specialty centers subject to evaluation and approval of the DBM and in accordance with civil service laws, rules and regulations.
Criteria and planning within PHFDP
- Specialty center establishment must follow DOH guidelines on planning and prioritizing health facilities using these criteria:
- Upgrading of hospitals based on the Resource Stratified Framework developed by the DOH for each specialty care.
- Evidence of health needs and demands, including disease burden, in the catchment populations of DOH facilities.
- Hospital service capability and geographic or physical access.
- Appropriate level of specialized healthcare provider role in the continuum of care, including DOH hospitals as referral facilities for province-wide and city-wide healthcare provider networks.
- Availability of competent health human resources for specialized healthcare.
- Operational financial performance of DOH facilities, including accreditation, to avail of specialized healthcare packages from the Philippine Health Insurance Corporation.
- The DOH must include the establishment of specialty centers in the Philippine Health Facility Development Plan (PHFDP), which guides investments funded by the national government to rationalize the distribution of health facility capacity and capability.
- The DOH must establish at least one (1) specialty center in every region within five (5) years upon the effectivity of the Act, based on the top burden of disease and special needs in the area.
Roles of NSCs and authorized contracting
- NSCs must serve as the core information hub for the specializations and diseases they cover in coordination with concerned DOH offices.
- NSCs must lead in developing policies, protocols, and standards for their particular specialty and must provide the highest level of clinical services and training capability.
- NSCs must provide scientific leadership by conducting specialized clinical, public health, and operations research using a multi-disciplinary or multi-center approach.
- NSCs must provide specialty training and technical assistance to specialty centers to ensure quality services and strengthen the network of care across the country for their specialty.
- NSCs must conduct capacity and capability assessment of services provided by ACSCs and BCSCs for a particular specialty.
- NSCs, and DOH hospitals with ACSCs and BCSCs, are authorized to contract services of medical specialists or experts to provide specialty training and technical assistance.
- DOH hospitals with ACSCs and BCSCs may send medical, allied medical, and other necessary personnel to NSCs for training and capacity development.
Reporting to Congress and evaluation timeline
- The DOH must provide Congress through the Committee on Health of the House of Representatives and the Committee on Health and Demography of the Senate an annual report of the activities, accomplishments, and operational plans of specialty centers.
- Five (5) years after the start of the effectivity of the Act, the same committees must conduct a systematic evaluation of implementation, accomplishments, and impact, including the performance of established specialty centers, to determine remedial legislation.
Implementing rules, appropriations, and enforcement framework
- Within sixty (60) days from effectivity, the DOH, in consultation with NSCs, DOH hospitals, and other concerned agencies, must promulgate implementing rules and regulations necessary to carry out the purposes of the Act.
- The amount necessary for initial implementation must be charged against the DOH’s current year’s appropriation.
- Thereafter, the DOH must include in its program the establishment and operationalization of specialty centers, with funding included in the DOH’s budget under the annual General Appropriations Act.
Separability, repealing, and effectivity mechanics
- If any provision of Republic Act No. 11959 is declared unconstitutional or invalid, the remaining provisions not affected continue in full force and effect.
- All laws, decrees, orders, rules, and regulations, and other issuances, or parts inconsistent with Republic Act No. 11959, are repealed or modified accordingly.