Shaping the Next Generation Health System of the Philippines: Policy Alternatives in the Health Sector July 4, 2007 Elmer S. Soriano, MD Institute of Public Health Management

Why “Next Generation” Health System? Builds upon current DOH initiatives Redesigns some features to cope with new challenges From financial capital to knowledge capital. From hierarchy to wirearchy. From sectoral to “hyper”sectoral Need for institutional leaders in the health sector.

Builds upon current DOH initiatives

Redesigns some features to cope with new challenges

From financial capital to knowledge capital.

From hierarchy to wirearchy.

From sectoral to “hyper”sectoral

Need for institutional leaders in the health sector.

Phases in the Phil. Health System Centralized Devolution – 1992 Health Sector Reform Agenda – 1998

Centralized

Devolution – 1992

Health Sector Reform Agenda – 1998

Globalization and Migration of Health Personnel No.1 exporter of nurses and No.2 for MDs 163,756 (or 85 % of all employed nurses) are abroad 70 % of all Filipino nursing graduates are working overseas. over 100T nurses left the country in the last ten years. more than 50,000 licensed nurses opted to work abroad 2000-2003 68% of Filipino MDs were working overseas in late 70s 17,927 Filipino MDs in US 3,500 Filipino doctors have left as nurses since the year 2000. 2,000 doctors leave yearly (Philippine Medical Association)

No.1 exporter of nurses and No.2 for MDs

163,756 (or 85 % of all employed nurses) are abroad

70 % of all Filipino nursing graduates are working overseas.

over 100T nurses left the country in the last ten years.

more than 50,000 licensed nurses opted to work abroad 2000-2003

68% of Filipino MDs were working overseas in late 70s

17,927 Filipino MDs in US

3,500 Filipino doctors have left as nurses since the year 2000.

2,000 doctors leave yearly (Philippine Medical Association)

Globalization and its effects on the Philippine Health System Emerging infectious diseases (SARS, Avian Flu) Migration JCI hospital accreditation for Medical Tourism US Embassy Accreditation of St.Lukes for TB treatment of Filipino migrants Seasonal OFW Beekeepers Globalized Health Governance of Health Human Resources –Gov.Chavit Signs Nurses MOA with Governor of Hawaii Global Health Ecosystem

Emerging infectious diseases (SARS, Avian Flu)

Migration

JCI hospital accreditation for Medical Tourism

US Embassy Accreditation of St.Lukes for TB treatment of Filipino migrants

Seasonal OFW Beekeepers

Globalized Health Governance of Health Human Resources –Gov.Chavit Signs Nurses MOA with Governor of Hawaii

Global Health Ecosystem

Health Policy Analysis using the Knowledge Management Framework Have we surpassed knowledge-carrying capacity for health? Types of Knowledge Capital Human knowledge capital Structural knowledge capital Customer/stakeholder/relationship knowledge capital Ecosystem Approach Managing Ecosystem Architecture to increase velocity of innovation

Have we surpassed knowledge-carrying capacity for health?

Types of Knowledge Capital

Human knowledge capital

Structural knowledge capital

Customer/stakeholder/relationship knowledge capital

Ecosystem Approach

Managing Ecosystem Architecture to increase velocity of innovation

Possible Features in the NGHS 1/3 a. Build alternative service delivery systems Build up 1 midwife per Barangay De-sectoralized health system (school-based health, employer-based health, workplace-based health) Telemedicine Knowledge process outsourcing

a. Build alternative service delivery systems

Build up 1 midwife per Barangay

De-sectoralized health system (school-based health, employer-based health, workplace-based health)

Telemedicine

Knowledge process outsourcing

Possible Features in the NGHS 1/3 a. Build alternative service delivery systems Build up 1 midwife per Barangay De-sectoralized health system (school-based health, employer-based health, workplace-based health) Telemedicine Knowledge process outsourcing

a. Build alternative service delivery systems

Build up 1 midwife per Barangay

De-sectoralized health system (school-based health, employer-based health, workplace-based health)

Telemedicine

Knowledge process outsourcing

Possible Features in the NGHS 2/3 b. New Business Models Medical Tourism Medical Education-tourism – 35,000 Koreans in the Philippines, many learning English Micro-franchising – foot spa, nail spa, tooth spa, eye spa, kidney spa, heart spa? (multiplies human, structural, and customer knowledge capital) build social architecture-based biz models, social contracts Wikinomics-based businesses

b. New Business Models

Medical Tourism

Medical Education-tourism – 35,000 Koreans in the Philippines, many learning English

Micro-franchising – foot spa, nail spa, tooth spa, eye spa, kidney spa, heart spa? (multiplies human, structural, and customer knowledge capital)

build social architecture-based biz models, social contracts

Wikinomics-based businesses

Possible Features in the NGHS 2/3 b. New Business Models Medical Tourism Medical Education-tourism – 35,000 Koreans in the Philippines, many learning English Micro-franchising – foot spa, nail spa, tooth spa, eye spa, kidney spa, heart spa? (multiplies human, structural, and customer knowledge capital) build social architecture-based biz models, social contracts Wikinomics-based businesses

b. New Business Models

Medical Tourism

Medical Education-tourism – 35,000 Koreans in the Philippines, many learning English

Micro-franchising – foot spa, nail spa, tooth spa, eye spa, kidney spa, heart spa? (multiplies human, structural, and customer knowledge capital)

build social architecture-based biz models, social contracts

Wikinomics-based businesses

Possible Features in the NGHS 3/3 c. New Governance Models e-Governance for health DOH University (learning management system), DSWD University Inter-state health governance – expand unit of health governance; re-circulate Migrant Health Personnel – 10+2 – Chavit arrangement

c. New Governance Models

e-Governance for health

DOH University (learning management system), DSWD University

Inter-state health governance – expand unit of health governance; re-circulate Migrant Health Personnel – 10+2 – Chavit arrangement

Thank you.

Thank you.

Sources: Sources: www.philippineservicescoalition.com/docs/Health%20Services%20Sector%20by%20Dr.%20Galvez%20Tan.pdf Sustainable Health, Sustainable Wealth; Asian Institute of Management Policy Center, Volume XI, No.1, 2007

Sources:

Sources:

www.philippineservicescoalition.com/docs/Health%20Services%20Sector%20by%20Dr.%20Galvez%20Tan.pdf

Sustainable Health, Sustainable Wealth; Asian Institute of Management Policy Center, Volume XI, No.1, 2007