Lawmaker questions DOH’s low disbursement rates

MANILA — Following Health Secretary Ted Herbosa’s breakdown of allocation of the agency’s proposed 2025 budget on Tuesday, a visibly irked Senator Pia Cayetano questioned the agency’s low disbursement rates of its Health Facilities Enhancement Program (HFEP).

In the hearing of the Senate Committee on Finance on Tuesday, the health chief said that the biggest chunk of the Php 222-billion proposed budget of the agency — around P94.8 billion — will be used to fund operations of DOH hospitals.

The breakdown of the remaining proposed budget are:

• -Php 26.9 billion for the provision of medical assistance for Indigent and financially incapacitated patients;
• -Php 23 billion for Health Facilities Enhancement Program (HFEP), which supports the construction and completion of 688 rural health units, 7 polyclinics, 230 local government unit hospitals, 67 DOH hospitals, and 299 medical transport units, among others;
• -Php 18 billion for the national health workforce system;
• -Php 10.2 billion for family health immunization, nutrition, and responsible parenting;
• -Php 5.1 billion for the prevention and control of communicable diseases;
• -Php 4.5 billion for disease prevention and control;
• -Php 3.5 billion for the prevention and control of non-communicable diseases;
• -Php 2.9 billion for health information technology; and
• -Php 1.9 billion for health promotion.

But Cayetano noted, based on information relayed to them by DOH staff as of August, the low disbursement rates of its HFEP.

“The data I have is that the disbursement rate from 2019 to 2024, is 18%, 29%, 36%, 34%, 36% [respectively]. For 2024, it’s 13%. Wala man lang umabot ng 40%. Paano ba ‘yan? Ang hirap naman kasi. (None reached 40%. How can that be? It’s difficult.) I’m your self-declared champion here. From the sin tax law that provides the funding from pushing to the funding, making interventions. But if your utilization is so low, kaya there’s hesitancy in supporting these programs,” Cayetano asked.

However, Herbosa corrected the lawmaker and gave out higher disbursement rates. As of October 7, 40.6% of the P18 billion funds for HFEP have been obligated. The 12-13%, he explains, is because of construction which have not yet been fully realized.

“For 2023, the obligation is 86.7%, the disbursement is 54.7%. For 2022, the obligation is 85% and the disbursement is 79.8%. For 2021 it was 83.55% the disbursement is already 89%. The farthest is 2020, 100% obligation, 95% disbursement,” Herbosa explained.

Among the reasons for what he calls as “low absorptive capacity” are project modification.

“Marami sa aming budget sa HFEP comes in after the GAA is published. So when we look at them, some have land that is not yet ready or the preparations are not ready. So we end up modifying or transferring them. [The] solution to this is instead of putting in the net the specific location, we only give the specific province. This way we are able to move the project to a different area,” the secretary said.

Some approved projects are also stalled because of the lack of architectural and engineering designs. There are also delays, according to the health chief, in terms of preparing agreements and terms of references as well as failed bidding.

“There are those that win the bidding, then they run. After the first tranche, they don’t continue the project anymore. So we have those cases in the HFEP project.”

But Cayetano lectured Herbosa saying that there are will always be ways to avoid delays in projects which would eventually affect the service the department provides to the public. Among them is getting a validated list of contractors.

“Lahat ng sinabi mong reasons valid ‘yun. Pero kung napa-revalidate ‘yun, eh ‘di hindi na dapat pumasok ‘yung projects doon. It’s not that difficult to get a validated list,” she said.

(All the reasons that you say are valid. But if you just re-validated then those projects shouldn’t have been awarded to them.)

“I-ban niyo ‘yung mga sinasabi niyong mag-bi-bid, mananalo, tapos mawawala. I feel bad because your intentions are very good,” the senator advised.

Cayetano later on suspended the hearing to give time to the department and its agencies time to comply with other requests from the committee. They have until October 11 to consolidate all final requests of the committee.