Philippine Laws: January 2011

In the absence of any new law approved in January 2011, it may be interesting to discuss the legislative bill that has created a lot of ruckus in recent weeks—the Consolidated Reproductive Health (RH) Bill of the 15th Congress. 

By way of background, there have been five RH Bills filed with the 15th Congress—(a) the 28-section House Bill No. 96, introduced by Hon. Edcel C. Lagman; (b) the 25-section House Bill No. 101, introduced by Hon. Janette L. Garin, M.D.; (c) the 24-section House Bill No. 1160, introduced by Hon. Rodolfo G. Biazon; (d) the 7-section House Bill No. 1520, introduced by Hon. Augusto Boboy Syjuco, PhD; and (e) the 36-section House Bill No. 3387, introduced by Gabriela’s Hon. Luzviminda C. Ilagan, Anakpawis’s Hon. Rafael Mariano, ACT Teachers’ Hon. Antonio Tinio, and Kabataan Partylist’s Raymond Palatino.

The Consolidated RH Bill proposes to enact “The Responsible Parenthood, Reproductive Health and Population and Development Act of 2011.”  Its Declaration of Policy appears laudable as it declares that (i) the State recognizes and guarantees “the exercise of the universal basic human right to reproductive health by all persons, particularly of parents, couples and women, consistent with their religious convictions, cultural beliefs and the demands of responsible parenthood” and, toward this end, “there shall be no discrimination against any person on grounds such as sex, age, religion, sexual orientation, disabilities, political affiliation and ethnicity”; (ii) the State recognizes and guarantees “the promotion of gender equality, equity and women’s empowerment as a health and human rights concern” and “the promotion of the welfare and rights of children”; (iii) the State likewise guarantees “universal access to medically-safe, legal, affordable, effective and quality reproductive health care services, methods, devices, supplies and relevant information and education thereon even as it prioritizes the needs of women and children, among other underprivileged sectors”; and (iv) the State shall “eradicate discriminatory practices, laws and policies that infringe on a person’s exercise of reproductive health rights”.

So, why then are there vehement oppositions to the Consolidated RH Bill, especially from certain church leaders and stalwarts?

This may probably be understood if we consider that the “Modern Methods of Family Planning” which, under the Act, the State is supposed to promote “without bias” with natural family planning, refers to “safe, effective and legal methods, whether the natural, or the artificial that are registered with the Food and Drug Administration (FDA) of the Department of Health (DOH)”.  Because “Family Planning” is defined as encompassing artificial family planning methods, the following provisions of the Consolidated RH Bill, among others, have become objectionable especially to certain church leaders and stalwarts: 

a. Section 7, on Access to Family Planning, which mandates that “all accredited health facilities shall provide a full range of modern family planning methods”; such services for poor patients shall be “fully covered by PhilHealth Insurance and/or government financial assistance on a no balance billing”; and “after the use of any PhilHealth benefit involving childbirth and all other pregnancy-related services, if the beneficiary wishes to space or prevent her next pregnancy, PhilHealth shall pay for the full cost of family planning”;

b. Section 10, on Family Planning Supplies as Essential Medicines, which mandates that “(p)roducts and supplies for modern family planning methods shall be part of the National Drug Formulary” and “shall be included in the regular purchase of essential medicines and supplies of all national and local hospitals and other government health units”, for which purpose, under Section 30, on Appropriations,  additional sums shall be included in the General Appropriations Act;

c. Section 11, on Procurement and Distribution of Family Planning Supplies, which provides that the DOH shall “spearhead the efficient procurement, distribution to Local Government Units (LGUs) and usage-monitoring of family planning supplies for the whole country”;

d. Section 12, on Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs, which mandates that the DOH shall “endeavor to integrate a family planning and responsible parenthood component into all anti-poverty programs of government, with corresponding fund support”, and Section 13, on Roles of Local Government in Family Planning Programs, which mandates that the LGUs shall “ensure that poor families receive preferential access to services, commodities and programs for family planning”, strengthen the role of Population Officers in the family planning effort, and capacitate the Barangay Health Workers and Volunteers to give priority to family planning work;

e. Section 16, on Mandatory Age-Appropriate Reproductive Health and Sexuality Education, which mandates that “age-appropriate Reproductive Health and Sexuality Education shall be taught by adequately trained teachers in formal and non-formal educational system starting from Grade Five up to Fourth Year High School using life-skills and other approaches”, with sex education including “Family Planning methods” which, as discussed earlier, includes Modern Methods of Family Planning (There has also been a lively debate as to whether or not Grade Five is the appropriate age when sex education  should commence.);

f. Section 17, on Additional Duty of the Local Population Officer, which mandates that each Local Population Officer of every city and municipality shall furnish free instructions and information on, among others, family planning, to all applicants for marriage license, and Section 18, on Certificate of Compliance, which declares that no marriage license shall be issued unless the applicants present a Certificate of Compliance that they had duly received adequate instructions and information on, among others, family planning, from the local Family Planning Office;

g. Section 24, on Right to Reproductive Health Care Information, which declares that the government shall guarantee “the right of any person to provide or receive non-fraudulent information about the availability of reproductive health care services, including family planning . . . “, and the DOH and the Philippine Information Agency  shall “initiate and sustain a heightened nationwide multi-media campaign to raise the level of public awareness of the protection and promotion of reproductive health and rights including family planning . . .”; and

h. Section 28, on Prohibited Acts, which prohibits, among others, (i) any healthcare service provider, whether public or private, who shall “(k)nowingly withhold information or restrict the dissemination thereof, and/or intentionally provide incorrect information regarding programs and services on reproductive health, including the right to informed choice and access to a full range of legal, medically-safe and effective family planning methods”; (ii) any public official who, personally or through a subordinate, “prohibits or restricts the delivery of legal and medically-safe reproductive health care services, including family planning; or forces, coerces or induces any person to use such services”; and (iii) any employer or his representative who shall “require an employee or applicant, as a condition for employment or continued employment, to undergo sterilization or use or not use any family planning method”.

Because of the opposition regarding the promotion of artificial family planning methods in these provisions, the following apparently laudable provisions of the Consolidated RH Bill are almost forgotten:

a.   Section 5, on Midwives for Skilled Attendance, which mandates that the LGUs, with the assistance of the DOH, shall “employ an adequate number of midwives to achieve a minimum ratio of one (1) fulltime skilled birth attendant for every one hundred fifty (150) deliveries per year”, with people in geographically isolated and depressed areas being provided the same level of access;

b.  Section 6, on Emergency Obstetric Care, which mandates that each province and city, with the assistance of the DOH, shall “establish or upgrade hospitals with adequate and qualified personnel, equipment and supplies to be able to provide emergency obstetric care”, and that “for every 500,000 population, there shall be at least one (1) hospital with comprehensive emergency obstetric care and four (4) hospitals or other health facilities with basic emergency obstetric care”, and, again, with people in geographically isolated and depressed areas being provided the same level of access;

c.  Section 8, on Maternal and Newborn Health Care in Crisis Situations, which mandates that LGUs and the DOH shall “ensure that a Minimum Initial Service Package (MISP) for reproductive health, including maternal and neonatal health care kits and services as defined by the DOH, will be given proper attention in crisis situations such as disasters and humanitarian crises”, and that temporary facilities, such as evacuation centers and refugee camps, shall “be equipped to respond to the special needs in the following situations: normal and complicated deliveries, pregnancy complications, miscarriage and post-abortion complications, spread of HIV/AIDS and STIs, and sexual and gender-based violence”;

d.  Section 14, on Benefits for Serious and Life-Threatening Reproductive Health Conditions, which mandates the PhilHealth programs to give maximum benefits to all serious and life threatening reproductive health conditions such as HIV and AIDS, breast and reproductive tract cancers, obstetric complications, menopausal and post-menopausal related conditions;

e.  Section 15, on Mobile Health Care Service, which mandates that each Congressional District shall be provided with at least one Mobile Health Care Service (MHCS) in the form of a van or other means of transportation appropriate to coastal or mountainous areas, which MHCS shall “deliver health care goods and services to constituents, more particularly to the poor and needy, and shall be used to disseminate knowledge and information on reproductive health”;

f.  Section 19, on Capability Building of Barangay Health Workers, which mandates that Barangay Health Workers and other community-based health workers shall “undergo training on the promotion of reproductive health and shall receive at least 10% increase in honoraria, upon successful completion of training”;

g.  Section 21, on Employers’ Responsibilities, which mandates the Department of Labor and Employment (DOLE) to ensure that employers respect the reproductive rights of workers, and obliging employers (a) to provide reproductive health services to all employees in their own respective health facilities (if with more than 200 employees), or through partnerships with hospitals, health facilities, and/or health professionals in their areas (if with less than 200 workers); and (b) to monitor pregnant working employees among their workforce and ensure that they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that the pregnant employee is employed in their company or organization (subject to reimbursement from the Social Security System or the Government Service Insurance System, as the case may be;

h.  Section 22, on Pro Bono Services for Indigent Women, which mandates private and non-government reproductive health care service providers, including but not limited to gynecologists and obstetricians, to provide at least 48 hours annually of reproductive health services free of charge to indigent and low income patients, especially to pregnant adolescents, and including these 48 hours annual pro bono services as prerequisite in the accreditation under the PhilHealth; and

i.  Section 23, on Sexual And Reproductive Health Programs For Persons With Disabilities (PWDs), which mandates the cities and municipalities to ensure that barriers to reproductive health services for persons with disabilities are obliterated by, among others, (a) providing physical access, and resolving transportation and proximity issues to clinics, hospitals and places where reproductive health services are provided; (b) adapting examination tables and other laboratory procedures to the needs and conditions of persons with disabilities; (c) increasing access to information and communication materials on sexual and reproductive health in braille, large print, simple language, and pictures; (d) providing continuing education and inclusion rights of persons with disabilities among health-care providers; and (e) undertaking activities to raise awareness and address misconceptions among the general public on the stigma and their lack of knowledge on the sexual and reproductive health needs and rights of persons with disabilities.

It appears that the debate on the Consolidated RH Bill will continue to rage for a while. Which side are you on?