UP expanding the PGH to serve more Filipinos

The University of the Philippines (UP) is one step closer to providing ordinary Filipinos greater access to its brand of world-class and affordable tertiary hospital care and comprehensive cancer care through two upcoming projects: the UP Philippine General Hospital (UP PGH) Cancer Center and the UP PGH Diliman.

On March 10, 2022, the proposals for the two major infrastructure projects were elevated by the Investment Coordination Committee-Technical Working Group (ICC-TWG) to the ICC Technical Board (ICC-TB) for re-endorsement to the ICC Cabinet Committee (ICC-CC). The ICC-CC is the highest decision-making body in the Executive Branch that approves major capital projects.

Hopes are high for the ICC-CC’s elevation of these priority health projects to the National Economic and Development Authority (NEDA) Board. Once the NEDA Board approves the projects, the bidding for private sector partners will begin.

High-quality and affordable cancer care for poor Filipinos

Cancer affects all age groups and all bodily systems and is now the second leading cause of mortality in the country after diseases of the heart and the vascular system. The UP Manila National Institutes of Health’s Institute of Human Genetics study showed that 189 of every 100,000 Filipinos have cancer. In comparison, four Filipinos die of cancer every hour, or 96 cancer patients every day. In 2020, over 150,000 new cases and 90,000 deaths were recorded[1]. During the first half of 2021, over 27,000 deaths from cancer were recorded by the Philippine Statistics Authority or 9% of the total deaths during this period.

The UP Philippine General Hospital in UP Manila, Ermita. Photo from the UP PGH Facebook page.

 

The UP-PGH Cancer Center is the University’s response to cancer care’s growing challenge and complexity. It will be a 200 to 300-bed dedicated cancer center within the University’s Manila campus in Ermita. With at least half of all beds exclusively serving underprivileged Filipinos, the new facility will offer advanced, integrated, and affordable oncology care services to those who cannot otherwise access the kind of treatments available in private hospitals.

The UP-PGH Cancer Center will be structured as a 30-year Build Transfer Operate (“BTO”) arrangement under the Build-Operate-Transfer Law and its Implementing Rules and Regulations. The private partner will design, finance, construct and commission a new standalone hospital building with a dedicated 150-bed area for charity patients and a 50-150 bed area for paying patients. The UP-PGH will provide all clinical services free of charge for charity patients, while the private sector will offer clinical services to paying patients. The private partner will also provide all major equipment, including replacement equipment, and undertake maintenance and management of the facilities and non-clinical services such as cleaning, catering, laundry, and security for the entire hospital under a 30-year PPP concession.

The UP-PGH in northern Metro Manila

The UP PGH is the largest government tertiary hospital in the country and the only national referral center for tertiary care. From its 10-hectare site in the UP Manila campus, and with its 1,100 beds and 400 private beds, the UP PGH provides direct and high-quality medical and healthcare to more than 600,000 patients every year, including thousands indigent Filipinos from all over the country.

But with the growing population of Metro Manila alone, 13.4 million as of 2020 and counting, the UP PGH has been constrained by its limited space and capacity from serving more patients and reaching more communities, especially the underserved communities in northern Metro Manila as well as in nearby provinces. The proposed UP PGH Diliman, to be built on a 4.2-hectare area in the UP Diliman campus in Quezon City, near the Philippine Nuclear Research Institute, is envisioned to fill that gap, making world-class hospital care accessible to more Filipinos, especially the poor.

The UP PGH Diliman will be a 700-bed public tertiary hospital accessible to the poor. It aims to complement and enhance the capacity and services of the original UP PGH in Manila. Drawing on the University’s knowledge and research capacities in many disciplines, from the STEM fields to the social sciences to the arts and humanities, the UP PGH Diliman hopes to be the top research hospital in the country. It will complement and enhance the network of health facilities and specialized hospitals in the Quezon City area.

The UP PGH Diliman will include, among others, an outpatient department building, a main hospital building, a central podium/administration building, a College of Medicine and Research Laboratory building, and a parking building. It will offer the following specialty services:

  • Genomics and Genomic Research
  • Neurovascular Surgery and Neurosciences
  • Oncology and Wellness Center
  • Hospice and Palliative Care
  • Primary Care in a Multispecialty Outpatient Facility
  • Integrative Medicine
  • Rehabilitation and Musculoskeletal Center
  • Biomechanical Devices and Equipment Center
  • Sports Medicine
  • Hematology
  • Infertility and Difficult Pregnancy
  • Geriatrics and Home Care
  • Disaster Risk and Reduction
  • Special Services—Toxicology

The first two services will also provide much-needed research on diagnosis, prevention, and treatment of Rare Neurological Diseases (RND).

For the UP-PGH Diliman Project, the private sector partner or concessionaire will take on the task of designing, engineering, constructing, and commissioning the buildings and procuring and installing the medical and non-medical equipment. The private sector partner will also operate and maintain all non-clinical services, including facility maintenance, cleaning, laundry, catering, and security. On the other hand, the UP PGH will be responsible for providing the clinical, teaching, and research services and assume the costs of the clinical workforce, drugs, and consumables. The concessionaire’s contract length for the UP-PGH Diliman Project is 25 years.

PPPs for healthcare

The UP Oblation in front of the UP PGH. Photo by Jonathan Madrid (UP Media and Public Relations Office).

The UP PGH Cancer Center and the UP PGH Diliman are Public-Private Partnership (PPP) projects. Through these projects, the Philippine health sector may develop a precedent for private-sector cooperation and coordination in providing cancer care for the population and, more broadly, for guided private-sector support of and participation in the public healthcare agenda. For most of the past decades, health investments in the public sector have not kept pace with population growth, and much of the sector’s growth was in the private health sector. Despite this, compared to their private counterparts, public servants in health are expected to serve a more significant and poorer fraction of the population in more challenging locations and with fewer colleagues. They also contend with inflexible and often laborious administrative burdens that hamper the work of specialty health care. Many government hospitals use outsourcing to meet their needs more responsively while also freeing up their human resources to focus on value-adding health care services for indigent patients. Back-of-the-house functions like janitorial, maintenance, and security services; critical systems like hospital information and communication technology; and advanced, highly clinical applications like hemodialysis units and laboratories are usually outsourced.

The PPP structure was chosen for the two infrastructure projects after an intensive study found it the most cost-effective and efficient way to implement the projects, with a lower financial impact on the University than public procurement. Without the need for phased government financing, PPP also has a faster timeline for completion. The PPPs will not be privatized. UP remains the owner and operator. The University retains control of the

private partner activities through contractual means, including the Minimum Performance Specifications and Standards (MPSS) and Key Performance Indicators (KPIs).

Through agencies such as the DOH and the PPP Center, the national government has been encouraging the use of PPP as a possible delivery mechanism where the government can partner with the private sector in delivering quality and cost-efficient health services. Hospitals and other healthcare infrastructure are a vital necessity for the country during the pandemic and in a future where climate change, natural disasters, and new, potential diseases threaten the welfare of the people.

Through the UP PGH Cancer Center and UP PGH Diliman projects, UP creates a model for state universities and colleges (SUCs) and other government agencies to conceptualize and implement their health infrastructure and services, all to ensure healthy lives and promote the well-being of all Filipinos from all walks of life.