HIGHLIGHTS OF THE FORUM OF THE COMMITTEE ON LABOR AND EMPLOYMENT ON THE CENTRALIZED MEDICAL REFERRAL DECKING SYSTEM (“DECKING SYSTEM”)
5 February 2004, 1:30 p.m., Ramon V. Mitra Jr. Bldg., Batasan Complex, Q.C.
The Committee on Labor and Employment held a forum to discuss issues surrounding the implementation of the centralized medical referral system or “docking system.” This matter was brought to the attention of the Committee by overseas workers, recruiters and concerned organizations because of important implications on the employment and welfare of Filipino workers bound for the Gulf Cooperative Council (GCC) States, i.e. Saudi Arabia, Oman, Qatar, Kuwait, UAE, and Bahrain.
According to GAMCA representatives, the decision of the Executive Board of Health Ministers Council for GCC to establish the “decking system” was to address the proliferation of fake medical certificates, existence of rebates that grossly affect the integrity of the medical testing done, and the need to protect their constituents from being infected by communicable diseases. The “decking system” is currently being practiced in six countries (excluding Philippines ) all over the world.
because of its circuitous and time consuming procedure. There are also apprehensions about the equal distribution system since the accredited clinics will not be motivated to improve their services and equipment, being assured of a regular share in the referrals. There might also be an uncontrolled increase in medical fees, which the workers already find exorbitant as it is, for the same reason.
The workers also observed that the implementation of the “decking system” is essentially a competition for the P1,000.00 rebate or commission given to the referring entity from the P2,600.00 medical fee paid by each patient to the medical clinic. The workers appealed that the P1,000 rebate be removed, whether this is part of the “decking system’ or not, because this is a burden to the workers.
Philippine medical clinics without coordination with the Department of Health. They added that the GAMCA referral system is a cartelization of the medical services for overseas workers bound for the GCC STATES and could be a bad precedent not only for other countries but for other aspects of the overseas employment industry. They were also of the opinion that it would be too inconvenient for workers to come to Manila for a GAMCA referral, when they can go directly to clinics of their choice near their home provinces. On the issue of the rebates, the recruiters expressed their willingness to do away with the commission. They also appealed that the “decking system’ be permanently stopped. They said their main concern is for a smooth process in sending workers to the GCC States.
On the issue of rebates, the Philippine Medical Association (PMA) stated that medicine is never a business but is a public service, and that the quality of health care should always be given priority. The PMA also said that if GAMCA is a corporation, then it is violating the Medical Act of 1959 because juridical entities cannot practice medicine. The patients’ right to select their own doctors was also emphasized.
“decking system” does not promise much for the welfare of OFWs. There is apprehension since the GCC is a major market, and roughly about 350,000 workers a year will have to be diagnosed by only seventeen (17) clinics of GAMCA. Clearly, the quality of medical service will be compromised.
The inconvenience of he system for the worker was also pointed out by POEA. There are also reports that OFWs might be forced to undertake unnecessary examinations involved in Phase II of the medical protocol, where the workers pay for it even if they are not sure they passed Phase I.
POEA further said that they do not like that those institutions that the Philippine government accredits are not being respected. There are avenues for which disciplinary measures can be done to address the abuses cited by GAMCA.
Finally, POEA said they do not like additional barriers to market entry in the GC States. They are of the position that OFWs should not be disadvantaged by any system, particularly if it provides layering in the process.
was issued by the Department of Health (DOH) suspending the implementation of the GAMCA Centralized referral System, pending the issuance of the Department of Foreign Affairs (DFA) of a policy on the matter.
the Royal Embassy of Saudi Arabia, which represents the Chair of the GCC Health Ministers Council, regarding the selection and accreditation of the seventeen (17) medical clinics without prior coordination with proper Philippine authorities. To date, there is no response from the government of Saudi Arabia .
The DFA presented its official position on the issues raised about the “decking system”, as follows:
The DFA stated that they will accept a more mature concept of GAMCA where the majority would be happy.
implementation of the GAMCA referral system for workers bound for Kuwait , Qatar , and Oman . GAMCA member clinics refuse to accept workers bound for these countries for their medical examinations unless referred by the GAMCA central office. In the case of Kuwait , medical examinations have stopped since February 1, 2004 and have caused the delay of workers leaving for the said country.
B. Recommendations:
1. For the DOH to assert its regulatory functions by looking into violations of
Admin. Order No. 5 and apply appropriate sanctions to erring parties.
2. For the POEA to assist in monitoring violations of Admin. Order No. 5.
a) That the “decking system” is circuitous and costly
b) On the suggestion that there be only one payment for Phases I and II of the medical examination
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