JEANETTE A.

CALAMOHOY
State Auditor IV
OIC- Supervising Auditor
Office of the provincial Auditor
Province of Zamboanga del Sur
Capitol Building, Pagadian City

Thru: ATTY. KATRINA Q. ACANA

State Auditor IV
Audit Team Leader

Mesdames:

In compliance with your Audit Observation Memorandum No. 2020-10(2019) date January 27, 2020
regarding the excessive payment of Hazard Pay, Laundry Allowance, and Subsistence Allowance under
the Magna Carta for Public Health Workers (PHWs) to our doctors due to erroneous interpretation of
24-hpour working hours to three days, we have the following comments and underlying circumstances
to explain on the rationale behind these duty hours:

1. The undersigned Head of the Department (ZDSMC) authorized our doctors to go on a 24-hour
duty according to the demands of public service to our patients;

2. The number of doctors we is not enough to cover the increasing number of our patients and the
turn outs (resignation/transfer) of our doctors. In fact there were more than 12 plantilla
positions for doctors that remain unfulfilled;

3. We believed that having this number of duty hours will fill up the gap for a particular shift of not
having a doctor on duty;

4. Needless to say we are a government hospital and we have to cater the needs of our indigent
patients who are unable to afford the Professional fees of private medical specialists;

5. All government hospital has this 24-hour duty of some doctors thus our facility is not an
exemption of this 24-hour duty hours.

6. Most importantly, our doctors need to monitor their patients that they have received during
their duty hours up to the time these patients are discharged from our hospital.

In particular, our Doctors reporting for 24-hours were considered as equivalent to three days in the
computation because as public servant we are only required to work eight (8) hours a day. Thus the 24-
hour duty of a doctor is considered as 3 days duty of 8 working hours per day. Republic Act 386 refers to
standard number of hours in a day but not on the standard number of hours a public servant has to
work while Republic Act 7305 stated as normal working hours of eight in a day. This means that there
are working hours allowed beyond this “normal” number of hours. Further RA 7305 and even the
subsequent circulars pertaining thereto Hazard Pay is (SECTION MISSING) them to risk, danger,
occupational risk etc. when a PHW worked for 8 hours a day in the hospital means the worker is exposed
to hazards for 8 hours also and the rest of the day the worker is out of danger. Following same precepts,
when the doctor is on a 24-hour duty this means that for 24-hours the doctor has been exposed for their
entire duty; and that is equivalent t 3 days duty of 8 hours per duty. Furthermore, Joint Circular No. 1
dated July 15, 2016 section 3.6 stated that “Officials and employees who are under any, combination, or
all of the following instances for at least eleven (11) working days in a month shall not be entitled to
Hazard Pay. 3.6.. On Vacation or sick leave with or without pay; 3.6.2 On full time attendance in training,
seminar, scholarship grant, or any other similar activity; 3.6.3. While availing for other leave
privileges…..” Pursuant to this provision the hospital management counted on the days they were on
leave or out on official time or official business.

This 24-hour duty is believed to be more effective, efficient and economic on the part of the
government. Effective and efficient because there is continuity of care to the patients from admission
to discharge. This is the standard policy of every doctor. Having many attending doctors in one patient
due to 8-hour per shift duty is contrary to the policy of giving “continuous medical care”. Economic
because the doctors have been working at night without extra compensation a provided in RA 7305.

Hospital operates on 24-hour a day and 7 days a week without interruptions and closures of services for
our admitted patient. Allow us to cite the following situations to give emphasis that we are very much
different with office hours in an ordinary in an ordinary office which closes at 5:00pm and opens the
next day at 8:00am;

1. Every hour should have a doctor on duty. If in a day there is no attending physician on duty, this
means that a poor patient has to pay for a private physician t look after her/him

2. Every second counts in the hospital since emergencies and even death comes unexpectedly and
we are accountable if it happens in our facility because of negligence

3. Surgeries cannot be done when drugs, medicines, equipment/instruments and medical supplies
are incomplete; the surgeons and anesthesiologists on duty has to wait even beyond their 24
hour duty since they have to finish their job to that patient under their care. More so, after
surgery they have to check on their patient and see to it that utmost care is done not minding
that it is not yet their duty.

Doctors who have committed themselves to work in a government hospital are applauded for allowing
themselves to serve the poor – first they cannot choose patients at their convenience; second they are
not paid due professional fees as they want to determine (as specialists has different fees with general
practitioners) because they are governed by rules (Philhealth case rates); third anytime of the day they
are being called for referrals; and fourth they have no unlimited choices as to when they will be on duty
or not even if they have their own personal reasons to be absent putting their patients as a priority.

Subsistence allowance on the other hand, per RA 7305 IRR Section 7.2 are granted “Based on the
number of meals/day included in the duration when they rendered actual work including their regular
duties, overtime worked or on-call duty” at P50 per meal in an 8-hour shift or Php 1,500 per month (P50
x 30 days ). This was before the Joint Circular No. 1 2012 was issued of which the computation has been
changed to Php 50 per actual duty (P50 x 22 days + 1,100 only). The same guidelines were followed
except for the number of days from 30 days maximum to 22 days only. Laundry allowance is per month
at P 150 given to PHW who rendered actual service on all workdays in a month or P6.818 per day of
actual duty. These two allowances were given considering 24-hour duty as 3 days.

All of the above statements are explanations to express our sentiments. We have, however considered
your recommendation. In fact we have suspended the payroll preparation and processing of the Magna
Carta benefits of our doctors for the month of January 2020 to look into the possibility of wrong
interpretation of the laws, rules and regulations of the Act coupled with the review of Duty Schedule of
our Doctors who are on the 24-hour duty with the present numbers of doctors at ZDSMC.

We would like to appeal to please forego with the issuance of the Notice of Disallowance that you have
stated in the memorandum holding with our best hope that we have given enlightenment to the subject
matter – 24 hour duty would mean 3 shifts or 3 days on an 8 hours per shift.

Praying that you will also consider our side for the benefit of our poor patients and constituents over the
cost of hiring doctors mostly with specialties and to encourage more doctors to work in the government.
Highly marginalized patients having equal opportunities with people who can afford of availing the
services of such medical specialists trained in prestigious hospitals.

We shall appreciate very much for whatever favorable decisions you have to make in the interest of
good public service.