Republic of the Philippines

UNIVERSITY OF THE PHILIPPINES DILIMAN

School of Labor and Industrial Relations

IR201-SIJK. Introduction to Industrial Relations. 2nd Semester AY 2022-2023

ANALYSIS ON REINFORCING COMPENSATION AND DEPLOYMENT POLICIES

FOR GOVERNMENT NURSES IN THE PHILIPPINES

Submitted in partial fulfillment of the course requirements in IR 201 Introduction to

Industrial Relations

CARLA JANE E. GOB, RPm

Diploma in Industrial Relations

June 24, 2023

Honor statement and disclaimer: This is an original paper submitted as part of the academic
requirements for the course, in compliance with the university’s standards of excellence and research
ethics. Statements, conclusions and recommendations came after consultations and discussions, and
are the responsibility of the author. The options, conclusions and recommendations do not constitute
the official position of the University of the Philippines.

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 TABLE OF CONTENTS

Title Page ………………………………………………………...……………………….……. 1

Table of Contents …………………………………….…...……………………..…….……… 2

Synopsis ………………………………………………...………………………..……….…… 3

Chapter I: Introduction ……………………………………………………………………… 4-8

1.1 Background ………………………………………………………………...... 4-7

1.2 Problem Statement ………………………………………………………….. 7

1.3 Case Objective ………………………………...………………………….…. 8

Chapter II: Theoretical Paradigm ……………………………………………………….… 9-14

2.1 Dunlop’s Systems Theory …………………………………..……………… 9

2.2 Pluralism ……………………………………………………………………… 9

2.3 Socialism/Marxism ……………………………………….………………..… 10

2.4 Corporatism …………………………………….…………………………….. 10

2.5 Theory of State ………………..……………………………………………… 11

2.6 Strategic Choice ………..………………………………………………….… 11

2.7 New International Division of Labor ………..………………………………. 12

2.8 Scientific Management ………..………………………….……………….… 12-13

2.9 Workers Participation …………….………………………………………..… 13

2.10 Labor and Gender Issues …………….………………………………..… 13-14

2.11 Structural Adjustment …………….…………………………………….…. 14

Chapter III: Problem Analysis and Findings ………………………………………..…… 15-17

3.1 Problem Identification and Analysis ………………………………..…...… 15-17

Chapter IV: Conclusion and Recommendation ……………………………………....… 18

4.1 Conclusion ……………………………………………….…………….…..… 18

4.2 Recommendations ………………………………………………….…….… 19-20

References …………………………………………………………………………………..… 21-22

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 SYNOPSIS

The labor group Federation of Free Workers (FFW) has voiced its strong support for a
proposal advocating a starting monthly salary of P64,000 for government nurses. FFW
has called on Congress to swiftly pass the proposed measure, which would elevate the
salary of public nurses by six notches according to the Salary Standardization Law. House
Bill 5276, filed by Representative Marvin Rillo of Quezon City's 4th District, aims to
increase the basic pay of nurses in government hospitals from Salary Grade 15 (P36,619)
to Salary Grade 21 (P63,997).

FFW commends the House of Representatives for taking this initiative, recognizing the
benefits of the proposed wage increase for public health workers and the
acknowledgement of their societal value and expressed hope for the swift passage of a
similar measure pending before the Senate. FFW official Manuel Payao stresses the
importance of providing competitive salaries and benefits to nurses working in public
health institutions to incentivize them to continue serving the Filipino people. They also
highlighted the heroism demonstrated by Filipino nurses and other health professionals
on the frontlines during the COVID-19 pandemic.

In addition to supporting salary increases, FFW calls for the lifting of the current
deployment cap for nurses and health workers seeking employment abroad. FFW argues
that the annual cap of 7,500 deployments is unconstitutional and oppressive to labor,
calling for its review by the Marcos administration. While supporting the push for higher
salaries for nurses within the country, FFW emphasized the urgent need to address the
deployment cap, warning that failure to do so may result in the loss of nurses to countries
where they can earn significantly more than in the Philippines. The World Health
Organization has previously warned of a global shortage of nurses, including a projected
shortage of 249,843 nurses in the Philippines by 2030, unless immediate investment is
made to retain them within the local health sector. This paper analyzes the FFW’s strong
support on the removal of the deployment cap and a salary increase for government
nurses. By employing labor and industrial relations theories, this paper aims to offer
valuable perspectives and suggestions to foster the establishment of a sustainable
healthcare workforce and guarantee the provision of high-quality healthcare services for
the Filipino population.

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 CHAPTER I
INTRODUCTION

1.2 BACKGROUND

House Bill 5276

House Bill 5276, introduced by Representative Marvin Rillo of Quezon City's 4th District,
aims to address the migration of Filipino nurses to other countries by increasing their basic
pay in government hospitals from Salary Grade 15 which currently stands at P36,619, to
Salary Grade 21, amounting to P63,997. The bill recognizes the valuable role of nurses in
the healthcare industry and the need to provide competitive compensation to retain them
in the Philippines. It is duly proved on research that the Philippines offers the lowest
earnings for nurses compared to other countries1. It highlights the significant wage
disparity between the Philippines and other countries, which contributes to the outflow of
skilled nurses.

By offering better salaries and benefits, the bill aims to safeguard the Philippine healthcare
industry and promote the welfare of nurses, aligning with the objectives of Republic Act
9173, also known as the "Philippine Nursing Act of 2002" and emphasizes the importance
of policy in ensuring the welfare and professionalism of nurses. The passage of this bill is
seen as a crucial step in ensuring the retention of skilled nurses and enhancing the overall
healthcare system.

Supply of Nurses in the Philippines

The COVID-19 pandemic in the Philippines has revealed the challenges experienced by
Filipino nurses, often overlooked but considered as unsung heroes. Over the years, these
nurses have been compelled to seek opportunities abroad due to the struggle for improved
wages and working conditions. Despite their efforts to advocate for better treatment, they
have found solace in countries that offer more favorable prospects for their professional
and personal growth.

DOH records showed there are 44,602 physicians and 178,629 nurses working in the
country, a far cry from Professional Regulatory Commission’s records showing that there
are 95,000 licensed doctors and 509,000 licensed nurses2. Nearly a third have meanwhile
shifted to other careers moving to other professions such as teaching, Business Process
Outsourcing, among others, or are either unemployed or underemployed.

1An Act Further Upgrading the Minimum Base Pay of Nurses Working in Public Health Institutions, amending for the Purpose Republic Act No. 9173,
otherwise Known as the “Philippines Nursing Act of 2002”, House Bill 5276, 19th Cong. (2022)

2 DOH Data quoted in GMA News Online “DOH: 12 to 23 years to address shortage of nurses, doctors under existing policies”, GMA Integrated News
(2023)

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As economies are opening up and more countries are adjusting their travel restrictions,
healthcare workers may now take advantage of opportunities available. The exodus does
not only involve nurses, but also other members of the country’s healthcare workforce.

Data from the Philippine Overseas Employment Administration (POEA), showed that
Saudi Arabia, United Kingdom, Qatar, Germany, United Arab Emirates, Singapore, United
States, Ireland, Oman and Kuwait are the healthcare workers’ top countries of destination.
As of March 28, 2022, 8,752 healthcare workers have left the country which is expected
to go higher as the total number of healthcare workers who migrated on 2021 stood at
22,8953.

DOH officer-in-charge Undersecretary Maria Rosario Vergeire said that it would take 12
to 23 years for the country to address the shortage of nurses and doctors under the current
situation and existing policies4.

Current salary of Filipino Nurses in Public and Private sectors

It is important to underscore the long-standing issues related to the healthcare workers

such as low pay, high turn-over rate of trained personnel, and out migration of the
country’s experienced health professionals.

On July 17, 2020, the Department of Budget and Management (DBM) has issued Budget
Circular (BC) No. 2020-45 which upgraded the salary of the Nurse I position from Salary
Grade (SG) 11 to SG 15. Consequently, DBM has issued BC No. 2021-2 on August 25,
2021 which reinstated with only the salaries of Nurse I and Nurse II positions upgraded to
SG-15 and SG-16, respectively.

The table below provides a summary of the modifications made6:

Prior BC No. 2020-4 & 2021-2 BC No. 2021-2
(2019) effective June 1, 2021
Amount Equivalent Amount Equivalent
Position Title SG from SSL
Position Title SG from SSL
2019 (4th tranche) 7 2021 (2nd tranche) 8
Nurse I 11 20,754 Nurse I 15 33,575
Nurse II 15 30,531 Nurse II 16 36,628
Nurse III 17 36,942 Nurse III 17 39,986
Nurse IV 19 45,269 Nurse IV 19 48,313
Nurse V 20 51,155 Nurse V 20 54,251
Nurse VI 22 65,319 Nurse VI 22 68,415
Nurse VII 24 83,406 Nurse VII 24 86,742

3 POEA Data quoted in philstar.com “No shortage of nurses but low pay, lack of tenure driving them abroad”, philstar global (2022)
4 GMA News Online “DOH: 12 to 23 years to address shortage of nurses, doctors under existing policies”, GMA Integrated News (2023)
5 DBM Budget Circular No. 2020-4, Upgrading of the Entry Level of Nurse Positions, issued July 17, 2020
6 DBM Budget Circular No. No. 2021-2, Modification of Nurse Positions, issued August 25, 2021
7 DBM BC No. 575, Implementation of the Fourth Tranche Compensation Adjustment for Civilian Personnel in the National Government, issued March 25,

2019
8 DBM BC No. 584, Implementation of the Second Tranche of the Modified Salary Schedule for Civilian Personnel in the National Government pursuant to

RA No. 11466, issued January 6, 2021

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On the other hand, for the private sector, according to the Department of Labor and
Employment (DOLE), an entry-level registered nurse receives an average salary of
P8,000 ($158.54) to P13,500 ($267.54) per month. Registered nurses hired by hospitals
commonly receive an average salary of P9,757 ($193.36) a month. In private sector, the
rate average is around P10,000 ($198.18) per month9. Based on the 2017 data of the
Organization for Economic Co-operation and Development (OECD), Western countries
can pay nurses as much as P5 million per year10 which is dozen times more than the
starting annual wage of nurses in the Philippines.

The government’s move to increase the salary of newly hired/entry level public nurses is
a welcome development to keep them in the service even as the government has directed
the temporary stop for them to leave for overseas employment. But the recent upgrading
in the salary scale of government nurses may still not be enough. COVID-19 is expected
to linger for some time, and health workers will continue to be in harm’s way. Health
workers are demanding for COVID-19 hazard pay on top of the current hazard pay the
are getting, the provision of ₱100,000 to all COVID-19 positive healthcare workers, and
implementation of a seven-day work with two-weeks quarantine work schedule (Gonzales,
2020).

The labor unions in the healthcare sector have also emphasized the need to extend the
salary increase for nurses and healthcare workers to include those working in private
medical institutions. Recognizing their crucial role in the nation's health and well-being,
the unions assert their commitment to negotiate for higher wages and better benefits
through collective bargaining. However, they express their support for the inclusion of the
private sector in the proposed law (House Bill 5276) from the outset, as many healthcare
workers in this sector still require or have not yet established their unions.

Deployment Cap on Filipino Nurses

On April 2, 2020, the POEA has issued the Governing Board Resolution No. 09 Series of
2020 which imposed a moratorium on the overseas deployment of identified health care
workers (HCWs) including nurses, by placing them under the framework of mission critical
skills (MCS) until the national state of emergency is lifted and subject to the lifting of
COVID-19 travel restrictions at destination countries. It was issued in response to the
COVID-19 pandemic, which had caused a shortage of HCWs in the Philippines. The
resolution was intended to protect the health and safety of HCWs and to ensure that they
are available to provide care to Filipinos in the Philippines.

9 Data from DOLE quoted in Pacheco et. Al (2021) “The Working Conditions of Overworked and Underpaid Nurses in the Philippines during a Pandemic”
via legalresearchph.com
10 Id

6
The said resolution was lifted on January 1, 2021, with another issuance of Governing
Board Resolution No. 17 Series of 202011, which lifted the deployment ban on nurses,
nursing aides and assistants. However, this resolution has imposed a deployment cap
of 5,000 new hire nurses per year. This applies to all nurses who are newly hired by
foreign employers but does not apply to nurses who are already working abroad, nurses
who are returning to the Philippines, or nurses who are being deployed to work for
government-to-government agreements. Pursuant to the resolution, the POEA has the
authority to increase the deployment cap if the IATF (Inter-Agency Task Force for the
Management of Emerging Infectious Diseases) determines that the public health
emergency caused by COVID-19 has lessened.

In June 2021, the POEA has raised the deployment cap to 6,500, and was then raised
to 7,500 on 2022 after the government was pressured to allow more new-hire healthcare
workers with mission critical skills to be deployed overseas.

The labor group Federation of Free Workers (FFW) argues that the deployment cap is
unconstitutional and oppressive to labor, as it restricts the opportunities for nurses to seek
better wages abroad. The failure to address the deployment cap may result in a significant
loss of nurses to countries offering higher salaries, exacerbating the projected shortage of
nurses in the Philippines.

1. 2 PROBLEM STATEMENT

The labor group Federation of Free Workers (FFW) supports the proposal for a salary
increase for government nurses and calls for the removal of the deployment cap on Filipino
nurses seeking employment abroad. However, the current salary scale for nurses in the
Philippines, both in public and private sectors, remains comparatively low, leading to a
significant outflow of skilled nurses to countries offering better opportunities. Additionally,
the deployment cap restricts the number of nurses who can pursue employment abroad,
further exacerbating the shortage of nurses in the country. This situation poses a
challenge to the retention of skilled nurses within the local healthcare sector and hinders
the provision of high-quality healthcare services to the Filipino population. Therefore, there
is a need to examine the impact of the proposed salary increase and the call for the
removal of deployment cap on the healthcare workforce and explore viable solutions to
ensure competitive salaries and retain healthcare professionals in the local health sector.

11POEA Governing Board Resolution No. 17, s.2020 titled “Lifting of the Moratorium on the Deployment of Nurses, Nursing Aides and Assistants and for
Other Purposes, issued on December 7, 2020

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1.3 CASE OBJECTIVE

This paper aims to provide perspectives through labor and industrial relations theories on
FFW’s position and to analyze the potential impact and implications of the proposed salary
increase for government nurses and the call for the removal of the deployment cap on
Filipino nurses seeking employment abroad. It aims to focus on the following key areas:

1. The potential benefits and challenges associated with increasing the salaries of
government nurses, particularly in terms of retaining skilled nurses and enhancing
the overall healthcare system.

2. The impact of the deployment cap on Filipino nurses seeking employment abroad,
including its constitutionality, labor implications, and the potential consequences of
failing to address this issue.

3. Recommendations for policy changes, legislation, or other measures that can

ensure competitive salaries, improve working conditions, and retain healthcare
professionals in the local health sector.

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 CHAPTER II
THEORETICAL PARADIGM

2.1 DUNLOP’S SYSTEMS THEORY

This approach defines industrial relations as a system consisting of three groups of actors-
workers and their organization, managers and their organizations, and governmental
agencies concerned with the work community (Dabscheck, 1983). It focuses on the
relationship of the three mentioned factors - management, governmental organizations,
and labor. According to Dunlop's theory, the labor system is seen as a complex web of
relationships and interactions between different actors. In this case, the FFW represents
the interests of the workers, the government plays a regulatory role as well as employers
for public nurses, and nurses are the employees in the healthcare sector.

The call for the salary increase and lifting of the deployment cap highlights FFW's
recognition of the external factors influencing the labor market, such as the global shortage
of nurses and the potential loss of skilled healthcare workers to other countries. By
addressing these external factors and advocating for policy changes, FFW aims to create
a more sustainable healthcare workforce in the Philippines. This aligns with the state
component of Dunlop's systems theory, which emphasizes the role of the government on
the establishment and administration of rules in the workforce which guides the actors in
the system.

2.2 PLURALISM

Pluralism acknowledges diversity or the existence of multiple interest groups in the

workplace, including workers, management, trade unions, and government agencies.
(Dabscheck, 1983). In this case, it recognizes perspectives of employers, employees, and
labor unions, and emphasizes the importance of bargaining and negotiation between
these groups. The FFW's call on Congress and the Marcos administration to pass the
proposed measures demonstrates their engagement in the bargaining process and their
efforts to influence policy outcomes.

This concept helps understand the dynamics of conflicting interests and the importance of
collective action and negotiation in labor relations. FFW's efforts to advocate for the rights
and welfare of nurses through the proposed salary increase and the lifting of the
deployment cap exemplify the pluralistic nature of labor relations, where various interest
groups seek to shape policies and promote their respective agendas.

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2.3 SOCIALISM/MARXISM

Socialism places a strong emphasis on social justice and the well-being of all individuals,
regardless of their social class or economic position. This aligns with the FFW's support
for an increased starting monthly salary of P64,000 for government nurses, as they
advocate for equitable wages, benefits, and working conditions.

Additionally, the FFW's call to eliminate the deployment cap on Filipino nurses seeking
employment abroad can be seen as a response to the perceived oppressive nature of this
restriction. Socialists often critique policies or regulations that restrict workers' freedom of
movement and hinder their ability to pursue better opportunities.

Marxism argues that the capitalist system is inherently exploitative. Under capitalism, the
bourgeoisie, who are the owners of capital, exploit the proletariat, the working class, by
extracting surplus value from their labor. This concept can be applied to the low wages of
nurses in the Philippines, highlighting the exploitation of labor within the healthcare sector.

2.4 CORPORATISM

According to this theory, the state directly intervenes in the operation of the political or
economic system under the banner of the public interest. Conflict and competition must
be replaced by cooperation and consensus in pursuit of the common good. The state and
representatives of capital and labor interact and make decisions for the good of all
(Dabscheck, 1983).

Corporatism promotes the concept of collaboration and cooperation between interest

groups and the government in shaping policies and making decisions. In this particular
case, the FFW, as a labor organization representing the interests of nurses and healthcare
workers, is advocating for a salary increase for government nurses and the elimination of
the deployment cap on Filipino nurses seeking jobs abroad. These initiatives are in line
with the principles of corporatism, as the FFW engages in collective bargaining and
negotiations to enhance the wages and working conditions of its members. The FFW
proposes that these interest groups, together with the government, collaborate to achieve
common objectives and resolve conflicts.

The actions taken by the FFW are rooted in the idea that the government, interest groups,
and the wider public should collaborate to establish a fairer and just society, consistent
with the principles of corporatism.

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2.5 THEORY OF STATE

According to the theory of the state, the state assumes a central role in shaping the
dynamics of industrial relations through the enactment of laws, regulations, and policies
that impact the relationship between employers and workers. In this case, House Bill 5276
seeks to raise the salaries of nurses employed in government hospitals. The bill
acknowledges the importance of nurses in the healthcare sector and aims to provide
competitive remuneration to encourage their retention within the Philippines. This
legislative proposal signifies the state's intervention to address the issue of low wages and
the emigration of skilled nurses from the country.

The FFW's endorsement of the proposed salary increase and their call for the removal of
the deployment cap can be interpreted as their active engagement with the state to
influence labor-related policies. By expressing their support and urging Congress to swiftly
pass the proposed measure, the FFW exerts pressure on the state to tackle the wage
disparity and create incentives for nurses to remain in the service of the Filipino population.
This theory acknowledges the role of the state in shaping labor relations, both through
legislative actions like House Bill 5276 and by imposing limitations such as the deployment
cap.

2.6 STRATEGIC CHOICE

Strategic choice theory says that industrial relations practices and outcomes are shaped
by the interactions of environmental forces along with the strategic choices and values of
managers, union leaders, workers, and public policy decision makers (Kochan et. al.,
1986). It focuses on the rational decision-making of individuals and organizations in
pursuit of their goals, considering the external environment and available options.

This concept provides valuable insights into how different stakeholders make decisions
and strategic choices regarding the proposal for increasing salaries for government nurses
and lifting the deployment cap on Filipino nurses. The theory emphasizes the significance
of considering multiple factors, including compensation, working conditions, and the
retention of skilled professionals, when developing effective strategies to address the
challenges faced by the healthcare workforce and ensure the delivery of high-quality
healthcare services. These principles are in line with the objectives outlined in the
Philippine Nursing Act of 2002, which underscores the role of policy in safeguarding the
welfare and professionalism of nurses.

According to strategic choice theory, organizations and groups are considered rational
actors that make strategic decisions to achieve their objectives. The theory also highlights
the role of top management in making informed decisions based on interactions and
environmental influences. This perspective aligns with the government's choices in
creating regulatory policies that aim to address the needs of the healthcare workforce.

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2.7 NEW INTERNATIONAL DIVISION OF LABOR

The theory of the New International Division of Labor (NIDL) provides insight into how
global labor markets and the division of labor have undergone restructuring due to
economic globalization. It examines how countries and regions specialize in specific
stages of production and engage in global value chains. When considering healthcare
workers, such as nurses, the theory suggests that countries can specialize in
producing and exporting healthcare services. This is often achieved through the
migration of skilled healthcare professionals to countries with greater demand and
better pay.

The NIDL theory provides insight into how countries position themselves in the global
division of labor and the challenges they face in retaining skilled healthcare workers.
The Philippines has been recognized as a significant source of healthcare workers,
including nurses, for other countries. However, the deployment cap imposed by the
Philippine Overseas Employment Administration (POEA) limits the number of nurses
who can pursue employment overseas. This restriction can be viewed as an effort to
retain skilled nurses within the country and address the local shortage. On the other
hand, the call to eliminate the deployment cap can be seen as a push to provide
Filipino nurses with more opportunities to seek employment abroad, aligning with the
NIDL theory's notion of labor mobility across international borders.

The comparatively low wages for nurses in the Philippines, whether in public or private
sectors, demonstrate the unequal allocation of labor value in the global division of
labor. Filipino nurses frequently pursue job opportunities overseas due to the
substantial wage gap and more favorable prospects found in other countries. This
trend is influenced by the global demand for healthcare workers and the higher
salaries offered in destination countries, typically associated with more advanced
economies.

2.8 SCIENTIFIC MANAGEMENT

Scientific Management theory, developed by Frederick Winslow Taylor in the early

20th century, focuses on improving efficiency and productivity in organizations through
the scientific analysis and optimization of work processes. Taylor's principles
emphasize the importance of matching workers' skills and abilities with the tasks they
perform, as well as providing appropriate incentives to motivate employees.

Taylor’s concept of "a fair day's pay for a fair day's work" in the context of the proposed
salary increase for government nurses, can be related on offering a competitive
compensation. This increase in salary can serve as an incentive to retain nurses in the

12
Philippines, as they would be more fairly compensated for their work, thus promoting
job satisfaction and motivation.

2.9 WORKERS PARTICIPATION

Workers' participation theory underscores the significance of involving workers in

decision-making processes that have an impact on their working conditions, salaries, and
overall well-being. FFW actively demonstrates its commitment to workers' participation by
strongly supporting House Bill 5276 and urging Congress to swiftly pass this proposal. In
doing so, FFW effectively represents the interests of nurses and advocates for their
welfare.

This theory acknowledges the value of granting workers the freedom to choose their
employment options and pursue opportunities that offer improved wages and working
conditions. By advocating for the removal of the deployment cap, FFW advocates for the
rights of nurses to explore better opportunities outside the country, which can contribute
to their professional and personal growth.

2.10 LABOR AND GENDER ISSUES

Examining the labor and gender issues provides valuable insights into the structural
inequalities and systemic obstacles that impact the nursing profession in the
Philippines. Throughout the history, nursing has been closely associated with
femininity and caregiving roles, contributing to the devaluation and under
compensation of nurses, who primarily consist of female workers. Based on the
Department of Health (DOH) National Database of Selected Human Resources for
Health (NDHRHIS)12, there are a total of 71,748 nurses in the Philippines as of
December 2022, which consists of 54,315 (76%) female nurses, and 17,433 (24%)
male nurses.

The proposal for a salary increase for government nurses can be viewed as an attempt
to address the gendered nature of low wages within the nursing profession. By
advocating for higher salaries, the aim is to rectify the gender-based wage gap and
acknowledge the worth of the predominantly female nursing workforce.

Moreover, the call to remove the deployment cap on Filipino nurses seeking overseas
employment is also intertwined with gender-related concerns. This cap imposes
limitations on the opportunities available to nurses, particularly women, who wish to

Distribution of Selected Health Providers According to Sex as of December 2022, data from Department of Health - Health Human Resource
12

Development Bureau, National Database of Selected Human Resources for Health (NDHRHIS), https://ndhrhis.doh.gov.ph/

13
explore better job prospects in other countries where they may have the potential to
earn higher incomes.

2.11 STRUCTURAL ADJUSTMENT

Structural adjustment theory focuses on the impact of economic and political reforms on
different social groups, including labor. The proposal for a salary increase and the request
to eliminate the deployment cap can be interpreted as endeavors to rectify the underlying
inequities within the healthcare industry and are in line with the principles of structural
adjustment theory. The introduction of House Bill 5276, which seeks to enhance the
salaries of government nurses, can be understood as a reaction to the structural
disparities prevalent in the healthcare sector. The plea to eliminate the deployment cap
acknowledges the necessity for labor market policy adjustments to tackle the shortage of
nurses and retain proficient healthcare practitioners within the Philippines.

14
 CHAPTER III
PROBLEM ANALYSIS AND FINDINGS

3.1 PROBLEM IDENTIFICATION AND ANALYSIS

Low salary scale for nurses in the Philippines, both in the public and private sectors, leads
to a significant outflow of skilled nurses to other countries. This situation is exacerbated
by the deployment cap imposed on Filipino nurses seeking employment abroad. The labor
group Federation of Free Workers (FFW) supports the proposal for a salary increase for
government nurses and calls for the removal of the deployment cap to address these
challenges. The problem highlights the need to examine the impact of the proposed salary
increase and the call for the removal of the deployment cap on the healthcare workforce
and explore viable solutions to ensure competitive salaries and retain healthcare
professionals in the local health sector.

Implications of the proposal of 64,000 pesos entry level pay for public nurses

The proposal aims to address the issue of low salaries for nurses and provide them with
a more competitive and equitable compensation package. Increasing the entry-level pay
recognizes the value of nurses' work and the importance of attracting and retaining skilled
healthcare professionals in the public sector. By offering a more competitive salary, the
proposal aims to incentivize nurses to continue serving in the Philippines, thereby
addressing the shortage of healthcare professionals.

However, it is also important for the government to examine its budgetary implications. A
comprehensive financial analysis wherein the fiscal capacity of the government,
identifying potential funding sources shall be conducted to carefully study the long-term
sustainability of the salary increase and its overall economic implications. It is crucial to
ensure that the proposed salary adjustments are financially feasible, taking into account
the overall budgetary constraints and priorities of the government.

The proposal will also likely have a ripple effect throughout the public sector in aligning
and adjusting other government positions in accordance with the DBM allocation of
positions in line with the Salary Standardization Law. It may create expectations and
demands for salary increases among other government employees who perceive a
discrepancy in their compensation compared to the revised scale for nurses. This could
lead to broader discussions and potential adjustments to maintain fairness and equity
within the public sector.

Balancing the effect on the arrangements of government positions and budgetary

implications with the goal of providing competitive salaries for nurses requires careful

15
consideration and planning. It is important for the government to ensure the sustainability
and affordability of the proposed salary increase while maintaining the overall financial
stability of the public sector.

Legality of the Implemented Deployment Cap for Health Workers

In 2021, the POEA imposed a deployment cap of 5,000 on newly hired healthcare workers
which has been raised to 7,500 this year. The cap was imposed in response to the COVID-
19 pandemic, as the government feared that a shortage of healthcare workers would
worsen the pandemic. However, the deployment cap has been criticized by many, mostly
by healthcare workers, who argue that it is unnecessary and harmful.

According to a senate press release13 on November 18, 2021, former Senator Richard J.
Gordon argues that the deployment cap for healthcare workers implemented by the
Philippine Overseas Employment Administration (POEA) is unconstitutional. He believes
that the restrictions violate Article II, Section 9 of the 1987 Constitution, which promotes
policies for full employment, whether locally or abroad. In addition, Article XIII, Section 3
of the 1987 Constitution also affirms that, "[t]he State shall afford full protection to labor,
local and overseas, organized and unorganized, and promote full employment and
equality of employment opportunities for all.”14

Whether the deployment cap for healthcare workers implemented by POEA is

unconstitutional is a matter of legal debate. FFW argue that the cap violates the right to
work, as guaranteed by the Philippine Constitution. They argue that the cap restricts the
freedom of movement and association of healthcare workers, and that it interferes with
the right to earn a living.

Others argue that the cap is constitutional. They argue that the government has a
legitimate interest in protecting the health and safety of its citizens, and that the cap is a
reasonable way to achieve this goal. They also argue that the cap does not violate the
right to work, as healthcare workers are still free to work in the Philippines.

Shortage of Nurses amidst of surplus

According to an article from GMA News 15, DOH records indicate that there are
currently 44,602 physicians and 178,629 nurses actively working in the country.
However, these numbers are significantly lower compared to the records of the
Professional Regulatory Commission, which show that there are 95,000 licensed
doctors and 509,000 licensed nurses in total. Former DOH Undersecretary Maria

13 Senate of the Philippines 19th Congress Press Release, Gordon questions nurse deployment ban, November 18, 2021,
https://legacy.senate.gov.ph/press_release/2021/1118_gordon1.asp
14 Article XIII, Social Justice and Human Rights, Labor, The 1987 Constitution of the Republic of the Philippines
15 GMA News Online “DOH: 12 to 23 years to address shortage of nurses, doctors under existing policies”, GMA Integrated News (2023)

16
Rosario Vergeire acknowledged that not all licensed doctors and nurses are practicing
within the health sector because many of them have chosen alternative professions
such as teaching or working in the Business Process Outsourcing (BPO) industry.

During a protest march on National Health Workers' Day, the labor group Filipino
Nurses United (FNU) responded to the Department of Health's (DOH) statement by
highlighting that there is not a genuine "shortage" of nurses in the country. Instead,
the FNU emphasized that the issue stems from understaffing in hospitals and the
absence of government measures to tackle retention and recruitment. Jocelyn
Andamo, the Secretary General of FNU, cited data from the health department
indicating that there are over 600,000 registered Filipino nurses, with around half of
them opting to migrate to foreign countries (De Villa, K., 2023).

This revelation the Philippines trains more health professionals than it can employ and
highlights the challenge the country faces in ensuring that a sufficient number of
healthcare professionals are actively working in the health sector. The disparity
between the number of licensed professionals and those actually practicing indicates
a significant gap that needs to be addressed.

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 CHAPTER IV
CONCLUSION AND RECOMMENDATION

4.1 CONCLUSION

In conclusion, the analysis on reinforcing compensation and deployment policies for

government nurses in the Philippines highlights the need for significant changes to
address the challenges faced by the healthcare workforce. The proposal to increase
the starting monthly salary of government nurses to P64,000 is a crucial step towards
recognizing the value of nurses and incentivizing them to continue serving in the
Philippines. However, careful financial analysis is necessary to ensure the long-term
sustainability and feasibility of the salary increase.

Additionally, the imposition of a deployment cap on Filipino nurses seeking

employment abroad has raised concerns about its constitutionality and its impact on
the healthcare workforce. It is important to note that the interpretation of the
constitutionality of the deployment cap may vary. It ultimately requires a legal and
constitutional analysis by relevant authorities, such as the supreme court, to make a
definitive determination. The question of constitutionality is a complex legal issue that
would require a comprehensive analysis and potential court decision to establish a
definitive answer. Furthermore, it was ascertained from the Department of Health’s
(DOH) data that a significant number of licensed nurses in the Philippines choose to
migrate abroad or pursue alternative careers. This situation can be traced back to the
root causes of inadequate compensation and unfavorable working conditions for
nurses within the country. The failure to address this underlying causes may lead to a
significant loss of nurses to countries offering higher salaries, exacerbating the
projected shortage of nurses in the Philippines.

This is an opportune moment to revisit the salaries and benefits provided to healthcare
professionals, ensuring that the risks associated with their profession are adequately
addressed and their services are appropriately rewarded. With the world grappling
with the consequences of this global pandemic, which demands an even greater
number of skilled healthcare workers, the allure of employment opportunities abroad
poses a threat to the already insufficient healthcare workforce in the country. It would
be wise for the government to take measures to curb the migration of healthcare
workers by providing them with compelling reasons to remain and serve their own
country where their expertise is most needed.

Ultimately, establishing a sustainable healthcare workforce and delivering high-quality

healthcare services to the Filipino population requires a holistic approach that
addresses both compensation and deployment policies for nurses.

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4.2 RECOMMENDATION

The following recommendations aim to provide a framework for addressing the workers'
demands while considering the broader context of labor administration relative to the
reinforcing compensation and deployment policies of Filipino nurses:

1. Addressing the Root Cause: Low Compensation and Poor Working

Conditions of Nurses in the Philippines

Considering the low salary scale for nurses in the Philippines and the significant
outflow of skilled nurses to other countries, it is recommended to consider the
approval of the congress to House Bill 5276 which proposes salary increase for
government nurses supported with a comprehensive financial analysis to ensure
the sustainability and affordability of the salary increase, taking into account the
overall budgetary constraints and priorities. Additionally, potential adjustments and
equity considerations for other government positions should be addressed to
maintain fairness within the public sector. The government may need to prioritize
healthcare spending and explore various funding options, such as reallocating
funds from other areas of the budget, identifying new revenue sources, or seeking
external support. It is crucial to ensure that the proposed salary increase is
financially feasible and sustainable without compromising the overall fiscal health
of the government.

2. Comprehensive Review of Healthcare Workforce Policies

The existing limit on the number of Filipino nurses permitted to work abroad should
be reevaluated and reconsidered, given the ongoing debate regarding its legality.
The government needs to assess the necessity of this deployment cap in light of
the current healthcare workforce situation, while also striking a balance that
ensures the retention of healthcare professionals within the country.

Furthermore, a comprehensive examination of holistic healthcare workforce

policies should be conducted. This review should encompass an evaluation of
salary structures, working conditions, and opportunities for career advancement in
both the public and private sectors. The objective should be to address the
difficulties faced by healthcare workers, such as inadequate compensation, high
turnover rates, and emigration, and to implement measures that enhance their
working conditions and professional development. Additionally, with the projected
shortage of nurses, it is important to prioritize investments in nursing education and
training programs to augment the pool of skilled healthcare professionals.

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 3. Collaboration and Stakeholder Engagement

The effective execution of the recommended actions necessitates cooperation and

active involvement of various stakeholders. It is vital to engage relevant
government entities such as DOH, DBM, and POEA (now the Department of
Migrant Workers), labor unions, healthcare organizations, and other involved
parties in the process of decision-making. By adopting this collaborative approach,
we can ensure that the proposed policies are well-grounded, viable, and in
harmony with the requirements and goals of the healthcare workforce.

Overall, it is necessary to consider policy changes, legislation, or other measures that

ensure competitive salaries, improve working conditions, and retain healthcare
professionals in the local health sector. This may involve revising the salary scale for
nurses in both public and private sectors, reviewing and potentially lifting the deployment
cap, and promoting collaboration between the government, labor unions, and healthcare
institutions to address the challenges faced by the healthcare workforce. By implementing
appropriate policies, the government can create a sustainable healthcare workforce and
provide high-quality healthcare services to the Filipino population.

20
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Jaymalin, M. 2023. Labor group backs P64,000 monthly pay for government nurses. The
Philippine Star, 15 May, accessed June 2023 from philstar.com

An Act Further Upgrading the Minimum Base Pay of Nurses Working in Public Health
Institutions, amending for the Purpose Republic Act No. 9173, otherwise Known as the
“Philippines Nursing Act of 2002”. House Bill 5276. 19th Cong. (2022).

DBM Budget Circular No. 2020-4, Upgrading of the Entry Level of Nurse Positions,
issued July 17, 2020

DBM Budget Circular No. No. 2021-2, Modification of Nurse Positions, issued August 25,
2021

DBM BC No. 575, Implementation of the Fourth Tranche Compensation Adjustment for
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Gonzales, C. (2020, August 14). Union calls on PGH, gov’t to resolve ‘sad plight’ of
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Pacheco et. Al (2021). “The Working Conditions of Overworked and Underpaid Nurses
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Navarro, D. (2023). “Expanded scope of nurses’ wage hike bill urged”. Daily Tribune
https://tribune.net.ph/2023/05/15/expanded-scope-of-nurses-wage-hike-bill-urged/

Atienza, K. 2021. Philippines raises deployment cap for health workers. BusinessWorld,
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De Villa, K. (2023, May). “DOH told: No nurse shortage, just gov’t ‘understaffing’”.
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Article XIII, Social Justice and Human Rights, Labor, The 1987 Constitution of the
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