COMPETENCY BASED HUMAN RESOURCES

PLACEMENT IN THE DEPARTMENT OF HEALTH:

A PARADIGM SHIFT

I. INTRODUCTION.

No less than the 1987 Philippine Constitution have guaranteed the

protection and promotion of the Filipino. Article two (2) State Policies,

Sections twelve (12) and fifteen (15) provides:

Section 12. The State recognizes the sanctity of family life and shall

protect and strengthen the family as a basic autonomous social institution.

It shall equally protect the life of the mother and the life of the

unborn from conception. The natural and primary right and duty of

parents in the rearing of the youth for civic efficiency and the development

of moral character shall receive the support of the Government.

Section 13. XXXXX

Section 14. XXXXX

Section 15. The State shall protect and promote the right to health of

the people and instill health consciousness among them.

The above-cited provisions are the cornerstone that led to fruition the

establishment, maintenance and operation of the Department of Health

under the Office of the President.

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This Department has no other mandate than to ensure that the above

provisions contained in the 1987 Philippine Constitution is realized by

protecting and promoting public welfare, public interest, public safety and

public health.

II. THE DEPARTMENT OF HEALTH.

From its very inception, the Department of Health has been headed by

physicians from the Secretary of Health, Undersecretaries, Assistant

Secretaries, Region Directors, Assistant Regional Directors and Chiefs

of Hospitals.

The arrangement of selecting and appointing physicians to manage,

direct and operate the Department of Health appears logical and

consistent with the demands of the 1987 Philippine Constitution.

The above template since the beginning has not been tampered with and

has been widely accepted. Suffice to say and generally, for all other

departments under the Office of the President or the Executive

Department, the same template has been observed with reference to

appointing human resources to positions based on their professions.

The current administration in Malacañang Palace however, is not too

keen in maintaining such practice or tradition. Without regard to the

political milieu, the current administration has been appointing

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Department Heads or Secretaries who professionally are not aligned

with the department they head.

For purposes of clarity and example, retired Brigadier General Ricardo

C. Morales was appointed by President Rodrigo Duterte to be the

President and Chief Executive Officer of the Philippine Health Insurance

Agency.

Morales does not have any background on health, health financing and

health governance. He does not know the nature and complexities of the

job because he was never exposed to such activities, nor trained. But

why was he selected and subsequently given the post in the Philippine

Health Insurance Agency as its President and Chief Executive Officer?

The same goes for General Roy A. Cimatu, also a retired soldier, is

appointed as the Department Secretary for the Department of

Environmental and Natural Resources. To further stress the point, retired

General Eduardo Año is the Department Secretary of the Department of

Interior and Local Government.

Perusing and scrutinizing the educational background and scholastic

records of the above-mentioned individuals, nothing appears to be

related to the current posts they hold today other than being

distinguished officers with a myriad of accolades during their stint as

officers of the Armed Forces of the Philippines.

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Then what is it in these individuals that the President of the Republic

recognizes that they be competent and qualified to lead and manage

their respective organizations. Does the President of the Republic

recognize their exemplary managerial skills so much so that the

necessity of being a doctor, an environmentalist or a lawyer could be set

aside if only to get the job done?

It is along these lines that the author feels there is a need to re-evaluate

the held on tradition that only physicians are to be appointed as head of

the different offices under the ambit of the Department of Health.

III. Commentaries and Literature Review.

Before delving head-on in the matter on hand, it is only but relevant that

commentaries and literatures be reviewed and the views of other

individuals be taken into consideration.

In the item entitled “Why The Best Hospitals Are Managed by Doctors” by

James K. Stoller, Amanda Goodall and Agnes Baker1, they are of the

view that doctors are the best managers for hospital based on the

premised that they understand the work that needs to be done and how

it should be done.

1
https://hbr.org/2016/12/why-the-best-hospitals-are-managed-by-doctors

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To quote a part of their literature:

When asked this question, Dr. Toby Cosgrove, CEO of

Cleveland Clinic, responded without hesitation, “credibility …

peer-to-peer credibility.” In other words, when an outstanding

physician heads a major hospital, it signals that they have

“walked the walk,” and thus have earned credibility and

insights into the needs of their fellow physicians. But we

would argue that credibility may also be signaled to important

external stakeholders — future employees, patients, the

pharmaceutical industry, donors, and so on.

The Mayo website notes that it is physician-led because, “This

helps ensure a continued focus on our primary value, the

needs of the patient come first.” Having spent their careers

looking through a patient-focused lens, physicians moving into

executive positions might be expected to bring a patient-

focused strategy.

In a recent study that matched random samples of U.S. and

UK employees with employers, we found that having a boss

who is an expert in the core business is associated with high

levels of employee job satisfaction and low intentions of

quitting. Similarly, physician-leaders may know how to raise

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 the job satisfaction of other clinicians, thereby contributing to

enhanced organizational performance.

Our research suggests that if a manager understands, through

their own experience, what is needed to complete a job to the

highest standard, then they may be more likely to create the

right work environment, set appropriate goals and accurately

evaluate others’ contributions.

It appears that knowing the job and knowing how the job is to

be done is an area greatly considered. The same line of

argument was made in the article entitled: “Why a Physician

May Be The Best Choice To Lead An Ailing Organization” by

John Figueroa, MBA and Christopher Krubert, MD, MBA,

dated September 16, 20192.

The above-mentioned article says:

With our years in executive healthcare positions, both as

former CEOs of healthcare companies, we propose that
physicians are uniquely qualified to lead not just hospitals, but
all types of healthcare organization to success.

Here are three main reasons:

Physicians understand healthcare. First, physicians literally

understand the business of healthcare from the bottom up—
something no financial executive can match. Who

2
https://www.medicaleconomics.com/news/why-physician-may-be-best-choice-lead-ailing-organization

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 understands the nuances and complexity of care delivery
better than a physician? Who has more experience at making
decisions under pressure than an individual who literally has
made life-or-death choices in a split-second? The “business of
healthcare” is as unique as healthcare is personal, requiring
an understanding that can take years to acquire as a provider
of care. It’s not necessarily the technical knowledge of
medicine that separates a physician CEO, but rather an
intimate understanding of what goes into the delivery of
compassionate, yet efficient and high-quality patient care.

And given that CEOs are ultimately held responsible for the
financial health of their organization, there are few more suited
to matching resources with care needs than a physician, who
has spent years practicing in the trenches in the face of
declining reimbursement. While they value care delivery
above all, the necessity of adjusting to new payment models
over the last few decades – especially as healthcare has
cycled through FFS, PPO, ACO, VBC and other models – has
forced them to build not just a short-term solvency strategy,
but a long-term organizational vision. This nimbleness, earned
from pressure to care for their patients often on a shoestring
budget, gives many physician CEO’s the creativity and
fortitude to deliver financial results and not skimp on quality.

Physicians understand the challenges. Another advantage of

hiring a CEO with a background firmly based in “boots on the
ground” is the intuitive knowledge of how to manage a
workforce with disproportionately high levels of burnout. A
recent study showed doctor burnout is costing the U.S. health
care system about $4.6 billion a year, costs no organization
can sustain. The study identified systemic burden like
bureaucracy and paperwork as major contributing factors to

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 burnout. Other research has identified an association between
burnout and indirect organizational costs like medical
mistakes, less satisfied patients, and malpractice litigation.

Physician leaders know that combating burnout takes more

than a group on to a yoga class. Rather, research suggests
interventions at the organizational level were more successful;
that is, leaders must prioritize less on providing coping
strategies and more on minimizing/eliminating potential
stressors. Of course, a non-physician CEO can implement
these interventions, but given that, 54% of physicians report
burnout, they may lack the same insight as an individual who
understands why they are so important. It is one thing for a
business professional to walk into a meeting with tired docs or
practitioners and ask for compromise or understanding.
However, when a physician can intimate that they truly
understand what they are going through after their own years
at the bedside, often the CEO becomes one of them.

Physicians understand data. Third, modern physician leaders

are also intimately familiar with the growing role of data in
healthcare delivery. Based on its integration into their medical
practices, they understand the need for data integration to
achieve actionable insights – using clinical data to achieve
better individual and population outcomes and improved
reimbursement, especially in a value-based environment
where hitting targets equals revenue.

While most executives conceptually understand that Big Data

helps to identify and understand trends, many companies are
not focused on using data and analytics to drive strategic
decision making. But physicians instinctively understand how
data drives performance in virtually every industry, whether a

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 large health system, a pharmaceutical company, or even a car
manufacturer or retail operation.

Combining a medical background with a business

management puts a physician in an even more competitive
path to the c-suite. A good MBA program in health
administration can buoy business fundamentals with
sophisticated, real-world business curriculum in finance,
operations, management and entrepreneurship.

Basically in the two articles, what is common is the assertion that

physicians know the demands and the nuances of the job, understands

the job and knows how to get the job done asserting further that the

healthcare industry is unique.

It is to be stressed however that first, lead authors of the articles, namely

Stoller and Krubert are doctors by profession, bias to the profession may

be a factor to such assertions. Second, the factual milieu of the studies

and comments do not fit the Philippine setting.

IV. The Paradigm Shift.

Before the paradigm shift is introduced, it is only but necessary and

relevant that the organizational set-up of the Department of Health3 is

presented.

3
https://www.doh.gov.ph/DOH_organizational_chart

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The above is the organizational chart depicting all the operating offices

of the entire Department of Health. Suffice to say, that out of all these

operating units, only a handful of offices are not headed by physicians.

Some of which are the Office for Legal Services and the Health Facilities

Services and Regulatory Bureau under the Health Regulation Team

which is quite obvious.

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While it is true that the Department of Health’s mandate is to protect and

promote the health and welfare of the Filipino People, it does not

automatically mean that it should be managed and operated by doctors

alone or the major part of it.

By way of argument, doctors are trained to manage and treat injuries

and diseases, while lawyers are trained to craft, interpret and apply the

law. In the same vein Human Resource Managers are trained in the art

of harnessing and managing Human Resources, while accountants are

trained to analyze financial transactions.

But let us further examine the operations of the Department of Health.

Does it provide direct patient care? Yes, it does but through its retained

hospitals. That is, hospitals owned and managed by the Department of

Health the likes of the specialty hospitals, JB Lingad Memorial Hospital,

Mayor Hilarion Ramiro General Hospital, Eversley Childs Sanitarium,

Zamboanga City Medical Center among others.

In some extraordinary circumstances, considering the availability of

doctors and nurses assigned in the different offices of the Department of

Health performing administrative and technical functions, are called upon

to provide direct patient care in instances such as the Typhoon Yolanda,

Typhoon Ondoy, Marawi Seige and other incidents.

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Basically therefore, the Department of Health and its regional offices are

not direct patient care providers. Its main mandate is to craft policies

based on public need and to provide for guidelines for the

implementation of health policies to be followed and observed by the

local government units.

Having laid out the premise for the introduction for the shift, we proceed

with the position of breaking away from the traditionally adhered view

that the Department of Health should be manned by doctors.

The author is of the view that different positions currently headed by

doctors in the Department of Health, with exception of course on the

technical matters relating to health issues, health programs and

formulation of clinical health protocols, could be well performed by other

professionals as well who have specifically been trained for the purpose.

Case in point, the position of the Secretary of Health. While to some

degree it would be advantageous for the Secretary of Health to be a

medical doctor wherein he could directly answer questions pertaining to

the onset of diseases, transmission of pathogens, incubation periods of

bacteria, effectiveness of interventions among others, but the larger

responsibility of ensuring promotion of health and protection from

disease and injury is not simply about the treatment and management of

diseases and injury.

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In the Philippine situation where service delivery was devolved to the

local government units pursuant to Republic Act 7160 or the Local

Government Code of the Philippines, a different approach needs to be

undertaken than the simple intervention of showing that all it needs to

solve the health problem is the routine vaccination which the local

government cannot even perform due to its inability to procure the

vaccines.

Always as it has been, public perception views the Department of Health

as providers of direct patient care services which is totally not true. This

is because this is how the Department of Health has portrayed itself

because the institution is headed by a doctor.

The Department of Health has always portrayed itself as a doctor

treating the nation, its patient, of its ailments. This is evident by patients

going to the Health Department seeking consults and medication instead

of going to the different health facilities appropriate to their health needs.

In this situation therefore, the Department of Health as an institution acts

as if it was also a health facility akin to health centers and hospitals.

But from a lawyer’s point of view, if appointed to be the Secretary of

Health, the approach to the problem would totally be different. The

implementing rules and regulations of the Local Government Code

provides:

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 ARTICLE 25. Responsibility for Delivery of Basic Services
and Facilities. — The LGUs shall, in addition to their existing
functions and responsibilities, provide basic services and
facilities devolved to them covering, but not limited to, the
following:
XXXXX
(c) Subject to the provisions of Rule XXIII on local
health boards and in accordance with the standards and
criteria of the Department of Health (DOH), provision of
health services through:

(1) Implementation of programs and projects on primary

health care, maternal and child care, and
communicable and non-communicable disease
control services;

(2) Access to secondary and tertiary health services;

and

(3) Purchase of medicines, medical supplies, and

equipment needed to carry out the devolved health
services.

(d) Provision of social welfare services through:

(1) Programs and projects for the welfare of the youth
and children, family and community, women, the elderly,
and the disabled;

(2) Community-based rehabilitation programs for

vagrants, beggars, street children, scavengers, juvenile
delinquents, and victims of drug abuse;
(3) Livelihood and other pro-poor projects;

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 (4) Nutrition services; and

(5) Family planning services.

Apparently, the Local Government Code provides that the provisions of

the basic health services are the responsibility of the local government

units and not of the national government through the Department of

Health.

Local Government Units are to craft and implement their own health

agenda “in accordance with the standards and criteria of the Department

of Health (DOH)” as the above-cited rule so provides.

Given the situation, coordination with the Department of Interior and

Local Government would be sound intervention to compel the Local

Government Units to provide the required basic health services as

mandated by the law.

This is precisely what the national government has done following the

actions of Mayor Francisco Dumagoso in ridding the streets of Manila of

illegal vendors and structures occupying the sidewalks and even part of

the roads which for so long a time has plagued the nation’s capital.

The national government through the Department of Interior and Local

Government mandated all local government units to clear all sidewalks

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of any and all forms of obstructions so pedestrians could avail the use of

these sidewalks providing a timeline for compliance. Local chief

executives who fail to comply with order given by the local government

unit would be sanctioned.

Local government units have no other recourse but to comply and the

Filipinos are happy except for those who were deprived of their

livelihoods.

This is also what the Department of Tourism and Department of

Environment and Natural Resources did in the Boracay issue where

there was a total disregard of national policies and law as regards the

conduct of tourism activities in the island devastating nature and the

tourism industry.

Through the Department of Interior and Local Government, erring local

officials who have failed to comply with the national policies on the

environment and tourism were castigated and were charged by the

Department of Interior and Local Government.

What the author seeks to emphasize is that a doctor’s view on this

matter is severely limited considering they were not trained for such

situations. Always the approach is a doctor treating a patient and not the

national-scale approach by utilizing inter-government authority to exact

compliance to the national policies.

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In like manner, the Director IV of the Health Human Resource

Development Bureau (HHRDB) is headed by a doctor. Why not hire

Human Resources Practitioners? Just because doctors, nurses, medical

technologist and other health-related human resources are being hired

that it justifies that the head of the Bureau should be a doctor.

Every HR practitioner would declare that the there is more to human

resources activities than just simply hiring and firing. On the matters of

job rotation, job enrichment, career pathing, human resources

investment, and like, are matters unheard of in medical school and

medical literature. The author is of the opinion that doctors are

incompetent to discharge the function.

In the article The 12 Key Functions of Human Resources 4, it says:

HR has a number of important functions in the organization.

These include recruitment, performance management, learning

and development, and many more. In this article, we will

explain the 12 key functions of HR.

But first, a definition. If we want to understand the functions of

Human Resources, we need to understand what Human

Resource Management (HRM) is.

4
https://www.digitalhrtech.com/human-resources-functions/

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 According to Storey (1995), HRM is a distinctive approach to

employment management which seeks to achieve competitive

advantage through the strategic deployment of a highly

committed and capable workforce, using an integrated array of

cultural, structural and personnel techniques.

In this article, we will go over the 12 functions of Human

Resources and explain how they help move the organization

forward. These functions are:

Human resource planning

Recruitment and selection

Performance management

Learning and development

Career planning

Function evaluation

Rewards

Industrial relations

Employee participation and communication

Health and safety

Personal wellbeing

Administrative responsibilities

In another article by Hassan Mohamed Elarabi and Fuadah Johari of the

Faculty of Economics and Muamalat, Universiti Sains Islam Malaysia

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(USIM), Negeri Sembilan, Malaysia, entitled The Impact of Human

Resources Management on Healthcare Quality5, they say that Human

Resource Management (HRM) includes all the functional area of

management such as production management, financial management,

and marketing management.

That is every manager from top to bottom, working in any department

has to perform the personnel functions. HRM functions (also called

processes) are carried out by the HR managers to fulfill the goals and

objectives of the organization.

As illustrated in Figure-1, they perform two sets of functions, namely

managerial functions and operative functions. The managerial functions

are the basic functions performed by the HR managers in their capacity

as managers or heads of their own departments. In fact, all managers,

irrespective of their departments, perform these functions. The operative

functions, on the other hand, are specialized activities performed

exclusively by the HR managers, usually for all the departments.

We shall first discuss the managerial functions.

Figure 1. Functions of HRM

5
Functions of HRM
http://www.ajmse.leena-luna.co.jp/AJMSEPDFs/Vol.3(1)/AJMSE2014(3.1-02).pdf

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 Functions of HRM Functions of HRM

 Planning  Procurement
 Organizing  Development
 Staffing  Compensation
 Directing  Maintenance and
 Controlling Motivation
 Industrial relations

Mathis (2006) states that the organization should use human resource

management input in the following organizational functions:

i. Establishment of a legal and ethical management system

ii. Job analysis and job design

iii. Recruitment and selection

iv. Healthcare career opportunities

v. Distribution of employee benefits

vi. Employee motivation

vii. Negotiations with organized labor

viii. Employee terminations

ix. Determination of emerging and future trends in health care

x. Strategic planning

While, McKinnies (2012) concluded that HRM comprises five broad

functions, which are:

i. Resourcing: Activities include HR planning, talent

management, succession planning and ending the

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 employment contract (including managing retirement and

redundancy).

ii. Performance: Managing individual and team performance

and the contribution of workers to the achievement of

organizational goals, for example, through goal-setting and

appraisals.

iii. Reward system: Designing and implementing reward

systems covering individual and collective, financial and non-

financial rewards, including pay structures, parks and

pensions.

iv. Learning and Development: Identifying individual, team and

organizational development requirements and designing,

implementing and evaluating training and development

interventions.

v. Employment relations: Managing employees,

communication, handling union management relations,

managing employee welfare and handling employee

grievance and discipline.

Given the above functions, would doctors be keen in undertaking the

said functions knowing fully well they are not adequately equipped to

discharge the same?

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In another article underscoring the importance of HR Practitioners in the

healthcare industry written by Alejandro Russell6, he states:

Human Resource, or HR, managers oversee employee

administrative affairs in an organization. Statistics from the

U.S. Bureau of Labor Statistics reveal that as of 2016 there

were 136,100 HR managers in America. The benefits of a

HR department have gradually gained recognition in

health care, owing to such challenges as economic

instabilities, health care regulations and a dearth of

experienced personnel. The American Society for

Healthcare Human Resources says that the presence of a

HR manager in a health care facility is essential in

delivering effective services. (Italics supplied)

Basically the articles featured above highlights what the Human

Resources should do and how important it is that they perform their

functions. Are the doctors who head the Health and Human Resources

Development Bureau in the Department of Health cognizant of this

functions? Do they understand this functions?

Then there is the Health Facilities Standards and Regulatory Bureau

which is currently headed by a lawyer with the rank of Director IV in the

Central Office.

6
https://work.chron.com/role-hr-manager-health-care-19031.html

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The Bureau’s primary mandate is to craft standards and requirements for

the operation of health facilities. The bureau conducts regular inspection

activities on regulated health facilities to ensure its compliance to the

standards and requirements according to the category and classification

of the health facilities.

The health facilities continuing compliance to the standards and

requirements set forth by these Bureau is a condition for the health

facilities to keep the licenses to operate issued to them. Otherwise, the

failure to maintain this continued compliance shall warrant the imposition

of penalties and to a certain degree, revocation of the license to operate

resulting to the closure of the health facility.

However, the regional counterparts of this Bureau which is the

Regulations, Licensing and Enforcement Division under the supervision

of the Regional Director are headed by doctors. Of the seventeen

regions, only two are headed by lawyers.

As such, it is very apparent during regional meets and dialogues of the

different health facilities that the regions headed by lawyers are referred

to as “very strict regions”.

It is the same situation during discussions and deliberations of the

regional office of the Department of Health that the highest rates of

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compliances to the regulatory and licensing standards as with these two

regions.

In like manner, the highest rates of health facilities that have been

penalized and/or closed are also with these two regions.

We cannot discount the fact that doctors do not understand the basic

principles of the inherent powers of the State, interpreting provisions of

laws and statutes, the principles of exhaustion of administrative

remedies, the imposition of penalties and a whole lot more.

The very essence of the Department of Health’s regulatory arm is to

protect and promote the welfare, interest and safety of the Filipino are

ensured through the licenses to operate issued to these facilities.

This regulatory arm therefore exercises the police power of the State to

promote the general welfare and not the ordinary power vested in the

Philippine National Police as understood by ordinary men.

In the case of Philippine Association of Service Exporters, Inc. versus

the Hon. Franklin M. Drilon as Secretary of Labor and Employment, and

Tomas D. Achacoso, as Administrator of the Philippine Overseas

Employment Administration, the Supreme Court has the occasion to

define the police power of the State as follows:

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 It has been defined as the "state authority to enact legislation

that may interfere with personal liberty or property in order to

promote the general welfare." As defined, it consists of (1) an

imposition of restraint upon liberty or property, (2) in order to

foster the common good. It is not capable of an exact definition

but has been, purposely, veiled in general terms to underscore

its all-comprehensive embrace.

"The police power of the State ... is a power coextensive with

self- protection, and it is not inaptly termed the "law of

overwhelming necessity." It may be said to be that inherent

and plenary power in the State which enables it to prohibit all

things hurtful to the comfort, safety, and welfare of society."

Pursuant to the definition above, in a number of landmark cases both

local and foreign courts, this inherent power of the State was ruled to be

valid to the point of depriving certain individuals of their liberty if only to

curtail the spread of a contagious disease as in the case of Lorenzo

versus the Director of Health where the Supreme Court ruled that:

Thus, to contain the spread of leprosy in the interest of

public health, the leper may be confined in a leprosarium

where he will not contaminate other member of the society.

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In upholding the legality of the Generics Law which required doctors to

prescribe using the generics formula or the active ingredient of every

drug, which is the case of Del Rosario versus Bengzon, the Supreme

Court said:

The purpose of the Generics Act is to carry out the

policy of the State to “promote and require the use

of the generic drug products that are theoretically

equivalent to their brand name counterparts for the

therapeutic effect of a drug does not depend on its brand

but on the active ingredient which it contains. The

medicine that cures is the active ingredient and not the

brand name by which it has been baptized by the

manufacturer.

Understanding the broad and basically unlimited application of the police

powers of the State with regard to the regulation of health facilities is not

an easy task.

It is an undertaking requiring the understanding of the law and how it is

to be read and applied taking into consideration all other concepts and

precepts.

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Then in the implementation of the law and application of penalties should

it be so warranted, another constitutionally protected right has to be

observed: due process.

In the case of Carlos R. Saunar versus Executive Secretary Eduardo R.

Ermita and Constancia P. De Guzman, Chairperson of the Presidential

Anti-Graft Commission, the High Court said:

To reiterate, due process is a malleable concept anchored

on fairness and equity. The due process requirement

before administrative bodies are not as strict compared to

judicial tribunals in that it suffices that a party is given a

reasonable opportunity to be heard. Nevertheless, such

"reasonable opportunity" should not be confined to the

mere submission of position papers and/or affidavits and

the parties must be given the opportunity to examine the

witnesses against them. The right to a hearing is a right

which may be invoked by the parties to thresh out

substantial factual issues. It becomes even more

imperative when the rules itself of the administrative body

provides for one. While the absence of a formal hearing

does not necessarily result in the deprivation of due

process, it should be acceptable only when the party does

not invoke the said right or waives the same.

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The landmark case of Ang Tibay v. The Court of Industrial

Relations,24 the Court eruditely expounded on the concept of due

process in administrative proceedings, to wit:

The fact, however, that the Court of Industrial Relations may

be said to be free from the rigidity of certain procedural

requirements does not mean that it can, in justiciable cases

coming before it, entirely ignore or disregard the fundamental

and essential requirements of due process in trials and

investigations of an administrative character. There are

cardinal primary rights which must be respected even in

proceedings of this character:

(1) The first of these rights is the right to a hearing, which

includes the right of the party interested or affected to present

his own case and submit evidence in support thereof.

(2) Not only must the party be given an opportunity to present

his case and to adduce evidence tending to establish the

rights which he asserts but the tribunal must consider the

evidence presented.

(3) While the duty to deliberate does not impose the obligation to

decide right, it does imply a necessity which cannot be

disregarded, namely, that of having something to support its

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 decision. A decision with absolutely nothing to support it is a

nullity, a place when directly attached.

(4) Not only must there be some evidence to support a finding or

conclusion, but the evidence must be "substantial."

"Substantial evidence is more than a mere scintilla It means

such relevant evidence as a reasonable mind might accept

as adequate to support a conclusion."

(5) The decision must be rendered on the evidence presented at

the hearing, or at least contained in the record and disclosed

to the parties affected.

(6) The Court of Industrial Relations or any of its judges,

therefore, must act on its or his own independent

consideration of the law and facts of the controversy, and not

simply accept the views of a subordinate in arriving at a

decision.

(7) In all controversial questions, render its decision in such a

manner that the parties to the proceeding can know the

various issues involved, and the reasons for the decisions

rendered.

For lawyers, the essence of due process is a basic tenet in each and

every proceeding. Compliance to this constitutionally protected right is

indispensable. Lawyers were educated and trained for these purposes

such as a doctor is schooled and guided to treat and manage diseases

and injury.
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Are doctors then in the right courtyard when the said same pertains to

regulation, licensing and enforcement?

V. CONCLUSION.

In the first two articles featured in this write-up, the authors are of the

belief that there is no other profession more equipped than doctors in

matters of health and healthcare governance.

This position is maintained by these authors based on the fact that there

is “peer-to-peer credibility”, that “when an outstanding physician heads a

major hospital, it signals that they have “walked the walk,” and thus have

earned credibility and insights into the needs of their fellow physicians”,

“a boss who is an expert in the core business is associated with high

levels of employee job satisfaction and low intentions of quitting.

Similarly, physician-leaders may know how to raise the job satisfaction of

other clinicians, thereby contributing to enhanced organizational

performance” and all other similar reasons are factors to be considered.

But these are not the only factors to be considered. These authors

themselves admit that the “boss” who knows the job, walked the walk is

associated with high levels of job satisfaction and enhanced

organizational performance.

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Based on this premise therefore, would it not be more prudent and logical

that the Procurement and Logistics Management Team of the Department

of Health should be headed by a person whose education, training and

expertise belong to this discipline? Right now it is also headed by a

doctor.

In like manner, the Health Regulation Team is also headed by a doctor.

Would it not be in better hands if a lawyer is at the helm. Would it not be

better if an accountant or financial manager be at the head of the Finance

and Administrative Team.

The list can go on but bottom line would it not be prudent and wise to put

people in their appropriate places based on competencies? Maybe in so

doing, the Department of Health would be more responsive to their

mandate with doctors focusing on the technicalities medical in nature and

all other profession focusing on the non-medical profession.

To the authors mind, the reason why the present administration has

deviated from the usual tradition of appointing individuals not necessarily

belonging to the bureaucracy or those related by profession is that, it has

taken into consideration the leadership and management skills of these

individuals in enhancing agency performance.

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Should this be the case, therefore the possibility of appointing a non-

doctor in the Health Department is a great possibility together with the

appointing of non-doctors at the regional offices and hospitals as

obviously they do not practice their craft is this positions but perform

managerial functions to get the organization going.

We take the above cue from the well-managed private hospitals where

medical directors are there to attend to the day to day concerns but the

actual policy makers and decision-makers are the board of directors most

of whom are not doctors.

A above-discussions are radical points to consider in the proposed

paradigm shift.

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