National Policy Framework for Medical Travel and Wellness Tourism Program of the Philippines

June 22, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0023

 

I. Rationale

International medical travel and wellness tourism (MTWT) is a potential growth market sector that can propel the Philippines to sustained economic development if developed and managed properly. The medical tourism global market alone has been estimated at US $40 Billion and is projected to grow to US $3 Trillion by this year. Countries all over the world have been aggressive in putting in place the necessary policy framework, infrastructure and human resource requirement to get a slice of this pie.

In terms of medical travel and wellness tourism, the Philippines is notably lagging behind other ASEAN countries. This is evidenced by trade negotiations for which the DOH participates in. Furthermore, there is no comprehensive policy framework or guidelines to regulate this sector.

With the advent of the internet, ease in travel and the country's reputation as providing reasonably priced but high quality medical service in internationally recognized local hospital, it makes for a logical choice for Filipinos to seek advanced medical treatment at home rather than abroad. The Department of Tourism's campaign for domestic tourism has shown an increase in local tourists exploring the country's scenic spots where wellness tourism services are being offered as part of the tour package.

Given the public nature of health services, and the DOH being the agency tasked with overseeing the health of every Filipino, it is imperative therefore for the DOH to design a framework to pursue medical travel and wellness tourism in the context of the country's public health objectives. The Department of Health differs from other tourism programs in the country primarily because of its focus on the improvement of the health care delivery system, ensuring that partner facilities are implementing quality care standards at all times and health regulation which is part of its mandate. The DOH should develop its capabilities to guide, monitor and assess the integration of medical travel and wellness tourism into the Philippine Health System. HTcADC

II. Objectives

A. General Objective

Set the national policy framework for the integration of international medical travel and wellness tourism into the Philippine Health Care System.

B. Specific Objectives

1. Establish the policy framework, both within the Philippine Health System and the broader society, for the integration of medical travel and wellness tourism into the healthcare delivery system.

2. Define the implementing guidelines, roles and responsibilities of stakeholders and strategies in the promotion and integration of medical travel and wellness tourism into the health delivery system.

III. Scope and Coverage

This issuance shall apply to all units of the DOH, including its attached agencies. It shall also apply to local government units, non-governmental organizations, private sector, professional organizations, academic institutions, international organizations and other relevant stakeholders and partners in the integration of medical travel and wellness tourism.

IV. Definition of Terms

A. Medical Travel — a phenomenon characterized by individuals who travel with intent to access or avail medical care at the point of destination due mainly to difficulty in accessing the same service in their point of origin because of various reasons.

B. Wellness Tourism — wellness packages designed for tourists that encompasses a wide variety of models and includes treatment that promotes relaxation, rejuvenation and a sense of pampering. It introduces a philosophy or way of life that is a break from the usual monotony of daily living.

C. Medical Traveler — an individual who travels to another place other than his area of domicile whether a local (domestic) or foreign resident of the country for the purpose of receiving medical care.

D. Medical Tourist — a tourist who gets injured or develops an illness while on vacation and has to seek or will require medical attention.

E. International Patient — an individual who is a non-national visiting or residing in the Philippines who elects to receive or requires health/medical or wellness services while in the country.

F. Philippine Council for Accreditation of Health Care Organization (PCAHO) — is the designated accrediting body for Medical Travel and Wellness Tourism of the DOH.

V. Legal Anchor

Globally, medical travel and wellness tourism is increasingly becoming a big network and health industry. Addressing health service delivery issues and concerns of this growth sector is very much aligned with international and national commitments such as:

• EO 372 s. 2004 — Creating Public Private Partnership Task Force for the development of Globally Competitive Philippine Services Industries

• EO 571 — Creating the Public Private Sector Task Force on Philippine Competitiveness

• General Agreement on Trade in Services (GATS) — a treaty of the World Trade Organization that was created to extend the multilateral trading system to the Services Sector

• RA 7916 Philippine Export Zone Authority Law — Provision of Incentives to Industries in the HealthCare and Wellness Industry Sector

• PEZA Board Resolution # 06-512 — Guidelines for registration of Medical Tourism Special Economic Zones (Medical Park/Center) and Medical Tourism Locator Enterprises under RA 7916

• Omnibus Investment Code of 1987 Memorandum Order No. 20 approving the Investment Priorities Plan of the Board of Investments Department of Trade and Industries identifying HealthCare and Wellness Facilities as one of the Preferred Activities that may be granted fiscal and non-fiscal incentives

VI. Guiding Principles

In addressing medical travel and wellness tourism, the DOH shall adhere to the following principles in keeping with the overall goals of the Philippine health sector:

A. Medical travel and wellness tourism should be a national initiative. This shall be considered a priority program of the national government and not just the DOH for its potential to contribute to the overall Philippine healthcare delivery system and the improvement of the national economy. aScITE

B. Promoting medical travel and wellness tourism is a matter of equity. Society should strive to eliminate inequities between local residents and foreign/domestic medical travelers. The gains that might be attained in this sector may be utilized for the benefit of the less privileged for improving the indigency program of identified participating health facilities.

C. Medical travel and wellness tourism should have a positive impact on the local health system of the country. Medical travel and wellness tourism should have a positive impact on the local healthcare system raising its level to address issues on global competitiveness.

D. Multi sector approach is needed for the implementation of the medical travel and wellness tourism program. The DOH shall foster inter-sectoral collaboration for medical travel and wellness tourism and engage with other government agencies as well as non-governmental organizations, private sector, academic institutions, international organizations and most importantly with the Department of Tourism and Department of Foreign Affairs.

VII. General Guidelines

The following strategies shall be initiated and adopted by the DOH, in collaboration with its partners, in the implementation of this National Policy and in the establishment of the Medical Travel and Wellness Tourism Program of the Philippines:

1. Policy and Planning — Medical travel and wellness tourism shall be included in the development of health policies and plans, whether they are system wide or program specific in scope.

2. Standards Setting & Regulation — Standards and regulations that are deemed necessary for health related services that are essential to the medical travel and wellness tourism program shall be developed.

3. Research — Evidence-based policy formulation and program evaluation shall be conducted and/or commissioned to examine the gaps and challenges encountered in the integration of medical travel and wellness tourism in the health service delivery system and network of the DOH.

4. Service Delivery — Health services shall be provided at hospitals, ambulatory surgical clinics and other health facilities that are identified as partner facilities of the program.

5. Promotion & Advocacy — Communication interventions shall be developed to promote medical travel and wellness tourism and raise awareness about and influence action across society.

6. Capacity Building — Existing programs and services that cater to medical travelers and wellness tourism shall be strengthened through training of health human resources, development of operational guidelines and upgrading of health facilities.

7. Knowledge Management & Surveillance System — Knowledge management and surveillance systems for generating reliable, relevant and up-to-date data essential for mounting timely and effective response to challenges in the medical travel and wellness tourism industry shall be established.

8. Resource Mobilization & Financing — Generation and allocation of resources from within the health sector and guaranteeing their equitable distribution for the effective implementation of medical travel health policies and programs and also seeking additional resources from other stakeholders to support efforts in promoting wellness tourism and medical travel shall be promoted.

9. Networking & Partnership Building — Engagement with other agencies and organizations, whether government, non-government or private shall be encouraged in order to influence other sectoral policies and programs and mount collaborative responses to major health issues in medical travel and wellness tourism.

10. Monitoring & Evaluation — Identify a commonly agreed set of indicators and conduct regular monitoring of progress of the program's implementation and evaluate outcomes and impact of medical travel and wellness tourism as well as documenting and sharing of good practices and lessons learned shall be regularly conducted.

VIII. Specific Guidelines

The DOH shall establish a medical travel and wellness tourism management unit which shall oversee the implementation of this policy.

1. Medical Travel and Wellness Tourism Program Management Unit.

The functions of this unit are as follows:

a. Serve as the focal point in the DOH for all issues related to medical travel and wellness tourism.

b. Lead in the coordination and collaboration with other DOH bureaus, offices and attached agencies, as well as other relevant government and non-government agencies, to operationalize the aforementioned strategies in addressing medical travel and wellness tourism issues.

c. Foster collaboration locally, nationally and internationally on medical travel and wellness tourism related activities and projects. HEITAD

d. Provide relevant updates and inputs to the Office of the Secretary.

e. Monitor developments in medical travel sector and wellness tourism industry as well as the broader aspect of trade in health.

2. Budget

Funding requirement shall be taken from the available fund of the Office of the Secretary. Budget allocated for the program shall be managed by the Office of the Undersecretary or Assistant Secretary designated by the Secretary of Health to oversee the program.

IX. Roles and Responsibilities

A. DOH Central Office

1. Bureau of International Health Cooperation

a. Review and develop policies on Trade in Health that includes mode 2 of supply (consumption abroad).

b. Ensure inclusion of Medical Travel and Wellness Tourism during Planning activities of the Bureau.

c. Closely coordinate with relevant stakeholders in utilizing the inter-sectoral approach to Medical Travel and Wellness Tourism and in strengthening diplomatic relations and trade negotiations with other countries for the implementation of the same.

d. Facilitate international cooperation on Medical Travel and Wellness Tourism with neighboring countries especially in the ASEAN and Asia-Pacific Region.

2. Health Policy Development and Planning Bureau

a. Assist in the development of policies, standards, protocols and guidelines relevant to Medical Travel and Wellness Tourism.

b. Support evidence based research on Medical Travel and Wellness Tourism for policy development.

c. Facilitate the inclusion of Medical Travel and Wellness Tourism in the Department's legislative agenda.

3. Health Facility Development Bureau

a. Assist in the identification of health facilities for repair and improvement in heavy tourist traffic areas of the country.

b. Assist in the development a health facility mapping system for Medical Travel and Wellness Tourism.

4. Health Facilities and Services Regulatory Bureau

a. Regulate the activities and operations of all clinics, sanitaria, TRC, Health Centers, Hospitals which offers health services to clients of Medical Travel and Wellness Tourism.

b. Provide relevant reports on adverse events/incidents occurring in these facilities.

5. Health Promotion and Communication Service

a. Provide technical assistance in the promotion of identified relevant health campaigns that are applicable to both private and public sector.

b. Promote the development of marketing programs for the country's health and wellness industry.

6. Knowledge Management Information Technology Service

a. Provide technical assistance pertaining to information and communication technology and management in the medical travel and wellness industry.

b. Assist the program in the development of an international medical travel reporting system that can capture industry statistics for evidence based planning and improved policy formulation.

7. Disease Prevention and Control Bureau

a. Develop timely, doable, appropriate, evidence-based policies and guidelines on the recognition, treatment, prevention and control of diseases that are consistent with recommendations from recognized international health bodies and authorities.

b. Provide technical guidelines or public health recommendations for the improvement of health service delivery and quality healthcare in health facilities, both government and private sector, with focus on primary level of prevention.

8. Legal Service

a. Provide technical assistance pertaining to legal matters in the medical travel and wellness industry sector.

b. Assist in the review of documents that are being processed by the MTWT program management unit particularly those requesting for favorable endorsements to investment promotions agencies.

9. Bureau of Quarantine

a. Develop and ensure compliance to protocols as defined in RA 9271 on entry/exit management of persons with airport and port authorities. ATICcS

b. Monitor public health threat in other countries and provide technical information and recommendations pertaining to medical travel, health and wellness tourism.

c. Provide effective networking and collaboration among BOQ stakeholders.

All other offices in the central office shall be called upon and mobilized to assist in the implementation of the Medical Travel and Wellness Tourism Program according to their respective mandates and scope of responsibility.

B. DOH Attached Agencies

1. Philippine Health Insurance Corporation

a. Through its Overseas Filipino Program, ensure the enrollment of all overseas Filipinos and their families into the NHIP in order to provide financial risk Protection.

b. Design benefit packages (short term insurance packages) that cater to the health needs of visiting expats and foreign nationals who will be staying in the country for a specific period of time.

c. Explore insurance portability with international health insurance providers and health maintenance organizations.

2. Philippine Institute for Traditional and Alternative Health Care

a. Provide technical recommendation on WHO-accepted and recognized traditional and alternative health care practices and guidelines relevant to medical travel, health and wellness tourism.

b. Promote indigenous traditional and alternative health care practices and modalities as part of the Medical Travel and Wellness Tourism Program.

C. DOH Regional Offices

a. Facilitate provision of health services that comply with standards and requirements set by the Medical Travel and Wellness Tourism Unit, through regional hospitals and other health facilities in their catchment areas.

b. Support the implementation of Medical Travel and Wellness Tourism Program in their region.

c. Identify a point person for Medical Travel and Wellness Tourism Program in the regional office who shall oversee the implementation of the program in the region.

d. Conduct education and promotion activities on Medical Travel and Wellness Tourism for staff and clients.

D. DOH-Retained Hospitals

a. Provide health services to non-nationals who are in need of emergency care and refer them to their foreign embassies as the need arises.

b. Support the implementation of Medical Travel and Wellness Tourism Program in their respective hospitals.

c. Refer to other MTWT implementing hospitals within their immediate jurisdiction.

E. Local Government Units — especially in tourist destinations or those with heavy tourist traffic shall:

a. Provide health services that comply with standards and requirements set by the DOH Medical Travel and Wellness Tourism Program.

b. Provide communication and transport facilities/system of referral for cases of emergent situations involving medical tourists/medical travels.

c. Conduct promotional and advocacy (information/education) campaigns on medical travel and wellness tourism.

F. Other Government Agencies, Non-Government Organizations, Academia, Civil Society Organizations and Private Sector Forming Part of the Technical Working Group on Medical Travel and Wellness Tourism shall:

a. Identify focal points to ensure smooth and orderly coordination with the DOH Medical Travel and Wellness Tourism Unit;

b. Advocate for medical travel and wellness tourism in their respective organizations;

c. Support the DOH Medical Travel and Wellness Tourism Unit, its policies, programs and activities;

d. Coordinate with the MTWT Program which facilities have undergone local and/or international accreditation for inclusion as partner facilities;

e. Assist in the continuous updating of the list of accredited health care providers for professionals and institutions recognized by the program for inclusion in the promotion and marketing of these facilities for international buyers;

f. Coordinate with the DOH to insure coherence between the DOH Medical Travel and Wellness Tourism Program and their respective programs and policies; AND TIADCc

g. Conduct promotional and advocacy (information/education) campaigns on medical travel and wellness tourism.

VII.  n Separability Clause

In the event that any provision or part of this Order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected by such declaration or ruling shall remain valid and in effect.

IX. Repealing Clause

Previous issuances and other related orders (AO 2009-0015) that are inconsistent or contrary to this order are hereby amended and repealed accordingly.

X. Effectivity

This Order shall take effect fifteen (15) days after publication in an official gazette or a newspaper of general circulation.

(SGD.) JANETTE P. LORETO-GARIN, MD, MBA-HSecretary of Health

n Note from the Publisher: Copied verbatim from the official copy. Irregular numerical sequence.