Written by Aileen Macalintal.

Patricia ‘Patchot’ Manuel, 33, has just finished her 12-hour nursing duty at an Intensive Care Unit (ICU) for babies. Over dinner at a Chinese restaurant in central London, she tells friends how she saves lives: ‘One time, I told this baby, you will breathe tonight, OK?’

If the British are proud of their National Health Service (NHS), Filipino nurses are proud of their brand of caring despite staff shortages, stress and homesickness.

Patchot belongs to England’s more than 10,000 Pinoy nurses who serve the NHS, the United Kingdom’s much-loved healthcare provider. Like ten million other overseas Filipino workers (OFWs), she contributes to roughly 2 billion Philippine pesos (Php) in remittances to the Philippines every month (nearly 67 million Philippine pesos, or 1 million pounds per day).

The British spend 9.9 per cent of GDP on healthcare, which is more than double the Filipinos’ 4.4 per cent, according to the latest World Bank figures. Figures from the United Nations (UN) show that its measly percentage puts the Philippines almost below the ‘least developed countries’ classification. This is ironic, given the billions of pesos in remittances sent by OFWs.

Since 2016, Patchot has been with the University College of London Hospital. There she watches over babies suffering from congenital heart disease, birth trauma and other ailments. Aside from monitoring vital signs and changing nappies, Patchot helps operate technological devices, runs laboratory tests, assists deliveries, and dashes to Accident and Emergency (A&E) units.

How do Pinoy nurses such as Patchot survive the daily grind?

Little worried, Brexit protest walk. Patchot received training to meet the needs of the UK’s newborns and infants.

A home away from home

To survive the demanding work of the NHS, theatre nurse Jovilyn Deuda draws strength from her family. At 34, she is settled in England. She says: ‘I didn’t know I’d like it here. I thought it’d be temporary, but here we go, I started a family here. My kids are Brits, we are Brits, but still Pinoy at heart.’

Deuda has been practising her profession in London at the West Middlesex University Hospital NHS Trust for almost a decade now. The operating room is her stage, her multi-disciplinary team the actors.

NHS Staff as of June 2018. Source: House of Commons Library

Asked how she finds the NHS, Deuda cannot hide her admiration.

She says: ‘One hundred per cent of the British population are health insured. Their health services are fully funded. Socialised health care is the concept. Everybody is treated fairly, rich or poor.’ Unlike in the Philippines.

She continues: ‘The British have a very good referral system from the community setting to acute care and tertiary settings such as hospitals, rehabilitation and social care.’ Unlike in the Philippines.

And again: ‘Work-wise, EU laws have many provisions specifying how many hours people can safely work, and these are strictly observed in the NHS. There should be at least 11 hours rest in between shifts.’ Unlike in the Philippines.

After Brexit, however, many things about the NHS could change.

NHS pains

Deuda, who has worked at Biñan Doctors Hospital in Laguna, is no stranger to healthcare problems. She says: ‘Although we give our best for the NHS, every year demand and pressure rise.’

This, she says, is due to an increasing number of elderly patients, patients with multiple diseases, and managers who demand numerous changes. And like in any other profession, they must keep up with new technologies.

Indeed, the NHS has plenty of its own problems, big and small.

Jane Ungoco, a nurse at King’s College Hospital NHS Trust, says: ‘Sometimes, the NHS is abused. For example: there are drunks or druggies who get admitted and discharged the next day. Some people – they just act sick; give them free coffee or tea at the A&E and they’re fine.’

Homeless people also hang out in the A&E, and at times, the police bring in people who have passed out on the street due to drunkenness, she says.

Despite all this, both nurses find fulfilment in doing their job. Pinoy care is something they are willing to share not only with the British but also with the rest of the world.

Ungoco, who is also in her 30s, has worked in the charity division at the University of Santo Tomas Hospital in Manila and volunteered in Nepal for a year.

A wish for the Philippines

While there is plenty of room for improvement in the NHS, the Philippines can take a page out of the UK health service’s book.

While the NHS finds relative ease in dealing with more than a million patients in England every 36 hours, the Philippines healthcare system seems to be under severe stress.

A source from the Philippine Department of Health (DOH) says: ‘Admittedly, there’s a bigger budget for the Human Resources for Health (HRH) today than before, but it needs more.’

The HRH Programme deploys doctors, nurses and other health professionals to help attain universal healthcare in the Philippines. The DOH also runs the ‘Doctors to the Barrio’ programme, a government scheme which sends medical practitioners to remote provinces.

‘The figures are not sufficient for the programme to provide ideal health services. The government slashed the DOH budget for 2019 from [around] Php 100 billion to Php 70 billion. This will be felt at the bottom. The budget should trickle down to the local government level,’ says the DOH source, who requested not to be named.

Mountain Province barrio (low-income municipality). The farther away from Manila, the less access there is to healthcare.

For Deuda, inequity in Philippine healthcare is real. Private is better than public.

She says: ‘Our government hospitals are severely outdated and underfunded. And there are only a few nurses, doctors and midwives who want to stay in the Philippine health sector, especially public institutions.’

Coming home

Like Deuda, Patchot always thinks about the Philippine healthcare services. Even in conversations with Uber drivers in London, she makes small talk about how the Southeast Asian country should boost its political will to fix its many problems.

During the dinner with her friends, two of them who work for UN organisations murmured something about how they shouldn’t complain about stress in their communication jobs now, after hearing about Patchot’s daily ordeals at the ICU. A bigger source of stress for the Filipino people, however, is the serious lack of quality healthcare for its more than 100 million citizens.

Later on, Patchot says that even though it can be exhausting every day, what keeps her moving is the day she will go back home. Patchot has no baby of her own, but the Philippines will always be her bundle of joy.

Aileen Macalintal specialises in Business & Financial Journalism at City, University of London. She was a faculty member at the Department of Humanities, University of the Philippines Los Baños. Find her on Twitter @aiscracker. Image Credit: Aileen Macalintal. Main Image: Comfort food for the comforter. If not cooking Pinoy food, Patchot can be found at an Asian restaurant after a long shift.

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