September 08, 2006

Digging deeper into the leakage

By Carol Pagaduan-Araullo

Digging deeper into the leakage

As a medical student learns early on, signs and symptoms are mere indicators of an underlying illness; real cure comes from diagnosing and treating the disease, not just mitigating its manifestations. The concept is not difficult for even the layman to understand since it is grounded on the truism that problem solving requires digging deep at the root causes if a genuine solution is to be found.

Why then the seeming inability, or perhaps unwillingness, of government to see beyond the current scandal of the nursing board exam leakage? Is this just another case of unscrupulous government officials colluding with profiteering owners of nursing schools and review centers to allow unqualified examinees to cheat their way to their licenses? Or is there something more here than meets the eye?

The magnitude of the problem is laid bare by the following: the filing of charges against two examiners from the Board of Nursing (BON) of the Professional Regulation Commission (PRC); the forced resignation of the President and Vice-President of the Philippine Nurses Association implicated in the leakage and its cover-up; and the alleged involvement of scores of nursing schools and review centers in disseminating the leaked exam questions to their students. There are worrisome signs that cheating has become systematized and a criminal syndicate in cahoots with government officials is on the loose.

Worse, the PRC, relying on the BON findings instead of creating an independent investigative body, initially denied any possibility of a leakage with the assertion that the examination system “has been so streamlined that leakages are now a thing of the past.”
When it could no longer sweep the problem under the rug it admitted the leakage and pinpointed responsibility to just two of its examiners.

Now the PRC appears to have taken the unprincipled tack of minimizing the impact of the leakage on the integrity of the examinations. The PRC cited some statistical manipulations that they claim “solved” the problem and hastily administered the nursing oath to those they certified to have passed (until a court restraining order stopped the oath taking). They stood pat on the position that there was no need for a retake of the examinations by any of the examinees, including those who reviewed with the R.A.Gapuz Review Center (RAGRC), a center that witnesses claim distributed answers to exam questions the night before the June 11 board examinations. Not surprisingly, RAGRC now boasts of having bagged the 3rd to 10th place in the exams.

From news reports, the PRC even brought in supposedly well-placed labor recruiters who assured the examinees that they would still be eligible for placement in US hospitals despite the controversy surrounding their licensure exams. It appeared to be a calculated move to counter reports that local as well as foreign hospitals had indicated they would refuse to hire nurses from batch 2006.

Meanwhile Malacañang has chosen to uphold the PRC position hook, line and sinker. While vowing to go after those responsible for the leakage, it immediately exonerated the PRC itself of any responsibility and peremptorily declared that the nursing leakage was more of an exception rather than the rule. Mrs. Arroyo even praised PRC Chair Leonor Rosero, her personal dentist whose husband is a close friend and fellow Rotarian of the First Gentleman, for doing a great job. She also took the “no retake” position popular with the examinees in what seemed to be a classic GMA trick of pandering to the crowd when no major personal or political stakes are involved.

There is no indication that the Arroyo administration sees the current brouhaha as a reason, or even an occasion, to seriously study what ails the nursing sector. Consider that nurses (as well as doctors-turned-nurses) continue to be one of our top exports as a labor exporting country . The alarm has been raised by the World Health Organization that the Philippines faces the prospect of a major crisis in its health care system with the exodus of health personnel for more lucrative jobs abroad.

Is it so difficult to see that the scandalous extent and circumstances of the recent board exam leakage is in direct proportion to the degree of commercialization of nursing education as exemplified by the proliferation of substandard nursing schools churning out unqualified, if not incompetent, graduates? Shall we be content with merely calling for better regulation by the PRC and by the Commission on Higher Education?

Shall we not examine what fuels this soaring demand for a nursing diploma and license to practice the nursing profession that provides fertile ground for all sorts of corrupt scams victimizing students, their parents and future patients at that?

Certainly it is not a sudden surge of humanitarianism, of people wanting to care for the sick and infirm. On purely economic terms, the demand is fed by the desire to go abroad and earn a decent income that can provide a comfortable life and a secure future for one’s family.

Such a modest, middle class dream is no longer possible for the vast majority in the Philippine setting. What everybody seems to know is that the passport out of the Philippine Rut into the American Dream is indeed that nursing license.

Rather than address the endemic problem of unemployment and underemployment, successive governments from Marcos to the present have pursued a short-sighted policy of exporting labor. From a stop-gap measure, the export of Overseas Filipino Workers (OFWs) has evolved to become the major dollar-earner and life-saver of a chronically floundering economy with roughly eight million OFWs, a tenth of the population, remitting US $10 Billion last year.

Thus the demand for nurses in the US and UK has become the main driving force shaping the development of nursing education and the profession today. Not the needs and requirements of a highly underserved people in the throes of hunger, malnutrition and preventable diseases.

When government cannot see beyond dollar remittances and will do anything and everything to keep them coming, it will turn a blind eye to the deepening crisis of the Philippine health care system; it will paper over the festering problems in nursing education and the nursing profession that the recent leakage scandal has so glaringly exposed.

With provincial and even major urban hospitals scrambling to stay open despite the steady loss of its doctors and nurses, the future is bleak while government policies remain unchanged. Needless to say, the long and short of it is that the majority of our people end up, once more, on the losing end.#


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