The first few years of decentralization of Iloilo hospitals and health care proved too daunting for the provincial government of Iloilo. One of the biggest problems was delivery of health services as the province took over 11 district hospitals and the Iloilo Provincial Hospital. Taking in hundreds of health personnel while offering maintenance and management of the hospitals and health units chewed up a huge amount of the provincial budget, resulting to the depletion of funds for other services and general administration of the Provincial Government.
Before 1991, there was a negative impact from the public regarding the Iloilo provincial hospitals due to insufficient and poor maintenance of the facilities, absence of well-trained medical personnel, and inadequate supplies and other resources. The negative perception remained immediately after decentralization due to further deterioration.
Likewise, the financial assistance of the local government for devolution was primarily intended for personnel expenses and minimal was left for maintenance and operating expenses. Cleanliness and sanitary conditions in provincial hospitals were alarming. Capital outlays were not provided during the first years of decentralization. Only marginal improvements for equipment and facilities were implemented.
The problem of the Iloilo Provincial Government was compounded by the fact that the capacity building of hospital personnel was severely affected and there was no organization for human resource development. The lack of medical personnel to assist the number of patients were insufficient and became worse. The confidence of the public in provincial hospitals deteriorated as well.
The Hospital Operations and Management Service (HOMS) of the Provincial Health Office spearheaded the reorganization of the Iloilo health system. The system was designed to restructure the functional departments of provincial hospitals. Under the new system, hospitals were divided into the following units: Nursing, Clinical, Laboratory, Dietary, Pharmacy, Social Services, and Administrative.
Each of the departments would be tasked to coordinate and manage the provincial hospitals for the purpose of planning, development and management of human resources, operations, and procurement and physical development of both District and Provincial Hospitals. Aside from that, each unit of the HOMS would collaborate with their hospital counterparts in discussing needs and problems, in formulating plans and determining the needed actions to solve problems.
For its part, the HOMS was responsible for clearing problems as well as establishing a link between the hospitals and the Provincial Government while ensuring immediate action regarding the needs and problems of hospital facilities.
With the implementation of the HOMS in 2002, one of its initial moves was to perform a baseline assessment of the conditions of the 11 District Hospitals and the Iloilo Provincial Hospital. The task of assessing the condition of each hospital was provided for as a basic requirement of Administrative Order 70-2 Series of 2002 and Administrative Order 147 Series of 2004 of the Department of Health regarding the implementing rules and regulations of the registration, licensing, and operation of hospitals and other health facilities in the country.
The HOMS Information System served as the benchmark for all other Iloilo hospitals and health care. It established a Data Bank, Hospital Monitoring Tools, and Statistical Report.