73.
Tondo Medical Center Employees Association vs Court of Appeals
GR number 167324 July 17, 2007
FACTS: DOH launched the Health Sector Reform Agenda. It provided for five general areas of
reform: (1) to provide fiscal autonomy to government hospitals; (2) secure funding for priority public
health programs; (3) promote the development of local health systems and ensure its effective
performance; (4) strengthen the capacities of health regulatory agencies; and (5) expand the
coverage of the National Health Insurance Program (NHIP).
Petitioners questioned the first reform agenda involving the fiscal autonomy of government hospitals,
particularly the collection of socialized user fees and the corporate restructuring of government
hospitals. Government hospitals must be allowed to collect socialized user fees so they can reduce
the dependence on direct subsidies from the government. Their critical capacities like diagnostic
equipment, laboratory facilities and medical staff capability must be upgraded to effectively exercise
fiscal autonomy. Such investment must be cognizant of complimentary capacity provided by public-
private networks. Moreover such capacities will allow government hospitals to supplement priority
public health programs. Appropriate institutional arrangement must be introduced such as allowing
them autonomy towards converting them into government corporations without compromising their
social responsibilities. As a result, government hospitals are expected to be more competitive and
responsive to health needs.
Petitioners also assailed the issuance of a draft administrative order issued by the DOH, entitled
"Guidelines and Procedure in the Implementation of the Corporate Restructuring of Selected DOH
Hospitals to Achieve Fiscal Autonomy, and Managerial Flexibility to Start by January 2001; and
Administrative Order No. 172 of the DOH, entitled "Policies and Guidelines on the Private Practice of
Medical and Paramedical Professionals in Government Health Facilities, for imposing an added
burden to indigent Filipinos, who cannot afford to pay for medicine and medical services.
Petitioners alleged that the implementation of the aforementioned reforms had resulted in making
free medicine and free medical services inaccessible to economically disadvantaged Filipinos. Thus,
they alleged that the HSRA is void for being in violation of the constitutional provisions in Article 3
Section 1, Article 2 Section 5, Article 2 Section 9 to 11, Article 2 Section 13, Article 2 Section 18,
Article 15 Section 1, Article 15 Section 3, Article 13 Section 14, Article 2 Section 15 and Article 13
Section 11.
President Joseph Ejercito Estrada issued Executive Order No. 102, entitled "Redirecting the
Functions and Operations of the Department of Health," which provided for the changes in the roles,
functions, and organizational processes of the DOH. Under the assailed executive order, the DOH
refocused its mandate from being the sole provider of health services to being a provider of specific
health services and technical assistance, as a result of the devolution of basic services to local
government units.
Executive Order No. 102 was enacted pursuant to Section 17 of the Local Government Code
(Republic Act No. 7160), which provided for the devolution to the local government units of basic
services and facilities, as well as specific health-related functions and responsibilities.
Petitioners contended that a law, such as Executive Order No. 102, which effects the reorganization
of the DOH, should be enacted by Congress in the exercise of its legislative function. They argued
that Executive Order No. 102 is void, having been issued in excess of the President’s authority.
ISSUE: 1) Whether or not HSRA is void for violating Sections 5, 9, 10, 11, 13, 15, 18 of Article
II; Section 1 of Article III; Sections 11 and 14 of Article XIII; and Sections 1 and 3(2) of Article
XV, all of the 1987 Constitution, which directly or indirectly pertain to the duty of the State to
protect and promote the people’s right to health and well-being.
2) Whether or not the President was empowered to issue Executive Order No. 102.
RULING: 1) NO.
The aforementioned provisions of the Constitution are not self-executing; they are not judicially
enforceable constitutional rights and can only provide guidelines for legislation. These provisions,
which merely lay down a general principle, are distinguished from other constitutional provisions as
non self-executing and, therefore, cannot give rise to a cause of action in the courts.
They failed to substantiate how these constitutional guarantees were breached, petitioners are
unsuccessful in establishing the relevance of this provision to the petition, and consequently, in
annulling the HSRA.
The HSRA cannot be nullified based solely on petitioners’ bare allegations that it violates the general
principles expressed in the non self-executing provisions they cite herein. There are two reasons for
denying a cause of action to an alleged infringement of broad constitutional principles: basic
considerations of due process and the limitations of judicial power.
2) YES.
The President may, by executive or administrative order, direct the reorganization of government
entities under the Executive Department. This is also sanctioned under the Constitution, as well as
other statutes. Section 17, Article VII of the 1987 Constitution, clearly states: "The president shall
have control of all executive departments, bureaus and offices."
Furthermore, the DOH is among the cabinet-level departments enumerated under Book IV of the
Administrative Code, mainly tasked with the functional distribution of the work of the
President. Indubitably, the DOH is an agency which is under the supervision and control of the
President and, thus, part of the Office of the President. Consequently, Section 31, Book III, Chapter
10 of the Administrative Code, granting the President the continued authority to reorganize the Office
of the President, extends to the DOH.
Clearly, Executive Order No. 102 is well within the constitutional power of the President to issue. The
President did not usurp any legislative prerogative in issuing Executive Order No. 102. It is an
exercise of the President’s constitutional power of control over the executive department, supported
by the provisions of the Administrative Code, recognized by other statutes, and consistently affirmed
by this Court.
Therefore, HSRA and Executive Order 102 are valid.
