The principles and practice of devolution : reform of health services in the Philippines : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Resource and Environmental Planning at Massey University

Abstract

1992 saw radical reform to local government in the Philippines through enactment of a new Local Government Code. This provided for the devolution of powers, resources and service functions from central government to local government. The process of devolution is now in its third year. This study has been undertaken as a preliminary assessment of the factors that influenced implementation of devolution in the health services, its impacts and its effectiveness. The study is based mainly on survey techniques. Face-to-face interviews were undertaken with policy makers to establish motivations underlying devolution, what they believe has been achieved, and what they think promote or impede implementation. Face-to-face interviews were also undertaken with key local officials to identify the health services and functions transferred from central to municipal governments, and to identify the degree of discretion these people now have in policy formulation, implementation, monitoring, and evaluation, and in fiscal and personnel matters. An opinion survey was administered to assess the perceptions of key players in the management of decentralised responsibility (elected officials, transferred health personnel, and advisory board members) to determine their views of the objectives, the factors that promoted or impeded devolution, and changes in the way things are done as a consequence. It was concluded that devolution is moving towards local autonomy as intended. The necessary structural changes have been met. Local government responsibilities, resources, and authority have increased, and public participation in local government has been institutionalised. Substantial benefits have been realised particularly in terms of local self-reliance, participation, and competence development. Devolution has also been effective in changing people's behaviour. The results indicate that the key to successful devolution and to decentralised responsibility is the nature of local leadership and local commitment.