An Act Requiring All Provincial Government Hospitals in the Bangsamoro Autonomous Region in Muslim Mindanao to Establish, Maintain and Operate a Dialysis Unit in Their Respective Hospital and Provide Free Dialysis Treatment to Indigent Patients, Appropriating Funds Therefor

This requires all provincial government tertiary hospitals in the region to establish, operate and maintain a dialysis ward or unit within 1 year of effectivity — adequately staffed and equipped with complete dialysis machines, equipment and supplies.

Dialysis is to be free to indigent patients in all provincial tertiary hospitals. Section 5 then sets out what a patient must produce to qualify: an Affidavit of Indigency, and a Certificate of Indigency from the national social welfare department or from the city or municipal social welfare office with jurisdiction over the patient's residence — or a Certificate of Indigency and/or No Income from the office of the Punong Barangay.

The health ministry issues the rules within 90 days, and funding comes from its current appropriations and then the annual appropriations act.

The bill takes the narrowest scope of the 3 dialysis measures and pairs it with the shortest deadline, which is a coherent judgement: provincial tertiary hospitals are the facilities that already have the theatre space, the specialists and the referral load to run a dialysis ward, and requiring it of them within a year is achievable in a way that requiring it of every government hospital is not.

The documentary provisions point to a second concern. Free treatment without a defined eligibility test invites either abuse or arbitrary refusal, and the bill's answer is to name exactly which papers establish indigency and which offices may issue them.

The documentary requirement is the provision to weigh, and it cuts both ways for the patient it is meant to help. Requiring an Affidavit of Indigency plus a certificate from the social welfare office or the barangay chairperson gives a hospital a clear rule and an indigent patient a defence against arbitrary refusal. It also puts 2 pieces of paper between a person in kidney failure and a treatment they need 2 or 3 times a week — an affidavit means finding someone to notarise it, and a certificate means a trip to an office that keeps its own hours. Bill No. 88 takes the other route entirely, having the social services ministry identify indigent patients rather than making them prove it.

The narrowing to provincial tertiary hospitals is this bill's strongest and weakest feature at once. It is realistic: those hospitals have the infrastructure, and a 1-year deadline against a handful of facilities is a deadline that could be met. It also leaves out everybody who cannot reach a provincial capital 3 times a week, which in Sulu and Tawi-Tawi is most of the population — and those are island provinces where the provincial hospital is itself across water from much of the province.

The 1-year deadline against an unnamed budget is the internal contradiction. Equipping and staffing a dialysis ward is a procurement and a recruitment, and 12 months is short for both even with money identified; funded "against the current appropriations of the MOH" it is a deadline the ministry cannot be held to. Of the 3 bills, only Bill No. 145 pairs its requirement with a figure, and it is the 1 that asks for the least.

Three bills in this registry address dialysis and they pick 3 different scales. Bill No. 88, filed by MP Mawallil in October 2022, requires a dialysis unit in every government hospital in the region within 5 years. Bill No. 145, filed by MP Sema in February 2023, builds 1 centre at 1 named hospital with ₱20 million behind it. Bill No. 279, filed by MP Dilangalen in February 2024, requires provincial tertiary hospitals to have a unit within 1 year. All 3 are at Second Reading, Committee Stage, and none has become law.