Renzo Guinto, Planetary Health Specialist
Director, Planetary and Global Health Programme
St Luke’s Medical Centre College of Medicine (Philippines)
Can you introduce yourself briefly and share your connection to patient engagement?
Renzo: I’m Renzo Guinto, a physician by training, and am the inaugural director of the new planetary and global health programme of the St Luke’s Medical Centre College of Medicine in the Philippines. The St Luke’s Medical Centre has been in existence for more than a century and it’s one of the country’s leading private hospitals and academic medical centres. We have a medical school which has been existing for more than a quarter of a century and patient centeredness is really central to both the hospital and in medical education. We emphasise the importance of truly working collaboratively with patients and overcoming the divides and hierarchies between providers and patients. I work in planetary health which refers to the health of human civilisation and the state of the natural systems on which it depends.
From your perspective, as a planetary health doctor and working in an academic medical centre, what does a sustainable health system mean to you?
Renzo: A sustainable health system means that a health system is not only able to provide patients’ needs, respond to patients’ concerns, but also is able to provide continuous care for patients of all kinds, and this care that is being provided is of high quality not just some of the time, but all of the time. That means we need to put in place the necessary infrastructure, services, and health workers, all of which should be well equipped and also well supported. They should be happy all the time so that the health services that patients receive are of good quality, are acceptable and truly respond to their needs.
How do you think patient engagement can support sustainable health systems?
Renzo: As a physician, I always thought that patients do play a critical role in the therapeutic alliance, working together with their providers on what’s best for them in terms of their care, their management and treatment of their disease conditions. I think we need to expand this concept of therapeutic alliance and turn it into a health system alliance between policy makers, providers, decision makers and most especially the patients. And in the context of a sustainable health system, if you want a health system to sustain the provision of high-quality care to all kinds of patients we need to make sure that patients are able to co-create solutions and policies and protocols ,that there is a system put in place to garner their feedback in a timely and meaningful manner, not in a token fashion. And that patients are also included in various steps of policy creation and decision-making. So I think that is the role of patients in ensuring that health system alliance to function towards sustainability.
In what ways are patients are being engaged either in your own country or other countries?
Renzo: In the Philippines, there is some level of patient engagement already happening, for instance, at the level of national health policy when the universal healthcare law was designed and eventually passed here in the Philippines. There are patient groups that have provided a lot of inputs and also advocated for the law’s passing. There are also representatives of patients for instance in different bodies or organisation such as in our national Health Technology Assessment Council and the governing board of the Philippines national health insurance corporation.
What more do you think can be done in patient engagement ?
Renzo : Of course, we can do much better in terms of meaningful and sustained patient engagements. These patients should not just be involved in some activities and decision-making moments but throughout the entire process of policy, not just formulation but also monitoring and evaluation, policy implementation and other aspects. I think patient engagement is not starting from scratch in a country like the Philippines but certainly there are a lot of areas where we can improve and enhance the degree by which patients are engaged in health policy and in health systems operations.
What can multistakeholder regional platforms like CAPE do to support advancing patient engagement in Asia?
Renzo: I think the value-add of CAPE is one, to gather countries together, to learn from each other’s experiences, to share good practices because at the end of the day, we want patients from across the region to be meaningfully involved in health policy and systems work. I think CAPE can also be a hub for the latest most up-to-date evidence regarding patient engagement, how best to do patient engagement, again for the benefit of influencing health policy work in the different counties in the region. Finally, I think CAPE can also be a very strong advocacy platform to ensure that the evidence that is generated, the lessons that are learnt are actually translated immediately into policies and practice, again for the benefit of patients across the region.