Metro Manila (CNN Philippines, July 11) — In her regular hospital visits, Cecilia, not her real name, spends at least two days in a "dirty" stretcher, crammed with many other patients along the hallway of a government hospital in Manila.

Hospital beds are a luxury, Cecilia said. The mother of three goes to Jose R. Reyes Memorial Medical Center (JRRMMC) in Manila at least twice a year for blood transfusion, after she was diagnosed with a blood disorder in 2015. She requested not to be named as she is scheduled to return to the hospital this July.

"Kapag may namatay, pwede na akong lumipat sa loob (When someone dies, that's the only time I can transfer to a room)," Cecilia said. Moving to a room at the charity ward means finally having a bed, even if it's "dilapidated," she said of the 72-year-old hospital, which opened in 1945 as a 100-bed facility for children.

But she accepts this because she can use the room for free, Cecilia said. "Sa akin naman ang importante lang masalinan ako ng dugo (What's important is I am given blood)." She stays in the hospital for up to one week, depending on the availability of blood donors.

Even as many Filipinos struggle with health care costs, over ₱300 million worth of medicines and medical equipment were unused and wasted in some hospitals in 2016. This is according to the latest audit report of the Commission on Audit (COA) on the Department of Health (DOH) released last July 10.

Wasted resources

Over ₱240 million worth of equipment were not utilized, including 94 mechanical beds at the JRRMMC worth ₱2.5 million, COA said.

COA said these were "due to lack of trained operators/users, lack of coordination among offices concerned, uninstalled essential parts, incomplete integration, and defectiveness, among others." In the case of JRRMMC, COA said four floors of a building which could have housed the beds and the patients were idle.

The auditing body slammed what it called a "wastage of government funds."

The unused equipment were exposed to deterioration. Supposed beneficiaries were also deprived of better health facilities, COA said.

Auditors carried out ocular inspections in six hospitals in the country, which were randomly selected.

They also found ₱5.4 million worth of expired medicines, which were still displayed in some hospitals' pharmacy. COA feared these "may mistakenly be dispensed if left unnoticed."

COA also noted an overstock of ₱16.43 million worth of drugs, while medicines nearing their expiry date are at ₱3.95 million.

While the Health Department extended ₱293 million in medical assistance to poor patients, COA said 40 percent, or ₱186.5 million was left untouched in 2016.

This amount could have been used to help pay the hospitalization of more than 33,000 patients, based on the country's out-of-pocket health expenditure of ₱5,589 per person annually.

"The full utilization of the allocated budget could have further improved the DOH's implementation of the program," COA said.

Idle infra projects

In an interview with CNN Philippines' The Source on June 30, Health Secretary Paulyn Ubial said that during the Duterte administration's first year in office it has improved Filipinos' access to health care through the Health Facilities Enhancement Program.

Also read: DOH chief: Gov't targeting one health worker per barangay by 2022

Under the program, the government spent ₱70.28 billion for the construction and improvement of barangay health stations, rural health units, district, city and provincial hospitals, and other government health facilities nationwide.

However, COA found ₱291.74 million worth of completed infrastructure projects idle or unutilized at the JRRMMC, Baguio General Hospital Medical Center, Philippine Orthopedic Center in Quezon City, and DOH's regional office in Davao City.

COA said these could not be used because of various work defects in the buildings, such as damaged ceilings, cracks on walls and flooring, faucet leak, and even lack of power supply.

These are all part of an even bigger problem – the delayed implementation of over ₱1.5 billion worth of infrastructure projects. COA said these were not completed within the time specified in the contracts and some were not started throughout 2016 mainly due to poor planning.

Also under the Health Facilities Enhancement Program were ₱58.19 million worth of medical equipment and ₱43.45 million in mobile dental vehicles left idle in hospitals in Metro Manila, regions of Cagayan, Zamboanga Peninsula, and Caraga.

Moving forward

COA urged the Health Department to address the underutilization of an estimated total of ₱1.86 billion in unused equipment and idle infrastructure projects.

The DOH should ensure the maximum utilization of all government equipment and fast-track the completion of delayed projects, the COA said.

It ordered the DOH to "facilitate full operation of newly built structures and ensure immediate installation of needed equipment, electrical power, and other needed utilities."

To address the expiration of drugs and medicine stocked in shelves, COA said the DOH should effectively plan and coordinate procurement, taking into consideration the demand for these medicines and their expiration dates.

COA also called on DOH to impose sanctions against erring suppliers of defective equipment and the health personnel who accepted such without proper inspection.

COA said the Health Department agreed to work on its recommendations, most of which were already "partially implemented."

JRRMMC Director Emmanuel Montaña on July 12 told CNN Philippines the hospital's concerns have been addressed and the hospital's charity wards are under renovation with a target completion date of August 2017.

He admitted that their mechanical beds are "too old," along with other equipment.

Montaña also explained that the third to fourth floor of one of their buildings were not used because there was no power supply, which they also target to address by August.

As for the "expired" medicines that the COA found in their pharmacy, Montaña clarified they were just "near expiry" and were already removed.

He said the hospital management hopes to improve their facilities and change the way the public looks at government hospitals. "Sana walang difference ang private and government hospitals (I hope there would be no difference between private and government hospitals)."

On June 27, the JRRMMC, along with the Research Institute for Tropical Medicine in Manila and Amang Rodriguez Memorial Medical Center in Marikina, also told the Health Department they were "fully utilizing" their formerly idle mobile dental vehicles, COA said.