San Juan City is among Metro Manila’s wealthiest local government units, generating about P2.7 billion in annual revenue and consistently ranking high in per capita spending. Yet its lone public hospital still lacks basic diagnostic equipment that can be found in less affluent cities — a contradiction that has reignited political tensions and put Mayor Francis Zamora’s record back under scrutiny.

Seven and a half years into his tenure, Zamora is facing fresh criticism from Senator JV Ejercito, who points to what he describes as only incremental improvements at the San Juan Medical Center.

Zamora has acknowledged the ongoing upgrades but has also blamed the previous city administration for failing to modernize the facility.

The clash is the latest chapter in the long-running political feud between the Zamora and Ejercito-Estrada camps. Their fallout dates back to the 2016 elections, when then Vice Mayor Francis Zamora and his father, Rep. Ronaldo Zamora, were dropped from the Ejercito-Estrada slate.

The Zamoras claimed they were expelled to make way for the Ejercito-Estrada clan’s control of local posts, while JV Ejercito countered that it was the Zamoras who wanted to secure both the mayoral and congressional seats.

That same year, both sides were also dragged into a graft complaint before the Sandiganbayan over the alleged misuse of P2.1 million in city funds for the purchase of high-powered firearms in 2008, further deepening their divide.

The feud peaked in 2019 when Zamora defeated Janella Ejercito for mayor, ending the Ejercito-Estrada family’s nearly five-decade hold on San Juan.

Controversies in office

Zamora’s administration though has not been free of controversy.

In June 2020, he and a six-car convoy were flagged in Baguio for allegedly bypassing a quarantine checkpoint during the strict Covid-19 travel restrictions.

Zamora said he was taking his wife, who was battling breast cancer, to the Baguio Country Club, but the incident sparked public criticism and calls for him to be declared persona non grata in Baguio City.

In 2024, Ejercito accused Zamora and Councilor Paul Artadi of receiving kickbacks from the government’s TUPAD cash-for-work program. He also alleged that the mayor withheld terminal leave benefits from retired city employees linked to his political rivals.

Zamora denied all the allegations, calling them politically motivated and unsupported by evidence.

City hospital under-equipped

At the center of the current dispute is the San Juan Medical Center.

Critics and hospital insiders say that despite a significantly increased budget — reportedly around P634.5 million — the hospital still lacks key equipment, most notably an MRI machine, as well as other advanced diagnostic and cardiac facilities.

The hospital serves roughly 134,000 residents as the city’s only public health facility. Patients with serious conditions are often referred to private hospitals or facilities in neighboring cities due to the limited equipment and services.

Questions have also been raised about spending priorities, including the decision to prioritize a wellness center over a dialysis facility, and reports that some equipment purchased back in 2019 remained unused.

City officials point out that San Juan has received “unmodified opinions” from the Commission on Audit in recent years, indicating clean financial records. CoA auditors, however, assess bookkeeping compliance, not whether spending aligned with urgent public health needs.

Comparison with smaller city

The debate has been sharpened by comparisons with Navotas City, which operates on a budget of about P1.1 billion — less than half of San Juan’s.

Despite its smaller revenue base, Navotas City Hospital reportedly offers CT scans, has more dialysis machines, automated laboratory systems, and expanded ICU and bed capacity.

The contrast has fueled questions over whether San Juan’s issue is financial capacity — or allocation of priorities.

Defense and deadlines

Zamora has consistently rejected the criticism, dismissing it as political attacks and “fake news,” while pointing to gradual upgrades and inherited deficiencies from past administrations. He has also set a target of 2028 for the full modernization of the San Juan Medical Center.

Whether that timeline will be met or be seen as another political promise remains uncertain.

What is clear is that San Juan’s strong fiscal position makes the hospital’s shortcomings harder to explain. For many residents, the issue has moved beyond political rivalry and into a more basic concern: why does one of the country’s richest cities still struggle to equip its only public hospital with essential tools?

As the debate continues, pressure is mounting for answers that go beyond blame — and for improvements that patients can actually see and use.