FILE | NATION A nurse attends to patients at Nyeri Provincial General Hospital during a doctors’ strike in 2011. Most employees working in public hospitals will be under county governments.
By GATONYE GATHURA gathura@ke.nationmedia.com AND PAULINE KAIRU polinekairu@yahoo.com
Posted Sunday, February 26 2012 at 22:30
Posted Sunday, February 26 2012 at 22:30
IN SUMMARY
- Proposed law to create new institutions, jobs and change way new administrations hire and fire employees in the profession
A Bill that will radically alter health care provision and create new institutions to run the sector in a devolved government has been drafted.
The ministries of Public Health and Medical Services are rushing the draft Health Bill through the legislative process which they say will be law within three months.
A legal brief accompanying the draft says four of the most crucial institutions, the Health Council, the Health Services Authority, Public Health Facilities Service and a procurement body should be running already.
“These bodies must be functional in the course of 2012 if devolution of the health sector is to function, at least in part, by the end of the calendar year,” says the brief.
In a move which could trigger strong resistance from the over 16 professional bodies in the health sector, the draft Health Bill proposes the creation of a Council of Health Professions where all disciplines will be uniformly represented.
Other jobs will also be created across the country with the proposed creation of 47 County Executive Health Committees which will be led by a county director.
According to a position paper submitted to the Constitution Implementation Taskforce for review, the committees will only be answerable to the Governor and the County Assembly. A Director General of Health will also be recruited.
More senior job openings will be created as 13 provincial hospitals are elevated to national referral institutions. Other medical institutions to be promoted to national referral status will be Pumwani Maternity Hospital, Mathari Mental Hospital and the Spinal Injury Hospital in Nairobi.
A National Health Inspectorate Service will also be created with more autonomy and a larger mandate which will bring under one roof the various health authorities in existence today, including the Pharmacy and Poisons Board.
All health workers currently employed by the Public Service Commission will automatically be seconded to the county they are working in immediately that county’s constitution becomes operational. Those working in national institutions such as the Kenya Medical Research Institute or provincial hospitals will however, be exempted.
The proposed law is clear that the seconded workers will not lose their benefits, their allowances will not be reduced but can be increased if the new employer so wishes. But they can be deployed to new sections within the county.
The ministries’ position paper is clear that counties will be responsible for the recruitment and paying of salaries for their health workers, assures those already in employment will not lose their pensions but it does not say who will pay them.
This may create a problem for older workers about to retire who would be viewed by county employers as a liability.
“This could be a double-edged sword for less developed counties as they may not be able to attract older and more experienced health workers,” said Dr Wambui Waithaka an official with the Kenya Medical Practitioners, Pharmacists and Dentists Union.
The draft does not guarantee that jobs in the sector won’t be lost but to make sure counties don’t grossly underpay workers or employ low quality personnel, standards and levels of pay will be determined by the national government.
However, hardship counties are encouraged to offer incentives to their health workers to keep the best.
But Dr Waithaka says incentives must go beyond money.
“You cannot retain a top specialist if there are no facilities and auxiliary staff in the county. Neither can you retain the same if there are no good schools for their children or there is political tension,” she said.
According to the union’s chairman, Dr Victor Ng’ani the conduct during and after the next general elections will more than anything else decide where doctors choose to work.
Since the 2008 post-election violence, he says, doctors are posted to where they feel most comfortable and safe to work in.
But in an interview, the Director of Medical Services, Dr Francis Kimani, said this practice had been discontinued and the ministries had since gone back to the normal posting procedures which included balloting.
The doctors’ union is opposed to the proposal to have doctors employed by counties. “Richer counties will attract all the doctors while poor ones are left with none,” said Dr Ng’ani.
The top governing body in the new structure, which will be the Health Council will be led by an experienced chairman.
The Health Services Authority will act like the human resource arm of the devolved health sector.
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