Situation: Kenyan doctors’ strike for implementation of KMPDU-MOH 2013 CBA
This is an open letter to the president of the Republic of Kenya
His Excellency Mwai Kibaki (Kenyan president 2002 – 2013) did two things for doctors:
- He promulgated the new constitution that gave freedom of association. This led to the formation of KMPDU that was able to advocate for the rights of doctors who had been sat on since independence under the yoke of “essential services”. They used this line that doctors are not unionisable to mistreat them.
- He brought the doctors’ pay from negative to zero. I thank you for you were part of the implementing team then as the then minister of finance. Your legacy now is to take them a little higher from zero to near where they are suppose to be many years ago.
Doctors were involved in the crafting of the health part of the constitution. It was very clear to me then what devolution of health was. Devolve primary health to governors (Primary Care). Secondary and tertiary care were to be at national level under the human resource component would be managed by the Health Service Commission. The basis for this is that when primary care is done well by the governors 70% of disease is prevented. In Naivasha the COE sneaked out the HSC and left it to parliament to return it under an act of parliament. Had it been retained this problem would not have arisen.
Nevertheless we are where we are. When the governors forced the executive to unconstitutionally devolve health “in toto” by unfortunately portraying the executive as anti-devolution I am sure you did not realize you were throwing doctors under the bus. Tribalism, nepotism, grandiosity and other vices have prevailed in the treatment of doctors by governors.
Luckily for doctors a CBA had been signed between the government and the doctors. It clearly outlines how doctors should be treated. A doctor’s life is different and unique. He is in school for many years. After many years of school and working a little he needs to go back to school for further knowledge. He is in charge of life and death. But he is still a person who needs to look after extended family, pay rent, eat and have transport to move around. Unfortunately he has to work 25 hours a day to make ends meet. That is also the reason a doctor cannot easily be lumped within a civil service HR system. This is the source of majority of the problems that has led to this stalemate we are in. The CBA has solved ALL these problems.
To follow the law ask the ministry of health to implement the legally signed CBA of 2013 between MOH Kenya and KMPDU. The role of SRC is advisory for non state actors. It should not be used as an excuse to subvert justice. Medicine is not law. Doctors do not look for loopholes in the body of a person as an excuse not to treat. Doctors treat. It is a life and death situation.
How much will it cost to implement the CBA? Almost nothing. Have a look at this maths
8,000,000,000 / 2,400,000,000,000. It comes to a very small figure of the national budget. So yes I know you may be worried about the cost. It costs nothing. This is the only investment that will bring a return to your investment 100 times more than you anticipate. Try it out.
Let me thank the First Lady Margaret Kenyatta for her efforts in promoting primary health. I had an opportunity to meet her in the course of her work. She has played her role in preventing disease. And doctors support her efforts. Unfortunately a disease that requires treatment has escaped all efforts to prevent it. The doctors of Kenya have screened it and seen the problem. The CBA has not been implemented. You, the president of the republic of Kenya is the doctor to this disease. The jubilee manifesto promised to improve the working terms of doctors in their manifesto. When the government implements the CBA it can then use it in the campaign platform as an achievement.
To finish up let me a list public service doctors Legacies of Kenya’s Presidents
1971 – Government Doctors Strike – Doctors resign from public service – health services deteriorate
1981 – Doctors strike – Doctors resign from public service – health services deteriorate
1994 – Doctors strike viciously dealt with by the government – doctors resign – health services deteriorate
The doctors have never forgotten how badly they were treated in this period.
1996 – Doctors strike – public health services literally collapse
2000 – 2010 No doctors strike due to government listening to doctors advice on how to improve doctors remuneration. Retention of doctors started. Health services started improving. Hospitals led by doctors started collecting more money and being run more efficiently. I guess this is what hood-winked the governors to force unconstitutional devolution of health.
2011 – 2013 Doctors strike to improve the WORKING CONDITIONS of public hospitals. Musyimi Task Force report is developed addressing medical equipment and human resource issues.
The government buys medical equipment and forgets to improve the remuneration of the very same people who are suppose to operate these equipment
2013 – Collective Bargaining Agreement signed between KMPDU & MOH to address the injustice and set the path for a future with doctors working well in the public sector Doctors are still waiting for its implementation.
2013 – to date – County disasters in managing doctors following unconstitutional devolution of health
2016 Doctors’ Strike demanding implementation of the 2013 CBA
This can be ended by the stroke of your pen.
The hashtag is #Lipakamatender