Doctors' deal-breaker

PSC CS Moses Kuria, Labour CS Florence Bore, Health CS Susan Nakhumicha, Head of Public Service Felix Koskei and Council of Governors Chairperson Anne Waiguru addressing the media at KICC, Nairobi on April 23, 2024, after their talk with Health workers officials collapse. [Boniface Okendo, Standard]

In a dramatic turn of events, negotiations between the government and striking doctors hit a dead end, prolonging the suffering of millions of Kenyans seeking healthcare in public hospitals.

Moments after the government announced an offer to end the ongoing strike, the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) rejected the proposed return-to-work formula, raising the intern doctors issue as the deal breaker.

Head of Public Service Felix Koskei, Council of Governors chairperson Anne Waiguru and Health Cabinet Secretary Susan Nakhumicha yesterday underscored the deepening rift between the two parties.

Speaking at the Kenya International Convention Centre, Mr Koskei said despite concerted efforts by the government to resolve what he termed illegal strike through court directives and negotiations, the doctors union has continuously flouted court orders and backtracked on agreements reached during marathon meetings.

KMPDU officials failed to turn up to sign a return-to-work formula which the government had agreed to postpone to yesterday, said Koskei.

“The dispute has been before the courts, which have declared the ongoing strike as illegal and ordered the illegally striking Union members to return to work,” said Koskei.

Addressing the media soon after, KMPDU Secretary General Davji Atellah and Deputy Secretary General Dennis Miskellah reiterated their unwavering stance on implementing the 2017 CBA in its entirety, including the contentious issue of internship compensation.

“We are not discussing the internship matter. It’s non-negotiable,” Davji said, in response to the government’s proposal to slash doctor-interns’ allowances from Sh206,000 to Sh70,000, a move the union deems exploitative and illegal.

The officials accused the government of attempting to “cherry-pick” terms from the CBA while disregarding others, a move they vowed to resist at all costs. “We can’t sign a CBA through blood, sweat and tears only for it to end up in some dark garbage pit,” Miskellah said.

The failure of the union to honour agreements has left the government with little choice but to explore all necessary measures to ensure provision of healthcare services.

Said Koskei: “The union’s new demand is an all-or-nothing out-of-court settlement. The continued stand by the union will undoubtedly continue to deny millions of Kenyans life-saving treatment.” 

Ms Waiguru outlined the county governments’ commitment to address the concerns raised by healthcare workers. She said agreements were reached on various issues, including medical insurance, release of doctors for postgraduate studies, recruitment of doctors, and payment of salary arrears.

She however blamed the running standoff on the doctor’s union. Waiguru said the CoG will seek legal recourse, including filing status reports and appealing court orders, to ensure the provision of uninterrupted healthcare services to Kenyans.

Kept waiting

“There have been various meetings where the Council of Governors has been participating. The meetings of 18th, of 19th and of 21st, where despite the whole of government team being kept waiting, they patiently stayed and negotiated until close to midnight and initialed, the agreement that was to be lodged in court,” she said.

Health Cabinet Secretary Susan Nakhumicha said the government is making efforts to review healthcare policies and has secured funds for salary arrears, internships, and postgraduate training. Despite these efforts, the strike continues to disrupt healthcare services.

“The ministry has received Sh6.1 billion to settle issues raised by the striking doctors,” she said.

She said the Ministry has secured Sh3.5 billion for payment of salary arrears going back to 2017 up untill 2024.

“This amount will be disbursed in five installments annually,” she said. She added: “Furthermore, Sh2.4 billion has been allocated for internship payments, with disbursement scheduled to commence after June 2024 “.

The Ministry has also allocated Sh200 million for settlement of postgraduate arrears for doctors who have completed specialty training, with payments to be made directly to the respective universities, a total of Sh2.2 billion for Linda Mama arrears to all health facilities, Sh1 billion to all faith-based facilities, Sh1.5 billion to government facilities and Sh2 billion to private health facilities.

Nakhumicha reiterated the government’s commitment to upholding the rule of law and ensuring welfare of all citizens.

She said the government has addressed 18 out of the 19 issues brought forward by the union. The union however considers the internship impasse the salient issue, without which doctors won’t return to work

Davji revealed the President had endorsed the Cabinet’s stance against the Sh206,000 figure, dealing a blow to negotiations and that is why the union remains defiant.

“We hope meeting the President will make him softly stand on this, as it is a legal and binding CBA negotiated in 2017,” he said. 

The doctors also took aim at governors threatening to sack striking workers, with Miskellah reminding them that 30 per cent of county healthcare services are rendered by interns. As the stalemate drags on, KMPDU has vowed to escalate its protests, including resuming Tuesday demonstrations in Nairobi and other parts of the country.

“Our fight is fueled by conviction, sweat and blood, and tears. It can go as long as it takes,” Davji said, signaling no end in sight to the bitter labour dispute crippling Kenya’s public health sector.

As the deadlock persists, concerns are mounting over the impact of the strike on Kenya’s journey towards achieving universal health coverage. The prolonged standoff not only jeopardises the health and well-being of millions but also raises questions about the effectiveness of governance and the rule of law.