State breached public service rules to train doctors in Cuba

Auditor-General Nancy Gathungu. [Mose Sammy, Standard]

The decision by the government to have doctors undergo family medicine training in Cuba breached public service guidelines.

Auditor General Nancy Gathungu said in the 2022/2023 Financial Year National Government Ministries, Departments and Agencies Audit report that the government breached set guidelines.

Gathungu, in the report, noted that training records showed that the Ministry entered into a contract to train 50 doctors in family medicine in Cuba for two years at a cost of Sh214,762,500 without evidence that the course was not available in Kenya.

She said the decision was contrary to the Guidelines on Managing Training in Public Service, 2017, which provide that approval to train in foreign-based institutions will only be granted in instances where the courses applied for are not available in local institutions.

The auditor noted that Sh15,168,550 was incurred on 35 Kenyan doctors undertaking family medicine training in Cuba.

A review of human resource records as per the audit revealed that the trained doctors are not employees of the Ministry but are employed by various county governments that manage their human resource matters, including training.

Gathungu said the management did not provide the criteria used in the identification, selection, and award of scholarships and why the training could not be done by the respective county governments.

She noted that since the Ministry does not manage the payroll for the doctors, the recovery of the 20 per cent training levy for the sponsored medics was not made, although management had requested various counties to recover the training levy.

Section H.5(2) of Human Resource Policies and Procedures Manual for the Public Service, 2016 requires that officers attending courses lasting more than four weeks in institutions outside the country will contribute at the rate of twenty per cent (20 per cent) of their basic salary per month for the duration of the course.

"In the circumstances, Management was in breach of the Human Resource Policies and Procedures Manual for the public service," she said.

At the same time the report revealed that some medical equipment in various facilities was not functioning as they were due for repair and maintenance.

The Managed Equipment Services (MES) equipment outsourced by the Ministry could not be repaired as the contracts between maintenance service providers and the Ministry had expired. Some equipment, including for renal dialysis, Intensive Care Unit (ICU), X-ray, and Imaging were not functioning and had not been serviced as of September 2023.

Gathungu questioned why microwave equipment in Narok county was still in sealed containers. The microwave equipment in Kisumu, though functioning, had a defect that had not been corrected due to the absence of a maintenance contract.