Port workers up in arms over new medical scheme

Mr Oluoch was reported to have been plucked from the Intensive Care Unit (ICU) just like his colleague Bernard Mumo who survived after being transferred to another private health facility by his family members on time.

But what is inside this controversial new medical scheme? How did it come into being and how different is it from the previous one?

A report by the JIC that was signed by a representative of the port union and KPA management gives details of a medical scheme that was supposed to be attractive to workers if cracks began to show.

Parties deliberated on the implementation of the new scheme between October 31 and November 2 last year in Kilifi County.

The agreement was signed on November 1, last year by DWU General Secretary Simon Sang, KPA human resource general manager Daniel Ogutu and the JIC chairman Linus Kariuki.

The agreed limits per family were that the lower cadre of staff would get Sh230,000 outpatient services (per family), Sh2.5 million for inpatient, Sh40,000 for optical, Sh30,000 for dental, Sh100,000 for maternity and Sh100,000 for rehabilitation.

Staff in management level were allocated Sh250,000 for outpatient per family, Sh3.2 million for inpatient, Sh40,000 for optical, Sh30,000 for dental, Sh110,000 and Sh100,000 for rehabilitation.

Those in executive positions were to get Sh350,000 per outpatient services, Sh5 million for inpatient, Sh50,000 for optical, Sh40,000 for dental, Sh130,000 for maternity and Sh100,000 for rehabilitation.

Under the new arrangement, the services were to be available to employees as principal members and dependents up to the age of 25 years. The inpatient cover is to include pre-existing and chronic illnesses.

The new medical scheme offers an ex-gratia amount up to a maximum of Sh1.5 million on a shared basis to be granted to an employee who has exhausted his or her inpatient limit. The employee is supposed to bear 25 percent of the ex-gratia granted which is on a case-to-case basis.

KPA also retains a hydrid system that incorporates National Hospital Insurance Fund (NHIF).

The outpatient services include consultation, laboratory services, pharmacy (drugs and dispensing), external referrals involving MRI, CT-Scan. Ultrasound and physiotherapy.

The inpatient services involves payment of hospital inpatient charges for contracted hospitals and rebates for inpatient services in public hospitals.

The JIC parties agreed that the medical services policy be implemented from effect from January 1, 2023 and a review to be done within six months and another again in six months.

"That the medical services policy be implemented with effect from 1st January 2023 and a review to done within six months and another six months," says the agreement.

But the union now says the new medical scheme is being implemented in an inhumane way and should be abolished immediately.

Sang noted that it was wrong to discharge a worker from the ICU at a superior health facility and put them in an ambulance only to dump them in another facility "to die."

He has threatened to call for industrial action and paralyse port operation if KPA management does not heed their demands.

"As a result (of the new medical scheme), many employees are being denied treatment at various hospitals while others are being kicked out of hospitals where they are admitted on the instructions of the KPA management," Sang protested.

He argued that even assuming that the scheme would be passed for implementation after the one year trial run, it must by law be first registered at the Employment and Labour Relations Court to become legitimate.

This sets the stage for confrontation with KPA management following a statement by acting managing director John Mwangemi that only JIC can review its earlier agreement to test-run the new medical scheme.

"The above agreement is a negotiated item derived through JIC and therefore any deliberations of the same shall be through the council where agreements reached are binding," Mwangemi wrote.

"The scheme was implemented with effect from January, 1 2023 and is subject to review within six months to address challenges and achievements."

Mwangemi defended KPA against claims of mistreating sick employees saying that the patient, Mr Mumo, was handled as per the agreement reached by JIC.

In the medical scheme registered in the current 2020-2023 Collective Bargaining Agreement, every unionisable employee is given a medical cover without any limit provided that 80 per cent of the cost is of medical services rendered to the employees and their dependents is borne by KPA while 20 percent is borne by the employee.