Cartels, graft at Afya House will test nerve of Health CS nominee Barasa

Dr. Deborah Mlongo Barasa, nominee for the Position of Health CS before the Committee on Appointments at the Mini Chambers, County Hall, Nairobi. August 1st ,2024 [Elvis Ogina, Standard]

Health Cabinet Secretary nominee Dr Deborah Barasa was on Thursday hard-pressed to defend her suitability to fight ‘Mafias’ and address policies in the ministry.

The Vetting Committee chaired by National Assembly Speaker Moses Wetang'ula said though Barasa, a medical doctor, has relevant qualifications, she needs a solid plan to manage the docket.

“You come across as a young, diligent professional, but I have doubts," said House Majority Leader Kimani Ichungwah.

"Will you be able to manage cartels in Afya House? Do you have what it takes to fight corruption at NHIF, cartels at Kemsa? Do you have what it takes?" Posed Ichungwah.

Barasa, who was the second nominee to appear before the committee, defended her competencies and capacity, saying she would consult all including the Director General of Health, Principal Secretaries and technical working groups to address challenges in the ministry.

But several MPs demanded specifics on how she will handle corruption.

Pokot South MP David Pkosing said the committee was not vetting a team but rather an individual for the CS position.

“You are running away from responsibilities. We are here to vet you, and not a group,” said Pkosing who appeared not satisfied with Barasa’s response.

The MP said the ministry has had historical scandals, including procurement of clinic containers at Sh10 million each.

Other scandals have been reported at the National Health Insurance Find (NHIF) where managers have been accused of colluding with private hospitals to steal billions of shillings and non-procedural procurement process undertaken at Kenya medical Supplies Authority (Kemsa)

“...again I will apply consultative efforts. It is important to think strategically. I will conduct a situational analysis and see where the gaps are,” the CS nominee said.

Barasa told the committee she will embrace technology to trace supply of medical commodities and procurement process to limit human interaction that triggers corruption.

“I think we need to strengthen processes and also digital platform to track how for example paracetamol gets from national stores up to patient's hand. We shall ensure seamless flow, digital platforms, and involve internal bodies and have routine meetings,” she said.

She said if approved, she will strengthen processes and procedures to curb corruption at the ministry.

Barasa said internal audit, and involvement of government agencies like the Ethics and Anti-Corruption Commission will also help fight graft at the ministry.

KIlifi North MP Owen Baya asked the CS nominee to share her leadership skills and policy understanding on handling the health sector.

“I hear you talk so much about situational analysis. Health sector is a big thing, with budgets as well. This (Health CS) requires high level of leadership is policy. I am not hearing you talk about policy issues apart from consultation,” said Baya.

He pressed Barasa to explain how she will bring real leadership to the docket.

Sabaot MP Caleb Amisi said that despite being a technical ministry, politics also takes centre stage.

“How are you equipped in terms of politics, and corrupt individuals, how will you deal with it?” Posed Amisi. 

“From leadership and management perceptive, it is always consultative. These people have been there, they understand situation and gaps. We need to identify gaps and come up with improvement plans. It is critical to give leadership and bring people together to synergise and improve services being given,” Barasa explained.

She was at pains to explain how she would turn Kenya into medical tourism like India.

The CS nominee told the vetting panel that currently, Nairobi hosts WHO expatriates who contribute to the country’s economy by purchasing locally available items.

Barasa said she will access and look at best medical tourism countries like India to know what they have done in terms of human resource, equipment and improvement of specialists.

She admitted that Kenya does not have quality care for patients.

“We need specialists and expand medical equipment to be utilised, infrastructure among other aspects involved, we need to have policies, but in terms of how to progress, we need to look at priorities in Kenya, we do not have quality care services for patients,” she said.

Amisi asked Barasa whether she will retain NHIF or have it repealed by Social Health Authority (SHA).

She said lack of proper transition plans might transition scandals witnessed at NHIF to SHA.

Barasa promised to have more public participation on the law.

“Service is for people of Kenya. We need to engage them, and have community feedback and see how we shall intervene,” she said.

She noted that the public was not involved in establishment of the laws, and changes in the medical scheme.

“It is critical to engage community to understand vision of SHIF and also contribute to have vision come to fruition,” she said.

Transitioning of health schemes has faced roadblocks and recently the High Court the SHIF unconstitutional, due to insufficient public participation.

The CS nominee further pledged to ensure Linda Mama that is incorporated in SHA, saying she has been a beneficiary.

Deputy Speaker Gladys Shollei however interjected her response on human resource at NHIF, saying it would result into unnecessary debate in future if approved.

“All (NHIF employees) will be reassessed and, if suitable, they will be absorbed. Some, their skills don’t match on what they are doing,” said Shollei.

Barasa denied allegations that she was deregistered by Kenya Medical Practitioners Council (KMPDC).

She clarified that she is a qualified doctor, who has been in clinical practise from 2007 t0 2020.

The CS nominee said she joined WHO as a policy advisor, where Kenyan license was not applicable, being an international agency.

After her nomination by President William Ruto, she renewed her license with the KMPDC.

Barasa is an infectious Disease Consultant at the World Health Organisation (WHO).

She worked at the Mater Hospital as an Internal Medicine physician before joining WHO as a consultant.

The CS nominee has more than 18 years in medical expertise and public health background.

Despite her vast knowledge and experience, Matungu MP Stephen Mule questioned how Barasa will manoeuvrer the health docket, coming from WHO where she was an advisor in policies.

The MP argued that Kenya’s health docket is complex and riddled with politics and interests.

Mule said as the CS, she will handle human resource, programmes and respective departments that require management skills.

“I believe you are getting to ministry where we have several departments, starting with doctors, programmes, everything. I want to hear from your management skills, from straight line of thinking, here is where the law applies, how will you streamline,” he said.

Transition of the scheme continues to spark anxiety among employees at NHIF, which the committee asked Barasa to give her stand on the same.

The nominee said she will review HR capacity, number of human resource required for new insurance, “but intervention would be to match and depending on their roles and responsibility to new area”