Talks without end: The intrigues and setbacks in bid to end doctors strike

Chaos, numerous disputes, including over sitting arrangement, and threats of jail are among the intrigues that have characterised the doctors’ strike, now in its 64th day.

But steadfast doctors’ union officials have held a series of talks with the Government, including one with President Uhuru Kenyatta, all aimed at resolving the strike.

Whereas the doctors are insisting on implementation of the controversial collective bargaining agreement entered into with the Government in 2013, the latter is adamant that the CBA is illegal and has to be renegotiated.

In one incident, according to details pieced together by The Standard from dramatic meetings between union and Government officials at State House Mombasa, a particularly concerned President was forced to storm talks as they were not making any headway.

And today marks the beginning of yet another week in which Kenyans hope that the biting strike, which started on December 5, last year – exactly five years after a similar nationwide strike in 2011 that ended in seven days – will come to an end.

Last Friday, another long-anticipated day in the corridors of justice dawned on the officials of the doctors’ union.

This time, the Kenya Medical Practitioners, Pharmacists and Dentists’ Union (KMPDU) had exhausted its five-day window period to call off the strike, failure to which the sword of Damocles – a suspended one-month jail term – would fall squarely on their heads. It was never to be.

Through Francis Atwoli, the COTU secretary general, they earned another seven-day reprieve.

The doctors had on November 14 issued a three-week strike notice, preceded by a series of meetings meant to avert this crisis.

A court ruling delivered by Justice Monica Mbaru on October 6, 2016, sought to bring KMPDU and the Ministry of Health to the table to resolve clauses not agreed upon in the Collective Bargaining Agreement (CBA) 2013, the subject of the strike.

On November 18, a task force on the CBA met at the Ministry of Health’s boardroom with an agenda to discuss the then four-day-old strike notice, the court ruling and the CBA. It was attended by 31 members from the ministries of Health, Labour, Public Service and Treasury, Public Service Commission, Council of Governors (CoG), AG’s office, Salaries and Remuneration Commission (SRC), and KMPDU. After a brief on the dispute by the union, this meeting set out rules of engagement and rescheduled to meet five days later.

According to union officials, the agenda of the next meeting was to conclude the outstanding issues in the CBA. The consensus was that other matters in the CBA were not a ‘big issue’ as administrative and policy guidelines were already in existence.

“Our point of departure was on SRC input and the CoG reservations on the legality and financial implications of the document,” said a union official. “The union maintained that the CBA should be funded from Treasury and therefore legal ways of enjoining them in the CBA should be sought.”

The source went on: “We later realised that these pre-strike meetings were meant to keep the union busy, take a list of attendance of meetings and later use these minutes in an affidavit in the Court of Appeal; an appeal filed by the Ministry of Health.”

The seeds of mistrust between doctors and negotiating Government officials may have been planted on the eve of the strike. On this day, according to union officials, the Cabinet Secretaries for Health and National Treasury, governors and other top Government officials addressed the nation on the strike without first meeting them.

A court order to suspend the strike was also published in the newspapers, addressed to what union officials said was a non-existent union – Kenya Medical Practitioners, Pharmacists and Dentists Board.

On the first day of the strike, the union was invited to several formal and informal meetings, in a last-minute attempt to mitigate the strike.

“On December 7, two days into the strike, the negotiation meeting was the most fairly constituted,” said the union officials. “But the Government had crafted a return-to-work formula that had a quick-fix measure of giving doctors an increment in some allowances. This was against the KMPDU’s demand for the 2013 CBA.”

This meeting had five governors, including the CoG chairman, the Secretary to the Cabinet, other officers from the Office of the President and the Cabinet Secretaries for Health and National Treasury.

“Bringing the return-to-work formula instead of discussing the CBA negated all other progress. Furthermore, the discussions collapsed because the CoG was not negotiating in good faith,” said the officials.

“While at the meeting, we learnt that warrants of arrest were to be issued against the union officials. Time has proven that they (Government) had ulterior motives.”

The union said Government emissaries have frequently urged them to continue with talks to end the strike as it was not only exposing Kenyans to suffering, but also tainting the image of the President. “They keep telling us that it is in (the President’s) interest that we should end the strike.”

And when it seemed that things were not moving, it was the turn of the Ministry of Labour.

It convened several informal consultative meetings, the first being tripartite talks held on December 15, 2016, which degenerated into chaos.

“Union officials were turned away as Cabinet Secretary Phyllis Kandie, who was the conciliator, opined that the team should be lean. Besides, the chairperson, secretary and treasurer of the union were not in the negotiating team. When these top officials were brought in, the meeting ended because of a dispute over sitting arrangement,” union officials told The Standard.

“The conciliator insisted on the secretary general sitting at the front of the table,” the union said.

“She was the conciliator, yet immediately she became part of the Government, giving instructions and insisting that there was no CBA,” said the union source.

A similar meeting the following day bore no fruit, and another meeting that was to be scheduled by Labour CS never happened.

On December 30, Director of Medical Services Jackson Kilonzo wrote to schedule a follow-up meeting on January 4, 2017, at Ministry of Health offices. But at this point, the union officials were meeting their members in Mombasa, and there was conflicting information of another meeting on the same day but at a different venue.

And the following day, December 31, 2016, the President met the union officials in an informal meeting. According to KMPDU, the President was very receptive to their demands and it was agreed that the CBA was basically concluded, save for Appendix A, and the union was required to give a scenario of implementation.

It was then that a formal meeting with key decision-makers at State House Mombasa was scheduled.

Before the meeting with the President, the Principal Secretary for Health, Dr Nicholas Muraguri, first met the union at Whitesands Hotel where a phased-out implementation of the CBA was tabled. Treasury CS Henry Rotich chaired the meeting, at which almost all players, save for the Council of Governors, were present.

According to the union, the Government instead offered them an old offer, which they rejected.

It was then that the President intervened.

“The President was concerned at the slow progress of the meeting and he called his Government officials first, then the union officials to find out why we were not progressing. We told him that his officers were not speaking the language of the union, which was the CBA,” union officials said.

“Later, he stormed in, asking: “Hamjaelewana?(You haven’t agreed?)”, our source said of the meeting with the President.

“He was clearly frustrated. He took the document, opened it page by page, did his own calculations and alluded that the difference between the union and the Government offer was Sh42,000, though he had already given Sh10,000 for medical risk allowance.”

Union officials said the President insisted that they had to come up with an agreement on the same day, however long it took. “We requested for time to consult our national advisory council as per our constitution.”

The doctors said it became difficult to get out of that meeting, and had to do with only water to quell their hunger pangs.

The unionists acknowledged that the President had shown genuine interest to bring the health crisis to an end.

But the Government offer, they claimed, was not impressive and their members later rejected it on January 6.

During the Mombasa meeting, an idea for ‘nationalisation’ of the human resource for health was floated as a long-term solution, and the Public Service Commission was tasked with crafting a grading system for doctors.

A follow-up meeting at the Treasury to communicate the union’s stand was to be short-lived, lasting only 10 minutes.

“We went to the Treasury boardroom where CS Rotich, CS Mailu and technical officers from the Government ministries, the PSC and the Office of the President were present. After giving their feedback, the union officials were asked to leave. “This shocked us as we had expected to engage in further negotiations. We left,” said our source.

Things came to a head, and the Government addressed the Press on the collapse of the talks.

A meeting at Mayfair Hotel on January 17, after the court had issued a one-month suspended sentence against union officials, made significant progress in discussing the CBA article by article, though not all players were represented.

“Talks on the second day of this meeting collapsed as the Government had changed position from negotiating the 2013 CBA to negotiating a new one,” said the officials.

“On this day, the CS left to consult with State House, and his PS was to continue but failed to come despite assurances,” said our source.

The following week, Tuesday, January 24, CS Mailu met with the union’s chair and secretary general early in the morning and made significant progress.

Later that afternoon, however, the meeting ended in disarray because of what the union called ‘a unilateral agreement’ by the ministry, which they were required to accept.

KMPDU left to ‘read’ the document. Sources from the ministry, however, insist that this document was a proposal to the doctors to consider so that negotiations could proceed.

We have established that the bulk of the content in this proposed agreement was as per minutes discussed between the union and the Ministry of Health at their Mayfair meeting.

The union officials insist they have made concessions on the CBA, including considering Job Group D1 as per the new SRC proposal, and having discussions to negotiate arrears on a phased-out approach as long as it is budgeted.

Kenyans will be closely watching to see if the talks spearheaded by Cotu’s Atwoli will make progress to end the strike, which has seen many Kenyans suffer for lack of proper medical attention.

— The writer is a medical doctor