The bitter labour dispute crippling the public healthcare system has taken new turn, with multiple county governments sacking striking doctors and union officials.

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) on Saturday told The Standard that several counties have started showing medics who have declined to heed ultimatums to return to work the door en masse.

The termination notices seen by The Standard cite the physicians' ongoing absence from work as grounds for dismissal and a breach of their employment contracts.

"This is an extremely concerning escalation that shows that counties are becoming more reckless and defiant in their crackdown against doctors fighting for their rights," said Dr Dennis Miskellah, KMPDU’s deputy secretary-general.

"Firing doctors simply for exercising their legal right to strike is not only unethical, but it violates a court directive expressly prohibiting such punitive actions until the labour dispute is resolved."

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Officials from the union claim that over 90 per cent of government-employed doctors have been hit with "show cause" letters, threatening further disciplinary action, including potential termination, if they do not immediately return to work.

"Most doctors are essentially working under these draconian show cause letters now," said a union member who did not want to be named.

In some cases, county authorities have gone even further to relieve the doctors of their jobs.

Nyeri County has issued termination notices to doctors participating in the strike. However, it is unclear if they have actually sacked them.

Kitui County, too, opted to stop remitting union dues for doctors still on strike.

Miskellah condemned the move by the devolved authorities as "an illegal and unjustified retaliation and victimisation of workers lawfully exercising their labour rights".

"We are totally disappointed with the county governors who are recklessly inflaming this crisis," he said.

"They know full well they lack funds to pay our salaries and arrears, yet they are vindictively punishing us for demanding overdue compensation. It's grossly unfair,” he said.

Miskellah further warned that unless county officials started negotiating in good faith to substantively address the doctors' long-standing grievances over medical interns' pay, staffing, promotions and working conditions, the union will scale up mass protests.

He claimed that some counties planned to hire overseas doctors, who he said would accept low pay and poor working conditions to replace striking doctors.

At the centre of the dispute is the union's key demand that the national and county governments fully implement long-standing policies governing the hiring, training and compensation for medical interns.

"We will not relent until they commit to paying us the Sh3.5 billion in arrears owed," said Miskellah.

The latest turn of events marks a new, yet dangerous point in the labour crisis that has paralysed public hospitals and clinics.

Patients have been left to their own devices, with some being forced to fork out more resources to get medical attention in private facilities. Yet some have already died over issues that could have been managed in public hospitals.

Negotiations between the two sides remain deadlocked, with the county governments accusing doctors of making exorbitant pay demands, and the union insisting counties have turned a blind eye to years of labour violations.

Beyond the doctors, clinical officers and laboratory technologists have also downed tools over own demands.