Amoth eats humble pie on clinical officers remarks

Acting Director General for Health, Patrick Amoth, was forced to apologise to clinical officers after MPs put him to task over past calls to allegedly scrap the cadre.

Speaking during his appearance before a joint parliamentary Vetting Committee on Health, Dr Amoth said his comments were taken out of context during an interview with media houses following the doctors' strike.

“In a media interview, I said there is a need to develop a clear career path in clinical training. With a lot of training, I was posing a question on going forward, how we manage resources on clinical officers and clear career path on delivery of healthcare services. I never said they should be wiped out,” he said.

It is at this point that he apologised to the clinical officers in the country.

“Clinical officers are the first point of call in primary healthcare facilities. If it was taken out of context, I apologise. It was not meant to demean and harm,” he said.

Despite Amoth being recognised locally and globally for his policies and impact in healthcare, he has been acting Director of Health for over four years now. He was appointed the Executive Chairperson of the World Health Organisation.

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Dr Wahome Ngare presented a petition against Amoth for his alleged push for abortion.  

Ngare claimed that the acting Director of Health is not suitable to be Kenya’s Director General of Health, for supporting abortion contrary to medical ethics.

Appearing before the committee, he claimed that in May 2023, Amoth, without the knowledge of the Health Cabinet Secretary, attempted to launch guidelines that provided for medical uterine evacuation procedure, thus illegally sanctioning the killing of unborn children up to 28 weeks for risky or unintended pregnancy.

The petitioner, who is an obstetrician and gynaecologist, told the committee that the guidelines would be contrary to Article 26 (4) of the Constitution and Section 6 (2) of the Health Act, (Cap. 241).

He pointed out that Amoth strongly pushed for the agenda, but luckily it was stopped by the Kenya Catholic Doctors Association and catholic bishops.

“He (Dr Amoth), was to approve guidelines for termination of WHO that is against the Constitution of Kenya,” Ngare told the committee, chaired by Dr Robert Pukose.

“It is against medical ethics. If a woman comes to me saying she is pregnant, medical ethics require me to take a history and come up with a diagnosis. The treatment will be dealt with social crisis the woman goes through and not termination of pregnancy,” he added.

Ngare argued that abortion is an English and not a medical word that brings pregnancy to an end, maintaining a strong opinion that life begins at fertilisation.

But in his defence, Amoth said that he does not support abortion.

“On maternal health guidelines, these guidelines were not guidelines of Amoth as a person,” he said.

Additionally, Ngare claimed that Amoth lacks the courage and independence of mind needed to protect the interests of Kenyans against the influence of international bodies such as WHO.

He also took issue with how the acting Director of Health handled Covid-19 pandemic, saying he subjected Kenyans to psychological torture by using fear, indicating that the respiratory infection did not have treatment and vaccines would be the only way to return Kenyans back to normal.

In an emotional response, Amoth, who was vocal during the pandemic, said: “I take this with pain in my heart. It was a wanting situation, not only for Kenya, but globally. Faced with a virus that was a threat to everyone but the most elderly, yet we never had a complex to implement. It was teamwork. I was the face behind the technical lead who channelled information critically analysing information, strictly guided by science, not anything else.”

Amoth pledged to address Kenya's long-standing human resource issues that continue to paralyse health services, if approved by a joint committee of the National Assembly Departmental Committee on Health and the Senate Standing Committee on Health.

He said unresolved health workers' grievances trigger industrial action across the country

“If approved by Parliament and confirmed to this position, I will be requesting your support in adequately resourcing this institution to help us address industrial strikes, such as the one concerning the posting of medical interns, and to manage the human resources within the Ministry of Health and the County governments,” he said.

Amoth used the opportunity to make a case for the Kenya Health Human Resource Advisory Council (KHHRAC) to be properly resourced to enable it to deliver on its mandate.

Under the Health Act of 2017, KHHRAC is mandated to review policies and establish uniform norms and standards for the posting of interns to both National and County Government facilities; as well as for the inter-county transfer of healthcare professionals.

The Act also confers the power to manage the transfer of healthcare professionals between different levels of government, oversee the welfare and service schemes for health professionals, handle the management and rotation of specialists, and maintain a master register for all health practitioners in the counties, to KHHRAC.

“Currently, KHHRAC is underfunded as well as understaffed, it has only the Chief Executive Officer (CEO) and three other staff. Therefore, being unable to execute its mandate effectively,” Amoth told the committee.

“One of the biggest challenges we have faced is human resource, that result to industrial disharmony that not only disrupts services,” he added.

Narok Senator, Ledama Ole Kina, applauded Amoth's plan on human resource, saying the issue has been a ‘thorn in the flesh’.

“Once interns are mistreated, doctors join them. Your role is to advise national and counties on public health,” said Ledama.

Amoth also pledged to reach out to counties to find better measures to handle healthcare providers for quality service delivery.

He promised to ensure that Kenya enjoys strong and resilient health systems that can respond to any shocks.

“I also want to shift focus on curative services, so that in the next five years, we can become the destination of choice for treatment of diseases," he said.

“This will require strategic thinking in view of the physical space what will also be able to prioritise resources that are available to create development multidisciplinary teams that are able to offer health services through the primary healthcare networks,”

Amoth promised to put in place systems to rationalise the utilisation of resources.

“I want to see a situation where going forward, our health services are patient-centred so that we create health and wellness squarely at the household level and individual level focusing in health prevention, health promotion and frequent screening, for common conditions, that is my view on how we can be able to operate health system going forward in terms of building any economic space,” he told the committee.

Regarding vaccine efficacy, Amoth emphasised that benefits outweighed risks, and therefore encouraged its uptake by Kenyans.

He that beyond saving lives, at least 100 laboratories were established across the country for quick response, if a pandemic is reported.

Kenya was forced to take her samples to South Africa during the outbreak pandemic, affecting turn-round time in fighting the virus.

“I believe we did our best and all decisions made were to save lives. When vaccines came, I was the first Kenyan to be vaccinated, withstanding fears that had been reported. Leadership needs tough decisions to be made,” said Amoth.

Ngare also took an issue with vaccination including Human Papillomavirus (HPV), malaria jab and family planning.

He argued that there should be alternative ways to prevent diseases as opposed to vaccination, and advised on ‘spacing of children, against uptake of contraceptives.

The vetting committee asked Amoth whether health should be reverted back to the national government, despite it being devolved.

Further, the committee demanded answers on what he will do, to harmonise health at national and county governments.

In response, Amoth said he will have a sitting with devolved units to understand the gaps, for smooth sharing of roles between counties and national government.

“We cannot go back to days when things were centralized we should support counties to deliver on their mandate by ensuring they have adequate resources and infrastructure to continue offering services,” he said.