Deal finally reached to end doctors' strike

Health Cabinet Secretary sips water when she appeared before the Senate Health Committee to deliberate on the ongoing doctors' strike on May 2, 2024. [Elvis Ogina, Standard]

Doctors and the government yesterday gave Kenyans hope that the strike that has crippled the health sector would be called off.

After 56 days of the nationwide strike, doctors will finally return to work following the signing of a return-to-work deal between their union and the government.

The agreement was inked on Wednesday in the presence of Head of Public Service Felix Koskei after marathon overnight negotiations prodded by recent court orders.

“We have signed a return-to-work formula paving the way for doctors to resume duties within 24 hours,” announced Davji Atellah, Secretary General of the Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU). “This marks the end of a 7-year, 56-day strike by the government.”

Health Cabinet Secretary Susan Nakhumicha, who seemed to rarely find breathing space from the protracted industrial action, said the “tough, protracted negotiations” tested the nation’s patience. 

“The doctors proved far more skilled negotiators than myself,” she said. “After long and painstaking negotiations that ran into the early hours for many nights, I am pleased that we have finally arrived at this milestone - the signing of a return-to-work formula agreement that has led the doctors’ union to call off their strike.”

The agreement between KMPDU, the Ministry of Health (MoH) and the counties was filed before Employment and Labour Relations Court Judge Byrum Ongaya.

Although the parties were agreeable on almost items, they could not agree on whether intern doctors should earn Sh206,000 a month. The government and counties had committed in the collective bargaining agreement to a slashed Sh70,000 pay dangled by the Kenya Kwanza regime.

Senior lawyer Ochieng Oduol, representing the Attorney General in the case told Justice Ongaya that his clients and union had agreed on a return-to-work formula that would be tabled in court by 4.30pm yesterday.

“Pursuant to the order of the court made on May 6, 2024, the parties in good faith and in earnest engaged in negotiations in a view to reach an agreement. We have made a lot of progress and filed in court two reports; one is the return-to-work formula between government and the union, and the second one is between the county governments and the unions,” he said.

While agreeing with Oduol, KMPDU lawyer Edgar Washika said that the two-day meetings were fruitful.

He, however, pointed out that the elephant in the room remained the intern doctors’ remuneration.

“I confirm that the parties have been engaged in a process that is very fruitful. As early as this morning we were in a meeting with the employers and confirmed that the documents presented to you represent the agreements between the parties save for the issue for doctor interns. Lordship, I agree with senior counsel that we require time to conclude. Save for doctor interns, the documents are largely accepted,” said Washika.

In the deal, the national government had to yield its stand on salaries arrears and harmonisation of terms of service for those working in national hospitals with those in the counties.

On the salary arrears, KMPDU will present the list of doctors owed by the national government within 15 days, after which they will be paid.

It also gave in on 81 doctors who were placed at Kenyatta National Hospital under the Covid-19 program and agreed that there should be a body that would progressively address doctors’ grievances.

The government also agreed that no disciplinary action would be taken against all those who joined the strike called on March 6 and that any action that had commenced or taken would be deemed to be null and void.

However, the government was deflecting the intern doctors' pay issue. It sought to have the issue put on ice until a case filed in Eldoret is heard in determined.

On the other hand, doctors held on to their stand that intern doctors should be paid the amount agreed upon in the CBA. The other issue was about counties paying Sh 3.5 billion owed to doctors between 2017 and 2021. The National Government committed that it would grant counties the amount in order to settle the same.

In the agreement between counties and KMPDU, doctors who do not have comprehensive medical cover and those who were seconded by the Ministry of Health will get them immediately. Governors also agreed that the counties that had not promoted doctors would do so within a month.

At the same time, governors approved paying the Sh3.5 billion in five installments from July They also yielded to a demand by doctors that they immediately pay all outstanding fees incurred by government-sponsored postgraduate registrars from 2018 to date.

On medical insurance, counties committed to reimbursing doctors who incur out-of-pocket medical expenses before they get the coverage.

Doctors also got a car loan and mortgage deal where it was agreed that would come into place within 90 days. In respect to Kirinyaga County, it was agreed that those who were fired will be reinstated while in Nairobi, those who were working under the now defunct Nairobi Metropolitan Service (NMS) would the hired immediately by the county under permanent and pensionable terms.

In the negotiations, KMPDU was pushing to have salary arrears be settled within the next financial cycle. It demanded that the first cycle should be remitted before September 1, 2024.

At the same time, it demanded that the grant to settle counties' debt to doctors be settled in three annual installments. The union also agreed that harmonization of terms of service ought to be done but within 90 days.

KMPDU was also agreeable on medical cover and the formation of a multi-agency taskforce that would resolve their issues. It also demanded that all medics working in Kenyatta National Hospital under a year contract should be given at least three years.

On the contentious medical intern issue, doctors demanded that they should get Sh 150,000 a month and be on duty for 40 hours a week.  It held that an intern doctor working for an extra hour should be compensated.

On the other hand, the government and counties demanded that doctors unions should immediately call its members back to work.