Mombasa Governor Abdulswamad Nassir has revealed that the Coast General Teaching and Referral Hospital will operate as a parastatal.
Nassir said the process, through the enactment of legislation, has started.
The hospital serves all six Coast counties, and it takes up more than Sh2 billion in operation costs annually.
The proposal, the Governor said, will give the facility autonomy and prevent the Executive from influencing its management, and guarantee financial independence.
"This means that the terms of staff service can only improve; pensions will be secured and salaries paid on time. Moreover, this will allow the hospital to plan with certainty as we include mechanisms for ring-fencing funds generated at health facilities for use in the health sector," said Nassir in a recent meeting with the hospital staff.
Nassir said the facility has been strained the large population it serves, even though it is only run from the county's budget.
"This strain has become greater with the cessation of the disbursement of conditional grants from the National Treasury that served to support the operations of level five hospitals in the counties," he said.
Founded in 1908, the 700-bed hospital caters for a primary population of about 700,000 and a secondary population of about 2 million per year.
In 2016, the Mombasa County Corporations Act came into force, leading to the establishment of Mombasa Investment Corporation and Mombasa Water and Sewerage Services Corporation.
If the proposal comes to pass, the hospital will join the ranks of other referral hospitals like the Kenyatta National Hospital and the Moi Teaching and Referral Hospital in Eldoret, Uasin Gishu.
"When you have your law, you stand on your own, and you're able to receive funding from the Executive. As you receive funding from the Executive, you're also entitled to be able to raise revenues," said Nassir.
"It has to be under an Act of its own. Right now, if they want to review their tariffs, it's a challenge."
The Governor said the county wage bill exceeds the acceptable percentage as set out in the Public Finance Management Act, 2012, which limits the county government's spending on salaries to 35 per cent of the total revenue.
Nassir said his administration spends about Sh497 million on salaries monthly, with staff working at the facility taking up about Sh100 million.
The Governor assured the staff that their pension and other benefits would not be affected by the proposed changes that will see the payroll transferred to the hospital.
He said that his administration would embrace dialogue to address concerns on sustainability, promotions, job security and management to boost efficiency at the referral hospital.