Striking doctors, state return to court after failing to reach deal

Kenya Union of Clinical Officers (KUCO) stage their weekly demos along Parliament Road, Nairobi on May 7, 2024. [Elvis Ogina, Standard] As doctors and the government appear in court Wednesday following the order to reach a return-to-work formula, the medics are adamant that they will only resume duty if their short-term demands are addressed. The short-term demands include posting of intern doctors, payment of basic salary arrears, harmonisation of salary scale of doctors and provision of medical cover. Striking doctors under the umbrella of Kenya Medical Practitioners and Dentist Union (KMPDU) said the government has remained non-committal on implementing the demands. "To be able to have a conclusive way forward, we should have at least four demands met," said KMPDU Deputy Secretary General Dennis Miskella. Dr Miskella wants the government through respective stakeholders to find solutions to intermediate and long-term issues. On Monday last week, the Employment and Labour Relations Court directed the government and doctors to conclude the return-to-work formula by Wednesday, May 7. Justice Byrum Ongaya said failure to get a solution, the court will hear the petitioners and determine all pending applications. The judge advised parties to handle the return-to-work formula in good faith. Despite the court's directive, the government and the doctors are yet to arrive at an agreement. In an interview with The Standard, Miskella said: "At least the government must commit to have doctors report back to work. We cannot solve anything, but at least there must be something for us to go back to work." He accused the government of lack of goodwill in finding a solution to end the strike. KMPDU wants intern doctors to be posted as per the Collective Bargaining Agreement (CBA) signed in 2017. They maintain that intern doctors should earn Sh206,000 basic salary and allowance. However, the government has said it can only afford to post intern doctors according to the new Salary and Remuneration Commission (SRC) circular of March 2024 at an all-inclusive gross pay of Sh70,000. "Interns must be posted as per CBA," said Miskellah. On basic salary, the government has agreed to immediately pay doctors who are owed and effect the changes on the payslip. But the striking doctors have disagreed with counties on how soon they will clear the arrears. According to Kenya Medical Dentist and Practitioners Council (KMPDC) Kenya has a total of 10,102 registered doctors. Of the doctors, 1,200 are employed by the national government, whereas 4,480 are working in county hospitals. "The county governments are non-committal on when they will affect the 2017 CBA basic salary on the payslip to stop further accrual of arrears," said the doctors. The government has committed to provide all doctors with an enhanced medical scheme by July 1, 2024. Counties however want to be given 90 days to procure and provide medical covers. The counties have also not committed to re-reimburse out-of-pocket medical expenses that may arise in the intervening periods before acquiring medical coverage. "The union considers the timelines provided by the counties as inordinately excessive and the refusal to reimburse medical expenses in the intervening period as manifestly unjust, and unfair and contrary to CBA 2017," doctors said. The government and doctors have disagreed on harmonisation of salaries. According to doctors, county governments should convert all contract employment to permanent and pensionable and immediately harmonise their salaries as per SRC and CBA 2017 to avoid discrimination amongst doctors performing similar duties. The government has agreed to harmonise salaries as per SRC but remains non-committal on the timeline. According to Miskellah, harmonisation of salaries is key as doctors perform same roles. "We must harmonise payment of all contracts. Some are on contracts, others are on permanent terms," added the union official. Postgraduate studies are also among issues raised by the striking workforce. So far, there is no divergence on fee payment, a role to be played by the Ministry of Health. Counties have also agreed to release doctors for postgraduate studies. Other issues raised include shortage of doctors, promotions and redesignation, delayed salaries and statutory deductions, unfair dismissal of Kirinyaga doctors and absorption of Nairobi Metropolitan Services (NMS). Additionally, KMPDU wants actualisation of car loan and mortgage schemes by counties, shareable revenue, university issues, Level 6 Hospital issues and Perennial issues solved. Initially, doctors had raised 19 issues, that have since been reduced to 15. The issues are being addressed through the Whole-of Nation approach committee, which brings together respective ministries. At least five meetings have been convened, chaired by the Head of Public Service Felix Koskei. On Friday last week, the government signed a return to work, in the absence of doctors. Doctors accused the government of not involving them in signing the return-to-work formula, saying they are yet to agree on some of the issues as directed by the courts. On Tuesday, Miskella said it is unfortunate that the government continues to accuse doctors of absconding duty despite not having gotten solutions to issues at hand. "The government cannot sign documents in its favour and rush to court saying it is a return to work formula. If such is done (signing return to work formula), we shall also sign ours and take it to the same court," he said. Meanwhile, major surgeries have been paralysed in hospitals. Amongst the hard hit patients are those battling chronic diseases like cancer, who are not able to undergo radiotherapy and chemotherapy, risking death and the spread of cancer cells. There is also fear of increased cases of maternal and child death, due to lack of specialists to attend to mothers during birth.

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