By Anyang’ Nyong’o

On September 13, the medical interns at the University of Nairobi went on strike. They were demanding that the Government pays a stipend of Sh92,000 a month to self-sponsored students doing their internship at the Kenyatta National Hospital (KNH).

Both the University of Nairobi and the Kenyatta National Hospital management have gone to great lengths in explaining this issue in special articles in our daily newspapers this past week. I will, however, try to give a full background to this issue and why both the university and KNH have declined to meet this demand.

When students graduate with medical degrees from public universities, they are required to work with the Government for at least three years before they proceed for post-graduate studies either locally or abroad. When the University of Nairobi or Moi University admits them for these studies, they do their clinical or practical work at the KNH under an arrangement between the hospital and the university.

During this time they are called interns or registrars. Having been employed in Government they continue earning their salaries as well as the following: Extraneous allowance of Sh60,000, and house allowance of Sh24,000 per month among other allowances. In summary, they enjoy the same pay package as any other doctor working in the public service plus allowances commensurate with their responsibilities.

KNH further provides registrars with housing facilities within its premises at subsidised rates of between Sh7,500  and 15,000.

There are, however, students who, soon after they graduate, choose to work for the Government for less than three years and then resign to sponsor themselves for postgraduate studies. Some other students are sponsored in their studies by foreign governments, companies, parents, and so on. All these are treated as self-sponsored students by both the university and the Government.

While doing their internship, they go through the same programme as those sponsored by the Government. They are all expected to put in 80 hours of work per week at the KNH as part of their training.

How, then, did the issue of paying self-sponsored doctors Sh92,000 per month as a stipend arise?

In December last year, the Kenya Medical Practitioners, Dentists and Pharmacists Union staged a strike demanding, among other things, that doctors be paid extraneous and call allowances, among others. The Government eventually met these demands in full; but they were not meant to apply to those not employed by the Government.

Subsequently, to expand the membership of the union, another demand was raised, which was not part of the dispute. This is the issue of paying extraneous allowance to privately sponsored students. This was not, and is not, acceptable to the Government.

Currently there are 265 privately sponsored registrars, whose upkeep is met by their sponsors. Foreign governments sponsor 68, while companies sponsor a few others.

When an assessment is done of those other Kenyans who are self sponsored, it is realised that most of them left before fulfilling the mandatory period of three years in Government service before seeking Government support for post-graduate work. How fair, just and equitable would it be to then give them stipend while their colleagues are still toiling, waiting their justifiable turn to go for post-graduate studies? Would this practice not lead to people resigning en mass to go for studies, thereby leaving patients unattended?

The stand we have taken is in defence of both the Kenyan taxpayer as well as the due process that has been in practice, which really cannot be changed simply to suit the interests of the leadership of the doctors’ union. Moreover, any new justified allowance needs to be sorted out now by the Salaries and Remuneration Commission and not by the Ministry of Medical Services or any other organ of the Government. That is in line with both the law and the Constitution.

The tragedy, however, is that as the illegal strike by the doctors progressed, they seem to have shifted the goal post from demanding for allowances to demanding that hospitals be built, equipped and modernised. We are already going on with the rehabilitation of our facilities with funds at our disposal. This is a process and not an event. We welcome ideas on how we can do things better. But we cannot respond to instantaneous demands in a strike as if building a hospital is like making an instant cup of coffee.

At Cabinet office there are at least four Cabinet memos from the Ministry of Medical Services waiting discussion and tabling in Parliament. All these are meant to deal with various aspects of the delivery of health services including those specifically demanded in the Constitution. Members of the union, along with other stakeholders, submitted numerous documents, which were discussed by the ministry and incorporated in our proposals to the Government.

Since there have been Cabinet memos which had to take precedence over others due to the schedules in the Constitution, ours have taken some time to become public. But soon this will be accomplished and a lot of the anxieties of the doctors will be allayed. This does not, however, mean that all outstanding problems will be sorted out in one week, let alone within our lifetime. Patience will still pay.

The writer is Minister for Medical Services and ODM Secretary General