Kiambu Woman Representative Gathoni wa Muchomba shot to the national limelight in 2017 when, prior to being sworn in, she made a pitch for better pay for Members of Parliament. This was done in direct defiance of the Salaries and Remuneration Commission (SRC) attempts to bring down MPs' salaries. She said she wanted to be "honoured for who she was".

More significantly, it came at a time when President Uhuru Kenyatta and his deputy William Ruto had volunteered to have their own pay cut and urged MPs and principal secretaries to take a similar route to contain the rising wage bill. Kenyans reacted angrily to Ms Muchomba's proposal, and after days of bashing, she ate humble pie and tendered a public apology.

A month ago, she stirred the hornet's nest again with calls to men to take up polygamy, notwithstanding that some religions frown on the practice. She was condemned and applauded in equal measure. In these two instances, the general feeling was that the woman rep had gone overboard.

But never one to shy away from speaking her mind, she made an observation last week that should, by now, be quite obvious to any discerning Kenyans.

It is evident that the health sector has gone to the dogs, and that happened after the health function was hurriedly devolved to the counties. Indeed, Muchomba was echoing sentiments made earlier by Garissa Town Member of Parliament Aden Duale.

She argued that cases of medical negligence were on the rise and indeed, there was enough evidence to support that contention. On this one, she hit the right chord. Something needs to be done urgently to improve healthcare.

Last year, a doctor at the Kakamega General Hospital lost his eight-month-old baby after nurses on strike locked up all the oxygen cylinders. Cases of misdiagnosis and wrong treatment abound.

In 2014, an individual was arrested in Eldoret's Moi Teaching and Referral Hospital, where he had masqueraded as a nurse for years. In 2015, two children died and seven others were hospitalised after getting measles vaccinations in Kerio Valley, Elgeyo Marakwet County, from someone who was not qualified.

That same year, wrong vaccinations in Busia County resulted in paralysis in 28 children. And in June 2016, two quack doctors were arrested in Nakuru County. So far, gynaecologists have been hit with 150 cases of malpractice, surgeons coming a close second with 130 cases. Reports show several hospitals have been ordered to pay more than Sh38 million for mistakes arising from negligence.

While devolution came with many benefits, there has been a lot of unease in the medical services sector. No doubt this has compromised the quality of work.

Over the years, there has been an exodus of doctors and nurses from Government-run hospitals to the more lucrative private sector, while others are seeking greener pastures abroad. The Kenya National Union of Nurses claimed in 2015 that more than 3,000 members had requested to leave Government employ.

By late 2016, close to 2,000 doctors had voluntarily left Government service in a country where only 3,300 doctors are employed against an estimated population of 45 million people. To a larger extent, this accounts for the declining standards in State-run hospitals and the proliferation of private medical facilities that charge an arm and a leg for their services.

Besides the agitation for better pay that saw doctors down their tools for a record three months last year, working long hours without basic facilities in hospitals that don’t even have drugs was another sticking point.

The back and forth over pay, the inability by county governments to employ doctors to meet World Health Organisation recommendations of one doctor per 1,000 patients, and poor services in former provincial hospitals that increase the cost of medical care by referring patients to referral hospitals for simple tests depict the counties as being ill-equipped to manage the health sector.

There is urgent need to remedy this situation. If need be, reverting medical services to the national government until such a time that proper structures are in place should be considered. These structures should guarantee fair play, better pay, promotions on merit, availability of medical stores and promising careers in medicine.