Ruto government under scrutiny over duplication of roles

President William Ruto's government seeks to establish Quality Health Care and Patient Safety Authority to regulate the development of health facilities’ infrastructure. [PCS]

The Kenya Kwanza administration is yet again under scrutiny over the perceived duplication of roles within government institutions amid a narrowing fiscal space in the country.

In a development that has triggered debate over the regime’s efficiency, the government has introduced a Bill that seeks to establish an authority to license hospitals, accredit facilities, inspect and audit, and enforce compliance with set health regulations.

This is despite similar roles already being performed by Kenya Health Professions Oversight Authority (KHPOA), Kenya Medical Practioners and Dentists Council (KMPDC) and the Ministry of Health.

The Quality Healthcare and Patient Safety Bill, 2025, that is currently before the National Assembly, also seeks to provide for the responsibility of the national and county governments in the realisation of quality of healthcare for patients.

“The principal object of this Bill is to establish a comprehensive legal framework to promote the improvement of the quality of healthcare in Kenya by establishing standards, accreditation mechanisms and ensuring the protection and promotion of patient rights. The Bill therefore institutionalises quality health care standards, accreditation mechanisms, and patient rights in Kenya for purposes of improving health outcomes, enhancing accountability in health systems and aligning the existing frameworks with global best practices,” reads the Bill in part.

To ensure the administration of healthcare in the country, the Bill proposes for the establishment of an Authority to be known as the Quality Health Care and Patient Safety Authority (QHPSA).

Its functions will be to regulate and guide the development of health facilities’ infrastructure; register, license and accredit health facilities; regulate the conduct of health facilities; inspect health facilities for compliance with quality of healthcare standards and inspect and accredit health facilities for purposes of internship and training.

Others include to establish and implement a system of accreditation of health facilities for quality of healthcare; accredit health facilities for purposes of empanelment and contracting under section 33 and 34 of the Social Health Insurance Act, enforce compliance with quality of healthcare standards and promote public awareness on quality of healthcare including on patient rights among others.

The Authority will be headed by a board which will have sweeping powers to enter, inspect and search any health facility and one where an offence is being committed or is suspected to have been committed. With the approval of the National Treasury Cabinet Secretary, it will invest any surplus funds of the Authority not immediately required.

The board will also be at liberty to levy or charge fees for the services rendered by the Authority and to further receive gifts, grants, donations or endowments and make legitimate disbursements therefrom.

Pundits however argue that while the Bill promises to reduce fraud and improve care, it not only risks centralising too much power, creating a duplication of roles.

There are fears that should the Bill get the nod from lawmakers, it would lead to an overlapping of mandates between authorities such as the KHPOA, KMPDC and the Ministry of Health.

This is premised on the fact that the Authorities and other regulatory councils are already performing the roles to be taken up by the new Authority and the new Bill does not provide for their scrapping.

Notably, functions of the KHPOA include training, registration and licensing of health professionals; coordinating joint health inspections; receiving and facilitating resolution of complaints and arbitration of disputes and conflicts; ensuring compliance of health professionals standards and monitor execution of respective mandates and functions of health regulatory bodies.

KMPDC is mandated with regulating the training, practice and licensing of medicine & dentistry, and healthcare institutions that include private and mission hospitals, medical, dental centers and clinics, nursing and maternity homes and standalone funeral homes.

On the flipside, the Kenya Medical Association (KMA), the umbrella professional association for doctors, supports the Bill noting that it would transform the healthcare landscape and advance quality standards.

“Kenya Medical Association (KMA) supports the Bill’s provisions on: Patient Rights because the Bill has comprehensively defined patient rights, including informed consent, dignity, and access to qualified professionals elements that represent essential standards in patient care which require clear operational guidelines and consistent enforcement,” reads a statement from KMA which was submitted to Parliament at the public participation stage.

“The inclusion of quality assurance mechanisms, rightly mandating safety protocols, risk management, and continuous professional development, reflects an attempt to address existing systemic gaps. Considerations for standardized regulation through the establishment of a dedicated Authority for oversight, accreditation, and enforcement is necessary for national coherence,” it adds.

Notably, the Bill is not the first time to elicit debate, the administration is facing over duplication of roles by the current regime.

Last year, the courts slammed the brakes on a multi-agency taskforce to fight graft formed by President William Ruto, arguing that it was a duplication of roles already vested in existing independent institutions such as the Ethics and Anti-Corruption Commission (EACC).

A broader look at other offices and Ministries in the public sector also reveals overlapping roles.

For instance, the Ministry of Public Service, the Office of the Head of Public Service, and the Public Service Commission have similar roles.

While Public Service CS is responsible for the general public service docket, supporting and facilitating performance management for effective service delivery, the Public Service Commission also promotes good governance and ensures efficiency in public service.

Head of Public Service Felix Koskei, also has duties that include promoting ethics, good governance, efficiency, and effectiveness in public service through the deployment of the right skills, values, and leadership.

The duplication of roles now casts a dark shadow over the administration’s promise to reduce public expenditure in light of the country’s ballooning wage bill.