County governments yesterday boycotted the signing ceremony of a Sh38 billion equipment tender for decentralising specialised health services.
This ceremony went ahead even as it emerged that Council of Governors (COG) Chair Isaac Ruto, Jack Ranguma (Kisumu) and James Ongwae (Kisii) had been invited to State House, Nairobi, to be part of the occasion.
The letters addressed to the three governors and signed by Health Cabinet Secretary James Macharia, read in part: “As part of the ministry’s flagship projects and pledges by the Jubilee government to transform Kenya’s health sector that will positively impact citizens lives, the Ministry of Health undertook to ensure that 94 hospitals in all the 47 counties are equipped with state-of-the-art medical equipment.”
“The purpose of this letter is to inform and invite you for the formal signing ceremony...,” the invitation read.
But in an interview with a governor who requested not to be named, the county chiefs snubbed the event because the health equipment tender was planned single-handedly by the Government locking out the Council of Governors. “The invitation came through the COG, but our concern was that we were not involved in the entire process. We feel left out,” the governor told The Standard on Saturday by telephone.
The governor further revealed that COG had requested for a postponement of the signing but was rejected by the national government.
However, Transition Authority chairman Kunuthia Wamwangi, defended the national government saying what it had done was within its mandate legally and constitutionally.
“This is not a matter beyond dialogue. If the negotiations began before the county governments came into place, then it was just necessary it concluded the process. If a foreign financier was involved, it would have been difficult for the county governments to take over the negotiations, because we have not established a legal mechanism within which such negotiations can be taken over by county governments,” he said.
Governors had planned to meet on Monday to discuss the issue that the governor who spoke to us termed as “a project championed by the Ministry of Health leaving out governors”. “We are the ones to implement this project, yet the entire planning was done by the Ministry of Health. We do not know even the basics – like funding for instance.”
Macharia, however, downplayed the issue terming failure by governors to attend the function as pure politics. The CS said the county governments were involved in the entire process, listing a number of meetings held between his ministry, county government executives in charge of Health and the governors.
“The county governments have been on board since early 2013, and their failure to turn up at the signing ceremony is politics. When we began the planning project, we held a two-day session with all county executives in charge of Health and they later explained the same concept to governors,” Macharia said in an interview with The Standard on Saturday, yesterday.
Thereafter, he said, the ministry held a meeting with all the 47 governors at the Great Rift Valley Hotel in Naivasha to deliberate further on the matter, and they resolved to support the initiative.
“COG chair was present during the meeting and they pledged support saying it would change the face of healthcare at county level,” added Macharia.
Wamwangi sought to steer clear of the standoff between the two levels of government, saying he does not understand the terms of engagement in the deal.
“Since I don’t understand their terms of engagement, it becomes difficult for me to conceptualise the existing dialogue. But this is not the first time the national government is supporting county authorities through provision of equipment. It happened in the past during the procurement of hospital and agricultural equipment. What the national government is doing within its functions,” the TA boss pointed out.
But in what would have complicated matters, COG requested for funds last year to roll out the project in their respective counties. This request, the CS said, was rejected with an explanation that the project was a national initiative being given. According to Macharia, COG sent a congratulatory message to the Ministry of Health on Tuesday, for what they (governors) termed as ‘a milestone in the provision of specialised health services countrywide.”
An aide to COG chair Isaac Ruto who spoke to us on condition of anonymity because the matter revolves around the Presidency, said the position of COG remains that Health is a devolved function and anything touching on the sector should be handled by counties. “COG will issue a comprehensive statement on the matter later,” he said.
Through the initiative, all counties will have one Level Four and one Level Five hospital equipped with theatre, laboratory, renal, intensive care and radiology equipment, thereby making available diagnostic services at the county level.
Launching the initiative yesterday at State House, President Uhuru Kenyatta termed it as a major milestone towards the realisation to transform healthcare by delivering equal access to high quality treatment to all.
“This will ensure Kenyans lead healthy productive lives with dignity, equity and opportunity,” President Kenyatta said.
Cabinet Health Secretary James Macharia, was optimistic that the project would greatly impact lives of Kenyans by decentralising specialised healthcare services from national referral hospitals to county ones.
Some of the 94 hospitals identified include Garissa and Nyeri PGH, Hola, Lamu, Mandera, Kericho and Iten District hospitals as Level Five hospitals amongst others.
Other Level Four hospitals earmarked to benefit from the initiative include Baragoi, Nyambene, Makindu, Kisumu East, Kianyaga and Malava sub-district hospitals, among others.
The World Health Organisation projects the four leading chronic diseases globally as measured by their prevalence as cardiovascular diseases (CVDs), diabetes mellitus (diabetes), chronic obstructive pulmonary disease (COPD) and cancer.
The global health body warns that all four of these diseases are projected to continue to increase in prevalence in the near future given the demographic trends and lifestyle changes.
“We want to collaborate with county governments and the medical profession to ensure Kenyans travel abroad for treatment only because they want to, and not because they have to.”
— Additional reporting by Juma Kwayera