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State plans to make health care affordable deliberated

By Graham Kajilwa | January 9th 2019 at 12:00:00 GMT +0300

Kenya Medical Practitioners and Dentist Board Chairman George Magoha (center) accompanied by other medical practitioners during an external stakeholders forum to review doctor's professional Fees at a Nairobi hotel. [David Gichuru/Standard]

The Government is pondering a number of proposals to make healthcare affordable.

Among them is a suggestion to waive accumulated medical bills if a patient dies.

There is also a plan to scrap minimum caps to facilitate lower doctors' fees, as well as the elimination of varying day and night hospital charges.

Alternatively, the Government could consider a proposal by the Medical Practitioners and Dentists Board (MPDB) to reduce the current maximum and minimum doctor charges by 20 per cent.

However, as revealed by MPDB Chairman George Magoha yesterday during a public participation session, the proposal has met opposition from some medics.

Instead, the medics represented by 28 medical professional bodies decided not to alter the minimum doctor charges, but agreed to reduce the maximum fee by 20 per cent.

Health Cabinet Secretary Sicily Kariuki, who is set to hear the proposals from the medics this Friday, was however said to be supportive of the idea to slash the minimum fees levied by doctors.

This might not go down well with doctors practising or moonlighting in private facilities, who are the major targets of the changes.

A cut in their fees would mean patients stand to benefit since the doctor's fee is usually between 10-20 per cent of the total hospital charges.

 Target lawyers

If the proposals are implemented, it would mean Government-run facilities would the best places to work for medics.

It would kill the practice that has evolved where Government doctors diagnose and refer patients to private facilities where they work part-time, thus profiting from them.

Yesterday, the National Assembly Constitution Implementation Committee Chairman Jeremiah Kioni proposed radical changes.

Mr Kioni proposed to have minimum doctors' fees scrapped, saying this was already contained in a legislation that would soon be presented to Parliament.

He said the legislation did not only target doctors, but also other professionals such as lawyers.

“Countries like Singapore and Romania have done away with minimum fees. So even if we talk of reducing minimum doctor charges by 20 per cent, we should be aware that other countries have done away with them in totality, while others have them capped,” said Kioni.

The Ndaragwa MP said in some cases, the minimum fees as stipulated in the 2016 Professional Fees Guidelines for Medical and Dental Practitioners was not within the reach of many Kenyans.

Yet that is what they are expected to pay when they visit a private facility.

“There are many issues that I will take back to Parliament, for example, why should we charge fees for the dead. Is it possible for the Government to even waive mortuary fees?" asked Kioni.

What informed yesterday’s deliberations was the case of Matilda Anyango, whose family was slapped with a bill of over Sh850,000 when she died after a 12-hour stay at a hospital in Nairobi.

The family was not allowed to collect the body, with the hospital demanding that the bill be cleared first.

However, when the case found its way to the National Assembly Health Committee, the hospital accepted Sh25,000 from the family.

Prof Magoha yesterday described the case as "obnoxious by all standards".

Patient's ability

The hospital later explained that the charges were within the stipulated guidelines, which Magoha countered, saying even if the charges were justified, the ability of the patient to pay was not considered.

“Please, before you, doctors, charge patients, ask the patients if they have the ability to pay,” Magoha said.

While the National Council for Persons with Disabilities, represented by Bramuel Ashibira, maintained that doctors needed good pay, the council called for a uniform charge. “It is true doctors need good money, but you need good money to treat the sick, not to cure the dead,” said Mr Ashibira.

Yesterday’s discussions, which were not attended by members of the Kenya Medical Association (KMA), was limited to doctors’ fees. KMA, through its president, Jacqueline Kitulu, had asked its members to boycott the meeting.

It said that while it was ready to discuss how to bring the cost of healthcare down, the talks should not be limited to what doctors charged.


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