Doctors abandon hospitals in search of more degrees

A doctor at work. The number of medics ditching public hospitals for private practice is alarming. [File, Standard]
The current shortage of doctors will continue until something is done to convince the medics to stay in public hospitals.

Statistics indicate that 700 doctors deserted government-run facilities between January and December last year. As a result, Sh2 billion spent by the Government to train the medics went to waste just like that.

The number of doctors leaving the public sector is slightly more than those graduating from the country's medical schools every year.

The Kenya Medical Practitioners and Dentists Union (KMPDU) says that up to 2,300 doctors left public hospitals between 2014 and 2016 for the private sector or to go abroad.

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According to the Medical Practitioners and Dentists Board (MPDB) only 6,020 out of the country's 11,331 doctors are practising.

Doctors' ratio

As a result, Kenya's doctor to patient ratio stands at 1:6,109, which is six times the recommended 1:1,000 ratio by the World Health Organisation.

Even as this haemorrhage is going on, doctors' union and the Government do not agree on how to make the medics stay in public hospitals or who is to blame.

According to KMPDU, a majority of the deserting doctors have been denied an opportunity to further their studies.

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“The biggest issue is career progression, which became an issue especially when the county governments came in place. For me it is not right for counties to deny doctors a chance to study,” said the union's Secretary General Ouma Oluga.

The secretary general cited a county that has refused to allow one of its doctors proceed for further studies in neurosurgery under an already paid scholarship.

"Scholarships are a lifetime opportunity, so if one does not grab it there is no other chance. Taking post graduate studies is a big challenge to doctors. The Government does not realise that to a doctor, studies are even more important than salaries,” said Dr Oluga.

But Medical Services Director Jackson Kioko said it was not entirely true that doctors were running away from  public service to the private sector for career progression.

“In the Government we have very flexible policies that allow doctors three years after their internship to proceed for their masters. May be some of them were just not aware of this arrangement,” said Dr Kioko.

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He claimed that after the Government improved their pay, more doctors were applying to work in the public sector.

“Our issue now is on distribution of doctors especially specialists. We are coming up with a system where we will have a pool of specialists move region by region to train the area doctors or have a mechanism of distributing them from a central place in term of needs,” said Kioko.

Still, the number of doctors in Kenya is way below international standards.

According to WHO standards, Kenya needs at least 63,000 more doctors.

However, the migration of nearly half of the country's medics from the public sector to private practice means that at least 6,000 Kenyans are left jostling for one doctor.

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It gets worse when narrowed down to specialists. In dentistry for example, statistics indicate that 34,615 Kenyans look up to one dentist.

The doctors' union blames counties for not quickly absorbing newly trained doctors and instead making it difficult for some medical interns to get employed.

According to KMPDU, up to 1,400 interns were still unemployed at the beginning of this year.

The union has been pushing for a Health Service Commission (HSC), akin to the Teachers Service Commission (TSC) to address training, employment and remuneration of doctors.

However, according to the medical practitioners board the leading cause of the current shortage of doctors in the public service is not because of migration to private practice.

Administrative positions

According to the board, the shortage exists because many doctors no longer practice but have been moved from the wards to offices in administrative positions.

“The biggest casualties are doctors who are moved to administrative positions. That is why there are 11,331 registered but just 6,020 practising,” said the Board’s Chief Executive Officer Daniel Yumbya.

This year, there are 2,830 registered specialists out of whom 2,416 are active.

As at March last year, there were 10,786 registered medical officers. Out of these only 6,716 were active.

There were 1,239 dentists (with 699 active) and 2,586 specialists out of whom 2,101 were active.

Foreign doctors stood at 2,565 registered and 1,481 who are active. There are also 45 active or retained dentists out of 114 registered.

Mr Yumbwa was quick to point out that the doctors' register may not give the exact picture of the number of doctors in the field and those who have left.

“Some of them could be practising but have chosen not to retain their names in the register,” he said.