Since its founding in 1968, the Kenya Medical Association has been a key stakeholder in the health sector, and has promoted the practice of high-quality medicine in Kenya.
This has harmoniously been through partnership with the Ministry of Health and its agencies in developing sound health policies that have transformed the health sector in Kenya.
Indeed, our involvement in the several technical working groups at the Ministry speaks highly of the pivotal role we have played in making our health system one of the best in East and Central Africa.
As the professional representatives of doctors who are fundamental to quality healthcare provision, KMA is an ardent supporter of the design and smooth implementation of Universal Health Coverage (UHC) in Kenya. Successful implementation of UHC will ultimately depend on the services we provide to Kenyans, in collaboration with other healthcare workers.
Therefore, doctors should regularly be consulted and their voices heard when developing policies in the management of healthcare in Kenya to forestall disastrous outcomes.
The World Health Organisation (WHO) has recognised Doctors as an essential pillar in the governance of healthcare systems. These professionals form a necessary representation on several health boards that are key in healthcare governance.
KMA is a member of the NHIF Board, where we have contributed to the reform agenda aimed at optimising the organisation in its readiness to implement UHC. The current proposed National Hospital Insurance Fund (Amendment) Bill, 2021, that leaves KMA unrepresented on the Board of NHIF, inadvertently reverses the gains championed by doctors, while muffling the voices of doctors in shaping the UHC agenda.
KMA recognises that the cost of healthcare in Kenya is expensive majorly due to a myriad of factors, among them hospitality charges, the high cost of health insurance, and supply chain challenges, including punitive taxes on health equipment and medication.
KMA has been key in trying to drive down the cost of healthcare by strategic payer-provider engagements, and lobbying the Ministry of Health to manage taxes and other factors that make healthcare expensive and inaccessible to the public, as opposed to the misguided notion that high costs are solely due to doctors’ professional fees.
A survey by KMA estimates that doctor’s professional fees are 15 per cent 20 percent of total hospital bills-and are already regulated through subsidiary legislation of the Medical Practitioners and Dentists Act (CAP 253). Honest conversation between the organizations representing the doctors, insurance providers, hospitals and the Ministry need to be held to address this issue in its entirety.
We also note with a lot of concern the rushed passing of legislation in the health sector without exhaustive stakeholder involvement and in most instances completely disregarding the input from key players in the sector. KMA is deeply concerned that the health care sector is being imbued with poorly crafted laws that in the long run will reverse the gains made in our healthcare system.
The observed attempts at isolating doctors in preference of business and political interests in health will erode the quality of services offered. That is besides making attainment of the highest quality of health under the Big Four agenda’s UHC a mirage for many.
KMA thus recommends the following: The National Assembly and the Ministry of Health consider the several memoranda submitted by stakeholders in the health sector, including those by KMA. Reforms in health governance be anchored on the agreed joint memoranda by the Ministry of Health and the Federation of Health Professionals Association of Kenya (FHPAK) as directed by the Health Committees of Parliament.
There is also need to suspend and withdraw the Health Amendment Bill 2021 and the National Hospital Insurance Fund (Amendment) Bill, 2021 from Parliament until proper consultation and exhaustive deliberations are done on the proposed changes in the governance of the health sector that are causing unease and anxiety among the doctors and other health professionals.
KMA also recommends that medical doctors be included in the UHC planning and execution as they key stakeholders and actual implementers of the UHC agenda.
Also, there is urgency in addressing the drivers of high cost of healthcare in Kenya through meetings with stakeholders in the health sector. Finally, the government needs to defend and uphold the dual regulatory framework between the State and doctors that aligns to the best practices of health governance as recommended by WHO and the World Medical Association.
KMA remains available to provide the National Assembly, the Ministry of Health and all other stakeholders in the health sector invaluable professional advice as espoused by best practices internationally in management of healthcare in Kenya.
The writer is, President, Kenya Medical Association and CBEH-HRH Fellow