Medics have weighed in on a proposed law that seeks to forbid public officers from engaging in any other gainful employment.
The Conflict of Interest Bill, which is set to undergo its second reading at the National Assembly, will require a public officer hoping to engage in any form of private practice to seek permission from the employer and the Ethics and Anti-Corruption Commission (EACC).
The medical practitioners said the Bill, if it becomes law, will be detrimental to patients and their careers.
The Bill says a public officer is in a conflict of interest if the officer exercises an officer’s power, duty, or function to further his private interests or the private interests of another person or his family, relative, or associate.
Clause 23 (3) of the Bill forbids a public officer from engaging in any other gainful employment without permission from the authority they report to and the EACC.
“A public officer shall not engage in any other gainful employment which is inherently incompatible with the official duties of the officer, results in a conflict of interest or the public officer is mandated to regulate,” the document reads.
The Kenya Medical Pharmacists and Dentist Union (KMPDU) and the Kenya Union of Clinical Officers (KUCO) feel confining medics to public hospitals may not work for two reasons; medics use their private facilities offer services that public hospitals don’t provide over lack of capacity, including lack of equipment and medical supplies. Also, unless the government is willing to pay medics well, it should allow them to supplement their meagre earnings by engaging in private practice during their free time.
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KMPDU secretary-general Davji Atellah says the medics are not against the Bill, but before the President assents to it, the government should consider remunerating doctors according to the work they do.
“Doctors are meagerly paid, and they work in public hospitals because of their human nature but the salary is very little. Most hospitals cannot hire consultants and most of them have no supplies and equipment. If that is sorted, the Bill would be an advantage to public health care,” Dr Atellah said.
He said for the Bill’s intentions to be fully achieved, the government needs to invest more in the public health sector.
“Doctors don’t rob public hospitals of their time of work, so one should not be stopped from offering their services to another hospital when off duty. But if the government wants to domesticate consultants and doctors, they should be ready to pay them,” said Atellah
He further adds that implementation of the Bill will not improve service delivery in the public sector if the hospitals are operating in deplorable conditions
“Most hospitals in the counties have no doctors, medicine and equipment. Doctors in public hospitals are struggling to offer services due to a lack of supplies. To improve services, governors should be deliberate in investing in health care.”
His sentiments are echoed by Peterson Wachira, the chairman of KUCO, who says medics operate their clinics during their free time to offer services lacking in the public sector.
“If the public hospital doesn’t have a certain equipment or medication, the healthcare worker can provide in their private capacity as they see the gap.”
Most medics work in private facilities due to a shortage of human resources. “We still fall short of the WHO doctor/nurse to patient ratio. That means those available should be able to offer services in different settings. Even those working in private facilities, if they are off duty, can offer their services elsewhere to cover the shortage,” he said.
Wachira adds that the Bill will affect patients more as they will end up lacking care because the specialists needed are stuck in a public hospital that lacks the necessary equipment yet they could render their services too in a private hospital after their hours in a public facility.
“What is ailing quality of services in our public hospitals is lack of human resource, equipment and supply.”
The Bill further reads that a public officer is required to take reasonable steps to avoid any real, apparent, or potential conflict of interest in connection with the official duty as a public officer.
“When you say someone should be able to declare potential conflict in the future, how do you know there will be a conflict in the future? When it comes to declaration does it mean I should declare that I do locums in my free time in certain hospitals? What about the rights of the employee, what I do with my private time should not be a concern to my employer. The bill goes against the employment act,” Wachira said.
About compliance measures likely to generate heat if the law is enacted is that every public officer shall submit to the commission a declaration of income, assets, and liabilities of himself, his spouse or spouses, and his dependent children under the age of 18 years.
The Bill states that a public officer is a person who renders government services, whether appointed or elected, full-time or part-time, permanent or temporary, and includes a state officer, employee, consultant, or volunteer. This definition also includes medical professionals.
“Conflict of interest is a situation where the private interests of the public officer can reasonably be perceived to impair or influence the public officer’s ability to act objectively in the performance of an official duty, or has private interests that could conflict with the duties of the public officer in future,” the Bill says further.
It continues to say that a public officer shall disclose, in writing to the reporting authority, any offer of outside employment that could place the officer in a situation of conflict of interest. The disclosure should be done within seven days of receiving the offer.
“Offer of outside employment means formal proposal made to a public officer to work for or privately do business with,” it states.
Health CS Susan Nakhumicha said it is in recognition of the need for improved accountability in service delivery that the government is taking various reform measures.
“Recently, the Cabinet approved the Conflict of Interest Bill 2023, which has been forwarded to the National Assembly, for further processing. It is envisaged that if enacted, into the law, the legislation will help to curb the challenge of conflict of interest such as procurement and financial management relating to health projects in the counties and at the national level,” the CS said.
She further added that the government, through the office of the Prime Cabinet Secretary, is undertaking robust reforms in the performance contracting framework which is aimed at addressing the accountability deficit witnessed in the performance of public duty.