Inside Ruto-doctors' agreement to rescue an ailing healthcare sector

KMPDU officials with Health CS Susan Nakhumicha, Head of Public Service Felix Koskei, Labour and Social Protection CS Florence Bore, and Public Service Commission CS Moses Kuria display documents during the signing of an agreement between the Doctors and the Government at KICC on May 8, 2024. [Boniface Okendo, Standard] President William Ruto will establish a Presidential Taskforce on Healthcare Reforms within 14 days following critical discussions with representatives from the Kenya Medical Practitioners, Pharmacists, and Dentists' Union (KMPDU). It is among the main items agreed on between Ruto and medical practitioners when the talks were held on Saturday, May 11, 2024, at State House. Those who were in attendance told The Standard that the talks were meant to address longstanding challenges within Kenya's healthcare sector and aim to usher in transformative reforms. According to the top State House officials and KMPDU officials, the establishment of the Presidential Taskforce on Healthcare Reforms is meant to address transformative changes that will reshape Kenya's healthcare landscape and ultimately improve healthcare delivery for the benefit of all Kenyans. They said that the success of these initiatives will hinge on sustained collaboration and proactive engagement between the government, the medical community, and stakeholders. "The government is keen on addressing the persistent human resource inadequacies that slow the realisation of universal health coverage," the President said three days ago, when he held talks with the leadership of the Kenya Medical Practitioners, Pharmacists and Dentists Union led by Secretary General Davji Atellah. The talks came after doctors stayed on the streets for eight weeks protesting the failure by the government to implement key provisions of Collective Bargaining Agreements (CBAs) and delays in intern placements. Before the strike, Dr Atellah complained that there had been a significant failure to implement key provisions outlined in the CBAs, which included the absence of comprehensive medical insurance coverage, mismanagement of the internship programme, and the failure to meet established staffing norms and standards for health workers. Additionally, there has been a lack of provision for training budgets for postgraduate medical officers and challenges with promotions and timely salary remittances. He added that there have been notable delays in negotiating new CBAs, despite resolutions urging prompt action by relevant authorities. The issues around salary harmonisation and contractual terms for doctors remain unresolved, adding to the frustration of union members. Moreover, the union has faced ongoing challenges with authorities ignoring court directives related to salary remuneration and the reinstatement of medical officers, as per recent court rulings. Other issues include the refund of housing levies, the conversion of all doctors to permanent and pensionable terms, and adequate funding for the health sector. In response to these persistent issues, the KMPDU gave a seven-day notice to go on strike if the government failed to respond to their demands. The new task force is expected to drive comprehensive reforms aimed at fortifying Kenya's healthcare infrastructure and ensuring equitable access to quality medical services for all Kenyans. "By continually engaging with stakeholders, including labour unions, we aim to promote industrial harmony and sustainable solutions to our challenges," Ruto said "Discussions around the undergraduate and postgraduate training and promotions of doctors also featured prominently in the discussions," said the secretary-general. A key outcome of the discussion was the government's commitment to reducing the payment period for salary arrears owed to healthcare workers. President Ruto has also pledged to address human resource shortages by employing an additional 2000 doctors and initiating annual recruitment drives. These measures are crucial for advancing efforts towards achieving universal health coverage and enhancing healthcare delivery across Kenya. "We also thank him for reducing the CBA basic salary arrears repayment period from 5 years in the RTWF to 2 years in July 2024/2025 and July 2025/2026. We had a total affirmation on the employment of the 2000 doctors and a plan on annual employment," the SG said. Dr. Davji Bhimji Atellah, Secretary General of KMPDU, expressed gratitude for President Ruto's commitment to resolving critical issues affecting medical professionals. He said that discussions have already commenced on the immediate implementation of agreements outlined in the Return to Work Function (RTWF), with follow-up engagements scheduled with key stakeholders, including the Council of Governors (CoG). "We thank him for accepting to reconsider his earlier position on the internship and for his commitment to have the matter resolved quickly to allow for the posting of the intern doctors," he said. During these talks, the government affirmed its commitment to swiftly resolve issues related to intern postings, undergraduate and postgraduate training, and promotions within the medical profession. Dr. Atellah underscored the importance of these discussions in addressing challenges that have hindered the healthcare workforce. Ruto's administration acknowledged the urgency of these matters and signalled its readiness to resolve outstanding issues promptly. This includes refunding unconstitutional housing levies, converting doctors to permanent and pensionable terms, and ensuring adequate funding for the health sector. "We also met Rt Hon. Raila Amollo Odinga, and we thanked him for his support during the strike. We had more conversation on the value of robustness in the health workforce and the role that CBA plays in ensuring harmonious labour relations," the SG said. State House officials speaking off the cuff explained that the collaboration between the state and medical practitioners aims to fortify the nation's healthcare system and address entrenched challenges that have impeded progress towards achieving universal health coverage. "As your leaders, we have a commitment to deliver and a CBA promise to keep. These require patience and continuous engagement. No one will be left behind," the SG said, adding, "Dear doctors, our solidarity is our strength, and we need each other to win and get every issue we agreed on RTWF implemented."

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