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There is need to dissect the much-hyped medics' CBA

By Ondeng'i Bwobonyo | January 20th 2017

There is a lot of controversy and secrecy surrounding the much-hyped CBA between the doctors’ union and the Government.

While it is clear to keen observers that there is a big mess in the health sector that needs to be cleaned, my submission is that the current strike will not help us sort the mess.

For a start, I agree with the Government that the CBA cannot be implemented as it is and at best is unconstitutional, because it recognises Ministry of Health, as the employer of doctors responsible for promotion and career development while the reality is that doctors are currently employed by county governments and each of the 47 governments are distinct and independent hence the issue of transfers across counties can’t hold.

Secondly, as part of the doctors’ rights, the CBA proposes establishment of a Research Fund available to doctors who seek to carry out research. While this is a noble idea, considering that resources are scarce and need to be allocated prudently, then it will be appropriate that established research institutions such as Kemri and universities get enhanced funding and any doctor wishing to carry out research can collaborate with those institutions.

Hospitals can be used for research but their core mandate is not medical research. The CBA here fails to recognise the separation of functions for different Government agencies. The issue of better equipped hospitals is indeed quite thorny.

Many of us can identify with the situation having been to a public health facility where they don’t have basic supplies leave alone specialised medical equipment and drugs. However, demanding instant and immediate solution to this problem is unrealistic and a bit naive.

This problem has been building up slowly over the years to the current alarming levels. What the two sides need to do is to come up with a strategic framework to be implemented progressively so as to alleviate the problem.

The other key issue is to have sufficient health staff in the health sector right from doctors, nurses to the support staff so as to serve the population well. This point is corroborated by the fact that Kenya is far from meeting the recommended doctor patient ratio by the WHO.

Well, this is a noble demand and which we definitely should aspire to see come to fruition as a nation. The question, however, is aren’t there any efforts geared at achieving this?

Currently, KMTC has expanded its intake and opened more branches so definitely we are having more health care professionals joining the job market. The number of universities with medical schools that train doctors has increased from the previous duo of UoN and Moi University with Egerton and KU joining and private universities like MKU are following suite.

The dark side is that the Government is not absorbing the graduates fast enough. However, Kenya being a free market and resource scarce economy, the graduates don’t need necessarily to end up in Government facilities. There is a similar situation in the education sector where though we have a shortage of teachers in public schools, there are still unemployed graduates.

To this end then, the CBA does not introduce anything new since based on budgetary constraints and the level of our development, there are limits to what the Government can handle.

Turning to the emotive issue of adequate compensation that was partly stirred by the release of the SRC job evaluation report, we need to acknowledge that what is ‘adequate’ is a relative term. And moreover, SRC does not have the power to set the salaries of public servants but does so for State officers.

SRC can only advise employers of public servants on what is reasonable pay.

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