Revealed: Intrigues behind Nairobi doctors' strike

A labour dispute has brought health services in Nairobi County to a standstill with many patients left to their own devices as public hospitals remain deserted.

Since August 14, 2020, doctors have had a push and pull with the county when they first announced a strike notice seeking the resolution of various issues such as the delay in salaries, reinstatement of specialists as well as promotions and job group re-designation for senior doctors.

The key issue, however, which 255 doctors employed by the county have sought to have resolved was that they are provided with a comprehensive medical cover by the National Hospital Insurance Fund (NHIF).

Since then, the talks between the Nairobi Metropolitan Services (NMS), Nairobi City County Government, and Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) have collapsed several times leading to the current crisis.

On August 21, the medics and NMS reached an agreement that resulted in a return to work formula that would ensure that they get the NHIF cover by September and have four consultant doctors included in the NMS payroll and paid arrears of 26 months.

The formula also stated that doctors would be promoted to their rightful job groups and be provided with quality protective gear and isolation centres for both symptomatic and asymptomatic Covid-19 patients.

Quality protective gear

Salaries would also be paid by the fifth of every month.

No sooner had the NMS drafted a Collective Bargaining Agreement (CBA) than the Nairobi County delayed the August salaries.

"Unfortunately, this time around, there is a delay in payment of the August 2020 salaries, which has been occasioned by lack of disbursement of the County Funds from the National Treasury arising from the ongoing debate in the Senate of Counties Share of Funds,” a letter from Justus Kangethe, who was the then acting county secretary stated.

A letter seen by the Nation, however, from the NMS Director-General Mohammed Badi shows that the delay was owing to the transfer of payroll data from the Nairobi County Government to the NMS.

"Lack of transfer of payroll data by the county to NMS led to the industrial action by some of our staff due to delay in the payment of monthly salaries. In (the) absence of the live payroll data that is being withheld by the Nairobi County Government, NMS has resolved to process salaries for the month of August, 2020 for the seconded staff using back-up payroll data provided by the State Department for Public Service," Mr Badi stated in the letter to Treasury.

The Nation understands that, to date, some doctors have not been paid their August salaries owing to the lack of transfer payroll data.

The agreement to have medics covered by the NHIF as agreed by the NMS and KMPDU also collapsed after a letter from the NMS informed them that the Nairobi City County government had already decided to have them covered by a different insurer.

“The NMS negotiated a comprehensive medical cover for all its staff with the NHIF. However, we received an advisory from the Head of Public Service not to proceed with (the) cover in consideration that Nairobi City County Government has already engaged AAR to provide the same,” the deputy director-general Kang’ethe Thuku said.

On the issue of reinstatement of four consultants, the Deputy Director-General states that their names were forwarded and were awaiting the response to take action.

However, Dr Ouma Oluga, the Chief Officer in charge of Health Services in Nairobi County said that doctors in the county have been paid between Sh600,000 and Sh1 million in arrears and their request for promotion and re-designation was fulfilled, seeing 57 doctors in move to Job group R.

“All these are things you cannot find in another county. The only thing we have not done is the insurance because they are all already covered by AAR,” he stated.

As the talks between the medics and the NMS continue, the crippling effects of the walkout are apparent with patients having nowhere else to turn to.