County governments will no longer pay salaries for doctors on study leave.
The Council of Governors (CoG) instead wants the Health ministry to cater for the doctors’ salaries while undergoing training. This comes amid increasing complaints by the medics that governors have been blocking their quest for specialised training.
Governors have said that, while they support training of their medics, their salaries should be paid by the national government.
“The Ministry of Health must pay for the training because we have no budget for that,” CoG Chairman Martin Wambora said.
The CoG Health Committee chairman, Prof Anyang’ Nyong’o, said that, legally, the national government is responsible for policy, training and standards.
“We [must] train our personnel. We support training, but the cost is too high. We want everybody to perform their duties. Counties are in charge of delivering healthcare,” the Kisumu governor said.
Prof Nyong’o pointed out that counties have referral hospitals where medics are trained while working.
Supporting the move, Seme MP James Nyikal said it will boost health services.
He said: “Doctors undertaking postgraduate training don’t just sit in class. They’re actually working. If the doctors are being trained at Kenyatta National Hospital (KNH), they’re their staff. If you remove them, KNH will be closed so it’s important that the ministry pays them while they’re working there.”
CoG and other health stakeholders have been meeting in Mombasa to discuss policy and legislative barriers to execution of devolved health services.
The county chiefs said they support ongoing reforms at the Kenya Medical Supplies Authority (Kemsa) and National Hospital Insurance Fund (NHIF).
Governor Wambora said the process must be speeded up for Kemsa to operate more efficiently “and as soon as possible. We’re happy with the ongoing probe so that the truth can be known. We want to know what’s happening because [the money that was lost belonged to the public].”
On Wednesday, Health Cabinet Secretary Mutahi Kagwe said cleaning up the mess at the agencies is critical.
“There are reports and strategic papers in both houses of Parliament that demand we take action on Kemsa and that’s what we’re doing. The process has not stopped, it’s continuing,” he said.
On procurement and distribution, the CS said the Kemsa Act outlaws acquiring of drugs and medical equipment by public hospitals from suppliers other than Kemsa.
President Kenyatta is expected to sign the NHIF Act to regulate and further reduce the cost of healthcare in the country.
Mr Kagwe said that, once the President assents to the NHIF Act, its implementation will begin immediately.
The governors resolved to review existing health policies and laws, including the NHIF Act, Kemsa Act, 2013 and the Pharmacy and Poisons Act to align them with the requirements of the devolved governance system.
“We’ve reviewed various laws and policies that are problematic in institutionalising and financing devolution. We will streamline all these laws and policies to be fully aligned to devolution or repeal them where possible,” Mr Wambora said.
CoG said governors will engage the national government to review budget-making and push for participation of the devolved units in development of the national budget policy statement and sharing of revenue. In the next budget cycle, the CoG said, governors will ring-fence funds for health services.
“Both levels of government support NHIF reforms in beneficiary management, benefits management, healthcare providers management, digital transformation, organisational transformation, and positioning NHIF as a strategic purchaser in line with the Kenya health financing strategy,” the CoG said.
