Duale: I’ll rehire all 7,414 Covid medics in referral hospitals if governors refuse absorption
Health Cabinet Secretary Aden Duale during the launch of SHA-Taifa Care and Digital of Health Ecosystem in Eldoret City on September 10, 2025.
What you need to know:
- The medics, initially hired in 2020 as Covid-19 frontline workers, were promised permanent and pensionable terms.
Health Cabinet Secretary Aden Duale has stated that he will be compelled to withdraw and rehire the 7,414 Universal Health Coverage (UHC) medics in national referral hospitals if governors refuse to absorb them on permanent and pensionable (PnP) terms.
The medics, initially hired in 2020 as Covid-19 frontline workers, were promised permanent and pensionable (PnP) terms.
While appearing before the Senate on Wednesday, CS Duale expressed frustration that governors are obstructing the medics’ absorption despite an explicit directive from President William Ruto and the availability of funds.
“We have the money, the salaries, the allowances, everything,” Mr Duale stated. “What is remaining is the transition from contract to PnPs, and because they work in the counties, I am still engaging with county governments. But I am frustrated because they don’t see how these UHC Covid-19 frontliners are suffering.”
In September, President Ruto had directed that the UHC health workers' current contracts be converted to PnP terms, announcing that the government had already released funds for the transition. The President assured governors that the national government would pay the health workers as per the Salaries and Remunerations Commission (SRC) rates to facilitate their transition.
Mr Duale confirmed the President’s position on the matter.
“The Sh6.2 billion needed to absorb the UHC medics who have for the better part of the year been protesting outside Afya House is very much available and was disbursed to the Health ministry. We are now also paying the health workers as per SRC rates after harmonisation was done,” he told senators.
Mr Duale said he was ready to transfer the UHC medics' payslips to the counties, but governors, led by Council of Governors Chairperson Ahmed Abdullahi vehemently refused.
The CS appealed to the Senate Health Committee, chaired by Senator Jackson Mandagor, to intervene. “You have some powers more than me as the custodian of devolution. You need to call us and ask governors why they are not transiting these good people to PnPs. If they refuse, I can take them to our referral hospitals because we have a huge shortage.”
The CS added: "There was a Presidential directive to employ these UHC health workers, who are vital to realising Universal Health Coverage under the PnP terms. However, the primary obstacle has been the governors regarding the confirmation of these terms. These health workers performed exceptionally during the Covid-19 pandemic and continue to do so. As the healthcare workforce is the most critical pillar for achieving UHC, we have already resolved the medical interns' issue and finalised collective bargaining agreements; which is why doctors' protests have ceased."
Earlier this month, the 17 cadres of 7,414 UHC medics drawn from all 47 counties downed their tools in a nationwide protest over the matter. This followed a broken promise from Mr Duale, who had announced in August that the health workers—who had been on strike for seven months at that time—would be absorbed to counties on PnP terms starting September 1, a commitment that ultimately went unfulfilled.
Regarding the staffing audit, a statement clarified: “Out of the 7,629 UHC staff verified, 215 failed to present themselves. These individuals have been identified as either ghost workers or unqualified health professionals.”
UHC Medics Representative Lynn Wanjiku Kihara told Nation that previously, they were uncertain about who their employer was as their contracts were issued by the 47 counties, “but our salaries came from the Ministry of Health”.
“However, this month the Labour Relations Court ruled that we are employees of the national government, specifically the Health ministry. This is also why President Ruto recently stated that they have the necessary resources to transition us to PnP terms.”
Sam Mtai, a clinician hired under the UHC contract, said: “To be fair, CS Duale has shown commitment to absorbing us into PnP terms. However, the Council of Governors (CoG) continues to frustrate these efforts, blocking what should have been a straightforward process. This tug-of-war between the ministry and CoG has left thousands of us demoralised and anxious.”
On CS Duale's proposal for the MoH to rehire and deploy staff to referral hospitals, Mtai expressed support: “I personally support it. If the counties cannot absorb us, then let the ministry take over. We need job security, stability, and respect for our work.”
Martin Mutunga a medical lab officer who was deployed to Covid-19 frontlines in Kwale County, said: “Harmonising our salaries is good, but it doesn't address our job security. With less than 10 months left on our contracts, the harmonisation is meaningless. Once a contract ends, that's it. We see what happened to our colleagues from the Global Fund: they had harmonised pay, but when their contracts ended, they were sent home. We are now beseeching the government for PnP letters to secure our futures. Even banks are denying us loans because our contracts are ending.
“I personally agree with CS Duale. If the counties are not ready to issue us PnP letters as the President directed, then let the Ministry of Health deploy us to national facilities. This endless push and pull is nauseating and has immensely affected our mental health,”
Governor’s emergency meeting
On August 31, governors convened an emergency meeting to discuss the standoff. The Nation learned that the governors were considering terminating the contracts of all UHC medics if CS Duale proceeded with his plan to transfer the health workers' payroll to the counties by September 1.
In his communication to CS Duale, CoG whip and Tharaka Nithi Governor Muthomi Njuki emphasised the need for a cooperative approach. “The relationship between the ministry and the counties is supposed to be collaborative, not directive,” he stated.
“While acknowledging the ongoing collaboration between the two levels of government in addressing the management of UHC staff, CoG wishes to clarify that it does not concur with the ministry’s position expressed in the press statement. It contradicts the previously agreed position between the two levels of governments,” he added.
Governor Njuki highlighted the Ministry of Health's failure to allocate the Sh7.7 billion that both parties had agreed upon for the absorption of the UHC medics.
The CoG Health Committee chairperson also insisted that the ministry must fully settle the gratuity it owes the UHC medics before any absorption can proceed. “Given these unmet conditions, the governors categorically reject CS Duale's decision.”
“On the transfer of the UHC staff, it was agreed that the ministry would first allocate adequate resources as per the approved SRC salary scale before transferring the payroll to the counties. Therefore, the decision to transfer the staff now is both premature and untimely.”
Mr Njuki also addressed the verification process, stating, "The report from the UHC staff verification exercise has not been validated or officially shared. Therefore, the transfer process proposed by the ministry is not agreed upon."
"On the matter of gratuity," he continued, "all UHC staff currently on contracts are entitled to it. The ministry must settle these payments in full before any transition to county governments. CoG reiterates its earlier commitment to absorb verified UHC staff and facilitate their salaries in line with the approved SRC salary scales.”
The governor said CoG recommends that the national government, through the ministry, allocates and channels the necessary resources to the counties to facilitate the absorption of UHC staff in line with County HR policy. “However, this can only proceed once two conditions are met: the allocated resources have been disbursed and all gratuity obligations have been honoured. Failure to do so will make the absorption of the UHC staff unattainable,” he warned CS Duale, reminding him that the Constitution
mandates that both levels of government relate through consultation, not directive.
