Sh6bn sendoff payout for 8,000 medics counties have refused to employ
Afya House, Nairobi.
What you need to know:
- When Covid-19 struck in 2020, the government recruited 8,571 medics, including doctors, nurses, clinical officers and laboratory technicians, on three-year contracts under the universal health care (UHC) programme.
- They were sent to public hospitals in the 47 counties to help Covid-19 patients, with the promise that they would be hired on permanent and pensionable terms.
- Three weeks ago, the national government absorbed 108 medics, with the rest to be employed by county governments. Some have died over the years.
The Ministry of Health (MoH) will pay a Sh6.3 billion gratuity to more than 8,000 medics who had a frontline role in fighting the Covid-19 pandemic but are out of work because the government has failed to absorb them.
After years of being tossed around, the 8,442 medics will collectively receive a farewell package of Sh6,300,385,920 after county governments refused to absorb them on permanent and pensionable terms.
When Covid-19 struck in 2020, the government recruited 8,571 medics, including doctors, nurses, clinical officers and laboratory technicians, on three-year contracts under the universal health care (UHC) programme.
They were sent to public hospitals in the 47 counties to help Covid-19 patients, with the promise that they would be hired on permanent and pensionable terms.
Three weeks ago, the national government absorbed 108 medics, with the rest to be employed by county governments. Some have died over the years.
The medics are paid between Sh40,000 and Sh50,000 a month.
But county governments have since refused to absorb the group, citing financial challenges.
Dr Sultani Matendechero, the deputy director general for health at the MoH, has said that if the county governments do not absorb the workers, the programme will be terminated when their current contracts expire.
“If counties refuse to absorb them, we shall have no option but to pay them gratuity then send them home,” Dr Matendechero said.
Read: The pain of being a medic in Kenya: My hopeless battle with debt, low pay and suicidal thoughts
A task force had proposed two scenarios: absorption of the group on permanent and pensionable terms at a cost of Sh7.7 billion or a severance package of Sh6.3 billion.
The Public Service Commission (PSC) approved the extension of contracts for UHC staff on May 17, 2023.
On October 8, the Council of Governors (CoG) wrote to the Principal Secretary for Public Health and Professional Standards, Mary Muthoni, about the stalemate over the "transition of human resources for health under the Global Fund".
CoG Chief Executive Officer Mary Mwiti recalled an agreement between Kenya and the Global Fund, executed by the National Treasury, which committed to absorb staff recruited under the Global Fund grant by December 2023 as part of the sustainability of the grant.
“It is regrettable that the national government committed and executed an agreement, which imposes additional financial obligations to county governments, without consulting or providing the requisite funding for counties to undertake obligations. Without availing the required funding, county governments may not be able to absorb the Global Fund staff,” Ms Mwiti stated.
In April this year, PS Muthoni said that a multi-agency taskforce, drawn from the National Treasury, PSC, MoH and CoG, had found that it was no longer tenable for the UHC staff to continue working on contract as the terms contravene employment laws.
“Further, the taskforce noted that the cost of translating the UHC staff to PnP amounts to Sh7,747,802,365 out of which Sh4,238,452,404 is available in the national government budget,” the PS wrote.
Alternatively, the PS asked the PSC to approve a service gratuity for the four years worked, with the total amount payable being Sh6,300,385,920 for 8,442 UHC staff.
The national government only employed 108 medics amid protests that nine were left out.
“Our group, made up of 117 medics that work in national health facilities, port health at Jomo Kenyatta International Airport (JKIA), Afya House, blood bank and spinal injury hospital as well as other ports of entry, would love to know why only 108 were confirmed into PNP in October this month leaving out nine of us who work in the same facilities with our terms of service remaining unchanged,” a medic who was left out of the list disclosed to the Nation. The medic added those left out presented a list of their names to officials at Afya House on October 28.
Speaking to the Nation on Monday, Dr Matendechero said the UHC staff were employed on three-year contracts with the understanding that counties would absorb them.
“The agreement was, let us give them a contract of three years during which they would be prioritised for absorption because as per the 2010 Constitution, health is a devolved function and this means that things around human resource are mainly within the counties where they employ through their county public service boards,” he explained.
“[As to] why the UHC staff have not been absorbed, I am not competent enough to say because we cannot force counties to do so as it is their prerogative.”
Given the stalemate, the ministry extended the contract by one year.
“That was granted even though there are many processes that were involved because of an intergovernmental mechanism that has to come in place featuring the Public Service Commission as well as the National Treasury,” Dr Matendechero explained.
“A provision for a three-year renewal was made. It could have been an oversight but what it meant was that we had to go back and renew the contract for three years,” he explained.
“Once the contract is fully executed and they are due for gratuity, arrangements have been put in place for them to get their gratuity. But the expectation is that we need to start seeing them being absorbed by counties so that we fold this UHC programme.
“In trying to get them absorbed by counties, we were trying to see how we could gradually phase off that post-Covid 19 UHC programme so that these people who we have trained over the few years can now be transitioned into the country establishment as permanent and pensionable."
Health Cabinet Secretary Deborah Barasa said the Human Resources for Health (HRH) committee at MoH has been meeting to deliberate on the issue.
“We need time to figure out what to do in this situation. I will get back to you on the progress soon,” Dr Barasa.
