Doctors have issued a seven-day ultimatum to the government to suspend with immediate effect the tax payment system or face a nationwide strike.
The Kenya Medical Association (KMA) said with the introduction of the Electronic Tax Invoice Management System (eTIMS) through the Finance Act, 2023 and in the public notice, the Kenya Revenue Authority is forcing doctors to disclose patients’ data which is against the Constitution.
“In light of the above and other issues that are likely to arise from the implementation of the eTIMS system by doctors, KMA calls for an immediate suspension by KRA of the rollout of the eTIMS system in the Medical Services Sector for Doctors, Dentists, Pharmacists and Hospitals within seven days to allow room for further discussions and agreement on a common position on the issues raised,” said Dr Simon Kigondu, President KMA.
“If the Authority does not have so suspend the roll-out of eTIMS , we will have no choice but to call for a nationwide strike with effect from next week on Tuesday and even pursue an urgent application in court to stop the eTIMS implementation because it is a clear violation of the Constitutional rights to healthcare and data protection and privacy,” he added.
Dr Kigondu further pointed out that Kenya is a major medical tourism hub and destination, with patients coming from all over the world and that their details would face the risk of compromise by the system.
“We are of the view that medical professionals can't process the sensitive health data required for invoicing under a system without violating the privacy of the patients. The KRA and Treasury mandarins appear unaware of the Constitution and the laws that govern Medical Practice in the Republic of Kenya," Dr Kigondu said.
"They are putting taxes before health and money before life. If the peoples’ health suffers from lack of medical care, and they are unable to work, whose incomes will they tax and for whose benefit?” he posed.
He indicated that doctors took an oath to safeguard, among other things, patient confidentiality, and forcing doctors to disclose patients' data, in the name of tax compliance, is a violation of the Constitution.
“When the KRA online system is not working and unavailable, medical service delivery will be compromised. Medical services cannot be made dependent on tax regulations based on untested software that fails even on simple data entry," said Dr Kigondu.
"To make medical services dependent on such a system is to risk human life and health. When patients die because the eTIMS system is down, who will compensate the families of such patients? Doctors will not accept to be subjected to systems outside of their professions in rendering lifesaving services,” he added.
He also questioned the introduction of the system without adequate public participation, policy guidelines and regulatory impact assessment in the healthcare sector.
“This (the system) has been designed to expose doctors to the double jeopardy of violating medical and privacy laws without protecting them from the consequences thereof," he said.
"When doctors are arrested for violating the Data Protection Act, will KRA pay the fines? When doctors are jailed for violating the law, will KRA staff volunteer to go to jail on their behalf? We cannot have a system or a law that forces doctors to violate the law. The rule of law does not condone that,” he added.
Dr Kigondu also said doctors' invoices sometimes take several years to be settled moreso by the National Health Insurance Fund, if the system is introduced, KRA will be collecting taxes on invoices that have not been paid and may never be paid
“This system has the effect of destroying both public and private facilities by refusing to pay their bills, collection of taxes against unpaid invoices and constantly engaging medical staff in non-core areas of debt and tax collection.
"The cost of compliance is unsustainable in a growing economy; every doctor will now be forced to employ an accountant just to handle the demands of the eTIMS system,” he said.
“Doctors will not accept the invoice as a basis for tax computation. If the eTIMS system is implemented, we will decline to see patients, reason, those patients will cost us revenue paid to the KRA as taxes on funds that will never be paid.
"This will deny patients a constitutional right to health services. Many Doctors will soon revert to the 5 cash-for-services model that the government and the public have been moving away from,.
“Blanket enforcement of the eTIMS system without considering the contextual outlay of the medical services sector would be fatal and counterproductive to the realization of the constitutional right to health,” Dr Kigondu said.
