A health crisis is looming in the country as doctors announce a plan to escalate their industrial strike by suspending the minimum services being offered by some of their members.
The declaration came after a stalemate between the medics and the Ministry, which prevailed upon the doctors to vacate some of their demands.
Instead, at a press conference - an hour after Health Cabinet Secretary Susan Nakhumicha told journalists that the two parties had agreed on most of their grievances - the doctors maintained that the strike is still on until all the demands made are met.
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The Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) officials acknowledged that even though the ministry had shown goodwill and commitment to ensure that the issues on the table were resolved, calling off the strike would be reneging on the members’ demands.
“We had an impromptu meeting with some officials from the Ministry of Health in what we hoped to be an attempt to make the first right. But from the beginning, I want to make it clear that the strike is still on,” said the Union’s national chairman, Dr Abidan Mwachi.
However, the doctors intended this to be the last strike and therefore called on the parties involved to get it right in the negotiations.
The doctors also denied earlier announcements by the CS that they had agreed on most of the grievances as presented to the Ministry by the Union.
“There is no particular matter that we agreed on, a little progress, but not anything tangible,” Mwachi added.
According to Davji Atellah, the Union’s Secretary-General, the doctors are apprehensive of the numerous promises that have dominated previous engagements with the government and were reluctant to continue trusting them.
One of those issues that the doctors have expressed scepticism about is the delayed posting of medical interns, which Atellah said they have been taking around in circles for a long time. He termed the CS’ pronouncement that the interns will be posted next month "just a promise like many others before".
He said that there have been commitments before with both the national and county governments, particularly in January 2023, but regretted that nothing has been implemented to date.
“Therefore as we go on with this strike, we are not going to accept promises.
“We know very well that we have had a promise before, that the interns were to be posted in February. We also had a promise that they would be posted in March. Today we have been given a promise that they will be posted in April,” noted Atellah, pointing out, “I must say that goodwill is earned and it's earned from the outcome of previous commitments.”
He stated that in the ongoing strike, the doctors will not accept commitments but outcomes for the doctors.
“We want outcomes for the basic salary arrears that have not been paid for seven years; letters posting interns as per the Collective Bargaining Agreement that was signed in 2017.
“We want outcomes that facilitate doctors struggling with their postgraduate to do their exams,” he said, adding that the Union wants doctors to be employed in the country to run the UHC.
“So it's not a strike of promises, but one for real outcomes,” he said.
He praised Justice Byrum Ongaya’s March 13 orders, one of them directing that the issues raised by the doctors and the response from the Ministry of Health require a ‘whole nation approach’ to resolve, saying the Union’s hopes are pegged on the meeting’s outcomes.
“Although this order instituting the whole nation approach was put ahead of the order suspending the strike, it’s the reason we are saying that the wise judge was quite smart to ensure that a whole nation approach is instituted," he said.
“Therefore, our strike is pegged on the whole nation approach to resolve the issues that we have put forward, so we are not going to call off the strike before that meeting,” he said, noting that the doctors would still be scornful of outcomes that won’t give value to the Union members.
The doctors’ sentiments come moments after the Health CS said the ministry had in the meeting agreed to begin posting interns from April 1 after receiving a confirmation from the Treasury that funds will be released.
In a briefing at Afya House, Nakhumicha said progress had been made in addressing issues that lie within the ministry. She disclosed that it had been resolved that issues which require a whole nation approach be escalated for further discussion.
“However, matters which require multi-stakeholder engagement will be addressed in a meeting which will be held later this week,” she told journalists.
The CS said most of the issues that the doctors had raised were crosscutting and would require the involvement of other stakeholders such as the Ministry of Education, the Council of Governors, the Salaries Remuneration Commission (SRC), the National Treasury, and the Head of Public Service.
“We also took note of ongoing conciliation meetings that are in progress and as a ministry together with the union we have agreed to participate fully, to give the conciliation team the information that they need so that the matters can be progressed,” Nakhumicha said.
She said that the sticky issue of the lapsed CBA of 2017 is one of the issues they agreed should be progressed with the conciliator.
“As a Ministry, we also discussed with the Union on the matters that solidly lie within the MOH,” she said explaining that from the matters that the doctors raised, there are those that should be handled by the Ministry and there are those they agreed that the Union move on.
“So on matters that are to be handled by the Ministry, I am happy to report that as a Ministry of Health we have made very good progress, and one of the issues was on the internship programme.
“So we have agreed that they're going to participate in the review of the internship policy that's currently ongoing - and chaired by the Acting Director General of Health, Patrick Amoth - so that we review the policy, and ensure that it's allied to the Universal Health Coverage and it addresses all the emerging issues that we have heard,” she said.
She said that the Ministry and doctors also agreed to proceed with the negotiations on the matter of the CBA that lapsed.
“The status as it is; is that the Union wrote to the Ministry, and the Ministry had written back with a counteroffer, but both parties were yet to sit and discuss,” she said, but pointed out that they have agreed that within this week, the ministry will host a meeting so that the matters that are in the CBA can be addressed and negotiations begin.
“We have also discussed and agreed on the pending arrears for registrars that PS Harry Kimtai is going to take charge of and have a discussion with universities so that reconciliation is done of all the outstanding arrears, and equally, we have received commitments from Treasury on the availability of resources,” she said.
Doctors Strike on
However, while dismissing the CS’ announcement of a ray of agreements reached, Atellah called upon doctors working at Kenyatta National Hospital offering minimum services and those working at the Moi Teaching and Referral Hospital, working on the same, to have the matter of the strike escalated “so that we can have a quicker resolution to it.”
He said in the CBA of 2017-2021, the government owes the doctors’ basic salary arrears of seven years, which several negotiation meetings have failed to unlock over Ksh3 billion owed to them.
"We have not seen any commitment to have this paid," he said and promised they would shut down KNH and MTRH, noting that over 70 doctors working at KNH have exploitative contracts.
"We want those doctors to be put on the right terms; we have a CBA which SRC has refused to approve for KNH and MTRH, and the reason we are going to shut KNH and MTRH is to allow SRC to come to their right mind and approve the CBAs," he said.
