MPs on Tuesday dropped a controversial proposal that would have seen the national government take over from counties the management of the 11 Level-5 hospitals.
The proposal was in the Health Bill, which went through a rigorous Third Reading last evening and is now a heartbeat away from being sent to the Senate for further scrutiny.
The decision to drop the proposal was made by the Health Committee of the National Assembly and initiated by its chairperson, Dr Rachel Nyamai. It was supported by a handful of MPs in the chambers.
Dr Nyamai said the decision was made “after very delicate discussions”, which is an allusion to the controversy the Bill provoked when it was first published. Governors had opposed the proposal on the basis that it would reverse the gains made under devolution.
In the Division of Revenue Bill for this year, the 11 counties that host the regional referral hospitals have been allocated Sh4 billion to be used exclusively for the management of the institutions.
A total Sh302 billion will be allocated to the counties as the National Assembly approved that Bill without any changes.
But the committee’s proposal to spare hospitals and medical workers punishment for failing to provide emergency medical care ran into difficulty.
The committee was proposing to have the provision dropped until the government sets up a fund to compensate the hospitals.
Rangwe MP George Oner initiated the debate to drop the committee’s proposal. But Dr Nyamai argued against his idea.
“We need to ensure that the government establishes a fund so that when an institution provides emergency health care, there is compensation,” she said.
But with MPs Millie Odhiambo (Mbita, ODM), Dr Enoch Kibunguchy (Likuyani, ODM) and Sabina Chege (Murang’a County Woman Rep, TNA) backing Mr Oner, the idea sailed through.
This means that legally, all hospitals, private and public, will be required to give emergency treatment to all patients.
However, the Level5 hospitals will no longer play the role of research centres.
“Research is a national government function. It is not a county function,” said Dr Nyamai, as she asked MPs to approve the proposed changes to the Health Bill.
If the Bill is approved by the Senate and then assented to by the President, only Level-6 hospitals will be managed by the national government. MPs also approved a proposal to have the counties establish their own referral hospitals.
“It’s just for the purpose of equity that our counties require to be given attention,” said Dr Nyamai.
There are only two referral hospitals in Kenya; the Kenyatta National Hospital in Nairobi and the Moi Teaching and Referral Hospital in Eldoret.
Mathare Hospital in Nairobi, which specialises in psychiatric care, and the Spinal Injury Hospital, are also under the national government.
The Cabinet Secretary will also have the power to downgrade a hospital if it is seen not to be living up to its class.
Dr Kibunguchy had proposed that all Level-5 hospitals be upgraded to Level-6 so that they can be taken over by the national government. However, that proposal was not provided for.