Doctors’ critical role is why the right to strike should not apply

From left: Former Health PS Nicholas Muraguri, Kenya Medical Practitioners, Pharmacists and Dentists Union Secretary General Ouma Oluga and chairman Samuel Oroko after signing the back-to-work formula on March 14, 2017. PHOTO | FILE | NATION MEDIA GROUP

What you need to know:

  • A strike is used as a last resort bargaining tool by workers and is meant to cause some degree of discomfort to the employer/industry to address workers’ grievances.
  • The recent strike paralysed operations, including emergency services, at nearly all the public hospitals.
  • Even the doctors who head the Ministry of Health decided to engage in an ego war with the doctors’ union, totally ignoring the plight of poor patients.

Withholding labour is considered a right of the worker, and at times defines the boundary between employment and slavery.

A strike is used as a last resort bargaining tool by workers and is meant to cause some degree of discomfort to the employer/industry to address workers’ grievances.

It is never meant to deliver a fatal blow to the industry as that would leave the worker jobless.

In the case of health care providers such as doctors, the patient is a third party whose plight and rights cannot be ignored.

Patients’ conditions can deteriorate during a strike, sometimes leading to permanent disability or even death.

HIPPOCRATIC OATH

In health care, returning to work cannot be seen to restore normalcy unlike in a teachers’ strike where the lost time can be recovered through extra tuition or the Judiciary, where pending cases can be disposed of through longer working hours.

It is no wonder that doctors take the Hippocratic Oath as a commitment to offer selfless services to the vulnerable.

But is the Hippocratic oath a prescription for altruism or fortitude? There are many versions of the oath named after the Greek doctor Hippocrates, who is considered the father of modern medicine.

A paragraph from one version of the oath taken by doctors worldwide says: “The practice of medicine is a privilege which carries important responsibilities. All doctors should observe the core values of the profession which centre on the duty to help sick people and to avoid harm.

I promise that my medical knowledge will be used to benefit people’s health. They are my first concern. I will listen to them and provide the best care I can. I will be honest, respectful and compassionate towards patients. In emergencies, I will do my best to help anyone in medical need.”

DIE FOR PATIENTS

Does the Hippocratic oath mean that doctors, like Jesus Christ, should die for their patients? What is the defining line if the administration fails to provide the tools necessary to deliver health care? Does the oath still apply when a doctor is away from the patient?

If doctors stay away from the hospital, are they still in violation of the oath? Kenyan doctors have argued that it is the duty of the government to staff public hospitals or close them down so that patients can seek treatment elsewhere.

Was the recent 100-day doctors’ strike in Kenya justified? Should the Constitution allow doctors to strike? If not, how should their grievances be addressed to minimise the pain and suffering and even death of patients?

There are a lot of similarities between the Kenyan strike and that of June 2012 one by junior British junior doctors that lasted only 24 hours.

In both cases, the doctors expressed concern about their working environments, including terms of service.

LABOUR DISPUTE

The doctors were accused of politicising the labour dispute and ethical issues on health care raised.

In both cases, public response to the strike was divided. Some accused the doctors of greed for more money and an equal number supported giving better terms of service to doctors.

The debate on whether doctors should strike or not will continue for a long time to come. What is not debatable, however, is the need to provide emergency services during strikes.

But will governments, especially in the developing countries where the elite and middle class go to private hospitals and leaders are impervious to civil liberties, be moved by such strikes?

The recent strike paralysed operations, including emergency services, at nearly all the public hospitals. That it lasted this long is a wake-up call to rethink the issue of labour relations involving health care providers.

POOR PATIENTS

To make matters more painful, even the doctors who head the Ministry of Health decided to engage in an ego war with the doctors’ union, totally ignoring the plight of poor patients.

For instance, there was no official communication on where one could seek help in case of an emergency such as complicated labour or a life-threatening accident.

Maybe the doctors should have offered emergency services, but the strike might have lasted 365 days, considering the don’t-care attitude of government officials.

Though doctors have a right to strike, their role is too critical for them to enjoy this right. Then they deserve special treatment. The government put in place a self-adjusting remuneration scheme that responds to economic fluctuations. Let us invest in our people’s health.

Dr Odhiambo is a senior lecturer at the University of Nairobi and a consultant maxillofacial surgeon. [email protected]