Without politics, health crisis can be mitigated

What you need to know:

  • Planning: Politicians took over devolution of health care and mutilated suggested structures.
  • The ongoing crisis in payment of health workers salaries is only the tip of the iceberg.

Health workers are, by training and nature, very attentive people, and they are constantly worrying about problems facing their clients and the general population.

Every waking hour is spent trying to discover new ways of easing pain and curing disease, in a continuous attempt to stay at least one step ahead of the ever-changing charge of disease and infirmity.

Whenever we visit health workers we are often in a state of extreme anxiety about our health, and hope for a quick solution to enable us to return to our usual routine as quickly as possible.

It should therefore be shocking to any observer that health workers in Kenya have been in the news for all the wrong reasons over the past few years, agitating for changes that they believe will make their work more meaningful.

The main thrust of their argument has been that while devolution of health services is necessary, it is not practical to transfer health workers to the counties without a system in place to ensure equitable distribution of the workforce, and career security for the workers.

INEVITABLE INEQUITIES

It was argued that human resources for health are scarce, leaving it to the counties to recruit and deploy them would result in inevitable inequities that can only be addressed by the national government.

Further, it was argued that wholesale transfer of the workforce would result in human resource management challenges whose net effect would be a reversal in gains made in the health sector.

To mitigate against these effects, health workers suggested that it would be necessary to have in place a Health Service Commission that would ensure that qualified health workers are trained, registered, recruited and deployed according to service need across the entire republic.

This commission was actually present in all drafts of the constitution until the then parliamentarians went to Naivasha and mutilated the draft to suit their own interests.

Subsequently, health workers have come up with several formula through which this Commission could be created and facilitated to carry out this important function. Unfortunately, at each stage they are met with disdain and fallacious claims that the health function was completely devolved and the national government has no role.

TIP OF THE ICEBERG

The ongoing crisis in payment of health workers salaries is only the tip of the iceberg. The truth is that many Kenyans are dying of preventable causes due to poor distribution of the health workforce, as well as the industrial disputes that keep cropping up.

In my opinion, it was a good idea to select a key social sector for near-total devolution. The mistake was to select a sector where even small mistakes result in irreversible changes in the lives of common citizens.

In experimenting with our people’s health, we demonstrated a level of callousness that we shall continue to pay for several generations from now. Every death attributable to this mistake should haunt all those that chose to inject politics in matters of life and death.

To prevent more pain and suffering, one expects the national and county governments to put their differences aside for the sake of their mutual employers, and agree to create a centralised mechanism to deal with human resources for health.

Whatever they want to call it, a national mechanism to ensure that health workers are managed appropriately must be put in place sooner rather than later.

Dr Atwoli is the national secretary, Kenya Medical Association and dean, Moi University School of Medicine. [email protected]