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Fresh row over medical equipment scheme

Tuesday May 14 2019


Meru Teaching and Referral Hospital staff receive an electric delivery bed courtesy of the Managed Equipment Service, on April 6, 2017. PHOTO | FILE | NATION MEDIA GROUP 

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There seems to be no end in sight to the controversy that has been the hallmark of the Managed Equipment Service (MES) programme, with the national government now saying counties do not pay a single cent.

Instead, Treasury Principal Secretary Kamau Thugge, in a letter to Health Chief Administrative Secretary Rashid Aman, said the national government foots the bill from its share of revenue.


The letter with the subject “Confirmation on the source of budget allocation for MES programme”, is dated December 4, 2018 and Dr Thugge was responding to Dr Aman’s November 2018 letter.

“The purpose of this letter, therefore, is to confirm to you that the funds allocated to MES programme are from the national government’s share of revenue raised nationally,” clarified the letter.

The letter stated that the law provides that revenue raised by the national government in respect of the financial year 2018/19 shall be divided among the national and county governments.


The Schedule of the Division of Revenue Act, 2018 allocated Sh9.4 billion from the national government’s share of revenue as an additional conditional allocation to county governments for leasing the equipment.

But the Council of Governors (CoG) said Dr Thugge’s letter is not wholly truthful and failed to acknowledge that by law, conditional grants to counties should be sent to county accounts and not appropriated on their behalf by the national government.

“The Constitution allows that county governments can be given additional allocations as conditional grants. The moment you say is a conditional grant means it is an allocation that is meant to go to the counties directly. That is what the law provides,” the CoG secretariat told the Nation.


CoG cited Article 207 (1), which establishes a Revenue Fund for each county government “into which shall be paid all money raised or received by or on behalf of the county government, except money reasonably excluded by an Act of Parliament” as the relevant part of the law that gave counties control over conditional grants.

When the Nation sought clarification on the document from Health Cabinet Secretary Sicily Kariuki, she insisted that counties are not paying anything for the equipment and that they should tell Kenyans the truth.

“I’m not trying to defend the programme but we should have a bigger and broader perspective on the programme. We should tell Kenyans the truth about the whole programme. I don’t understand why someone would lie. We are leaders and what we say matters a lot,” said Ms Kariuki.

CoG’s contention was that this money was not sent to counties as required by law.

“Similar conditional grants like the one that supports Level Five hospitals go directly to the counties that have such hospitals,” CoG said. “The national government says it has allocated but does not disburse. Why would the counties continue including a budget line that they don’t appropriate?”


Last week, CoG chairperson Wycliffe Oparanya complained before the Senate Health Committee that the government was directly debiting funds for leasing the equipment from their budget yet none of the 47 governors knew where the money goes.

Amid the dispute over the programme, ironically, a number of governors, including Mr Oparanya, have been requesting more equipment from the ministry.

Six years since the programme started, many grey areas and unanswered questions still exist.

For instance, the allocation increased from Sh97.7 million in the initial phase to Sh200 million. Counties say there has been no explanation for this.

The other contentious issue on MES has been why the national government is holding onto the health function, which the Constitution devolved.

Bungoma Senator Moses Wetang’ula raised concerns about the lack of information from the Treasury and the Health ministry regarding the programme.