President Uhuru Kenyatta, backed by the country’s 47 governors on Tuesday decided to play hardball with the doctors after they rejected a salary deal negotiated by the country’s most senior clerics.
The improved deal, which the President himself had agreed to on Monday night, is now withdrawn, the government has stopped all negotiations, the doctors’ union is at risk of being deregistered and the medics face disciplinary action for not attending to patients.
Doctors have generous pay expectations — they want a medical intern paid a minimum salary of Sh325,000 — and also allowed to divide their time and energy between public hospitals and their own clinics.
They also want the current system of registering and disciplining doctors to remain in the hands of doctors, even though the system is so totally broken, creating a culture of impunity where doctors are never punished for medical malpractice, negligence and incompetence.
Exasperation was evident all round because of the doctor’s shifting demands, unwillingness to compromise and their insistence on a culture that is no longer feasible where they are paid by the taxpayer but are free to work for themselves and where they are a law unto themselves in dealing with patients.
On Tuesday night, the medics were reeling from the government’s surprisingly strong reaction, compounding the country’s worst industrial action, now on its 94th day.
Kenya Medical Practitioners and Dentists Union rejected the additional Sh10,000 medical risk allowance on top of an enhanced offer of a 40 per cent pay rise which appeared to convince the government that there was more to the strike than an improvement of terms of employment.
The enhanced deal was actually a Sh10,000 increase of the medical risk allowance, initially set at Sh10,000 in the initial offer doctors were given in Mombasa. It would have been paid in arrears, from July 1, 2016.
“This additional offer was on condition that the doctors call off the strike and report to work today (Tuesday) morning,” read a statement by the Council of Governors chairman, Mr Peter Munya, in the presence of the President in Naivasha on Tuesday evening.
They described the 40 per cent increment, as well as the additional allowance — which would have increased the total payout by Sh600 million — as generous. Had the doctors accepted that offer, their annual wage bill as a singular budgetary item would be in excess of Sh14.5 billion.
NO FURTHER NEGOTIATIONS
“Consequently, as a result of the doctors’ failure to call off the strike, the government has now rescinded this offer and there will be no further negotiations on remuneration,” said Mr Munya in the brief press conference, introduced by President Kenyatta.
The leaders said each individual doctor, pharmacist and dentist within the public service will now have to negotiate with their particular employer, be they national or county government.
The government is now also reviewing the registration and certification procedures of the doctors’ union with a view to reverting its functions back to the Ministry of Health.
“Every doctor swears a solemn oath that he or she shall not do harm,” said Mr Munya. “Continuing with this illegal strike in the face of an enhanced government offer that is at the very edge of affordability and sustainability is to betray that solemn oath.”
Describing the strike as illegal, the governors and the President said they had made strenuous efforts to amicably resolve the dispute, up to late into the night on Monday.
The President and a number of governors and religious leaders were involved in the talks only for the doctors to turn around and rubbish the efforts.
NEVER SHOWED UP
A source within the negotiating team told the Nation that the clergy – John Cardinal Njue (Catholic), Archbishop Jackson Ole Sapit (ACK), PCEA’s Julius Mwamba and Sheikh Adan Wachu, arrived at State House on Monday night at 9.30pm after meeting with officials of the doctors’ union earlier in the day.
The clergy had promised State House officials that they would be accompanied by the KMPDU team, which never showed up.
The clergy told the President that they had been sent by the union officials to ask for more money, meaning the government had to add to the Sh600 million that had been given after Cotu secretary-general Francis Atwoli’s short intervention in the dispute.
But, even with the additional pay, the doctors took issue with some of the other issues. For one, the government and the governors had insisted, to the chagrin of the doctors, that with the new perks, doctors will have to devote all their time to public service and will not be allowed to run their private clinics.
The government also wanted doctors to give up the regulatory function of the medical profession to the Ministry of Health, which it felt had been preventing it from licensing and hiring doctors. But the doctors refused to relieve the Kenya Medical Board of that function.
Mr Wachu said the union officials sent the clergy to the President to seek additional funds, acceptance of the draft CBA, and a promise that no doctor would be victimized for going on strike.
RETURN TO WORK
“All these three were accepted,” said Mr Wachu. “The government and counties wanted the doctors to return to work immediately.”
However, after the State House meeting, doctors said they will not go back to work until the CBA had been signed.
“We filed our reports in court today. We have reached the epitome of our progress; we leave the rest to the courts,” said Mr Wachu.
Earlier Tuesday, President Kenyatta had set the stage for the events later in the day when he decried the doctors’ “lack of compassion” for constantly derailing pay talks by issuing fresh demands. The government, he said, will not allow itself to be blackmailed by a “hypocritical” group that, although on a declared strike, continued to work in their private clinics.
“Hawa watu wanafikiria sisi ni wajinga (These people think we are foolish),” said Mr Kenyatta while officially opening the fourth devolution conference in Naivasha.
“If this round of talks fails… we will sort them out,” he said, but did not elaborate what that “sorting” entailed. The move by the government later in the day to withdraw its initial offer and deregister the doctors’ union was seen by many as the President’s way of walking the talk.
REFUSED TO TAKE OFFER
Mr Kenyatta had asked why, even after doctors were given “better pay than their counterparts in private hospitals”, they had refused to take the offer.
“Intern doctors will be paid more money than doctors in Nairobi Hospital, Aga Khan and others,” said the President. “The irony is that they will only work for two hours before running to their private clinics.”
He said while the government was committed to a fair solution to the doctors’ dispute, it was equally concerned about the welfare of other public servants like the police and the military, who also offer critical service to the nation. He challenged doctors to be fair and accept the reality of the country’s economy.
“In as much as we also wish to have a world-class medical service, it cannot be realised immediately,” he said. “We will not achieve what you want overnight. Remember we are a developing country. You must pay attention to our national realities.”
Following last evening’s announcement, the Nation learnt that different county governments were in various stages of disciplinary measures against the doctors for the strike, which has been declared unprotected by the courts. But the elephant in the room was the decision to stop all public doctors from engaging in private practice, known as locums.
“All medical doctors, pharmacists and dentists shall strictly adhere to their terms of employment in regard to engaging directly or indirectly in any other gainful employment and or private practice as a partner, employee, consultant, director, manager, agent, associate, or otherwise,” read the return-to-work agreement, which would have paved the way for a new collective bargaining agreement had the doctors called off their strike on Tuesday.
Reporting by Dave Opiyo, Njeri Rugene, and Carol Wafula in Naivasha and Eunice Kilonzo in Nairobi.