Don't use MCA salaries as a template for doctors

What you need to know:

  • The high cost for this dispute will be borne by the taxpayer, both in terms of loss of life, loitering patients from the mental hospital and higher wages
  • What is strange is this belief that a wage hike must be granted to the unions without the further advice of the Salaries and Remuneration Commission
  • In angry or clouded thought, some Kenyans are advocating for everyone to be compelled to use poor services provided the same standard is available to all

While attempting to keep abreast of the impasse between health professionals and the Ministry of Health, I was appalled by the ideas that appear to be informing wage policy in the health sector.

So I choose not to referee the labour dispute between the union of medical workers and their employer.

The high cost for this dispute will be borne by the taxpayer, both in terms of loss of life, loitering patients from the mental hospital, and higher wages, which the profession will probably wring out of a government which lacks a sensible public sector wage policy.

Kenyans, I find, are hostage to the view that righteous anger shouldn’t be questioned. The massive corruption in the Ministry of Health, means the Executive truly has zero credibility to push back against medical professionals demanding more wages, allowances and better working conditions.

Truthful, sensible public reasoning is now hostage to the view that since the public sector loses billions of shillings to corruption, no claim by unions for wage adjustments should be questioned.

The popular refrain reads “Lipa kama tender” (pay it like a tender). This is, no doubt, a very smart expression of our indignation, but it cannot be the basis for policy.  

Secondly, the Ministry of Health has not published the agreement which forms the basis of the dispute, so the union of doctors is entitled to insist on its version. In spite of this concession, I find the advocacy for implementing the CBA to be based on very poor economic logic.

What is strange is this belief that the unions must be granted a wage hike without the further advice of the Salaries and Remuneration Commission (SRC). This cannot happen, because the Constitution specifically states the SRC must give advice to both county and national governments on the remuneration and benefits of all other public officers.

Article 230 (40) (b) does not provide an exclusion for any union or profession, hence the SRC's failure to publish an opinion on the agreement is stranger still.

RECYCLED IDEA

A third fallacy informing the discussion on health worker remuneration is that their preferred wages are justifiable because in Kenya, Members of County Assemblies (MCAs) and Members of Parliament (MPs) earn higher wages.

No doubt, legislators arm-twisted the SRC and kept their wages and allowances, but that does not mean public sector wage policy must be anchored on this bad example.

This idea, that some MCAs are barely literate yet earn a wage that places them in the top five per cent of all income earners in Kenya, does not mean everybody else should be paid what is unaffordable.  

Those rightly upset that MCAs and MPs always get their way with the acquiescence of the SRC should consider a referendum about what the acceptable wages ought to be. It is self-damaging to set MCA and MP wages as the benchmark for all public sector workers. 

Fourthly, an idea now being recycled is that the legislature should pass a law restricting all elected public officials to public health facilities only.

The thinking behind this proposal is that forcing these policymakers, and other professionals, to rely exclusively on public health facilities will incentivise them to match the standards in the private sector, where they seek treatment whenever they or their family members fall ill.

This view of the real constraints of public health policy is not only uninformed, but also a dangerous creep on civil rights, which must include the freedom to seek health care wherever one can.

WOOLY JOB EVALUATIONS

In angry or clouded thought, some Kenyans are advocating for everyone to be compelled to use poor services provided the same standard is available to all.

They forget that the people they target would now have added incentive to allocate health facilities in ways that would benefit them and their families. This would displace the poor and powerless back to quacks and marauding witchdoctors. Anger, however righteous, is not a good basis for crafting policy.

Despite the grave consequences of their agitation, public sector workers are entitled to demand better pay. What is not acceptable is for the Salaries and Remuneration Commission (SRC) to spend enormous sums on long reports about woolly job evaluations, only to go missing in action when the time comes to lay the hammer down and call out unaffordable demands.

This commission was created to stare down people making unreasonable wage demands, and its credibility suffered when it didn’t do that for Parliament.

Now, because the SRC reinforced the view that brinkmanship can indeed influence wage policy, the taxpayer is paying a cost.

Kwame Owino is the chief executive officer of the Institute of Economic Affairs (IEA-Kenya), a public policy think tank based in Nairobi. Twitter: @IEAKwame