Let’s end strike and go back to work

Kenya Medical Practitioners, Dentists and Pharmacists Union (KMPDU) Secretary-General Ouma Oluga (left) and National Chairman Samuel Oroko (center) address the media over the ongoing strike on December 31, 2016 in Mombasa. PHOTO | KEVIN ODIT | NATION MEDIA GROUP

What you need to know:

  • There is no reason doctors should work longer than 40 hours without adequate compensation according to the law.
  • We must continue to encourage our elected financial managers to keep striving at improving conditions for doctors.

The doctors’ strike is now in its second month.

The doctors are demanding the full implementation of a Collective Bargaining Agreement signed in 2013.

The agreement is laden with proposals for fundamental administrative and policy changes.

In addition, the doctors are demanding a 300 per cent pay increment.

One wonders why after 32 days, these Kenyans — the doctors and their employers — cannot find a solution that would save millions of Kenyans from misery.

Are the doctors’ demands rational and reasonable? Of course they are.

The CBA stipulates a 40-hour work week. Many doctors work for more than 40 hours per week without compensation.

The Employment Act limits a work week to 40 hours.

There is no reason doctors should work longer than 40 hours without adequate compensation according to the law.

It is surprising Kenyans require a CBA to implement what is clearly stipulated in the law.

Doctors in the public service also work under very harsh conditions.

THE RIGHT QUESTION

Many hospital spaces are plainly unhygienic and medical equipment is at best archaic where available.

My experience in the public service was horrible. You had to go an extra mile to do the right thing.

The system was not supportive. For example, to prepare patients for operations, I had to prick the patients to obtain a blood sample, take the sample to the laboratory, ask the laboratory in person to look for appropriate blood to infuse into the patient should the need arise, and then I would be expected to collect the prepared blood in the morning before the opening of the operating theatres.

Yet there are other health professionals trained for all these tasks.

The CBA stipulates doctors should get adequate “support staff” and “medical equipment”.

That cannot be too much to ask for.

There are also reports of harassment of doctors by the various Health ministries in the counties.

Sadly, and shamefully, most of this harassment is perpetrated by fellow doctors in administrative positions.

My understanding is that the national government and the Council of Governors representing the county governments have no problem implementing the contents of the CBA as outlined above.

The bone of contention seems to be the 300 per cent pay increment demanded by doctors but apparently not set out in the CBA.

Application of legalism on this matter — whether doctors can go on strike to demand implementation of something not set out in the CBA — is not useful in the long-term.

The question that must be asked and answered sooner rather than later is — is the doctors’ demand for a 300 per cent pay increment legitimate?

ECONOMIC ANGLE
The entry level pay for a medical officer in Kenya is Sh140,244 per month, and my understanding is that the government has offered to raise that to Sh196,289 per month.

Is this too little or too much? Obviously, most Kenyans would balk at our calling this too little.

One way of determining whether pay is appropriate is comparing what we are currently paying doctors with what other governments pay their doctors.

In South Africa, the entry level pay for a doctor is 240,000 rand per year.

This translates to about Sh200,000 per month. One would think that the Kenyan doctor is underpaid looking at these South African figures.

However, the South African GDP is about $400 billion compared to Kenya’s $66 billion.

A first year resident in the US (equivalent to Kenya’s intern) earns about $4,000 per month.

The US has a GDP of almost $19 trillion.

The size of the economy aside, per capita income may guide in understanding what a citizen earns in a given country.

The per capita income in the US is $57,000 per year, compared to Kenya’s $3,360 corrected for the purchasing power of the dollar (purchasing power parity).

Pushing salaries higher for public servants is not a sustainable way of raising per capita incomes.

Arguments for managing the public wage bill have also been made elsewhere.

RETURN TO WORK

There is something to be said about paying people what the economy can afford.

It has been said that our politicians are paid better than their counterparts in wealthier countries.

That may well be so. The question must be: are our politicians appropriately paid, or are they overpaid?

If you decide they are overpaid, you must campaign that their salaries must be appropriate.

All over the world, society puts inordinate demands on doctors for their service.

It appears no society has managed to compensate doctors adequately.

We must continue to encourage our elected financial managers to keep striving at improving conditions for doctors.

At the same time, doctors must appreciate that no one can ever pay them enough for saving a life.

We must strike a balance between the two positions — prudent financial management and appropriate compensation — with compassion being the overriding factor.

Let’s go back to work. All of us.

Dr Peter Gathirimu is a family Practice Physician