Let us kick out politicians for medics, nationalise healthcare

It has been all about Covid-19 these past few months and we have not heard the last of it as grim pictures emerged of high death tolls in Italy, Spain, the UK and the US.

If such countries with abundant resources are struggling, heaven knows how we would fare with our rickety healthcare system. The epidemic has exposed the gaps in our public hospitals, forcing the national government to step in.

I have written before to express my reservations on healthcare being a devolved function and my view has not changed.

Health is too important a department to be left to elected leaders, whereby it risks becoming a political campaign tool. Being politicians, governors will take the first opportunity to play politics with Kenyans’ lives.

Our hospitals are in dire state, not for lack the key personnel and funds but because we put them in the hands of unqualified people.

I do not believe politicians - who are beloved of overseas medical care - would have their heart in improving public hospitals for the poor. It is doubtful if the overseas trips will end after this pandemic.

It is time technocrats and medical professionals were brought in to manage healthcare as a national entity.

POOR REMUNERATION

Medics have been criticised for preferring to work in the private sector, and who could blame them if they get better remuneration there. But with adequate support, they should be in the public sector.

The disparity in the management of coronavirus across counties justifies the need for a centralised healthcare.

That will create a joined-up effort between medical experts and the national government. It will also create uniformity from capacity building to research and development to funding.

We have lately noticed how our medical professionals became the front and centre of the Covid-19 management plans.

KPMDU has been pushed to the side as counties wreaked havoc in our public hospitals. Nurses and doctors, who are key in achieving universal health coverage (UHC), have been rendered peripatetic as their contracts constantly become the bone of contention.

We have witnessed the never-ending battle between healthcare professionals and county officials over salaries despite county wage bills ballooning to pay relatives and unnecessary admin staff chocking payrolls.

To date, medical professionals complain about poor working conditions despite devolution being touted as the ladder to better healthcare standards.

FISCAL REGULATION

Devolution has, indeed, been effective in giving us 47 first ladies but minimal development.

Many of the projects that should have been initiated by now are either non-existent due to corruption or centred around prioritising construction of governors’ mansions over hospitals and provision of basic healthcare.

I am not naive to the fact that corruption is our national hobby and will be a challenge even to a nationalised healthcare system.

But with tight fiscal regulation and given the importance of the health sector to the economy, we should build an enviable national healthcare system.

A 2015 World Bank report revealed that Kenyans spent a third of their earnings on healthcare as ‘out-of-pocket’ expenses.

It went on: “This form of payment contributes to households’ poverty and impoverishment and acts as a major barrier to healthcare access by the poor.”

Anecdotally, the hardship endured by households, arising from high hospital expenditure, has not changed despite the launch of UHC.

Private hospitals continue to rake in millions from the gap in healthcare as the hold hostage Kenyans who struggle to pay for private care.

Little has been done to seal loopholes at Afya House despite millions of shillings being lost through corruption.

DETACHED LEADERS

The latest scandal, around the leasing of multibillion-shilling scanners by counties, speaks volumes on the deeply entrenched corruption in the health sector, where big-buck spending on equipment is prioritised over basic healthcare.

Nationalising the sector at least gives the country a monolithic approach in curbing waste of public funds.

Secondly, it will take the management of healthcare back to the medical professionals, who are better placed to run the sector.

They have proved their mettle in the way they are managing the Covid-19 pandemic.

Medics work hand in glove with the health sector and do not have a flitting relationship with it as Kenyan politicians do (if any!)

Many of our leaders have proved to be allergic to the very hospitals they are meant to manage by preferring to travel abroad for medical care.

How would they ever know the challenges the poor face in public hospitals?

A strong economy walks in tandem with a healthy nation; there can’t be one without the other. And, to achieve UHC, we must hasten nationalisation of healthcare.

Ms Guyo is a legal researcher. [email protected] @kdiguyo