If health care workers per capita, the quality of public hospitals, government spending on health care, the availability and affordability of health care, and doctors salaries are indicators of a nations health then we should be very worried about Kenya’s health.
Seriously worried, we live in country where we have the highest paid members of parliament, in the world, yet some of the lowest paid medical personnel. According to the an article in the Washington Post, yes the ongoing doctors’ strike is making international news, the starting wage for doctors in Kenya is approximately 36,000 shillings per month while a member of parliament’s salary is about 440,000 shillings per month excluding allowances. The contrast in the salaries of MPs and doctors is particularly startling when you think about it terms of output, or value for taxpayers’ money. Who gives more value for tax shillings doctors or MPs?
All you have to do is walk into a public hospital or talk to a doctor working in a public health care institution to realise that the doctor’s strike is probably way overdue. The Kenya Medical Practioners Pharmacists and Dentists Union has been in talking to the government for a year about overhauling the public health care system to no avail. The next logical step, industrial action, the doctors are demanding a 300% pay rise (reasonable when you take in account how little they are paid) and higher budgetary allocation for the health care sector (reasonable when you take into account the state of the public health care system).
In response to the strike the government has offered to increase the doctors’ extraneous allowances, not salaries but allowances, by Kshs 30,000 per month. The government proposed that the increment be implemented 3 phases starting in the January next year and ending in 2013/2014. The offer is ludicrous considering that tax will probably takes up around 30% of their salary, and inflation another 20%, add to that other taxes e.g VAT, rising interest rates on loans, the depreciating value of the shilling, the rising cost of living and its no surprise that the doctors rejected the government.
Taking a hard line stance, citing section 230 (4) of the constitution, the Assistant Minister for Medical Services Kambi Kazungu has told parliament that government is unable to raise the doctors’ salaries. The reason, raising the doctors salaries is outside the mandate of parliament, he argued that the constitution requires that salaries of state officers be set by the yet to be established Salaries Remuneration Commission.
However according to the wording of the Article 230 (4) (b) the role of the Salaries and Remuneration Commission with regard to the salaries of the public officers is an advisory one. The Article states that the role of the Commission is to “advise the national and county governments on the remuneration and benefits of all other public officers.” So contrary to the statement made by the Assistant Minister for Medical Services to parliament the constitution does not stop the government from raising the doctor’s salaries. It’s surprising how members of the government are willing to the rely on the constitution as a tool to abrogate their duties i.e. negotiate doctors salaries and are unwilling to following the provisions when it imposes obligations i.e. the requirement for all state officers to pay taxes…
The argument that there is no money in the public coffers to pay doctors is disingenuous, there’s been money for Operation Linda Nchi, there’s been money for the almost 1 billion shilling refurbishment of parliament. It’s a matter of priorities and right now the governments priorities seem to lean away from the improving the lot of the public health care systems those who work in it, but that could be because a bulk of them can afford private health care.