- I am sure the President will support you in this- for while campaigning, he promised to set up a Health Service Commission once elected for the presidency.
- In 2020, the Kenya Medical Association asked the government to come up with a Health Service Commission saying that it would help in ‘healing the sickly’ public health service in Kenya.
Image: HANDOUT
Dear Hon Susan Nakhumicha; the Cabinet Secretary for Health;
I am writing to acknowledge the vigour, understanding of issues and commitment to improving access to health that you have shown since being appointed to lead the health sector.
I am sure, in addition to dealing with the huge demand for health services by Kenyans, brain drain in the sector and the nearly stalled process of devolving health services, you notice that it’s one of the most demanding, people-centred and at the core of the country’s soul.
Sick people cannot invest or manage to generate income.
Your efforts in actualizing access to universal health are very commendable and on point policy and legal reforms initiated so far in the health financing targeting meeting patient costs through state-supported financing are visible, fighting vested interests in the sector is commendable, institutional reforms in key public agencies in the health sector, attempts to engage with devolved health departments among others are tough investments that the country requires as a matter of urgency.
Madam CS, I am sure that in your field visits, key stakeholder engagements and vast knowledge, the small issue of an overstretched and demoralized health workforce, lack of basic equipment in health facilities and the near privatization of health provision at the expense of investing in a functional public health system remains a big challenge.
Even as we work on improving health financing, managing the health workers in a professional and organized manner remains a missing factor in the process you are doing.
Health workers are managed in a very unprofessional and coordinated manner, that has in the process leads to a lack of ethical management of health care, lack of innovation and growth within the health public health system, failure to quality control and inspection of health facilities, mis categorization of facilities and misplacement of equipment in health facilities.
Several county-based health facilities have been placed in levels 2,3 or 4, yet they don’t even qualify or were simply pushed there during the hospital equipment project where Counties fought or were given facilities, they don’t have resources to use.
Madam CS, it’s a tough task but doable running the health docket as you have already shown through your focus, commitment, and energy. You have Kenyans at heart.
Please try, through an Act of Parliament, to establish a Health Service Commission to regulate the healthcare sector through registration, inspection, monitoring complaints and enforcement activities.
Such a sensitive sector must have a regulator to ensure order, compliance, and coordination.
I am sure the President will support you in this- for while campaigning, he promised to set up a Health Service Commission once elected for the presidency. It’s not a bad idea as people would like to appear.
In 2020, the Kenya Medical Association asked the government to come up with a Health Service Commission saying that it would help in ‘healing the sickly’ public health service in Kenya.
They indicated that the establishment of the HSC would help in addressing issues affecting public health, among them the shortages of health professionals in the country and boost Kenya’s ability to deal with eventualities through “a centralised mechanism for managing human resources for health”.
The commission would have the prerequisite professional competence to make decisions on health services.
The establishment of a Health Service Commission will also lead to a push and pull between the two levels of government – national and county – as some counties have invested in the training of health professionals.
Madam CS, these are other commitments that can be dealt with gradually like commitment by the government including providing 15 per cent of the national budget to health as committed through the Abuja Declaration has failed, regulation of medical health, and halting the migration of health professionals from the country because of poor or leaking financing are still struggling.
It would be the commission doing, for example, ensuring the health professionals just like the other commissions have done for their staff, data on current payroll and state of financing of the sector, recruitment and human resources issues, promotions and overseeing the remaining phases of devolving health- with structures including subcounty and county health services that will enable dealing with grassroots issues.
To achieve this milestone, the government promised to delink the Health Ministry from service delivery and concentrate on policy guidance to improve the management of health institutions primarily by devolution of health management to communities and healthcare experts to counties and national hospitals.
However, the operationalization of the body to harmonize these functions is missing- we have still maintained the old way of running health, thus expecting different results is surprising.
The establishment of a functional, professional, and structured health commission and you will have scored big, not just for yourself, but for the health professionals, health services and the country.
Some other things to consider may be the establishment of a government-sponsored word in a private health facility- because the government has the resources under the universal access to health facilities, technology and equipment are lacking in most out of town health facilities- so even with the medical card, you can still die in a public hospital.
We should also encourage medical tourism across counties- so that specialist health facilities and research centers within counties are strengthened- and can treat people from across other countries.
Big private health facilities in countries such as India have fully funded government wards that cater for general citizens who require specialist treatment and act as referrals thus reducing pressure on government facilities.
For example, a government-sponsored ward in the private facilities in Kenya would reduce pressure on Kenyatta National Hospital.