Taking public hospitals to court can address biting understaffing
The secretary general Kenya health provisional Union Mr Joash Matunda addresses journalists at coast general hospital where he issued a seven day ultimatum to the government before they down their tools on August 11, 2014. PHOTO | LABAN WALLOGA | NATION MEDIA GROUP
What you need to know:
Medical workers’ unions should demand that employers meet their part of the bargain by equipping hospitals, adhering to working hours and staffing rules for their members.
A recent newspaper advert by a local bank looking for “culture change consultants” points out how afflicted our workplaces are by “change-resistant practices.”
Coming in the background of another government staff rationalisation and registration, the advert by a commercial enterprise left me thinking. The rationalisation exercise targets the so-called ghost workers but perhaps what is needed more is a change in work ethic.
For the public health workforce, complaints from clients about performance are not encouraging. I do not know how health workers rank in overall performance of public institutions but we are unlikely to be rated as top performers.
Issues like chronic absenteeism and corruption have not endeared us to many. Of course, our hospitals are not the best places to work in given the lack of equipment, patient numbers and high public expectations. However, it is also a fact that regardless of these difficulties, our efficiency should improve.
It was thought that poor pay, long work hours, understaffing... were major reasons leading to dismal performance. Sadly, the recent pay rises did not result in commensurate improvement in performance, suggesting that money is perhaps not the motivating factor for many workers.
The annual entry of new doctors into the public workforce is also not showing any significant positive changes. Statistics like patient waiting times, doctor contact hours (a statistic indicating the amount of time doctors see patients during hospital visits) and average number of patients seen by a doctor are not encouraging.
Behaviour change
A survey released earlier in the year indicated that absenteeism, whether sanctioned or otherwise, is particularly high in the health and teaching professions. Reassessing and re-evaluating employee desires in the workplace is perhaps what is needed if behaviour change programmes like that sought by this bank are to work. Work ethic is also a major issue.
In the new era of medico-legal pitfalls, public hospitals may find themselves in litigation in cases of staff absenteeism. There is a need to know the responsibilities of hospital and an employee .
For instance, where a patient arrives at a hospital that is understaffed with doctors, culpability is on the facility. But if it is well staffed but patients are still not attended to on time, the issue could be personnel.
Ensuring staffing norms are adhered to should be every county’s obligation and priority. Medical workers’ unions should demand that employers meet their part of the bargain by equipping hospitals, adhering to working hours and staffing rules for their members. This helps to address culpability because both parties know their obligations.
Often, lawyers and doctors don’t like meeting, but this is one area where lawyers could actually help. Because, so far, none of our strikes have been successful in addressing these issues, perhaps suing hospitals would challenge resource allocation to healthcare.
Understaffing or ill-equipping of hospitals should be tackled through legal channels.
