Ideas & Debate

Doctors’ strike a chance to debate fiscal management

Doctors went on strike in December over issues including remuneration, working conditions, promotion and transfer policies, occupational safety and inadequate health staff and facilities.

Both the Press and national government have given Kenyans the impression the main demand by doctors is a 300 per cent pay increase.

However, a public announcement by the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) stated that “in all its offers the government has addressed itself solely to a non-existent 300 per cent pay increase demand and has refused to give its position on the non-monetary issues”.

Thus, while there are requests by doctors to improve compensation, there are other demands to benefit the greater health of Kenyans including hiring more doctors and better equipment.

However, it must be said that although the CBA is not solely on remuneration, doctors’ demands have financial implications. For example, there is a demand to hire 1,200 doctors yearly for four years.

It cannot be denied that honouring this request in addition to increased compensation and better equipment would be an expensive endeavour; and, that is likely why national government has yet to broker an agreement with the doctors.

The reality is that Kenya’s fiscal space is narrowing and the ability of national government to take on added costs is becoming increasingly limited.

Last year the government overshot its fiscal year debt target having borrowed Sh147.1 billion against a target of Sh106.0 billion.

Chronic over-spending

The public debt to GDP ratio stands at over 50 per cent, well above Treasury’s 45 per cent ceiling; and the fiscal deficit is at eight per cent, surpassing the five per cent target.

Indeed, the country has acquired public debt to the extent that a fifth of the budget is committed to repaying loans. The national government seems to have acquired the habit of chronic over-spending.

And while debt levels are still thought to be sustainable, bodies such as the IMF and World Bank have warned about the trend of government borrowing with concerns that it may lead to the country being over-leveraged, probably in a shorter time span than anticipated.

So, there is reason for national government to be concerned about the financial implications of the demands being made by doctors.

However, there is a clear flaw in the case being made by the government, attempting to use finance and economics to deny doctors their requests. Just as the government seems stuck in chronic over-spending, it also seems stuck in chronic financial mismanagement.

Kenyans will simply not believe that the government does not have enough money to meet doctors’ demands given the allegations of colossal corruption housed in national government bodies such as the Ministry of Devolution and Ministry of Health; allegations of graft in these bodies alone are estimated to stand at about Sh8.5 billion.

Public finance priorities

Last year MPs negotiated a deal that effectively made Parliament’s wage bill rise by more than Sh2 billion in a year. 

By 2013, reports indicated that Kenyan legislators were the second-highest paid lawmakers in the world, beating their counterparts in the US, Britain and Japan. Ergo, the issue is not a lack of money, the issue is what priorities are absorbing public finances.

Thus, while there are financial and economic implications to the demands being made by doctors, I fundamentally agree with their demands.

This is not only because the country can only develop on the foundation of a healthy and productive population, fiscal policy is wanting.

It is wanting not only in terms of fiscal mismanagement but also through the prioritisation of wages for some while failing to better equip hospitals and ensure the adequate compensation of doctors and other health staff.

Ms Were is a development [email protected]