The government and the Kenya Medical Practitioners Pharmacist and Dentist Union (KMPDU) have signed a return-to-work formula, ending the 56-day nationwide doctor’s strike.
Speaking during the signing Wednesday night, KMPDU chair Abidan Mwachi expressed disappointment because both parties had failed to reach an agreement on the posting and payment of interns.
“The loss of lives along the way has been heavy, and since we have been here before my advice is that we should never find ourselves here again. There is no victory here, we are in a hostage situation,” he said.
“I want to thank the leadership of KMPDU for believing and fighting for justice. I want to thank our leadership for advising the doctors to sign the documents and now we can return to work within 24 hours,” KMPDU secretary-general Davji Atellah said, adding that the government has assured them they are not conmen.
“As we sign, we have not yet agreed on the intern issue, they will not be posted within 60 days as we continue with the talks,” he highlighted before officially calling off the strike and asking doctors to resume work within 24 hours.
‘Give and take’
Council of Governors (CoG) chair Ann Waiguru said she is pleased and relieved that the strike is finally over.
She said in the process of negotiations there is “give and take”, which is why there was harmonisation on most issues CoG handled.
“We would like to thank the union for coming this far and working seamlessly with county governments, agreeing on all issues raised and also calling off the strike,” she said.
For Health Cabinet Secretary Susan Nakhumicha, after long, painstaking negotiations that ran into the night, she is pleased that KMPDU finally called off the strike.
Kenyan patients
“I have to give it to the doctors. I thought I could bargain and negotiate better but it was not so last night we found ourselves in an agreement.“
Ms Nakhumicha had a message for Kenyan patients who have been suffering for the last 56 days while doctors were on strike.
“To the families and patients who may have wondered when the strike would end, we understand your pain more so now that we are accelerating universal health coverage.
She reiterated the importance of making an agreement that the government can implement.
“We must find a lasting solution to the perennial issues. This is a deal that will be implemented by us all,” she said while announcing the formation of a presidential task force that will look into all health issues in the country. We are committed, and I call upon the unions to trust us. There will be the establishment of a presidential task force to address all issues.”
Ms Nakhumicha said the end of the strike marks a new beginning.
“I want to urge all of us to focus on service delivery, the country has anxiously waited for your return to work. If you are in public service, ensure Kenyans get quality services,” she said.
But how exactly did the government and KMPDU get here in 48 hours?
On Tuesday evening, the eight-hour night of long knives ended in a major disagreement over the posting and pay of intern doctors, yet again!
As Kenyans went to bed, government officials and KMPDU were engaged in intense heated negotiations until 4 AM on Wednesday.
This was in effort to beat Justice Byram Ongaya’s order of coming up with a return-to-work formula by 2.30 PM on Wednesday thereby ending the nationwide doctor’s strike that has lasted for over 50 days.
On Monday this week, the Labour Relations Court warned both parties that if they fail to come up with a return-to-work formula, it will be compelled to hear petitions and make a determination.
KMPDU first started by meeting the Council of Governors (CoG) at 4 PM on Tuesday for two hours, a meeting that birthed the first ‘return-to-work formula’.
With governors, they agreed on payment of all arrears, and medical insurance as there are 11 counties that do not have comprehensive medical cover for doctors within 90 days.
Governors agreed to release doctors for post-graduate training based on staffing needs, numbers and criteria of release, employment of doctors based on availability of resources and staffing norms.
Governors also agreed to engage the treasury within 90 days and give doctors car loans and mortgages.
The governors further agreed to work with doctors and put in place a new collective bargaining agreement (CBA) within 30 days.
Counties also agreed to pay basic salary arrears in five instalments, the same way it was.
On statutory deductions, governors agreed that they should be remitted within 30 days.
On promotions of doctors, the governors assured that they will start within a month and be concluded by 1st September 2024.
Harmonization of terms of service for doctors was agreed upon but no timelines were given.
CoG and KMPDU agreed that doctor’s issues in Kirinyaga and Nairobi Counties will be dealt by the Union and respective counties.
KMPDU promised to call off the strike and resume work within 24 hours upon ‘execution’ of the return–to–work formula.
CoG Health Committee chair and Tharaka Nithi Governor Muthomi Njuki who steered the negotiations on behalf of counties assured that no doctor who participated in the nationwide strike will be victimized for doing so.
After meeting CoG, at 8 PM on Tuesday night, KMPDU moved to Afya House for the second return-to-work formula negotiations.
The meeting would first not start for one hour after a visibly drunk medic who serves as a union leader of another union that represents health workers caused major disruptions and chaos before being thrown out.
The negotiations chaired by Health CS Susan Nakhumicha and attended by health ministry officials and state house officials and KMPDU however agreed on all contentious issues apart from the posting of intern doctors and their pay.
The government maintained it cannot engage KMPDU on the issue of paying interns Sh 206,000 as it is a matter that is currently before a judge and ongoing in court.
“The government cannot engage in subjudice; we cannot write something in a document as an agreement that is a matter of court determination. That court has not told us in any way to go and register a consent,” CS Nakhumicha told KMPDU.
“It is the Union that went to court, if it were government, we could have withdrawn our court case so that we sort it out once and for all but we have no control over the court case.”
The government told the Nation that earlier they had told KMPDU to drop the court case so that they agreed but the Union refused, entered on record as an interested party and maintained that they wished to proceed on with the court case.
On interns, KMPDU maintained that the posting and payment should be done in accordance with the 2017 CBA in which the government agreed to pay doctor interns Sh 206,000 each.
On basic salaries, KMPDU and the government agreed that the Union should facilitate names of doctors that have not been paid so that the government pays them in 15 days.
The national government agreed to facilitate Sh 3.5 billion to go to counties for payments within five years.
The bone of contention here has been that KMPDU wanted the money disbursed to counties within three years.
It was also agreed that harmonization of terms of service would be done within 90 days.
The government further agreed to pay post-graduate school fees for doctors from 2018 as it was by 1st of July 2024.
The government assured KMPDU that comprehensive medical cover for Kenyan doctors will be in place by 1st of July this year.
On the signing of a new CBA with doctors, the government agreed and suggested it be done in 90 days.
The negotiations between the government and KMPDU birthed a new addition.
“81 doctors at Kenyatta National Hospital (KNH) who were hired by the government and dispatched to counties under Universal Health Coverage(UHC) contracts during the Covid-19 pandemic will now be given three-year contracts instead of one year,” CS Nakhumicha said.
To address doctor’s issues at at the Kenyatta University Teaching, Referral & Research Hospital (KUTRRH), it was agreed that a new CBA will be put in place in the next 30 days.
Contracts for KUTRRH employees will also be extended from one year to three years.
The government agreed and committed to employ an additional 2,000 doctors to support the implementation of UHC by the financial year 2025/2026 in partnership with county governments.
In the last financial year, counties employed 800, CS Nakhumicha reminded while explaining how achievable this is.
The government assured doctors that it will immediately embark on promoting them within 90 days after they call off the strike with an intergovernmental taskforce being formed to look into all their human resource issues within 14 days after KMPDU signs the return-to-work formula.
“No doctor will be victimized for participating in the nationwide strike,” CS Nakhumicha assured during the heated negotiations.
