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Doctors reject NHIF deal with clinical officers

Doctors union secretary-general Ouma Oluga.
Doctors union secretary-general Ouma Oluga. FILE PHOTO | NMG 

The National Hospital Insurance Fund (NHIF) has finally agreed to pay for surgical procedures and imaging tests done by clinical officers, sparking protests from the doctors’ union.

The Kenya Medical Practitioners, Pharmacists and Dentists' Union (KMPDU) said that allowing clinical officers to offer the services could cause a rise in medical malpractices and cause harm to the public.

Thuranira Kaugiria, the KMPDU secretary-general for Nairobi region, said allowing clinical officers to prescribe imaging tests could expose patients to unnecessary radiation and worsen their plight.

“Nurses and even clinical officers have a limit of what they can do. When a patient requires some level of expertise they are often referred to the specialist. If a clinical officer asks a patient to do an MRI or CT scan and he cannot interpret or do surgery after that what is the point of it all?,” he asked.

Mr Kaugiria further argued that allowing the clinical officers to prescribe the tests could also stagnate patients to a certain level of care even in instances where they would benefit from referral to specialists.

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“We do not want patients stagnating because someone is holding onto them, everyone has to do what is within their scope,” he said.

Protests

NHIF had initially refused to cover any surgeries performed or procedures such as CT scans and X-rays prescribed by the clinical officers, causing the clinicians to protest.

But the NHIF and the Clinical Officers Association, in an agreement signed on Thursday last week, declared that the clinicians can now apply for a revision of the requisition forms for diagnostic and imaging to include clinical officers as per their scope of practice.

KMPDU secretary-general Ouma Oluga said the referral system allows patients to get the best services from the appropriate health workers and should be left to function.

Dr Oluga added that NHIF ought to limit the number of facilities and individuals who can send people for scans, arguing that some practitioners may just do so in pursuit of profit.

The Kenya Union of Clinical Officers (KUCO) had threatened to call a strike if the NHIF continued to reject their prescription of procedures such as CT scans and X-rays.

KUCO secretary-general George Gibore said clinical officers have different qualifications and are not limited to diplomas as is generally assumed.

General duties

“We have degree holders and the higher diploma holders who specialise in 17 cadres. Some of us are able to administer multiple procedures, including amputation.

"Those who specialised in reproductive health can do Caesarian sections,” he said.

Clinical officers ordinarily study clinical medicine while the doctors have Bachelor’s degrees in medicine and surgery.

Clinical officers are trained to perform general medical duties such as diagnosis and treatment of general diseases and injuries.

Gibore, however, said there was no need for alarm since regulations allow clinical officers to offer those services as per their scope of service.

“We are able to do this on other patients except the NHIF patients and it is denying patients immediate access to life saving procedures and this is unacceptable,” he said.

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