Wazua
»
Club SK
»
Politics
»
Doctors' Devolution Crisis
Rank: Veteran Joined: 11/15/2012 Posts: 1,110
|
Rankaz13 wrote:When the central gov't says they're devolving healthcare, they should state clearly what exactly it is they're devolving: is it payment of salaries for healthcare workers, is it construction & equipping of healthcare facilities, is it procurement of medical supplies, hiring of new healthcare workers,....nini haswa? And if devolution ultimately becomes a reality, what'll be the role of the public service commission in so far as recruitment, deployment and promotion of HCWs is concerned? As it is so far, it's being said that those who wish to be transferred from one county to another will first have to resign from their present county then apply for employment in the new county to which they seek to be transferred, which obviously means securing employment then will not be guaranteed, this in a country with less than 3000 public doctors serving a population of 40million.
Why do we persist in complicating what should be relatively easy, simple and straight-forward procedures?
In light of all this, what'll become of the various CBAs signed with the central gov't and to which county gov'ts were not parties? And if county gov'ts are let free to hire & fire HCWs as well as determine their salary and emoluments, what will become of the marginal and remote areas/counties where no one may apply but whose residents are nevertheless needy? And what happens should a county be unable to pay its HCWs? And who'll take up the role of retirement benefits? Devolution was not well-thought. There are so many gray areas.
Well, I'm not against devolution. I'm just pointing out the anomalies drafters of the constitution did not take time to think about. Live Full Die Empty - Les Brown.
|
|
|
Rank: Elder Joined: 12/17/2009 Posts: 3,583 Location: Kenya
|
Rankaz13 wrote:When the central gov't says they're devolving healthcare, they should state clearly what exactly it is they're devolving: is it payment of salaries for healthcare workers, is it construction & equipping of healthcare facilities, is it procurement of medical supplies, hiring of new healthcare workers,....nini haswa? And if devolution ultimately becomes a reality, what'll be the role of the public service commission in so far as recruitment, deployment and promotion of HCWs is concerned? As it is so far, it's being said that those who wish to be transferred from one county to another will first have to resign from their present county then apply for employment in the new county to which they seek to be transferred, which obviously means securing employment then will not be guaranteed, this in a country with less than 3000 public doctors serving a population of 40million.
Why do we persist in complicating what should be relatively easy, simple and straight-forward procedures?
In light of all this, what'll become of the various CBAs signed with the central gov't and to which county gov'ts were not parties? And if county gov'ts are let free to hire & fire HCWs as well as determine their salary and emoluments, what will become of the marginal and remote areas/counties where no one may apply but whose residents are nevertheless needy? And what happens should a county be unable to pay its HCWs? And who'll take up the role of retirement benefits? All those questions will be answered in due time - we wait and see how the counties will handle what they have been clamoring for, more functions
|
|
|
Rank: New-farer Joined: 7/22/2013 Posts: 31
|
InnovateGuy wrote:Rankaz13 wrote:When the central gov't says they're devolving healthcare, they should state clearly what exactly it is they're devolving: is it payment of salaries for healthcare workers, is it construction & equipping of healthcare facilities, is it procurement of medical supplies, hiring of new healthcare workers,....nini haswa? And if devolution ultimately becomes a reality, what'll be the role of the public service commission in so far as recruitment, deployment and promotion of HCWs is concerned? As it is so far, it's being said that those who wish to be transferred from one county to another will first have to resign from their present county then apply for employment in the new county to which they seek to be transferred, which obviously means securing employment then will not be guaranteed, this in a country with less than 3000 public doctors serving a population of 40million.
Why do we persist in complicating what should be relatively easy, simple and straight-forward procedures?
In light of all this, what'll become of the various CBAs signed with the central gov't and to which county gov'ts were not parties? And if county gov'ts are let free to hire & fire HCWs as well as determine their salary and emoluments, what will become of the marginal and remote areas/counties where no one may apply but whose residents are nevertheless needy? And what happens should a county be unable to pay its HCWs? And who'll take up the role of retirement benefits? Devolution was not well-thought. There are so many gray areas.
Well, I'm not against devolution. I'm just pointing out the anomalies drafters of the constitution did not take time to think about. I think those who drafted the constitution had a very idealistic mindset. There are so many problems with the way this ugatuzi thing was put together. I wonder why we couldn't have adopted a progressive devolution of functions over, say, 10 years.
|
|
|
Rank: Elder Joined: 5/21/2013 Posts: 2,841 Location: Here
|
Sadly, the way I see it, devolution (so tempted to call it devil-ution) as envisaged risks introducing serious inefficiencies in the entire healthcare service delivery pipeline. For instance, were we to devolve procurement of medical supplies & equipment for instance, how will the individual counties leverage on the economies of scale that KEMSA currently enjoys on account of procuring for the entire country? Such inefficiencies would then make some processes take longer than necessary and eventually more expensive to the end consumer, the Kenyan patient. Life is like playing a violin solo in public and learning the instrument as one goes on.
|
|
|
Rank: Elder Joined: 2/26/2012 Posts: 15,980
|
Rankaz13 wrote:Sadly, the way I see it, devolution (so tempted to call it devil-ution) as envisaged risks introducing serious inefficiencies in the entire healthcare service delivery pipeline. For instance, were we to devolve procurement of medical supplies & equipment for instance, how will the individual counties leverage on the economies of scale that KEMSA currently enjoys on account of procuring for the entire country? Such inefficiencies would then make some processes take longer than necessary and eventually more expensive to the end consumer, the Kenyan patient. Surely, when the gov insists that its not time to devolve some units...its said that there's a plan to sabotage devolution...sasa mnataka nini? "There are only two emotions in the market, hope & fear. The problem is you hope when you should fear & fear when you should hope: - Jesse Livermore
.
|
|
|
Rank: Veteran Joined: 11/15/2012 Posts: 1,110
|
Justice League wrote:InnovateGuy wrote:Rankaz13 wrote:When the central gov't says they're devolving healthcare, they should state clearly what exactly it is they're devolving: is it payment of salaries for healthcare workers, is it construction & equipping of healthcare facilities, is it procurement of medical supplies, hiring of new healthcare workers,....nini haswa? And if devolution ultimately becomes a reality, what'll be the role of the public service commission in so far as recruitment, deployment and promotion of HCWs is concerned? As it is so far, it's being said that those who wish to be transferred from one county to another will first have to resign from their present county then apply for employment in the new county to which they seek to be transferred, which obviously means securing employment then will not be guaranteed, this in a country with less than 3000 public doctors serving a population of 40million.
Why do we persist in complicating what should be relatively easy, simple and straight-forward procedures?
In light of all this, what'll become of the various CBAs signed with the central gov't and to which county gov'ts were not parties? And if county gov'ts are let free to hire & fire HCWs as well as determine their salary and emoluments, what will become of the marginal and remote areas/counties where no one may apply but whose residents are nevertheless needy? And what happens should a county be unable to pay its HCWs? And who'll take up the role of retirement benefits? Devolution was not well-thought. There are so many gray areas.
Well, I'm not against devolution. I'm just pointing out the anomalies drafters of the constitution did not take time to think about. I think those who drafted the constitution had a very idealistic mindset. There are so many problems with the way this ugatuzi thing was put together. I wonder why we couldn't have adopted a progressive devolution of functions over, say, 10 years. And the governors are not helping matters either. "Demanding" the immediate transfer of devolved functions without the necessary structures is a sure way to fail. Although there is an "academic" argument that governors have "contracts" with their people and there is no way they can deliver on those promises without having the full control of those functions, it would be "wise" if they can concentrate on setting the relevant structures first and then tackle the priority areas as they develop the capacity to take over the devolved functions from the national government. What would be the point of devolving health in paper while the counties do not have the capacity to procure drugs, refurbish structures, hire staff and equip hospitals? This would lead to a situation whereby the governors will be visiting these institutions to issue ultimatums without understanding the day to day operations within these institutions. Again, there are fears that once the funds are "wired" to the counties,they could be transferred to "projects" that are not budgeted. For example, if county X had allocated 45 M for roads, then they realize three months down the line that they had "underestimated" the cost of building roads and the governor has to show "results", monies meant to go into paying salaries would be diverted into roads. The result would be unpaid workers. Live Full Die Empty - Les Brown.
|
|
|
Rank: Elder Joined: 3/18/2011 Posts: 12,069 Location: Kianjokoma
|
For medics to realise this late that they are in trouble because of devolution is shocking. When the katiba was being debated with many drafts this was not a contentious issue.
|
|
|
Rank: Chief Joined: 5/9/2007 Posts: 13,095
|
Wait a minute...what r the doctors' worries exactly? That the salaries av not been paid or that the health will be devolved? 1. If its salos, today is 31st. So they cant really claim salos are late. Unless their contract states they must be paid by 20th of every month. 2. If its about devolving, its too late. Its already in the constitution. Health is one of the functions to be devolved to the county govts. They cant really strike against the constitution. They better engage on a dialogue on how best this can be sorted. "2 Zimbambwe cnts+16%VAT."
|
|
|
Rank: Veteran Joined: 2/3/2010 Posts: 1,797 Location: Kenya
|
1.they have insider info that salo will delay 2. they want the devolution to be in an organised manner that gurantees their pay I may be wrong..but then I could be right
|
|
|
Rank: Elder Joined: 4/22/2010 Posts: 11,522 Location: Nairobi
|
Kusadikika wrote:Doctors are threatening to go on strike over the issue of their payroll being devolved to the counties.
My question is, what is the problem with that? Health is one of the devolved functions and will now be handled at county level. Donge! So shida iko wapi?
What is it that Doctors want? I want to understand their stand and and their argument before I start casting stones. Nauliza nielimishwe. This thing cant work am at the parliamentary committee for health right now CS Waiguru is here...Dr.Nyikal on the floor now talking about costing and funding...I now totally agree it should be phased pole pole counties that can manage let them go ahead...we have politicised this things...very sad state of affairs... Lovely Dr.Wambui on my left...looking fly. possunt quia posse videntur
|
|
|
Wazua
»
Club SK
»
Politics
»
Doctors' Devolution Crisis
Forum Jump
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.
|