While the doctors’ strike has paralysed services in the public sector, the biggest beneficiary of the strike so far has been the private health sector occasioning great suffering to the ordinary citizen.
Allow me to “Mulika the Mwizi” that is the private health sector in Kenya.
The private health sector is dominated by four or five hospitals, all of which are registered as charities which means they do not remit any taxes to the exchequer. Over the years profits (or surpluses) for these hospitals have grown exponentially and unchecked. Over the same period of time health insurance premiums have become unaffordable to many and healthcare costs are now one of the biggest HR expenditures for many companies. A one big private telecommunications company for example has limited the type of health services its employees can access under its medical cover. In another company – one of the largest and most profitable banks in town – the health policy dictates that the employees pay upfront for medical care and seek for refunds afterwards beating the whole purpose of a medical scheme especially in cases of emergency. Although a few will argue that the draconian changes implemented by these two companies in their medical schemes are as a result of abuse of the health covers by employees; excessive bills charged by the private hospitals are largely to blame for the unaffordable healthcare.
Conspiracy between the Ministry of health – which benchmarks doctors’ salaries – and the private health care providers have seen doctor’s salaries fall in these private establishments over the last five years notwithstanding the high inflation rate and increased cost of living. The starting salary for doctor five years ago was 120,000 shillings in one of the leading private hospitals. Today the same hospital pays doctors a starting salary of 70,000 shillings. Within the same period that has seen a decline on doctors’ earnings, consultation fees and costs for other services have more than tripled.
Additionally, many of the board members of these private hospitals hold positions at the medical board and the ministries and will swiftly deregister and sack junior doctors who question the status quo. That is the nexus that is driving junior doctors to the wall and also crippling health care in the country.