My open letter to the Health Cabinet Secretary last week left me with a better appreciation of the challenges that his ministry faces as it seeks to entrench quality world-class healthcare into this country. As such, I choose to suggest five viewpoints that may energize our march towards better health in Kenya.
First, we all appreciate that Kenya is currently in disastrous need of many more medical practitioners. The World Health Organization’s doctor-patient ratio is one doctor for every 1,000 people. According to the latest data from the World Bank, Kenya has a doctor patient ratio of one doctor for 6,400 people. Interestingly, a few years ago, when our Government recruited Cuban doctors, it was most reported that we have one doctor for every 16,000. Irrespective of the actual number, it is clear that we need thousands more doctors in Kenya.
One sure way of increasing the number of qualified medical practitioners is through free or Government-sponsored postgraduate training for medical students. Their tuition fees, accommodation, and stipend expenses should be catered for by the Government. Nowadays, the cost of a postgraduate medical degree is so prohibitive that only the rich or sponsored students can afford it. In the first three decades of independence, postgraduate medical students used to study for free, receive a stipend and medical cover from the government. Accordingly, let the lawmakers get up and go for relevant policies so that the profession may attract passionate students from poor backgrounds. This moral obligation will drastically increase the quality and quantity of our physicians.
Secondly, I suggest that we abolish private practice from Government hospitals. The existing arrangement inevitably creates double standards in the delivery of medical services. Public hospitals should cater exclusively to the medical needs of patients and not the business needs of doctors.
Thirdly, private hospitals play a critical role in the healthcare ecosystem and no wonder half of all health facilities in the country are privately owned. Since millions of Kenyans depend on them, the government should ensure their affordability. One of the steps the government can take is to revise the tax regime on medical equipment. In July this year, a new medical oxygen plant that Kakamega County had imported from France was stuck at the port, awaiting tax payment of Shs 8million.
Kakamega County Governor frustratingly stated that ‘it is a shame that at this time of the Covid-19 pandemic we are being taxed on machines that are meant to save many lives.’
Indeed, every medical appliance exists to save lives. All these machines should be imported into the country either tax-free or at very minimal tax rates. That way, investors will not have to pass on the cost of importing them to helpless Kenyans.
Fourthly, our National Hospital Insurance Fund Universal Healthcare program is the best idea ever to happen to Kenyans. However, you may agree with me that NHIF has become a cash cow for some players both locally and internationally. Upsettingly, NHIF Chief Executive Officer Peter Kamunyo recently revealed that corruption robs them of Sh10 billion annually. I suggest support to the ministry of Health from relevant investigative agencies to analyze who the consistent recipients of the fund are. By following the money, we may find a well-guided solution to seal the dodges.
Finally, Kenyans are distressed by the high cost of prescription drugs. Time is ripe for price control in this sector. Government can also scheme to invest and produce drugs locally devoid of corruption. In India, the National Pharmaceutical Pricing Authority ensures fair pricing of pharmaceutical products. It’s no wonder that India has some of the lowest drug prices in the world. Kenya needs to follow suit even as it learns from India’s experience.
To crown it all, I suggest that CS Mutahi Kagwe attracts the power of thinking and acting green by calling for a broad-minded meeting to synthesize expertise, talent, and life experiences for common good. In this meeting, please invite the most experienced practitioners, Young Doctors, Traditional medicine practitioners together with your able officials and relevant sector representatives. The result shall be most transformative.