After almost two months of a bitter impasse that crippled the country’s public healthcare system, the national and county governments have reached landmark agreements with the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) to end a prolonged nationwide strike by doctors.
The comprehensive return-to-work formulae, signed on May 8, 2024, provide a roadmap to address long-standing grievances over salary arrears, medical cover, postgraduate training, staffing levels, and harmonization of terms of service across the devolved healthcare system.
The deals were formalized through two separate agreements: one between the national government and KMPDU, and another between the 47 county governments, represented by the Council of Governors, and the union. The agreements reflect a concerted effort to resolve the recurrent labor unrest that has plagued Kenya’s healthcare sector for years and improve the welfare of medical professionals, seen as critical to achieving Universal Health Coverage (UHC) goals.
Salary Arrears
The national government committed to settling outstanding basic salary arrears for its employees, while the agreement with county governments stated: “The County Governments shall make payments of the basic pay salary arrears accrued to the Doctors as contained in the CBA 2017-2021, pursuant to judgment delivered on 28th October, 2021 in Employment and Labour Relations Petition No. 6464, upon receipt of a conditional grant from the National Treasury (who have committed to pay from 1st July, 2024). The payment shall be made in a phased manner over a period of five (5) years.”
Medical Cover
The national government agreement specified: “The National Government shall provide a comprehensive medical cover to the Union Members employed by the National Government in accordance with the Public Service and Salaries Remuneration Commission (SRC) Guidelines by 1st July, 2024.” For counties, the deal stated: “County Governments that have not provided medical cover to the Doctors to commence the process of acquiring the medical cover immediately and conclude the same within 90 days. The cover shall be as per the Salaries and Remuneration Committee and Public Service Commission guidelines on medical insurance.”
Postgraduate Studies
“As part of residency clinical rotations (post-graduate studies), all registrars shall be on duty as per their clinical programme. The rotations shall not in any case exceed an aggregate 40 hours a week. In instances where the set threshold of hours is exceeded, the Registrar shall be compensated appropriately,” stated the national government agreement. Counties agreed to “continue releasing Doctors for Postgraduate Studies based on CBA 2017” and review policies to streamline the process.
Terms of Service
Both agreements stipulated harmonizing the terms of service for doctors within 90 days, following existing legal frameworks.
New CBAs
“The Council of Governors will initiate coordination process of negotiating a new CBA with each county within 30 days. Execution of the new CBA shall be signed within 90 days from the date of execution of this RTWF,” the county governments’ deal stated.
Employment
Quoting the national government agreement: “The government shall employ 2,000 additional doctors from the FY 2025/26 and thereafter establish a policy for annual recruitment and placement of Medical Doctors, Pharmacists and Dentists in accordance with the staffing norms and standards, fiscal management policies and existing legal framework.”
Interns
The issue of intern doctors remains under active consideration by the Parties, with the two positions held being as follows:
GOK Position: The medical officer interns, pharmacist interns, and dentist interns shall be posted immediately in accordance with 2017-2021 Collective Bargaining Agreement.
KMPDU Position: The issue of intern Doctors is the subject of the Employment and Labour Relations Court of Kenya at Eldoret in ELRC Petition No. EO03 of 2024. In that regard and pursuant to the Order of the Employment and Labour Relations Court of Kenya at Nairobi in ELRC Petition E032 of 2024 of 2nd May 2024, the issue is held in abeyance until the matter is heard and finally determined.
Notwithstanding these positions, the Parties shall commence and conclude negotiations on the issue within 60 days from the date hereof. In the intervening period, there shall be no deployment and or posting of medical officer interns, pharmacists interns, and dental interns.”
The agreements represent the most significant effort to date to resolve the longstanding grievances that have fueled frequent strikes by Kenyan doctors, which have severely impacted healthcare delivery and eroded public confidence in the system.
