Doctor’s sign return-to-work formula, ending 56-day national work boycott

The government and the Kenya Pharmacists and Dentists Union (KMPDU) have signed a return-to-work formula, ending the 56-day nationwide doctors' strike.

Speaking during the signing on Wednesday night, KMPDU Chairman, Abidan Mwashi, expressed disappointment that the two parties failed to reach an agreement on the recruitment and payment of trainees.

“The loss of life along the way has been huge, and since we have been here before, my advice is to never find ourselves here again. There is no victory here, we are in a hostage situation.”

“I want to thank the leadership of the KMPDU for believing in justice and fighting for it. I want to thank our leadership for advising the doctors to sign the documents, and now we can return to work within 24 hours,” KMPDU Secretary General Davji Attila said, adding that the government has assured them that they are not… Scammers.

“While we are signing, we have not yet agreed on the issue of trainees, and they will not be deployed within 60 days while we continue the talks,” he stressed, before officially calling off the strike and asking the doctors to resume work within 24 hours.

“Give and take”

Chairperson of the Council of Governors (CoG) Anne Waiguru said she was happy and relieved that the strike had finally ended.

She said that in the negotiation process there is “give and take,” which is why there was coordination on most of the issues dealt with by the CoG.

“We would like to thank the union for coming this far and working smoothly with the provincial governments, agreeing on all the issues raised and calling off the strike as well,” she said.

For Health Cabinet Secretary Susan Nakhomesha, after long and arduous negotiations that lasted into the night, she is happy that the KMPDU has finally called off the strike.

Kenyan patients

“I have to give it to the doctors. I thought I could bargain and negotiate better, but that was not the case last night, as we found ourselves in an agreement.”

Ms Nakhumisha had a message for Kenyan patients who have suffered for the past 56 days during the doctors' strike.

“To families and patients who may have wondered when the strike will end, we understand your pain even more as we work to accelerate universal health coverage.

She stressed the importance of reaching an agreement that the government can implement.

“We must find a lasting solution to the perennial issues. This is a deal that we will all implement,” she said while announcing the formation of a presidential task force that will look into all health issues in the country. “We are committed, and I call on the unions to trust us. A presidential task force will be formed to address all the issues.” .

Ms Nakhumisha said the end of the strike represented a new beginning.

“I want to urge us all to focus on service delivery, the country has been eagerly waiting for you to return to work. If you are in the public service, make sure Kenyans get quality services.

But how exactly did the government and KMPDU get here within 48 hours?

On Tuesday evening, the eight-hour Night of the Long Knives ended in a major row over the recruitment and payment of trainee doctors, once again!

As Kenyans went to bed, government officials and the KMPDU engaged in intense heated negotiations until 4am on Wednesday.

This was in a bid to overcome Justice Biram Onjaya's order to arrive at a return-to-work formula by 2.30pm on Wednesday and thus end the nationwide doctors' strike that has been going on for over 50 days.

On Monday this week, the Employment Relations Tribunal warned both parties that if they failed to reach a formula to return to work, they would be forced to hear the petitions and make a decision.

KMPDU debuted with a two-hour Council of Governors (CoG) meeting at 4pm on Tuesday, a meeting that generated the first “back to work formula”.

They agreed with the governors to pay all arrears and medical insurance as there are 11 provinces that do not have comprehensive medical coverage for doctors within 90 days.

Governors approved the release of doctors for postgraduate training based on staffing needs, numbers and criteria for discharge, and the recruitment of doctors on the basis of resource availability and staffing criteria.

The Conservatives also agreed to engage the Treasury within 90 days and give doctors car loans and mortgages.

The governors also agreed to work with doctors and develop a new collective bargaining agreement (CBA) within 30 days.

The provinces also agreed to pay basic salary arrears in five instalments, in the same manner.

Regarding legal deductions, the governors agreed that they should be remitted within 30 days.

Regarding the promotions of doctors, the governors confirmed that they will begin within a month and end on September 1, 2024.

It was agreed to harmonize the terms of service of doctors, but no timetable was set.

The CoG and KMPDU agreed that the issues of doctors in Kirinyaga and Nairobi counties would be dealt with by the union and the counties concerned.

The KMPDU promised to call off the strike and resume work within 24 hours after the “implementation” of the return to work formula.

CoG Health Committee Chairman and Tharaka Nithi Governor Muthumi Njoki, who led the negotiations on behalf of the provinces, assured that no doctor who participated in the nationwide strike would fall victim to doing so.

After the CoG meeting, at 8pm on Tuesday evening, the KMPDU proceeded to Afya House for the second return to work formula negotiations.

A meeting will not initially start for an hour after a clearly drunk paramedic who serves as union leader for another union representing health workers caused major disturbances and chaos before being sacked.

The negotiations, chaired by Health CS Susan Nakhumicha and attended by Ministry of Health officials, State Council officials and the KMPDU, agreed on all contentious issues except the appointment of trainee doctors and their salaries.

The government has maintained that it cannot engage KMPDU on the issue of payment of Sh206,000 to trainees as it is a matter currently before a judge and continuing in court.

“Government cannot practice subjugation; We cannot write something into a document as an agreement that will be a court decision. “That court in no way asked us to go and record the consent,” CS Nakhumicha told KMPDU.

“It was the union that went to court, if it had been the government, we could have withdrawn our case so we could resolve it once and for all but we have no control over the court case.”

The government told The Nation that they had earlier asked the KMPDU to drop the lawsuit until they agreed, but the union refused, registered as an interested party and confirmed their desire to proceed with the case in court.

Regarding the trainees, KMPDU maintained that posting and payment should be made in accordance with the 2017 CBA in which the government agreed to pay the trainee doctors Sh206,000 each.

On basic salaries, the KMPDU and the government agreed that the union should facilitate the names of doctors who have not been paid so that the government pays them within 15 days.

The national government has agreed to facilitate sending Sh3.5 billion to counties to make payments within five years.

The bone of contention here was that the KMPDU wanted to distribute the money to the provinces within three years.

It was also agreed that the terms of service would be harmonized within 90 days.

The government also agreed to pay postgraduate tuition fees for doctors from 2018 as of July 1, 2024.

The government has assured KMPDU that universal medical coverage for Kenyan doctors will be provided by July 1 this year.

Upon signing a new joint agreement with doctors, the government agreed and proposed that this should be done within 90 days.

Negotiations between the government and the KMPDU generated a new addition.

“The 81 doctors at Kenyatta National Hospital (KNH) who were appointed by the government and sent to counties under Universal Health Coverage (UHC) contracts during the Covid-19 pandemic will now get three-year contracts instead of one year,” CS Nakhumicha said.

To address the concerns of doctors at Kenyatta University Teaching, Referral and Research Hospital (KUTRRH), it has been agreed that a new CBA will be put in place within the next 30 days.

KURRH staff contracts will also be extended from one year to three years.

The Government has agreed and committed to recruiting an additional 2,000 doctors to support the implementation of Universal Health Coverage by FY 2025/26 in partnership with provincial governments.

In the last financial year, the counties employed 800 people, CS Nakomecha said while explaining how this was achievable.

The government has assured the doctors that it will immediately proceed with their promotion within 90 days after the strike is called off with the formation of an inter-governmental task force to look into all human resource issues within 14 days after the KMPDU signs the return to work formula.

CS Nakomecha stressed during the heated negotiations that “no doctor will fall victim to participating in the nationwide strike.”

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