Health is a devolved function, but it is easier said than done. This is a docket the national government has shown great reluctance to surrender to the counties. Of course, policy and level six hospitals are exclusively managed by the Health ministry.
Devolution was meant to enable access to quality and affordable medical care. However, when it started just over 10 years ago, the counties lacked the capacity to take full charge of this vital docket. And it is still the case even today.
This is, indeed, a tall order, and the friction between the national and county governments continues. The most enduring one is the leasing of medical equipment by the national government that has left the counties with hefty bills.
The latest bone of contention is the drafting of four Bills the governors say was done without their input. They are the Primary Health Care Bill, the Digital Health Bill, the Facility Improvement Fund Bill, and the Social Health Insurance Bill. On the spot is Health CS Susan Nakhumicha.
The county chiefs are demanding a review of the Bills approved by the Cabinet, which are at the core of President William Ruto’s radical health plan.
Ideally, this being a devolved function, they argue, their input should be incorporated before the proposed laws are tabled in Parliament. The proposed Social Insurance Health Fund to replace the National Health Insurance Fund will require all Kenyans to be registered.
Those who fail to enrol will be denied access to public services. It will be like the national identity card but the key to healthcare and other services. The governors feel their legal team should have engaged with the ministry’s to first agree on the issues.
But CS Nakhumicha says the Bills were derived from documentation that was jointly generated with the Council of Governors.
Quite contentious is the proposal that the CS be the custodian of all health data. These issues should be discussed fully and harmonised ahead of the expected launch of the Universal Health Coverage programme on October 20.
