They don't have to sign up. Counties that feel strongly they don't need....are not been dragged and forced to sign. Some have refused. Some have accepted.
From what I read the deal is good because the top manufacturers like General Electric would not agree to sign deal with little counties...so GoK has to step in so we get 36B worth of services from the world truly top class medical manufacturers.
County and National money is public money and for me the same standard need to apply....there should be no corruption...no wastage/
MP need to keep that in focus. Otherwise it is agreed that cancer is no 3 killer now and we need these equipment in mashinani...dialysis/radiology services..
Let us not be rigid. At some point if Counties cannot ran the health services...we should be flexible to move that out. It will be a big shame....but counties have to shape up. They have to treat esp doctors very well.
For now it would seem we need to re-look health..perhaps split doctors and human resources and have it national....and perhaps keep level 5 out counties..and have those national...because in any case most patient from bomet end up in eldoret Moi refferal or Kisii level 5 or KNH.
Bottom-line. No need for entrenched position if all of us are looking for the same thing. To improve the health of kenyans.
I totally dissagree with you. CS Macharia has no right to plan the finances of the counties even under the guise of "public demand".
When you write "counies do not need permission to improve schools" that is right but they do it with their own finances. I would not had a problem with the whole scheme had the national govt footed the bill with its own cash. Now the counties are cough over 90M Ksh per year for equipment that will go to two hospitals in the county. Some of these hospitals already have the same equipment and others do not even have the infrastructure not to mention the personel to maintain and run such equipment.