Author Topic: It was a mistake to devolve health beyond level 3  (Read 3381 times)

Offline RV Pundit

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It was a mistake to devolve health beyond level 3
« on: December 09, 2020, 02:51:51 AM »
This one requires BBI - Counties should manage health centres and dispensaries - manage nurses.

Level 3,4,5 and such should be managed by national gov. Doctors are very important people - so important we keep track of their number annually.

Kenya has 15,000 doctors. South Africa with 10M more people has 45,000 doctors.

Kenya need at least to have 30,000 doctors.

But Counties clearly cannot manage doctors. We need to build capacities of counties over a some period of time..

Primary education should be given to counties in exchange....clearly there is no value national gov is adding in primary education...I think teachers won't mind as long as their salaries is from TSC.

Offline Nowayhaha

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Re: It was a mistake to devolve health beyond level 3
« Reply #1 on: December 09, 2020, 05:07:47 AM »
RV sometimes I wonder if you ok upstairs

Offline RV Pundit

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Re: It was a mistake to devolve health beyond level 3
« Reply #2 on: December 09, 2020, 09:56:12 AM »
RV sometimes I wonder if you ok upstairs
What insane in what I wrote here attention seeking whore

Offline Nowayhaha

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Re: It was a mistake to devolve health beyond level 3
« Reply #3 on: December 09, 2020, 10:42:10 AM »
RV sometimes I wonder if you ok upstairs
What insane in what I wrote here attention seeking whore

I mean in good faith, when money is devolved means fuctions shoild be devolved too.

Offline Kadudu

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Re: It was a mistake to devolve health beyond level 3
« Reply #4 on: December 09, 2020, 10:53:50 AM »
Pundit, why health sector which is a devolved function, the national government through MoH has a higher budget than what is passed on to the counties for the health sector?
That is the reason why counties cannot pay doctors. They simply do not have the money for it. If the health sector is devolved, why do we still have KEMSA busy spending billions without any consultation with the counties that are to purchase the medical items from KEMSA?
Anyway, Kenya is just devolved system of government on paper. The Jubilee regime never believed in devolution. Now talk is of devolving 35% of the resources and there is no talk of which new responsibilities the county will take up with the increased budget. Should all that money go to health and agriculture?
Also ther over 2000 unemployed doctors in Kenya today. My friend's daughter finished her med school last year and tarmacked till August this year. Due to covid she got a govt posting and till today has not received even 1 Ksh payment from the government. That is how we treat our doctors and then we are surprised that they move to better pastures in other countries.
The mistake is not devolving the health sector, but the selfishness our our ruling elite wanting to centralise everything for them to steal big time.

Offline RV Pundit

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Re: It was a mistake to devolve health beyond level 3
« Reply #5 on: December 09, 2020, 10:58:35 AM »
Functions can be devoled vertically and horizontal. You can devolved part of health - not entire thing. Counties started from the scratch. We cannot experiment with critical services like health. I am all for deeper devolution and federalism eventually - but slowly.

We need to build capacities of counties first.  There is nothing for example wrong with devolving management and infrastructure of primary schools, primary health care, but retaining HR functions nationally.

I mean in good faith, when money is devolved means fuctions shoild be devolved too.

Offline RV Pundit

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Re: It was a mistake to devolve health beyond level 3
« Reply #6 on: December 09, 2020, 11:00:19 AM »
I agree on teething devolution problems. That is why doctors should not be part of such experiment. They should be paid direct from PSC or even the consolidated fund.

We should have seen that counties would not have the capacity - to do this.

I expect counties that are serious to pay doctors from their own resources. Heck earning from hospitals - where they charge user fees - should be enough to pay doctors.

But clearly we have a problem 1) National gov is broke and hasn't paid counties 2) Counties do not see seriousness of this.

Bottom-line - Doctors are a CRITICAL national resource - so few and so crucial - for nation healthcare.

Pundit, why health sector which is a devolved function, the national government through MoH has a higher budget than what is passed on to the counties for the health sector?
That is the reason why counties cannot pay doctors. They simply do not have the money for it. If the health sector is devolved, why do we still have KEMSA busy spending billions without any consultation with the counties that are to purchase the medical items from KEMSA?
Anyway, Kenya is just devolved system of government on paper. The Jubilee regime never believed in devolution. Now talk is of devolving 35% of the resources and there is no talk of which new responsibilities the county will take up with the increased budget. Should all that money go to health and agriculture?
Also ther over 2000 unemployed doctors in Kenya today. My friend's daughter finished her med school last year and tarmacked till August this year. Due to covid she got a govt posting and till today has not received even 1 Ksh payment from the government. That is how we treat our doctors and then we are surprised that they move to better pastures in other countries.
The mistake is not devolving the health sector, but the selfishness our our ruling elite wanting to centralise everything for them to steal big time.