REPUBLIC OF KENYA

Press Statement The Way Forward on Health Sector Issues and Transfer of Health Functions to County Governments

The National Government and the Council of County Governments today 9th December 2013 held a nine-hour meeting with the unions of health professionals (Kenya Medical Practitioners and Dentists Union, Kenya National Union of Nurses, and Kenya Health Professionals Union), at the Kenya School of Government, to discuss health sector issues and the transfer of health functions to County Governments. The meeting which was also attended by the Public Service Commission, the Commission for the Implementation of the Constitution, the Transition Authority, and the National Assembly Committee on Health, sought to address the teething transition issues in the health sector. The unions of health professionals raised three demands to be addressed as follows: 1. The retention by the national government of the management of the personal emolument function with regard to the health sector until a legal framework on the management of health functions in counties is enacted. Specifically, the unions wanted the Personal Emolument function to be retained until the enactment of the Health Act and Health Policy. 2. The establishment of a Health Service Commission to centrally address the human resource function of the health sector 3. The need to incorporate the unions during consultations with regard to development of policies and laws. After exhaustive deliberations, the national government and the Council of Governors made the following concessions as a basis for averting the planned strike by health workers and for further engagement: 1. That the Public Service Commission will immediately embark on a consultative process of developing a policy on harmonized schemes of service for county and national health workers. This will include standardization of job groups, job descriptions, training and development, promotion and career progression

guidelines and, through the Salaries and Remuneration Commission, salaries, allowances and remuneration packages. The purpose of this exercise of harmonization of the human resource function is to stabilize the provision of health as a public service, provide uniformity and to establish a framework for movement of health workers across counties and between the national and county levels of government. This framework will equally apply to all cadres of workers undertaking transferred functions in the different sectors. Harmonization will ensure equity and openness in dealing with staff issues across counties and at the two levels of government. The harmonization would also respect the constitutional safeguards granted to seconded staff with regard to existing terms and conditions of service. 2. That the timeline for the development of the harmonized schemes is planned to be completed by the end of February 2014. The steps to be taken during the process was agreed to include a development phase during the month of December 2013, stakeholder consultations during the month of January 2014, and a conclusive and legislative phase in February 2014. 3. That the harmonized schemes of service will be integrated in a Public Service Policy to cover all public service workers at the national and county levels and the specific schemes covering health workers will be contained in a Health Policy. The Health Bill will be the legislative instrument for the overall health policy. Both Bills will be developed and proposed to Parliament with a view to having them enacted by end of February 2014. 4. That in the meantime, the payroll function for health workers will continue to be administered by the national government beyond the current gazette period of December 2013 to February 2014. A Gazette Notice on the extension of the period by which the National Government will continue to administer the payroll function will be prepared and published by the Transition Authority. This amendment would in no way affect the transfer of functions to county governments. 5. The Ministry of Health will concurrently develop the health policy for and legislation on the health sector along the same timeframe as that provided for the Public Service Commission.

6. That the proposed establishment of a Health Service Commission was unconstitutional and cannot be the subject of discussion as it violates Article 234 of the Constitution. 7. That all the processes for developing the standards of harmonized schemes and legislation will be consultative and inclusive. The concessions above met every possible demand that was raised by the unions of health professionals. It was explained to the unions that the government could not guarantee the enactment of a law because that was the proper province of parliament. The government however did commit itself to develop the proposed Health Bill and table it by February 2014, which is the expected resumption date for Parliament. Despite all the efforts made by the national government, the Council of Governors, and the independent commissions present, and despite the plea made to the unions not to go on strike as we head to the festive seasons and embark on celebrations to mark the 50th anniversary of Kenyas independence, the unions nevertheless decided to proceed with the proposed strike action on the basis of the requirement of a Health Act. The national government and the Council of Governors continue to urge the unions of health professionals to call off the strike and consider the wellbeing of the Kenyan citizens. The unions have been requested to reconsider the implications of the strike, and the suffering that it would cause to Kenyans who depend on them for treatment and care. We regret that the union failed to take up the concessions and reach consensus. The national government was facilitating the consultations on the proposed strike by health workers because of its current management of the payroll on behalf of county governments. Going forward, the unions will have to engage with the individual 47 governments. We remain open to dialogue with the unions towards the resolution of this problem.

Dated this 9th Day of December 2013 For the National Government:

1. -----------------------------------------------Ms. Anne Waiguru Cabinet Secretary

Ministry of Devolution and Planning

2. -----------------------------------------------Mr. James Macharia Cabinet Secretary Ministry of Health

For the Council of Governors: 1. -----------------------------------------------Gov. Isaac Ruto Chairperson Council of Governors 2. -----------------------------------------------Gov. James Ongwae Chairperson Committee on Human Resources Council of Governors For Independent Constitution Commissions and Offices: 1. -----------------------------------------------Prof. Margaret Kobia Chairperson Public Service Commission 2. -----------------------------------------------Dr Elizabeth Muli Vice Chairperson Commission for the Implementation of the Constitution 3. -----------------------------------------------Mr. Kinuthia Wamwangi

Chairperson Transition Authority