BY DANN MWANGI
Hours after President Uhuru Kenyatta nominated James Macharia, an accountant, for the position of cabinet secretary in charge of health, a section of doctors led by Elly Nyaim have raised their objection to his nomination.
Their objection, through their umbrella body, Kenya Medical Association, is primarily because Macharia is a banker and not a doctor and therefore in their considered opinion, he cannot perform well in this ministry.
According to the doctors, “one of their own” is the best to lead the health ministry and although Macharia is successful banker, he cannot manage the ministry well.
The doctor’s remarks have generated a lot of public discourse, which is good, with opinion divided between those who support the doctor’s position and those do not support this stand. Nonetheless, there is unanimity among both groups that the need to transform our health sector is not only paramount but urgent.
Our health services are currently unaffordable and of bad quality to a big national population and without a paradigm shift in how our health sector will be managed, our state of health as a nation remains in tatters.
Although Kenya has trained many doctors and other health professionals, lack of health infrastructure and proper remuneration of the personnel have largely contributed to lack of quality health care to the majority poor.
Therefore, the need for Jubilee government to ensure that every Kenyan can get quality health care and health insurance services regardless of his economic status cannot be understated.
In this regard, the critical question of whether we need a cabinet secretary in charge of health who is a doctor as proposed by KMA or one who is a manager as proposed by President Uhuru must be answered.
In my considered opinion, we do not necessarily require a doctor to resuscitate the current mess in our health sector.
Our biggest problem today in the health sector is mainly because of lack of adequate infrastructure in health services and better pay and above all, mismanagement of existing health facilities and general indifference amongst section of health professionals in public hospitals.
To address lack of adequate funds in the health sector and managerial problems, we neither require a doctor nor a witch doctor.
We only require a good manager, a good resource mobilization team and above all, a government that is committed to support World Health Organization/Kenya Cooperation Strategy 2008-2013 which has largely not been achieved and Kenya Health Policy Framework 2012-2030.
In any case, once you have a health cabinet secretary with such qualities, which I believe Macharia has, the obvious expectation are that the principal secretary in this ministry with be a health professional with great acumen. This then creates a good blend and with both government and public support, they can transform our health sector.
In addition, I oppose the doctor’s stand that only a doctor can transform our health sector as there are local practical examples of success in health institution management by non-doctors. An example in mind is the current chief executive officer at our largest referral hospital, Richard Lesiyampe.
Lesiyampe is a management specialist who took over the helm at the Kenyatta National Hospital in 2011 and since then, we have largely seen tremendous reforms that he has initiated at the referral hospital despite lack of enough funds.
His reforms are not just in health infrastructure but also changing attitude and productivity of health professionals who work in KNH.
Previously, the hospital had been for many years run by medical practitioners and in an objective analysis, many performed poorly as compared to Lesiyampe who is not a medical practitioner.
Nevertheless, this does not mean that doctors cannot be good managers, they can and have been, but they should not just condemn other professionals who have been selected to head health institutions.
To give just a comparative of other countries which have one of the best health services in the world, albeit with full support of the government, cabinet secretaries in charge of health in the United States, United Kingdom and India are not medical practitioners.
In US, the health cabinet secretary is Kathleen Sebelius who is a holder of Bachelor of Arts degree and Master of Public Administration degree.
In UK, Jeremy Hunt, the health cabinet secretary is a holder of degree from Magdalene College, Oxford and was a businessman before joining parliament and subsequent appointment as health secretary.
Above all, in India, where many Kenyans have sought health care, the Minister for Health and Family Care, Ghulam Azad is not a medical practitioner.
Therefore inasmuch as KMA has a right to voice their concerns about Macharia’s nomination, it is incorrect and insincere for them to state that only a doctor can transform the health sector.