A few weeks ago, a young mother bled to death after giving birth in a county hospital because the blood bank was empty. Not long before, headlines captured other tragedies: a patient whose healthy limb was amputated by mistake, another who was wheeled into the theatre under the wrong name, a man who lost his leg after a forgotten tourniquet, a child who suffered the same fate and another who sustained severe burns during surgery. These stories are often described as isolated “horror cases,” but they are not. They are the visible cracks in a fragile health system that Kenyans are right to demand better from.
Parliament is currently reviewing the Quality Healthcare and Patient Safety Bill, 2025, a proposed law aimed at protecting patients. While the goal is commendable, the approach is dangerously flawed. By proposing fines of up to KSh 50 million and a prison sentence of up to ten years for hospitals and providers, the Bill risks creating a culture of fear, silence, and cover-ups. When health workers are too afraid to speak openly about errors or systemic problems, patients pay the price.
The uncomfortable truth is that most adverse outcomes in Kenyan hospitals are not caused by reckless negligence but by systemic failures – chronic staff and drugs shortages, broken equipment, overcrowded wards, and the overwhelming demand on underfunded facilities. In such circumstances, punishment does not improve care; it merely drives errors underground. Doctors and nurses may avoid treating high-risk patients, cover up mistakes, and resort to defensive medicine. Worse still, in a country already grappling with pervasive corruption, punitive laws risk becoming tools of extortion. The threat of crippling fines or jail terms hands extraordinary power to inspectors. Rather than strengthening patient care, such a system diverts scarce resources into private pockets. Patients, once again, pay twice –first with their money, and then with their lives.
The Bill also threatens to undermine one of Kenya’s most vital public health tools: the Maternal and Perinatal Death Surveillance and Response (MPDSR) system. This mechanism reviews every maternal and newborn death to understand why it happened and how to prevent future tragedies. Its success depends on health workers being able to speak candidly in these reviews. If what they say can later be used against them in court, the culture of openness that has made MPDSR effective will disappear. Globally, only about 20 countries provide legal protections for clinicians who report safety incidents — and most of these are high-income nations. Kenya should be leading by protecting openness, not undermining it through fear.
So, what should Parliament do? First, it must draw a clear line between deliberate misconduct and systemic error. Cases of gross negligence or wilful harm should continue to be punished under the Penal Code and professional disciplinary procedures. However, ordinary mistakes made under pressure in flawed systems should not attract criminal sanctions. Instead, they should prompt corrective action, retraining, or proportionate penalties. Second, learning systems like MPDSR, mortality reviews, and peer sessions must guarantee confidentiality, just as aviation protects pilots who report near-misses. A safe reporting culture is what turns mistakes into learning opportunities. Third, hospital accreditation and access to Social Health Insurance funds should be based on support rather than exclusion. Facilities that fail audits should be given phased compliance plans and technical support, not abruptly cut off – an action that leaves patients in poorer counties stranded without care.
The Bill must also place accountability where it truly belongs – on government as well as healthcare providers. If deaths occur because hospitals lack blood, medicines, or adequate staff, then the state itself should be held responsible. To criminalise frontline providers while allowing systemic failures at the county and national level to go unpunished is to be unjust. Finally, inspections must be led by qualified experts and benchmarked against recognised international standards such as KEBS, ISQua, and JCI.
Without such standards, inspections become arbitrary — and in Kenya, arbitrary too often means corrupt.
Globally, unsafe care kills more people every year than HIV, tuberculosis, and malaria – the leading infectious disease killers – combined. One in ten patients suffers harm, and about half of these cases are preventable. Yet punishing doctors or bankrupting hospitals will not solve this crisis. Real progress depends on building a culture of safety — one that ensures fair working hours, provides protective equipment, safe workstations, vaccination for at-risk staff, protection from violence, and, above all, psychological safety. Every health worker must feel free to raise concerns without fear of blame or humiliation.
Patients deserve hospitals that learn from mistakes, not hide them. Health workers deserve systems that support them, not ones that punish them for failures beyond their control. Parliament now faces a clear choice: to pass a law that entrenches fear, silence, and corruption, or one that fosters openness, learning, and accountability for everyone – including government itself. For the sake of our patients, Kenya’s lawmakers must act with foresight and restraint, not with rushed or reactionary measures.
Dr. Richard Mogeni is a Consultant Obstetrician & Gynaecologist, Chairman of the Kenya Obstetrical and Gynaecological Society – North Rift, and a Joint Commission International (JCI) Patient Safety Trainer of Trainers.
