Saturday, 27 April 2013

Political appointments perpetuate disservice in the Health Sector

For 50 long years Kenya’s health sector has been struggling along nearing death. For 50 years Kenya’s Ministry of Health has had all sorts of political appointees as Ministers all of whom save Prof. Sam Ongeri were lacking the necessary background in the health service. 

Barely one month into the new dispensation and the Jubilee government makes a political appointment that is simply a throwback to the 1980s when Ministers barely needed ANY qualifications to head a particular ministry. Some were not even educated.

I am sure James Macharia is an excellent banker and his qualifications in the finance sector leave you wondering why the horse trading that goes on politically could not find a better appointment for someone with such great qualifications for Finance. Here is what really happened – Jubilee had to come to an agreement on which party gets the finance docket, qualifications of the appointee notwithstanding. Poor James Macharia, having been promised an appointment nonetheless gets the health docket as a compromise.

There is nothing more evil then the ridiculous way in which our lives are compromised by politicians. Lest we forget the promises made only 3 months ago as concerns cabinet secretaries and the provisions of the constitution that those appointees should indeed be adequately suited to that particular post.
It was part of their political campaign pledge to Kenyans that the Jubilee government would take such appointments seriously enough to nominate the appropriately qualified persons to the right dockets. It’s also a part of the constitutional requirements that these people are aptly suited to the ministries they head.

So when a political compromise is reached, to the detriment of an entire sector it is the rankest and vilest propaganda to then have minions declare that doctors are not the only ones capable of running the health ministry when those doctors rightly raised alarm.

To claim that administration of the health sector is something anyone can do is utter gibberish. 50 years of letting anyone run the health sector has resulted in deplorable conditions and only a miserable 2300 government doctors available for 40 million people!

Look at the madness of an argument that in one instance declares that anyone can do the job not necessarily a doctor and in the same vein acknowledges that there would indeed be great need for consultancy with doctors! Its utter nonsense to justify putting a person as head of a ministry when he is so incapable of functioning that he would automatically require a host of the very doctors you refuse to head the ministry.

It’s a common fallacy by the way, that made the rounds on social media this week that Michuki was not a transporter but was able to fix the transport industry. Firstly Michuki was indeed a transporter having vast interests in the transport industry; secondly and more importantly health sector deals with people and not vehicles. Thirdly, what was fixed?

Even the notion of comparing Kenya with a first world nation like Germany to justify not appointing an appropriately qualified doctor displays the level of ridiculous excuses. Kenya is in no way anything like Germany, Kenya’s health sector is not only grossly mismanaged it is ridiculously underfunded. If we are to compare how Kenya’s health sector is run verses Germany’s then we would at the very least pay our medics a comparable salary and give them comparable resources and working conditions.

It is an international practice not to appoint as head the very medic that would be appropriate for such a job and the increasing reality is that those heads are not as competent in handling the sector as a medic would be resulting in a nation like the US having failures in its healthcare sector despite having the resources available. This is true in the reality that unless you have the right kind of insurance you will not receive medical attention in the US. Indeed the US is way behind even Cuba in terms of public health service.

A reasonable mind would instead compare Kenya’s failing health sector with a successful one like Singapore’s. Incidentally, the health minister is a doctor! Why Singapore? 50 years ago, Singapore and Kenya were at the same level in independence, political transition and development. Isn’t it just common sense to look at what they have been able to achieve and how they achieved it?

Of all the myriad excuses made this week, the most ridiculous has to be that doctors are not managers and running a ministry is not about treating patients. Firstly, doctors are indeed managers; they are managers of healthcare, of systems and of policies. Senior professionals have more than an MD they also have MBAs and further education tailor-made to suit the management of a healthcare organization. It is very insulting to insinuate that of all the brilliant minds in this country there was not one that was found suitable for the job.

Our healthcare sector needs a radical and drastic change immediately and there is nothing radical in appointing a non medic and yet for 50 years that is what has been going on with the results that we have today. There is no real justification for the Jubilee government to usurp their own pledges and the foundations of the constitution in making clearly inappropriate appointments.

As for those who argue that management of an entire health sector can be done by anybody so long as the person has the doctors to help him run the show – this circular reasoning is why stupid had a head start in Kenya and is winning the race.

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