By LUKOYE ATWOLI
Sunday Nation 19 September 2010
A couple of weeks ago, the Ministry of Medical Services, through the Director of Medical Services, Dr Francis Kimani, released a circular to all provincial medical directors, medical superintendents and medical officers in charge of health facilities advising them that, although selection of doctors to pursue post-graduate training had been finalised, they would not be released to go for studies due to lack of funds.
The circular practically embargoed all post-graduate training in the ministry, implying that even those who had already been selected to proceed to various universities for further studies would have to put their plans on hold and continue working in their stations until further notice.
This decision has only served to worsen the already low morale among junior doctors, who are now bound to continue working with poor remuneration and little prospects for professional development.
The only other option open to them would be to resign from the public service and raise enough funds to pay for their own post-graduate training, a difficult decision for many doctors at the beginning of their careers.
It should also be borne in mind that the DMS is also the registrar at the Medical Practitioners’ and Dentists’ Board, and is theoretically in a position to intimidate all registered doctors in Kenya.
Government sponsored post-graduate training is the glue that holds many young health workers in the civil service. They have continued working in the civil service with the knowledge that after a certain number of years, the government would offer them scholarships to pursue further studies in a field they are interested in.
This motivation has ensured that there is at least one doctor in most corners of the republic. The DMS’s circular is set to change all that.
Given that the government is the largest client of our universities as far as post-graduate training in medicine is concerned, this decision also has the potential to interfere with university programmes.
Many post-graduate programmes will not be able to mount courses this academic year in the absence of government sponsored doctors, and the greatest loser is the citizen who will continue to suffer from the shortage of specialised staff to provide high quality services.
With the proliferation of universities offering medical courses all over the country, there is already a shortage of skilled teaching staff, and this embargo will only serve to worsen the situation.
Further, the National Hospital Insurance Fund (NHIF) is angling to increase the contribution rates for its members, with a promise of better quality care almost anywhere in the country.
It is a mystery how this will be achieved with the current shortage of specialised staff and the expected exodus of young doctors as they seek greener pastures elsewhere in the country and abroad.
The problems bedevilling health service delivery in Kenya go even deeper, and are compounded by the continued split in the Health ministries.
Hopefully, with the expected reduction in the size of the Cabinet, these ministries will once again be reunited to reduce the massive duplication of functions and wastage of public funds that is resulting in the current mess.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s School of Medicine www.lukoyeatwoli.com