In Summary
- The Nairobi County Assembly is pushing for a groundbreaking bill aimed at decentralizing the management of public hospitals.
- Minority Whip Moses Ogeto highlighted the urgent need for reform, citing current challenges faced by both patients and medical facilities.
- The proposed legislation seeks to grant significant autonomy to various levels of hospitals, starting from the grassroots clinics. Under the new framework, any fees collected by these clinics, even a modest Kes. 100, would remain at the facility instead of being remitted to the central County Treasury Office.
The Nairobi County Assembly is pushing for a groundbreaking bill aimed at decentralizing the management and finances of public hospitals.
According to proponents of the move, it will drastically improve healthcare accessibility and efficiency for city residents.
Minority Whip Moses Ogeto highlighted the urgent need for reform, citing current challenges faced by both patients and medical facilities.
Ogeto painted a grim picture of the current state, where low minimum wages of Kes. 300-500 for some workers, coupled with a lack of staff in public clinics, leave many unable to access essential medical services.
“You see, they are unable to access public clinics simply because these public clinics don’t even have the staff,” Ogeto stated.
The proposed legislation seeks to grant significant autonomy to various levels of hospitals, starting from the grassroots clinics. Under the new framework, any fees collected by these clinics, even a modest Kes. 100, would remain at the facility instead of being remitted to the central County Treasury Office (CTO) in a Consolidated Fund Services (CRF) account.
“What we want to avoid is the management of the hospitals. We want to decentralize the management of the hospitals, especially when the budgets have been approved,” Ogeto emphasized.
He explained that, the current process is cumbersome, where even after budget approval by the assembly, further signatories are required from CTO department, creating unnecessary bottlenecks.
The Contents Of The Bill
The bill aims to eliminate bureaucratic hurdles, empowering hospital boards to oversee operations more effectively. These boards, mandated to meet quarterly, will monitor hospital performance.
Additionally, a new internal hospital board will be established for daily management. Crucially, the bill includes County Assembly members as official members of these boards, allowing them to directly monitor budget utilization at the hospital level.
A key focus of the reform is strengthening the position of hospital Chief Executive Officers (CEOs). Ogeto noted that current CEOs operate without clear legal authority.
“We want to strengthen the CEO position, so that he has… because currently they are there illegally, so we want to make them legal,” he explained.
This legalization would grant CEOs accounting officer powers, similar to those seen in entities like Nairobi Water and Kenyatta National Hospital, shifting financial authority from the Chief Officer for Health.
“We want the CC Finance to give the accounting officers who are the CEOs powers, so that we don’t want money to come from the hospitals to CTO. We want money to remain at the facility,” Ogeto declared. He cited examples like Mutuini Hospital and a hospital in Kajiado that are already self-sufficient, demonstrating the viability of this model.
The proposed changes extend to donations and grants as well. Under the new system, direct donations to hospitals would be encouraged, bypassing the need to funnel funds through the CRF.
Consequently Ogeto said that if the bill is passed into law, those wishing to donate to hospitals will do so directly, hence the bureaucracy in the current system that often requires donors to seek approval from the Governor’s office.
“Just go see the CEO, if you have a donation or a grant, you can go directly to the hospital. Not necessarily to CTO,” Ogeto said.
The Nairobi County Assembly is hopeful that this bill will usher in a new era of efficient and accessible healthcare for all Nairobi residents by empowering local facilities and streamlining financial processes.