Truth is, negotiations over compensation arrangements always involve legitimate self-interest. The seller of services (in this case a doctor) attempts to obtain as much compensation as possible, while the buyer (Government) attempts to obtain the service at the lowest possible cost.
That is why there needs to be an updated nation’s estimated fair market value for every profession at any point in time. But before we get to that, here’s a major problem we have as Kenyans:
Simple Math
In the new demands, the proposed minimum basic salary is Ksh.107,730 up from the current Ksh.35,910. That’s a 200% INCREMENT not 300%. The 300% reflects the proposed pay as a percentage of the current pay NOT THE INCREMENT! Including allowances, the proposed minimum gross pay is Ksh.325,730 over the current Ksh.127,910. That’s a 154.65% INCREMENT and NOT 300% INCREMENT with 254.65% being the proposed gross pay as a percentage of the current gross pay.
Since we’ve cleared the air on the math, basing our arguments around the 154.65% Total Pay increment is utterly misleading. The argument should instead be centered on whether the basic salary the physicians are asking for reflects their fair market value. We need to take note of the fact that the 154.65% basically indicates the deviation of the current pay from what the physicians perceive to be the current fair market value of the profession.
So do the pay demands reflect the fair market value of a Physician in Kenya? This should be the basis of the discussion.
The Fair market value in this case is determined by several factors but I’d like to bring one obvious one into the spotlight: The Patient Demand. According to a recent article on The Star on a recent study by KMPDU, the survey revealed that Kenya has 3,956 doctors in the public sector but the number drops by the month as more doctors resign, having already lost over 2,000 of them as a result of poor working conditions. 3,956 doctors in public sector means Kenya is a nation with an estimated doctor: patient ratio of 1:17,000 against WHO recommended ratio of 1:1,000.
A ratio of 1:17000 mathematically means that each physician does the work of relatively 17 physicians ceteris paribus. That’s a mathematical projection of the current patient overload on an average physician in Kenya. Cuba, on the other hand, with 70,000 trained physicians, currently leads the world with the lowest doctor to patient ratio of 1:155 as per 2012; it’s probably at 1:140 or less by now. Clearly the lowest patient overload in the world~ Just in case you were about to bring Cuba Physician pay into the picture.
India on the other end has doctor to patient ratio of 1:1,681 as per 2016. South Africa: 1: 1,298 against a minimum gross pay of about Ksh. 370,000 per month. Do not forget that the average Consumer Price Index of South Africa over the past 3 years has been around 120.5 while Kenya’s at around 161.
So what does this data show us? Kenyan Physicians are overworked. And more importantly, the market value for a physician in Kenya is approximately over 10 Times higher than a physician in South Africa or USA for instance. Sad story.
Ok…enough with the pay and the suffering of these poor doctors.
Money is a sensitive issue. Definitely why the other more important demands in the CBA are easily going unnoticed: Review of physician working conditions, job structures and criteria for promotions and training, addressing under-staffing of medical professionals in public hospitals, availing of appropriate Medical Equipment, Medical Research facilitation among others.
The truth is, the realities of public hospitals in Kenya are horrible. With the implementation of this agreement as it is, we can project improved services in public hospitals especially for the average Kenyan. We don’t need any more of us struggling with finances to get folks to India or South Africa.
A study of the confederation of Indian Industry in 2005 put the annual number of Medical Tourists at 151,000 and projected the figure to rise by 15% a year. Current estimates put the numbers at around 500,000. About 60% of Kenyans who travel for medical care go to India, with South Africa coming at a distant second with slightly above 15%.
Studying these two countries, their major Health Industry Strengths are: Better doctor to patient ratio, Better working conditions, Better medical equipment and Medical Research facilitation. These, among others, generally translate to better services in public hospitals.
The same is possible for Kenya with this agreement’s implementation. Besides access to quality Health Services for an average Kenyan, Kenya can become a hub of medical tourism in the East Africa Region. According to Pathway CEO in a recent article on Nation, every month we get up to 2,000 patients coming to Kenya Hospitals from the greater East Africa region. We can triple this numbers every year.
But our government simply wants to trade all that with a 40% pay rise just to silence the doctor’s strike.
This is a government that allocates only Ksh. 60.4 Billion to Health, 2.43% of the 2016/2017 budget. The same government has lost over Ksh. 600 Billion to CORRUPTION, 24.2% of the 2016/2017 budget. It’s a shame.
Think about it. And don’t stop.
Cliff Ochomo 