Governors yesterday opened multiple warfronts with the national government, demanding review of policies that interfere with devolved governance and disbursement of equitable revenue share, as well as a relook at the Sh39 billion medical equipment lease.
The county bosses, in a full council meeting, also demanded the extension of contracts for 9,000 Universal Health Coverage (UHC) employees whose terms end in May 2023.
“There is a potential disruption of health services if the staff leave hospitals due to lack of resources to sustain them,” said Ms Anne Waiguru, the chairperson of the Council of Governors (CoG).
“We urge the national government to provide additional budgetary resources to county governments for renewal of contracts for UHC staff at market rate salaries. The payroll management for the UHC staff should also be transferred to county governments,” she added.
The governors accused the national government of setting up three authorities in the Ministry of Health without consulting the counties. The three are the Kenya National Public Health Institute, the National Syndemic Diseases Control Authority, and the Kenya Tissue and Transplant Authority.
“This continues to be a trend whereby the national government creates institutions to undertake devolved functions. The council calls for the audit of all laws that had been passed before the inception of devolution in 2013 and post-2013 with a bid of aligning those to the devolved system of governance,” Ms Waiguru said.
The council further resolved to convene a meeting with the Health Ministr to address pending issues on infrastructure and equipment support programmes, among others.
These programmes include the Managed Equipment Services (Mes), microwave upgrading project and construction of 50 Level Two and Three hospitals in counties, as well as the upgrading of maternal and child health facilities in 12 counties.
On Mes, the council caved in, saying: “The council approves continuity of the Mes project, subject to the key minimum conditions being met.”
The governors demanded a stop to the procurement of medical equipment for counties being undertaken by the national government.
On community health volunteers, the governors demanded that the national government shoulders a 50 per cent burden on their pay, citing an agreement dated October 18, 2022.
On the implementation of the bilateral agreement on Cuban doctors, the governors said they will meet with the Health Cabinet secretary to review the performance, terms and conditions of engagement of the current cohort of Cuban doctors.
When it comes to the policies that interfere with the devolved governance structure, the governors rejected a proposal by the National Treasury which has been using the absorption rate as a basis of cash disbursement to the counties.
“It is imperative to note that the balances in the County Revenue Funds are not as a result of under-absorption by counties, but due to delays by the Controller of Budget to approve requisitions, which span over two weeks. These criteria are therefore misleading and unjustified,” said Ms Waiguru.
“We therefore call upon the National Treasury to expedite the disbursement of the monies owed to ensure service delivery in the counties,” she added.
Currently, the 47 county governments are owed Sh29.6 billion for October and Sh31.45 billion for November 2022 allocations.
The governors also demanded a review of the sharing of mineral royalties revenue, which favours the national government.