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Is pay ‘only one’ of 31 items in striking Kenya doctors deal?

Appearing in a morning talk-show on national television station NTV, panellist Herman Manyora weighed in on the country’s debilitating doctors’ strike, now in its third month.

“Out of the 31 or so items for negotiation in the CBA, only one is salaries,” said Manyora, a University of Nairobi lecturer who in 2009 helped negotiate a welfare deal between the lecturers’ union and universities.

The CBA (Collective Bargaining Agreement) was struck in June 2013 between the Kenyan government and Kenya Medical Practitioners and Doctors Union.

It is at the centre of claims and counterclaims around the strike, with the union insisting that implementing it is the “bare minimum” to resume duty. Among other positions, the government holds that the document is not properly recognised in law and should be renegotiated.

Where did the figure come from?


A screenshot of University of Nairobi lecturer Herman Manyora appearing on a morning show on Kenya's NTV station on 14 February 2017.
A screenshot of University of Nairobi lecturer Herman Manyora appearing on a morning show on Kenya's NTV station on 14 February 2017.


NTV tweeted Manyora’s statement to its 1.4 million followers as “out of 31 items in the CBA only one is salaries”. Manyora’s fellow panellists, two senators, also used the figure to back up their arguments on the show.

Manyora told Africa Check that he had heard the number 31 “from one of the people involved” in a television interview.

It seems he was referring to an interview the day before with Peter Wanyama, the advocate representing Kenyan governors, on Citizen TV, another station with national reach.

“There are 31 non-contentious issues in the CBA which doctors are going on strike over, issues which can be handled from policy and administrative interventions,” Wanyama said. “These are not issues that you are supposed to go on strike over; the only issue that warrants going on strike over is the issue of salaries.”

The governors want a seat at the negotiating table because under Kenya’s constitution, they now control health services, while the national government handles policy and runs referral hospitals.

Contacted, Wanyama told Africa Check that from a legal standpoint “there are 31 broad issues, but if you itemise all the issues in the Collective Bargaining Agreement, there are about 50 issues”.

He did not however list these “broad issues”.

How is the document organised?


The 27-page CBA states it is meant to improve both the doctors and authorities ability to do their work well and improve national healthcare.

It is ordered under nine articles. Each article deals with an aspect of doctors’ welfare, including their employment conditions, benefits, the lodging of grievances and disciplinary procedures.

In turn, the nine articles have a number of items listed under them. Africa Check counted 49 items in the agreement, which tallies with Wanyama’s estimation of “about 50 issues”.

For example, Article III, dealing with doctors’ rights, has job groups, promotions, resignations, transfer, training and research, residency and internship.

That of remuneration has three items– basic salary, allowances and increment - with an annex showing a breakdown of the numbers currently paid and those sought.

The items are not classified into either broad or minor issues:



Article I:

Terms of agreement
1. Sets out the effective date and duration of agreement, and when the next agreement after the expiry of the current one will be negotiated

2. Waiver clause, which allows parties in the agreement to mutually agree on issues not covered by the agreement, and then put these down in writing

3. A severability clause that makes any section of the document, which is contrary to the law or the Constitution, invalid

4. Procedure for amending the CBA

5. A Labour Management Committee, with three members of the union and three members from the Ministry of Health, which will meet every 3 months to assess implementation of the contents of the agreement

6. Dispute resolution mechanism
Article II:

Union Rights
7. The Kenya Medical Practitioners and Dentists Union to represent members on labour relations, healthcare policy-making, healthcare implementation and research

8. Ministry to deduct union dues via check-off system effective 1 July 2013, payments to be made within ten days to the union’s bank account

9. Union to have right of access to information and data in the ministry, especially data touching on its members

10. Union members to be allowed to meet at their work premises

11. Union officials to go on unpaid leave for the duration of their term in office
Article III:

Doctors’ Rights
12. Job groups  and a review of scheme of service*

13.  Promotions

14.  Resignations

15.  Transfers

16.  Training, development and research including a training policy, and 1% of the recurrent budget for the ministry being set aside for training

17.  Medical research fund

18.  Residency positions*

19.  Internship*

20.  Extension of internship
Article IV:

Remuneration
21.  Basic salaries

22.  Allowances

23.  Pay increment
Article V:

Employment conditions
24.  Work hours

25.  Compensation for work holidays

26.  Doctors’ room

27.  Call room

28.  Ministry to reasonably equip health facilities with tools and equipment for service delivery

29.  Adequate support staff

30.  Facilities to have health and safety measures

31.  Transport and security for night calls

32.  Staff housing

33.  Understaffing: Ministry to employ 1,200 doctors a year for the next 4 years to deal with doctor shortage in public health facilities
Article VI:

Leave
34.  Annual leave

35.  Sick leave

36.  Maternity and paternity leave

37.  Compassionate leave (death in the immediate family)

38.  Unpaid leave
Article VII:

Benefits
39.  Health insurance: Medical, dental, eye care

40.  Workman’s compensation

41.  Professional indemnity cover

42.  Retirement benefits and service gratuity

43.  Redundancy

44.  House mortgage

45.  Car loan
Article VIII:

Grievance & arbitration
46.  Basic principles

47.  Procedure
Article IX:

Disciplinary procedure
48.  Disciplinary procedure

49.  Termination of employment
* Items where the doctors’ union & government were unable to reach an agreement on certain aspects


Conclusion: Manyora’s count incorrect but salaries do take up a minor part of CBA


The agreement Kenya’s government and the Kenya Medical Practitioners and Doctors Union reached in 2013 consists of 9 articles, each containing various items. Africa Check counted 49 in total.

Article IV, which deals with doctor remuneration, has 3 items stipulating required basic salaries, allowances and pay increments.

The claim that “out of the 31 or so items for negotiation in the CBA, only one is salaries” is therefore incorrect. However, Manyora is right that salary demands take up a relatively minor part of the agreement.

He told Africa Check: “The point I was trying to make was that it was wrong for people to make the whole strike about salaries… there are other important things meant to improve public health in Kenya in that CBA.”

Edited by Lee Mwiti

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