Doctors have rejected two proposals from the government and the salaries regulator that would have seen medical interns earn a monthly stipend of between Sh27,000 and Sh70,000.

Correspondence between the Ministry of Health and the Salaries Remuneration Commission (SRC) showed that a medical intern in the lowest cadre would be entitled to a stipend of Sh27,000, while the highest will go home with Sh70,000.

This is an increase of Sh12,000 of what the lowest cadre which is a diploma holding Clinical Officer intern earned a year ago and Sh10,000 reduction for the highest cadre – a medical officer intern who earned Sh80,000.

In its response to two letters from the Ministry of Health dated March 6 and 11 on the stipend for Healthcare Internship Programme, the SRC proposed that Medical Officer Intern be paid between Sh47,000 to Sh70,000, while Pharmacist Intern be entitled to an estimated Sh47,000 to Sh70,000.

“The Salaries and Remuneration Commission (SRC) during its 593rd meeting held on March 12, 2024 approved a stipend for healthcare internship programme for the listed cadres subject to affordability and fiscal sustainability,” wrote SRC Chairperson Lyn Mengich in a letter dated March 13 and addressed to Health Cabinet Secretary, Susan Nakhumicha and copied to her National Treasury counterpart, Prof Njuguna Ndung’u.

Mengich indicated the new remuneration proposals would be effected on March 13.
The Kenya Medical Practitioners, Pharmacists and Dentist Union (KMPDU) rejected the proposals outright, terming them ‘exploitative’.

“These letters have annoyed us and we cannot proceed with conciliation if the government side keeps on digging in,” KMPDU Secretary General, Davji Atellah is reported to have said after a meeting with Ministry of Labour officials.

The latest proposals by the Ministry and SRC, he said, were irritating and only served to strengthen the union’s resolve to continue with the strike.

“We will go on with the strike until these issues are resolved. Tonight, we will withdraw our services at Kenyatta National Hospital and Moi Teaching and Referral Hospital,” Atellah said.

In the other stipend adjustments, the SRC proposes that the Dental Officer Intern goes home with between Sh47,000 and Sh70,000, while a degree holder Nursing Officer Intern earns from Sh35,000 to Sh50,000.

“A Clinical Officer (BSCCM) interns are entitled to a stipend of Sh35,000 to Sh50,000, and a Clinical Officer (Diploma Holders) Interns between Sh27,000 and Sh35,000,” Mengich says further in the Commission’s circular, whose purpose was meant to convey the advice of the Commission for the two ministries’ necessary action.

In the letter from the Ministry of Health to SRC, Nakhumicha proposed that a Medical Officer intern receive a stipend of between Sh50,000 and Sh70,000, while a Pharmacist Intern will be entitled to Sh50,000 to Sh70,000.

If the CS’ proposal could have been adopted by the SRC, a Dental Officer Intern could have gone home with Sh50,000 to Sh70,000, and a degree holder Nursing Officer Intern, an estimated Sh35,000 to Sh50,000.

In Nakhumicha’s proposals, a Clinical Officer (BSCCM) intern was entitled to Sh35,000 to Sh50,000, while a Clinical Officer (Diploma Holders) Interns, Sh25,000 to Sh35,000.
“Reference is made to our letter Ref. No. SDPH&PS 5/2/18 of 5th March, 2024 requesting the Salaries Remuneration Commission (SRC) to rationalise and determine the stipend that would be payable to Healthcare professional interns,” the CS wrote on March 11.

With a hope that the new proposals will soothe the doctors to call off the strike, Nakhumicha’s proposals were on a range of stipend for SRC’s consideration when determining the payable rates.

She argued that her proposals were based on the budgetary provision, the roles that interns perform in the facilities being the first contact with patients as well as comparison with rates payable to other internship programmes in the public service.

However, with the doctors’ firm stand that everything contained in their CBA, the country’s healthcare is staring at a bleak future.

The doctors are contending that the zero implementation of Article IV (A) and (B) as read with Appendix A on Remuneration on Basic Salary contrary to Judgment delivered by Honorable Lady Justice Monica Mbaru of 28th October 2021 NAIROBI ELRC E. 6464/2020, the strike will go on.

“Failure by medical training universities to sign of recognition agreement and deduction and remittance of Union dues; failure to harmonize clinical allowance and provision of medical cover, we shall not relent,” the doctors say in the CBA.

The medics are also calling for adequate funding of the health sector with budgetary commitment to fund all signed CBA’s beginning with increasing allocation to the counties to the tune of Sh425 billion.

They are also unhappy with the failure by Kenyatta University Teaching Research and Referral Hospital to sign a CBA, harmonization of salary for doctors on short term contractual terms, described as discriminatory; and conversion to permanent and pensionable terms, promotions of the consultants and provision for study leaves.

“Perennial delayed posting and payment and general mismanagement of the internship programme as agreed under Article IV of the CBA with the Ministry of Health, is still hurting our members,” Atellah said.
The Ministry of Health is expected to hold another meeting at the end of this week, to try and persuade the doctors.

A fortnight ago the Ministry of Health requested the Treasury for Sh4.9 billion to enable it absorb medical interns.

Nakhumicha said currently the Ministry has no resources to absorb the interns adding that action shall be taken once the funds are available.

The CS said the demand by the Union to post and pay the interns at Sh206,000 per month was untenable since the Ministry lacked the resources to foot the bill.