Mr. Speaker, Sir, I beg to ask the Minister for Roads the following Question by Private Notice. (a) What is the total cost of the contract for the on-going patching up of potholes on the Maili Tatu-Laare-Mutuati Road? (b) What is the identity of the contractors as well as the amount they have been paid to date? (c) Could the Minister table the contract documents as well as the certificate of registration of the contractors? (d) In view of the shoddy work done, could the Minister undertake to withhold payment until the contractors have done the job satisfactorily?

Mr. Speaker, Sir, I beg to reply. (a) The total cost of the three contracts for the patching up of potholes on the Maili Tatu-Laare-Mutuati Road is Kshs8,600,480. (b) I wish to identify the three contractors on that project and the amounts paid to them to date as follows:- (i) Capren Investment Company Limited – Kshs5,994,980. (ii) Sivad Enterprises Limited – Kshs1 million. (iii) Maua Works Construction Limited – Kshs1,605,500. (c) I wish to table the extracts of the minutes of the District tender Committee held on 8th and 21st April, 2009, as well as the Local Service Orders and the letters from the Chief Engineer, Roads, confirming registration of each of the contractors.

(d) The project involved limited patching works to address the deteriorating condition of the road. However, new potholes have since developed on some sections of the road. The contractors have been instructed to patch up the additional potholes. Payments cannot be withheld because the contractors have already been paid.

Mr. Speaker, Sir, the Assistant Minister has tried to answer the Question. However, that is an 18-kilometer road with three contractors on site. The contract was split up to defeat the threshold of competitive bidding and, hence, the shoddy work that was done. The Assistant Minister has not answered Part (d) of the Question. The payments were made upfront, even before the works started. The Assistant Minister has never been on the ground to know what is happening. But that is exactly what happened. How can potholes start developing on a road even before the construction work is completed?

Mr. Speaker, Sir, the hon. Member is correct. The three contractors were awarded a contract to do a very short stretch of road. However, that decision was taken by the District Roads Committee (DRC), where he is a Member. So, he should be able to tell us why his Committee did that.

On a point of order, Mr. Speaker, Sir. Is the Assistant Minister in order to mislead the House that the DRC, where the hon. Members sits, awards contracts? Members do not do that. It is the Executive arm of the Government that does that.

Mr. Speaker, Sir, the DRCs have a lot of powers. I wish to inform Members of this House that DRCs actually award contracts on specified roads. That is an example where the contracts were awarded on the powers of the minutes of the DRC. Secondly, I also note that potholes started forming immediately the contractors finished patching the road. That raises concern, not only to the hon. Member, but to me as the Assistant Minister. I intend to visit that road very soon.

Mr. Speaker, Sir, potholes on our roads have caused many accidents and deaths in the country. Is the Assistant Minister in a position to supervise the quality of the work done by the contractors and their track records before they are awarded the contracts? He seems to be going round in circles.

Mr. Speaker, Sir, it is true that a few companies have confirmed their inability to construct roads in this country. Any company that has been given some

Mr. Speaker, Sir, time and again, Members have talked about the quality of the work being carried out on our roads. The Assistant Minister has admitted that the contractors did a shoddy job on that road. What measures will he take against those contractors?

Mr. Speaker, Sir, as an Assistant Minister, I rely on the technical information from the engineers. I may not be able to take any action against those contractors because they did the work they had been told to do. They were contracted to patch an already dilapidated road. Just because new potholes have formed after they patched the old potholes does not make them inefficient.

Mr. Speaker, Sir, there is a tendency in this country, particularly in remote areas like Laisamis and Garsen constituencies, the contractors tend to do extremely poor quality jobs. That is not something that the Assistant Minister can solve by merely visiting those areas. In the Hola-Garsen Road, you will find that it is being constructed and yet, other things are going wrong along the same road. What measures, particularly in the remote areas, is the Assistant Minister putting in place to ensure that those roads are constructed to the required standards?

Mr. Speaker, Sir, we have noted that anomaly, especially in the far flung areas of this country. We are more diligent and we have focused more on those roads. We have put more strict supervision and inspection measures and I believe that shoddy works will be a thing of the past.

Mr. Speaker, Sir, the Assistant Minister has admitted that the contractors have fully been paid. He has said that he will approach the contractors to re- do the work. At the same time, he has said that there is nothing he can do about the contractors because the work has been done. Is he incapable? Is he a hostage of the contractors? Public money has gone to waste, a shoddy job has been done and the Assistant Minister cannot do anything to the contractors.

Mr. Speaker, Sir, no, I can never be a hostage to the contractors. I can only be a hostage of the contract that they signed. If they have completed doing what they specifically signed to do, then I am a hostage of that.

SHOOTING OF MR. JOB BAGETO ONG’ERA BY POLICE OFFICERS

Mr. Speaker, Sir, I beg to ask the Minister of State for Provincial Administration and Internal Security the following Question by Private Notice.

(a) What are the circumstances surrounding the shooting and subsequent death of Mr. Job Bageto Ong’era of Gesima Location, Kitutu Masaba on 22nd May, 2009, at Ikonge in Nyamira District?

(b) What specific action has the Government taken to ensure that the police officers responsible for his death are arraigned in court?

(c) Could the Minister give an update of the investigations and indicate when the Government will compensate the family of the deceased?

Mr. Speaker, Sir, I beg to reply. (a) The deceased, Job Bageto Ong’era of Gesima Location, Kitutu Masaba District, could have been shot by the police while attempting to deflate the tyres of a fleeing suspected vehicle, registration No.KBH 189J, Toyota Matatu, in which he was a passenger therein. Upon an intelligence report, the police officers had been informed that the vehicle registration No.KBH 189J, a Toyota Matatu, was being used to transit illegal bhang prohibited under the Narcotic Drugs and Psychotropic Substances Control Act No.4 of 1994, Laws of Kenya.

(b) Investigations into the incident to establish the cause of death commenced immediately and an Inquest File No.13/2009 was opened by the District Criminal Investigation Officer (DCIO), Nyamira. The ballistic evidence will indicate the exact gun that exited the fatal bullet. The specific officer will be arraigned in court immediately.

(c) The inquest file was forwarded to the Attorney-General for advice vide DCIO, Nyamira, letter, reference No.CID/C/CRI/7/7 Vol.5/172 dated 26th June, 2009. The file was returned to the DCIO vide Attorney-General’s letter reference No.AG/KSI/CR/12/2009/510 dated 30th June, 2009, for further investigations and later resubmitted to the Attorney-General vide DCIO, Nyamira letter reference No.CID/C/CRI/7/7/Vol.5/183 dated 7th July, 2009, after the points raised by the Attorney General were covered. The file is awaited from the Attorney-General for action. The issue of compensation is upon the court’s discretion after having considered facts and evidence before it. (d) No innocent passengers have lost their lives as a result of shooting by the Kenya Police in the last 12 months.

Mr. Speaker, Sir, I thank the Assistant Minister for the detailed answer. However, I would like to know from him when we will get the ballistic results so that we can know whether the bullet was from the police or another quarter. This is because it is my concerted believe that the gunshot must have come from the police. Secondly---

Order, Mr. Nyambati! It is Question Time. You should ask one question at a time for supplementary questions!

Mr. Speaker, Sir, we are also concerned with this incident. We asked the police to fast-track investigations in order for us to know the gun that fired the bullet that killed this person. We will relay the information to Mr. Nyambati within a week or three weeks after the ballistic expert identifies the gun that was used in this case.

Mr. Speaker, Sir, the number of times that the Assistant Minister has told this House that files have been forwarded to the Attorney-General’s Chambers for advice are becoming too many. The procedure for holding public inquest is being misused by the police. Every time there is a shooting incident and Kenyans die, the police do not conduct full investigations. Files are forwarded to the Attorney-General’s Chambers with incomplete statements and the result is that the Attorney-General orders that the files be closed. What is the Ministry doing to ensure that before files are submitted to the Attorney-General’s Chambers, full and proper investigations are conducted and evidence is adduced?

Mr. Speaker, Sir, that is a very good question. Mr. Olago is a lawyer by profession and he knows that there is no way we can act without getting advice from the Attorney-General. In any case, if Mr. Olago wants to fast-track this case, he should amend the law so that we can take action without necessarily referring to the Attorney- General.

Mr. Speaker, Sir, whenever there is suspicion of police involvement in the shooting of innocent citizens, we are always given amazing answers that the same police station is investigating the same police officer. What is the Assistant Minister doing to establish a special unit that will investigate this police officer? It is wrong and will never yield any results to send the same---

Order, Mr. Mungatana!

Mr. Speaker, Sir, what is the Assistant Minister doing to correct that anomaly?

Mr. Speaker, Sir, it is, indeed, true that it will not be possible for us to get something concrete from the same police officer who was involved in such an incident. That is why we established a task force to look into reforms in the police force. Who knows? We might include that proposal so that the same policeman should not be an investigating officer.

Mr. Speaker, Sir, I think I am astonished by the answer given by the Assistant Minister. The issue is very clear; that the police cannot investigate themselves. Does the Assistant Minister require a new law to get an independent body to investigate these cases all over the country?

Mr. Speaker, Sir, I have accepted the anomaly. I have said that we have made some of those proposals to the task forces.

Order, Mr. Assistant Minister! The question is straight forward. Do you require a new law?

Mr. Speaker, Sir, we do not require a new law on this case. We will allow police officers from other divisions to be assisted by those who are on the ground in order for us to know where the truth lies.

Mr. Speaker, Sir, could the Assistant Minister confirm or deny that there is a go-slow in the police force and that is why they delay investigations?

Mr. Speaker, Sir, there is no go-slow that I am aware of. In any case, the police officers are doing a wonderful job. As I speak here, criminal activities have gone down even in towns. I would like to inform my colleagues that, as a department, we will release even the General Service Unit (GSU) officers to patrol the streets of Nairobi and the estates in order to bring down criminal activities. So, as I speak here, there is no go-slow and my officers are doing a wonderful job.

Last question, Mr. Nyambati!

Mr. Speaker, Sir, whenever there are incidences of shooting by the police, they normally come up with flimsy excuses. There have been a lot of shootings in my constituency and people have died. Could the Assistant Minister table in this House evidence showing that the vehicle was carrying bhang as he has said?

Mr. Speaker, Sir, that appears like a different Question. However, the information we have is that the vehicle was impounded together with the occupants. That vehicle is still at Nyamira police station. The rolls of bhang which were found in the vehicle and are at Nyamira Police Station will be used as exhibits. Once the officer who

asked the Minister of State for Provincial Administration and Internal Security:- (a) if he could confirm that there is a boundary dispute between the Pokot and Turkana communities living along the common boundaries of Lorogon, Kainu and Kapedo which has caused increased insecurity and frequent cattle raids; (b) what the outcome of the various Government initiatives is, including peace meetings by the Provincial Commissioner, the Minister and the Boundary Review Committee which were launched in 2002; and, (c) the concrete steps the Government is taking to resolve the boundary disputes once and for all.

Mr. Speaker, Sir, I beg to reply. (a) I am aware. (b) The Districts peace committees for Turkana South, West Pokot, Central Pokot and East Pokot have been and continue to hold joint peace meetings to encourage harmony between the two communities along the common border. Although the meetings have been held at the Ministerial, Provincial and political level, there is need to cascade these meetings to grassroots level. (c) The Government, together with the communities concerned, will ensure that the boundaries as established by the District and Provinces Act No.5 of 1992 are respected.

Thank you.

Mr. Speaker, Sir, the Assistant Minister in answering part “a” of my Question says he is aware. However, part “a” of the Question further asks him to confirm whether there is boundary dispute or not. When he says he is aware, I believe he is confirming that there is a boundary dispute. The Question also asks him to confirm whether this dispute has caused increased insecurity and frequent cattle raids. So, when he says he is aware, I assume he is also aware that it has caused insecurity and frequent cattle raids.

On parts “b” and “c” of the Question, he is not offering any solution that I requested him to respond to. I feel I cannot proceed with a supplementary question when he confirms what is happening and the specific requests are not met.

Mr. Speaker, Sir, I need your guidance.

Fair enough! This is Question Time. Are you saying that you have no further questions?

Quite to the contrary, Mr. Speaker, Sir. I am saying that the response by the Assistant Minister in terms of peace meetings is not offering any solution to what I requested him. What is the outcome of the peace meetings?

Order, Mr. Ethuro! Let us use our time properly. You have asked a Question in three parts. The Assistant Minister has endeavoured to give you an answer. It will appear that you are not satisfied with his answer. Could you ask supplementary questions that will cause him to give you the answers that you are looking for? Begin with one question.

Mr. Speaker, Sir, my question is basically asking the same Question on the Order Paper because it has not been answered. What is the outcome of the various Government initiatives, including peace meetings? The Assistant Minister says they will continue with peace meetings. Those peace meetings are not yielding any returns. In part “c” of the Question, I am asking what concrete steps the Government is taking to resolve the boundary dispute. He says that the Government will ensure that boundaries are established.

Mr. Speaker, Sir, my question, for purposes of your directive, is that the Districts and Provinces Act No.5 of 1992 has been there since 1992. We are now in 2009. These communities have not observed these boundaries resulting in about 100 people dead, including his own policemen. When will he make sure that every community will abide by their respective boundaries? That is what we are asking. When will he stop people from killing each other?

Mr. Assistant Minister, you have two questions there, which are clear. Answer them!

Mr. Speaker, Sir, I appreciate where hon. Ethuro is coming from on these issues. The outcome has not been very fruitful since 1992. I think when the Act was passed, not sufficient education was carried out to sensitize communities where the boundaries are. There have been several meetings. In these meetings, each party turns up with their maps. I want to recommend that we have a meeting with Members of Parliament from the region, so that we discuss the way forward because this is a very sensitive matter. The cause of cattle rustling is not just as a result of quarrels over boundaries. Even where boundaries are very clear we still have cattle rustling going on. So, I would appeal to my colleague to attend a meeting the Minister intends to call. In fact, we have called two meetings over the last three weeks and we did not achieve quorum.

Order, Assistant Minister! So far, you have not given any direct answer. What concrete steps are you taking to resolve the boundary disputes once and for all? If you are calling a meeting, say so to the House. I have convened a meeting on whatever date it is.

Mr. Speaker, Sir, there is already established a Boundaries Review Commission which will finalise these matters. But as of now, we intend to have a meeting on the ground.

When?

Mr. Speaker, Sir, I would want this matter done after the census.

On a point of order, Mr. Speaker, Sir. Is it in order for the Assistant Minister to continue misleading this House? My problem is we have had meetings. I have cited that. We have had peace meetings by the Provincial Commissioner and the Minister

Mr. Assistant Minister, are you able to put on record any intended action?

Mr. Speaker, Sir, an intended action will be to take the surveyors and show the community where the boundaries are in accordance with the Act of 1992, but it will not help the people represented by the hon. Member. It will only escalate conflicts in the area. This is why I want to appeal to---

On a point of order, Mr. Speaker, Sir. The Assistant Minister is actually helping the Government to abdicate its responsibility in the manner in which he speaks. Is he in order to say that, that action will fuel more conflict when, in essence, it is their primary role to ensure that they resolve boundary disputes? This is a national problem. It is not actually a problem in Turkana alone. Is he in order not to be very clear in taking up his responsibility and help Kenyans resolve conflicts amicably?

Mr. Speaker, Sir, there is a Boundaries Review Commission which will go through this exercise much more in detail and solve this problem amicably. That is why I was going for the route of Members of Parliament from Pokot and Turkana districts meeting together, so that we cool down our people. There is already a lot of tension there. Whatever side we determine the border is at this time, is likely to create problems. So, we want to go down and talk to our people. That is the appeal I want to make.

Mr. Speaker, Sir, could the Assistant Minister confirm that there is a silent policy on the part of the provincial administration to perpetuate boundary disputes by burying their head in the sand? I think that is what he is doing in this House!

Mr. Speaker, Sir, I cannot confirm hearsay. I totally deny that the Provincial Administration is perpetuating boundary disputes.

Mr. Speaker, Sir, the Assistant Minister, up to this point has not given this House the concrete steps the Government is taking. He is still running away from this question. Could he do so?

A quick answer, Assistant Minister!

Mr. Speaker, Sir, I think a boundaries review Commission has been established.

Mr. Speaker, Sir, what I know is that between the Pokots and Turkanas, there is a boundary dispute. But what I want the Assistant Minister to confirm is that the Turkanas are keen on being expansionists and creating territories. There is now a dispute between Turkanas and Samburus in Isiolo District, which is 1000 kilometres away from Turkana. Could he put in place measures that will stop these trends of

Mr. Speaker, Sir, we are in a live transmission and that is why I was appealing to have a meeting with hon. Members because it is not proper for me to take sides and say whether it is the Pokots or Turkanas. So, I deny that there is an expansionist agenda being held by any of those parties. Those communities have the capacity to live peacefully, especially now when there is drought. You need to cross the borders and look for grass but you need to negotiate the grazing and water rights. So, let

Mr. Speaker, Sir, could the Assistant Minister tell us what measures he is going to take so that there is no intrusion that leads to the same struggle again? The trend is that pastoralists move left and right, north and south and when it rains or there is good grass, they settle there. That is what happened in Lorogon and Kapedo. The Turkanas settled there after some calamity struck the other side. So, what measures is the Ministry taking so that this trend does not take us through the circle, again and again?

Mr. Speaker, Sir, I stated that the Provincial Administration, through the peace committees, will arrange for those movements so that there are no permanent settlements. With regard to the problem of the Kapedo boundary which has also been raised by Mr. Ethuro, I leave that matter to the Boundaries Review Commission.

Last question, Mr. Ethuro!

Mr. Speaker, Sir, as you have noticed, the Assistant Minister and the Government are not treating this matter very seriously. We had a meeting with the Provincial Commission (PC) on 29th June, 2009. Since then, there have been killings on a daily basis. That is why I am not asking for more meetings. Meetings have taken place and reports have been written. What we expect is the Government to act and act decisively. When is the Government going to ensure that these boundaries are clearly demarcated and that they put up sufficient security operations on the corridor between the two communities to ensure no more killings take place? We want concrete steps and action!

Mr. Speaker, Sir, we intend to add more security in that area although we already have 130 security personnel there. So, we will definitely push this matter within the month of August.

asked the Deputy Prime Minister and Minister for Finance:- (a) why, given the Government policy of bringing services closer to the people by creating new districts, the Government has not extended the same policy to KRA by creating offices in towns like Kitale, Kapenguria and Lodwar in order to avoid the inconvenience for the residents who have to travel up to Eldoret for the services; and, (b) when the Government will open such offices.

Is the Deputy Prime Minister and Minister for Finance here? Is there a Minister that will hold brief for him?

What about a Cabinet Minister? There is collective responsibility. You are the Minister for Planning, National Development and Vision 2030, so you can answer this Question on behalf of your colleague.

Fair enough! That Question is deferred to tomorrow.

asked the Minister of State for State for Public Service:- (a) whether he could provide a breakdown of the respective total earnings of the Director-General of the Kenya Revenue Authority (KRA) and the Director of the Kenya Anti-Corruption Commission (KACC); and, (b) the steps the Government is taking to harmonize salaries in the Public Service to ensure fairness.

Mr. Speaker, Sir, I beg to reply. (a) The Kenya Revenue Authority pays a consolidated package of Kshs1, 500,000 to the Director-General. The package has been negotiated. The Director-General of KACC’s total earnings are as follows: Basic salary, Kshs1, 500,000; allowances, Kshs1 million and the total is Kshs2.5 million. (b)The Government has taken the following steps to harmonize remuneration in the public service:- (i) Setting up of a permanent Public Service Remuneration Review Board. (ii) The development of a Pay-Policy for the Public Service, 2006. (iii)Adoption of the banding system. (iv) Development and adoption of a harmonization instrument which is a prototype salary structure reflecting the respective bands so that staff performing comparable jobs across the Public Service are paid comparable remuneration. (v) Development of a policy paper providing for a framework for salary reviews in the Public Service. (vi) The State Corporations Advisory Committee has also issued remuneration guidelines on terms and conditions of service for State corporations.

Mr. Speaker, Sir, my Question was very specific. In part (a) I was asking for a breakdown of the respective total earnings. But you can see that in part (a) (i) there is no breakdown and even in allowances. Could he provide that to the House?

Mr. Assistant Minister, the hon. Member is asking for the breakdown in part (a) of the Question.

Mr. Speaker, Sir, I am sorry I did not come with the details of the breakdown of the first part but I could still provide that tomorrow if required. I will bring it in the House.

That is what the Question asked you to do. So, if you prepared to answer this Question, then you should have had that information as the bare minimum. I will, therefore, defer this Question to tomorrow at 2.30 p.m.

Most obliged, Mr. Speaker, Sir. I will bring the breakdown.

asked the Minister for Environment and Mineral Resources:- (a) whether he could table the details of projects and programmes that were implemented during Phase I of the Lake Victoria Environmental Management Programme (LVEMP), indicating their respective locations and cost; (b) whether he could list the projects to be implemented during Phase II of the programme, indicating those targeted for Emuhaya District; and, (c) what management mechanisms are in place to ensure that Phase II of the programme achieves the set goals and objectives.

Mr. Speaker, Sir, I beg to reply. (a) The Phase I of Lake Victoria Environmental Management Project was initiated in 1996 while an agreement on the same was signed by the three Member States of the East African Community namely; Kenya, Uganda and Tanzania. The implementation of the programme began in 1997. It was later transferred to Kenya Agricultural Research Institute (KARI), Ministry of Agriculture in 2003. Before reverting to the Ministry in 2005, the project was implemented through the following nine main components whose output, objectives, costs and goals are also indicated. I have been requested to lay the report on the Table of the House; I would like to do so now.

Mr. Speaker, Sir, I want to take this opportunity to thank the Ministry for giving a very comprehensive answer on what happened on Phase I of this World Bank project. I appreciate what was done. In Phase II of this World Bank project, we were supposed to get implementation of the project because Phase I was mainly

Mr. Speaker, Sir, component No.2, points also to pollution control and prevention. This component aims at reducing environmental stresses within the lake and its literal zones through the rehabilitation of priority waste water treatment facilities, promotion of industrial cleaner production technologies. With regard to installation of navigation equipment and the implementation of a contingency plan for oil spills and hazardous waste management in the lake Victoria Basin, the component has three sub- components; namely, rehabilitation of waste water treatment facilities, promotion of cleaner production technologies and pollution risk management and safety of navigation. The main activities under this component include development of pollution control plans, designing and construction of official wetlands to treat the municipal effluent nutrients of Kisumu City and Homa Bay; rehabilitation of the sewerage treatment facilities and designing a special sewer line for off-loading sewerage from vessels in Lake Victoria at Kisumu and Homa Bay. Others include training of targeted industries on cost effective measures of reducing waste and installation of navigation equipment in Lake Victoria.

Mr. Speaker, Sir, looking at the answer given by the Assistant Minister, with due respect, it is clear that the first phase of this project involved surveys and research on a number of components mentioned here. This project extends to my constituency, Budalang’i, and many other constituencies bordering Lake Victoria. Following the research, the survey already conducted under Phase I of this project, what specific projects can we look forward to in terms of development of our fisheries, environmental management, rehabilitation and reclamation of swamp lands and wetlands in this region? Could the Assistant Minister give us some specific projects that are anticipated under this project beyond the general survey outlines that he has provided?

Mr. Speaker, Sir, in the report which I have just laid on the Table, there are nine components and what the hon. Member is asking is covered in the report. I would ask him to go through that report because it is covered.

Mr. Speaker, Sir, from the answer given by the Assistant Minister, a sum of nearly Kshs250 million was assigned for the control of hyacinth and it is reported that hyacinth is under control. Hyacinth in the Winam Gulf, particularly on the shores of Kisumu Town are back in full swing. Is it possible for part of this money to be utilized to engage the youth to remove the hyacinth physically?

Mr. Speaker, Sir, the hon. Member is very right. Everybody knows that with the introduction of Kazi kwa Vijana, we will support that move.

Mr. Speaker, Sir, I would like to know how much money we are receiving from the World Bank under Phase II. From the answer, the Assistant Minister has indicated that we shall have district co-ordination committees. I want to know which districts will be involved in forming up committees for the implementation of this project. I want to know whether Emuhaya is going to be one of the districts.

Mr. Speaker, Sir, my report is very clear and I know that the hon. Member went through it. I have said very clearly that what we are doing is for all the areas bordering the lake and not specifically for Emuhaya but by doing this, Emuhaya is covered. So, it includes so many constituencies, districts and so on. With regard to the issue of money, it is also mentioned in my report. This report is very comprehensive and

Fair enough! Next Order!

Mr. Speaker, Sir, last week, I sought a Ministerial Statement from the Minister for Public Health and Sanitation on polio outbreak in Turkana. It was supposed to have been issued today.

Minister for Public Health, are you ready with the Statement? The Minister is not here! Could the Minister’s counterpart in Medical Services indicate when this Statement can be issued?

Mr. Speaker, Sir, let me give an undertaking that the Statement will be ready on Tuesday next week.

Fair enough!

Mr. Speaker, Sir, indeed, last week there was a debate on when it can come. The issue is about polio outbreak and we know that polio is a contagious disease. We need to know what action the Government is taking. One week from now is too long.

Mr. Minister, is it possible that this can come earlier?

Prof. Anyang-Nyong’o): Mr. Speaker, Sir, if the hon. Member is impatient, then Thursday this week.

Fair enough, it is so ordered!

On a point of order, Mr. Speaker, Sir. I rise to seek a Statement from the Minister for Environment and Mineral Resources---

Order, Mr. Outa! I have no notice that you are going to make this request.

Mr. Speaker, Sir, it is more of an urgent matter to this House.

Order, Mr. Outa! It does not matter that it is urgent. What you should have done is draw the attention of the Chair to the request, not later than the convention of the House.

I apologise, Mr. Speaker, Sir.

I am afraid you are out of order!

Thank you, Mr. Speaker, Sir.

We have rules which you, yourselves, passed and we must live within those rules. The least that you would have done, hon. Outa, is really to approach the Chair before this Session started. Order, hon. Members! Before we move to Order No.8, I have two communications to make.

Mr. Speaker, Sir, I beg to initiate debate on Vote No.11 - Ministry of Medical Services.

Mr. Speaker, Sir, the vision of my Ministry is to be an efficient and cost effective medical care system for a healthy nation. Further, the Ministry’s mission is to promote and participate in provision of integrated quality curative and rehabilitative services. The goal of the Ministry is to contribute in the reduction of health inequalities and improve the health impact and outcome indicators. The Ministry’s vision, mission and goal translate into strategic objectives which are the following---

Order! First, you have to move the Motion and then present your arguments. You are supposed to beg to move. You are now moving!

Mr. Speaker, Sir, I beg to move.

You are supposed to say: “I wish to move the Motion that Mr. Speaker do now leave the Chair”, and then proceed!

But I thought you said that comes at the end. But, anyway---

Order, Prof. Anyang’-Nyong’o! You have been in this Parliament long enough! I think this is your fourth term! When you move a Motion, you actually move it!

Mr. Speaker, Sir, I got a little bit confused by your Communication from the Chair.

Mr. Speaker, Sir, I beg to move that Mr. Speaker do now leave the Chair to enable me to initiate debate on Vote No.11 – Ministry of Medical Services.

Fair enough. Proceed!

Mr. Speaker, Sir, the vision of my Ministry is to be an efficient and cost effective medical care system for a healthy nation. Further, the Ministry’s mission is to promote and participate in the provision of integrated quality curative and rehabilitative services. The goal of the Ministry is to contribute to the reduction of health inequalities and improve the health impact and outcome indicators. The Ministry’s vision, mission and goal translate into strategic objectives which are as follows:- 1. Increase equitable access to health services particularly by establishing a universal social health insurance scheme guaranteeing access to health care to all Kenyans, particularly the poor. 2. To improve the quality and responsiveness of services in this sector. 3. To improve the efficiency and effectiveness of service delivery. 4. Enhance the regulatory capacity of the Ministry. 5. Foster partnerships in improving health and delivering services. 6. Improve the financing of the health sector. 7. Build capacity to achieve the Ministry’s mandate. Among the functions of the Ministry of Medical Services, as outlined in the Presidential Circular No.1 of 2008, include medical services policy, curative services, maternity services, hospitals, registration of doctors and paramedics, parastatals like Kenyatta National Hospital and Moi Teaching Referral Hospital, Kenya Medical Training College (KMTC), National Hospital Insurance Fund (NHIF) and the Kenya Medical Supplies Agency (KEMSA). According to the national health accounts study of 2005/2006, 36 per cent of the total health expenditure was borne by households. The high level of household expenditure leads to impoverishment and deprivation of households in light of the fact that 46 per cent of the population live in absolute poverty. In recognition of this fact, the Government will continue to provide free drugs for Malaria, Tuberculosis and HIV/AIDS in public and faith-based health facilities. A healthy population is critical for promoting economic development. This is in recognition of the fact that good health boosts the human capacity to be productive. Subsequently, this will enhance economic growth, contribute to poverty reduction and the realisation of the Kenya Vision2030’s social pillar goals. My Ministry is implementing reforms and flagship projects to meet the objectives of the Vision 2030 as well as the sector objectives which include management and accountability of health systems, improving hospital infrastructure, improving use of ICT and e-health in health delivery systems and strengthening the referral system and quality of care including giving provincial and high workload district hospitals namely Coast,

Fair enough. You did well professor. Who is seconding?

Mr. Speaker, Sir, I was to be seconded by the Chairman of the Health Committee, Dr. Monda, but I cannot see him here. He was sitting here. Is he in the House?

Mr. Duale.

Mr. Speaker, Sir, I second the Motion on the Vote of the Ministry of Medical Services. This is a very crucial Ministry. We are talking about a sum of Kshs27 billion that will have a major impact on the social, economic and health status of the Kenyan nation.

Mr. Speaker, Sir, the Minister has elaborated on the number of the provincial general hospitals that are set to be referral hospitals. Having said that, we all know the health of the people has a major fundamental bearing on all sectors of the economy. A healthy nation will have a major impact on livestock keepers, farmers and the

Dr. Monda, as the Chair of the Committee you have 15 minutes. We had called your name.

Madam Temporary Deputy Speaker, as Chairman of the departmental Committee on Health, I rise to support the Motion that, the Speaker Do Now leave the Chair to enable the House to resolve into the Committee of Supply.

The hon. Members of the departmental Committee on Health include myself as the Chairman, Dr. Nuh Nassir, Vice-Chairman; Mr. Sheikh Mohammed Dor, Mr. C. Omolo, Mr. Fredrick Outa, Mr. Joseph Magwanga, Mr.Thomas Mwadeghu, Mr. Victor Munyaka, Dr. David Eseli, Dr. Bonny Khalwale and Mr. Joseph Lekuton.

Thank you, Madam Temporary Deputy Speaker. I would like to support. As I support, I would like to raise a few issues. The first issue I would like to raise relates to national hospitals and especially, the Kenyatta National Hospital. For years, scandals have ridden this hospital. We have read about scandal after scandal. However, I must say that of late, we have been impressed with the work that the Kenyatta National Hospital is doing. The burden on Kenyatta National Hospital is too much. I would like to speak as a woman and say that district hospitals must be improved so as to relieve the pressure on the Kenyatta National Hospital. When pressure is relieved on the Kenyatta National Hospital, it will not only improve the services offered in this biggest hospital, not only in Kenya but also in the region, but it will also allow the district hospitals to be more relevant to the people they are serving. There is no point of having a district hospital that has no x-ray machines and cannot conduct basic surgeries and yet all the machines are taken to the Kenyatta National Hospital. If some of these machines were taken to the district hospitals, we would see a great improvement in the health services. I want to speak about the National Health Insurance Fund (NHIF). Last week, as the Chair of the PIC spoke here, it was a shame to hear the kind of money that is lost through the NHIF. This money would help us have free access to reproductive health for women if well managed. To hear that Kshs2 billion was collected in a certain year and only Kshs713 million went into healthcare and the rest of the money is unaccounted for and lost in fraudulent deals, it is a shame. It is a shame to continue talking about such amount of money being paid by taxpayers to a Fund which cannot be managed well. We have been crying for free reproductive health for women for very long because issues of reproductive health are not the making of a woman but are our genetic making that requires that free medical services be given to women. Why do I say that? Without a healthy nation, with healthy women, we cannot develop. I say this convinced that statistics have shown that healthy women population in a country is a developing nation. We are back to a situation where women are dying while giving birth. Instead of improving the reproductive health services for women, we have gone back. The issue of family planning continues to lay heavily on the support of donor community rather than money that is put in by the Government to ensure that we have proper family planning services available to our womenfolk. I would like to ask that we look critically into putting money directly, through the Budgeting process to the issue of reproductive health for women and not to wait for western countries to support us in this issue. This is really a national issue. There are many other Votes which can be given support by the West but not definitely, issues such as those of family planning. Madam Temporary Deputy Speaker, I would like to conclude by speaking about something which I have watched on news of late. This is about Chinese herbal medicines.

Thank you Madam Temporary Deputy Speaker, for giving me this chance to support this Vote of the Ministry of Medical Services. Owing to time constraints, I will move very fast. First of all, it is pointless to make Ministries make strategic plans when their budgetary allocations cannot enable them to meet these plans. They have performance contracts. How will they possibly meet their performance contracts when they are not given the means by which they can perform? The whole Estimates for the Ministry of Medical Services showed that there was a shortfall somewhere and a very serious one considering that we were part of the signatories that accepted that 15 per cent of our budgetary allocation would go to health and yet we are not doing that. The idea that it should have been 15 per cent was not a figure that was just picked off from somewhere without any reasonable thought being put into it. There is a reason why it was said that 15 per cent of our budgetary allocation should go to the health sector because that is the only way we would take care of our growing population like the one we are dealing with in Kenya right now. So, the issue of inadequate funding needs to be looked at because if we knock out buying ambulances totally, then we are fighting the medical systems that we are setting up. The ambulances are an essential tool in the referral system of the hospital system in this country. If we do not have ambulances, then the referral system virtually breaks down. I think it is important that if we knock out things from the budget, we should know which we ones which should knock out and which ones not to knock out. While I say that, I would like the Ministry to be aware of one fact that we brought out. I think it is important that I bring it out again. Possibly, there is some money that the Ministry is not looking at. This is what we call Appropriations-in-Aid at district hospital level and at the provincial hospital level. I fear we are losing a lot of money because we do not have enough personnel in the accounts department and computerization to collect funds adequately from those levels. I believe we can increase the money that ends up in the Treasury from that source. I fear a lot of money is being lost at that level, unless we put in place good accounting measures.

Madam Temporary Deputy Speaker, I also wish to support this Motion. Indeed, looking at the allocation of about Kshs27 billion to this very crucial Ministry compared to what had been requested - over Kshs36 billion, it is not adequate to provide and fund this vital Ministry. Indeed, for many years, we have been referring to the Abuja and Maputo declarations. We have talked about governments in this continent setting aside about 10 per cent of their budgets towards agriculture to ensure national food security. Indeed, this has become a song. We have talked about this year in, year out. When it comes to health, the Abuja Declaration has become a similar song. If you look at the allocation to this Ministry this year, you will find that it is not sufficient. However, we are glad that the Ministry has plans to ensure that there is accessible and affordable healthcare for all Kenyans. The proposed National Health Insurance Fund Bill that will be brought before this House is something that will receive our support because it is overdue. There have been previous attempts to bring such a Bill before this House. When Mrs. Ngilu was the Minister for Health, she moved the Bill before this House but it did not go through. We hope this time round, when the Bill that is now

Thank you, Madam Temporary Deputy Speaker, for giving me this opportunity. I would like to join my colleagues in supporting the Vote of the Ministry of Medical Services. Madam Temporary Deputy Speaker, it is quite clear that there is a lot of work to be done in this Ministry. However, I would like to start my contribution by congratulating the KNH for a job well done. In spite of the fact that they have faced many challenges, if you visit the hospital, especially the casualty department, you will find marked improvement. It is up to the Ministry to ensure that it supports the KNH on a continuous basis. I know there are many problems in terms of management of the resources, particularly financial resources and accountability issues. I think the hospital needs continued support because of the immense challenges it faces. The support should be in availability of equipment. I hope the Minister has taken note of this. We will continuously revisit the issue of the KNH because they are doing a good job.

Madam Temporary Deputy Speaker, Sir, I want to go straight into the issue of the National Hospital Insurance Fund (NHIF). I have heard what the Minister said about the reforms he intends to bring in place. I want to urge him to move with speed into this area. It is an area with a lot of resources and cash. Even the management of the cash itself is a problem. That is why it is prone to corruption. That is why there is lack of accountability in the NHIF. I know in the past, there have been attempts to improve it, but it is not easy. He needs to go in and do a serious surgery to start with. When we talk about reforms in

Thank you very much, Madam Temporary Deputy Speaker. I also rise to support the allocation for the Ministry of Medical Services.

I wish to echo my colleagues’ view by saying that health funding is inadequate. The Government should be serious in whatever declarations it commits this country to in the region. The Abuja Declaration was signed almost eight years ago. But up to today, we are still allocating 5.4 per cent as budgetary support to the health sector. That is ten per cent less than what our country committed to do by signing the Abuja Declaration. So, I would like the Ministry of Finance to ensure that the health sector gets more funding.

A lot has been said about health workers. I would also imagine that training a health worker such as a medical doctor or nurse is very expensive. But currently, most of our health workers are looking for greener pastures in other countries. It has come to a point where some countries even do not invest in training these medical staff. They just wait for Kenya to train them and then absorb them in their health sector. That is why we have a lot of brain drain from our health sector. The medical staff seeks better jobs overseas.

Madam Temporary Deputy Speaker, Sir, I also want to comment on the stimulus package, to allocate Kshs20 million to every constituency to establish a model health centre. I would imagine that the Ministry will not overlook MPs during implementation

Thank you, Madam Temporary Deputy Speaker, Sir, for giving me this opportunity to contribute to this very important vote.

I stand to support this Motion. This Ministry is very much under-funded. The Ministry was allocated only Kshs13 billion which is a drop in the ocean. As you realise in our country today, medical services require much more than what has been budgeted. It is also important that the little money the Ministry received is utilized efficiently and effectively, so that services can reach mwananchi. For instance in my constituency, through the CDF, we managed to put up more than 15 dispensaries. Up to date, not even a single dispensary has been given staff. So, those projects meant to give services to mwananchi are almost white elephants. So, we need the Ministry to recruit new staff using the meagre resources that it has been allocated, so that medical services can reach the local people, especially the rural folks. The rural folks need medical services more than people in urban centres because they trek long distances to reach medical facilities.

Madam Temporary Deputy Speaker, for many years, the Ministry of Health has been given a raw deal through budgetary allocations. Every time somebody talks, they refer to obsolete equipment, especially in the laboratory, x-rays, dispensaries and lack of heart machines. It is very important that this Ministry should be given money. At least in every district hospital, we require equipment which can reduce referrals to provincial hospitals or to Kenyatta National Hospital (KNH). For example, KNH is an institution which should be supported fully. It should be a referral centre in our region for two reasons. Nairobi is a hub of treatment in East Africa. With specialized treatment, we could attract more money from people being referred within the region. Can you imagine that our own people are being referred to South Africa; a country which just got independence in the 1990s? So, KNH should be a referral centre within the region. It should be a research centre for medical research. We have a highly developed university in the region; University of Nairobi. Therefore, KNH should be a serious centre for medical research. In the next Parliament, we need to demand for money for this very independent institution.

Madam Temporary Deputy Speaker, the other thing that I would like to comment on is the expansions of district and provincial hospitals. It is important that we look at health in totality. We need not refer people all the way from Kisumu to Nairobi. The Kisumu Provincial Hospital should have specialized medical equipment.

Your time is up!

Madam Temporary Deputy Speaker, since there is nobody standing, may I just complete in one minute.

It is important that we support this Ministry. With those few remarks, I support.

Madam Temporary Deputy Speaker, thank you for giving me this opportunity to make my contribution towards this very important Ministry. First and foremost, health to any nation is such an important component and that the provision of the necessary facility is so important that if the country must progress and achieve its intended course, it must ensure that provision of health services is made so that people at all levels can access medication at the cheapest and most convenient way possible. When we look at the funds that have been allocated to this Ministry, it is saddening that we have allocated it about Kshs8 billion less than what they asked for. That means their budgeted provisions cannot be achieved. When an issue like that has been raised, then it is important that Treasury ensures that sufficient funds are made available so that we can provide this very important component to the people of our country.

Madam Temporary Deputy Speaker, what is very important is that as we develop as a country, there have been things happening in the countryside. For example, the promotion of health facilities to the level of sub-district hospitals. It has been very discouraging to note that there is lack of what is required for those facilities to function well. What we are saying is that it is time to make those facilities functional. Therefore the Ministry concerned must ensure that within their meagre resources, they must make sure that personnel are provided. For example, there are facilities which do not have nurses or there is only one nurse in a populated area. When you ask why there is not enough personnel, you are told that there is no money to hire them. If we can allocate enough money to buy artillery for the military, which one of the two is important; good health or enough arms in anticipation of an aggression? I would recommend that the Ministry and the Government look at it more objectively to see to it that funds are allocated towards providing health to the people.

Madam Temporary Deputy Speaker, if you look at the funds that people contribute towards institutions like the National Hospital Insurance Fund (NHIF), it is a lot of money. Instead of the money being ploughed back to the beneficiaries, it is used to pay big salaries or a source of employment to people rather than to provide good quality service in health. Part of the money is invested but not put back to its core purpose. That is something that the Ministry should look at and amend the Act to allow the Ministry to use the surplus money to make the hospitals in the countryside to be operational and more effective. They should also have modern facilities that will enable them discharge services more effectively. Today, it is used for other purposes like investing in buying houses. This is not necessary in terms of providing good health.

Madam Temporary Deputy Speaker, if you look at what is happening in provincial and district hospitals; patients are just given prescriptions. They are sent to go and buy the medicine in private pharmacies. This is something that the Ministry should look at very carefully and address it so that patients can get prescription, treatment and medication in the public facilities. Regarding the question of personnel, there is a shortage of doctors. The Minister said that we require about 20,000 doctors. That should be a priority. Most of those funds

Time up!

Madam Temporary Deputy Speaker, with those few remarks, I beg to support.

Madam Temporary Deputy Speaker, I also rise to support Vote 11, Ministry of Medical Services. We all know that this is a very important Ministry. During the campaigns, the pledges the Government made from Independence, health was one of the three or four key components. This Ministry has been here since 1963 but we still find that what is being voted in Parliament, there are still problems in the constituencies and hospitals. A lot has been achieved through direct funding through the Constituencies Development Fund (CDF). This is an area where I was thinking that what the Deputy Prime Minister and Minister for Finance read in this House and what the Minister – I am happy that both the Ministers are here – if we can combine forces so that whatever we are talking about here is not channeled the way it has been channeled in the past because the moment money is channeled through a single person as a civil servant, it is very difficult to account for this money and all of us have witnessed this. It is happening with roads and health facilities. At least, there is accountability when the money gets to through the people who are elected to represent their constituents in Parliament. So, I support the Vote but the allocation is very insufficient. When you look at the Printed Estimates, we always say that in our Budget, we are putting more emphasis on Recurrent Expenditure; that is, on salaries and putting less emphasis on Development. But if you look at this Ministry, everything is short because we do not have enough doctors. Somebody will come and say that the allocation was skewed towards Recurrent Expenditure but it is still not sufficient at all. When the Minister was moving the Motion, he said that he is hoping that next year, Parliament will vote more money for the Ministry. I think he was placing that in the wrong place. This is something that they, as a Cabinet, with their supply officers in the Ministry of Finance, should go and push for, bring the figures and we support them. Even if we double these figures, I am sure the hon. Members will still support the way I see the situation in this country. We are supposed to be at a stage where the poor people are being taken care of by the Government when it comes to healthcare. Every day, like today, I have had about seven cases of people who are having either patients in hospital or others are bereaved and they cannot afford it. We are almost getting to a stage of showing the public that in our pay slips, we are given money to pay for this medical care. But the public believes that because they already go for the easier option. Just because they have voted for a Member of Parliament, they think that he can finance them. It is not possible. I support this Vote and say that the Recurrent Expenditure--- Whatever the Minister has said, the introduction of the medical scheme, I think what we have suffered here is the mismanagement of funds in the National Hospital Insurance Fund (NHIF) for

Thank you, Madam Temporary Deputy Speaker, for the opportunity to contribute to this very important Motion. Firstly, I wish to thank the Minister for Medical Services for ably presenting his estimates to this House. We note that the entire Ministry was very much under-funded to the tune of about Kshs13 billion. This amount, if it was allocated, would have gone a long way in improving the health care of our people. To indicate one area that would have benefited tremendously is the KNH. The KNH is the biggest hospital in Eastern Africa and we recognize the best brains and the best doctors are there and they have been under-utilized. If more money was invested in that hospital, the kidney transplants that are forcing our people to go to South Africa and even India would have been treated here at home. The KNH started well ten years ago by way of effecting open heart surgery. It is like this exercise is going down because the funding in the same facility is not adequate. Again, at the KNH, if they had more money, the issue of holding treated patients would not be there. We note there are patients who have been treated, cured and have been held at ransom by the KNH because they are not able to pay the medical bills. If the KNH had adequate funds, these people would be out and become productive in the countryside. Another area that we need to note is the role of the private hospitals in this nation. Some of them have played major roles by way of providing very satisfactory services to our people but other private hospitals have not been co-ordinated properly. We have our patients going there; they do not find proper qualified doctors. They find quack dentists and even fake theaters in these places. I would urge the Ministry to pay more attention to this sector. The other critical area is the role played by the herbalists in this nation. Where do they get big titles like doctors? Who designates these people? They cheat innocent Kenyans and when they go there, they get wrong prescriptions and they end up dying! Madam Temporary Deputy Speaker, the other issue that should be given more thought and more funding is the emergence of new districts in the nation. To date, we are talking about 254 districts. We need to upgrade the facilities. We need to have ambulances. We need to have doctors and other people. So, more money must be released to those new districts.

Thank you very much, Madam Temporary Deputy Speaker, for allowing me a chance to contribute to this very important topic. It is obvious, as shared before by other hon. Members, that a healthy nation is a nation that will perform to the expectations of the citizens. Generally, it will be an energized nation. I will say that for us to perform in academics, we need to have a healthy nation. For us to perform in other areas like agriculture and even move powerful bulldozers around, we need to have a healthy nation. That is why I support and concur with my colleagues that more money should be added to that important Ministry. Madam Temporary Deputy Speaker, improved health of our people will give us a healthy nation. To achieve that, we need doctors and qualified people. We should equip them to undertake health campaigns in the rural areas. They should create sanitary awareness in rural areas that do not have hospital facilities like urban areas. Madam Temporary Deputy Speaker, I would strongly suggest that for us to carry out medical services to the expectations of our people, we must have facilities such as x- rays and laboratories. We should post technicians to district hospitals. Blood banks and blood transfusion equipment are very essential in our hospitals to improve the health of our people. So, the Ministry should be equipped enough to take those facilities to sub- district and district hospitals. That will enable them to curb the population that is pouring into the district headquarters and district hospitals. We should equip the sub-district hospitals so that not too many referral cases pour into the districts. Madam Temporary Deputy Speaker, we should have good plans in the Ministry to take services to isolated and remote rural areas that are populated. That is because in some places such as West Pokot and other remote districts, sick people walk for many miles to reach the nearest medical facility. So, the Ministry should take medical services closer to the people. Madam Temporary Deputy Speaker, we should train more nurses and doctors and spread them well over the districts. To curb brain drain, we should train adequate personnel so that we can send them to the rural areas. If we do not have adequate personnel, we should go to the source; that is the training. We should have a training facility for every three districts. That way, we can produce enough personnel to man the medical services in the districts in the rural areas.

Your time is up! Proceed, Mr. Kioni!

Thank you very much, Madam Temporary Deputy Speaker. I beg to support.

Thank you, Madam Temporary Deputy Speaker, for giving me this opportunity to support this Motion. The Ministry got 5.43 per cent of the total Budget, which is way below the 15 per cent that was recommended in Abuja. That is, again, very far below what was recommended by the World Health Organization (WHO). Madam Temporary Deputy Speaker, we are aware of the Millennium Development Goals (MDGs) that we need to achieve in terms of reducing child mortality, improving maternal health and also combating HIV/AIDS, malaria, TB and other such diseases. I say that because the budget that has been allocated to the Ministry is clearly below what, perhaps, would have helped the Ministry to make a better impact on the health of our nation. It is in that line that I join others in urging that, perhaps, in the future Budget, we would want to see a higher allocation of resources to this Ministry, so that we could actually have a much healthier nation that should be able to engage in more productive activities and enjoying a better level of health. Having said that, Madam Temporary Deputy Speaker, I think there is also a number of issues that the Ministry also needs to address. One of them had been mentioned by one of the speakers earlier. It is that when you are dealing with cost- sharing, it is important that the Ministry pays attention to its personnel within the health centres who actually maintain pharmacies right outside those health centres. They are very quick to recommend that the patient sources for the medicine from the same units that they own and they will certainly benefit from the profits much later on. That in itself undermines the quality of healthcare offered to our people. Secondly, there is the issue of balancing which is very important. In my new district Ndaragwa – I do not want people to think that I am talking about it because it is new – we have nine health centres or dispensaries, without a single doctor. There is one clinical officer who works on a rotational basis. He is in one hospital in the morning and another one in the afternoon. This is not something that is replicated in other regions in this country. One can see lack of balancing of the inadequate staff that we have. We agree that we should have more doctors and nurses. It is, however, important that we have fair distribution of these personnel. Therefore, it is up to the Ministry to consider the way it distributes the few health officers who are available so that some areas do not suffer while others have abundant staff. It is important that we share this burden equally, so that we move on together as a nation.

Madam Temporary Deputy Speaker, we have the Kenya Medical Supplies Agency (KEMSA). We are now in the age of decentralizing issues. It is important that we devolve the KEMSA, so that medicine is availed at the grassroot in good time. If we start the distribution of medicine from Nairobi, even after providing a lot of money, certainly a lot of time would have been lost by the time the medicines get to the other places. That can be taken care of, if we devolve the activities of the KEMSA like we are doing in other sectors.

Thank you, Madam Temporary Deputy Speaker. I also rise to support this important Motion. I would like to start my contribution by reiterating that the approved budget for this Ministry stands at 11 per cent when the agreed budget should be 15 per cent of the national Budget. This is an important indication of how this Government is taking health issues in this country. We should make sure that we are within the agreed 15 per cent, since we are signatories to the Abuja Declaration.

Even as the Ministry tells us how much it will spend, we should ask how much the citizens spend on health. This is not an amount that is budgeted for. It seems to me that the budget has not made any meaningful impact in making health services affordable to all. I would like to request the Ministry to consider spending a lot more on preventive care than curative care whose expenditure keeps on rising. I would like to confess that my contribution cuts across the two Ministries. The Government should re-prioritize preventive care than curative care.

What is the Ministry doing now that the CDF has been assisting them with infrastructure? We expect the Ministry now that the CDF has relieved it the burden of putting up dispensaries and health centres, to allocate more money to prevention care and service delivery to the people. The Ministry should budget for personnel and equipment for the facilities that have been handed over to it.

Madam Temporary Deputy Speaker, Sir, with regard to equity, we would like to know how much has gone into rural communities and the urban poor vis-à-vis the urban centres. The indication is that only 30 per cent of the budget has gone to the rural communities and the urban poor. Where is the 70 per cent? From the records, we are reliably informed that about 30 per cent of the budget goes to Kenyatta National Hospital and Moi Referral Hospital, Eldoret. The question is: “How many Kenyans access those facilities?”

With regard to funding programmes aimed at combating the HIV/AIDS pandemic, I believe that it should not be funded by donors. The affected Kenyans take the HIV/AIDS drugs on a daily basis. If the donors were to withdraw their support, do we expect the victims to die? We should fund that from our resources.

I would like to know the status of the National Social Health Insurance Fund from the Minister. I believe this is one way we can address equity in our society. If each one of us will have a card that will enable him or her access medical services, we will address a very important issue that quite often divides this country.

The issue of training cannot be overstated. We need more nurses to be trained and employed. Last weekend, I visited a health centre which was being manned by a

Hon. Members, it is now time to ask the Minister to respond for a maximum of ten minutes before the next Minister moves her Motion.

Madam Temporary Deputy Speaker, Sir, let me begin by thanking all the hon. Members who contributed very constructively to this Vote, and particularly my dear friend, Mr. Monda, who is the Chairman of the Departmental Committee on Health. I appreciate the concerns of hon. Members regarding the under-funding of the Ministry. I hope that when I say that in the next year’s Budget things could be better, it means that we want to work together with Members of Parliament (MPs) and the Departmental Committee on Health to make representations to the Government for that increase in budgeting. Madam Temporary Deputy Speaker, there has been a lot of concern about the National Social Health Insurance Fund (NSHIF). Hon. Laboso has just spoken about it. Other MPs spoke about it earlier. Let me say that we are very advanced in making this happen. We have already crafted a Cabinet Memorandum, which is currently with the Ministry of Finance. We have made proposals towards amending the National Hospital Insurance Fund Act. The Bill amending the Act will have to come to Parliament with the requisite memorandum, explaining why it is being done. I believe, as hon. Laboso said, that when we have the NSHIF, it will address a lot of issues regarding health funding, particularly for the poor. The concerns that have been expressed about the KNH, as one hon. Member said, is really because when poor people go for medical attention, they may not have the money to pay for them to be attended to but the KNH has to admit them. Once KNH has admitted and treated them, it has to recover its costs. If these people were covered by a NSHIF, the KNH and other hospitals – both private and public – would really not worry about whether these people have money or not, because they would be covered by NSHIF. It is in the interest of this nation for us to have an effective, efficient and accessible healthcare; it is for us to expedite the implementation of the NSHIF Scheme. Madam Temporary deputy Speaker, Mrs. Shabesh and other MPs raised a very important issue that I would like to respond to - the money being lost at the NHIF. In the past, the NHIF implemented projects that are not its core business. When I was the Chairman of the Public Investments Committee (PIC) in the mid1990s, we also addressed ourselves to this question. I must say that since the mid 1990s to date, there has been improvement at the NHIF. Currently, our proposal is that the NHIF should address itself to its core business. That is why we are moving very fast to establish the NSHIF. We have also cut down considerably on pilferage at the NHIF, by putting in place an Information and Communication Technology (ICT) system, so that the management of the Fund is taken away from the subjective hands of human beings into a computerised system that will make accountability much more effective.

Thank you! I now call upon the Minister for Public Health and Sanitation – Vote 49 – to present her Estimates.

VOTE 49 – MINISTRY OF PUBLIC HEALTH AND SANITATION

Madam Temporary Deputy Speaker, I beg to move:-

THAT, Mr. Speaker do now leave the Chair. Madam Temporary Speaker, I beg to submit the Vote 49, Ministry of Public Health and Sanitation expenditure estimates for the 2009/2010 Financial Year.

The mandate of the Ministry as defined by the Government in Presidential Circular No.1208 covers the following functions: Public Health and Sanitation Policy; preventive and promoted health services; community health services; health education; reproductive health; food quality and hygiene; health inspection and other public health services; quarantine administration; oversight of all sanitation services; preventive health

Hon. Members, debate continues! Mr. Ethuro, please, proceed!

Madam Temporary Deputy Speaker, I wish to support this Motion. In supporting this Motion, I want to tell the Minister that she was to respond to my request for a Ministerial Statement on polio outbreak and she decided that, that was not a priority. She knows very well that we have about 16 cases of polio in Turkana District and this is a highly contagious disease. If it were the outbreak of swine flu in Kisumu, she would take the next available flight there. I want to agree with the rest of the Members that the Government committed itself in Abuja in 2001 and followed this with Maputo in 2006 by integrating some of these issues. The commitment by the Government to other African States is that the total allocation to the health sector should be at least 15 per cent of the national Budget. Health is such an important issue. However, in my place with all the rural health facilities which

Thank you, Madam Temporary Deputy Speaker. I rise to support the Vote of this Ministry. In doing so, I want to restate that at Independence, the Government said that it wanted to eradicate poverty by enhancing economic development, eradicate disease by providing good health get rid of and ignorance by providing education. However, if you look consistently, since Independence, we have allocated minimal resources to health care. For example, this year, the two Ministries of health combined are getting only an allocation of 5.3 per cent of our total Budget compared to 20 per cent

Thank you, Mr. Temporary Deputy Speaker, Sir. I would like to join my colleagues in supporting the Vote of the Ministry of Public Health and Sanitation. On the outset, I would like to congratulate this Ministry because it has faced very difficult

Thank you, Mr. Temporary Deputy Speaker, Sir. I rise to support the Motion and congratulate the Minister in the manner she has been handling the Ministry.

Mr. Temporary Deputy Speaker, Sir, I would like to urge this Ministry to have a more co-ordinated approach to preventive and promotive health, which would end up reducing the costs Kenya and Kenyans have to bear on illness, in terms of time and money. For this to happen it is important that primary health care services be looked into critically. At the dispensaries, we ought to have the basic facilities for monitoring and detecting illness at the earliest opportunity. We, therefore, need to have laboratories that are functional. We also need to have X-ray, scans and all the necessary equipment at that level, so that before people get into serious ailment, it is detected. I urge the Minister, if she has not already done so, to travel to Cuba and see how they handle their health care services. It is undisputed that Cuba has the best health services for all in the world. I urge the Minister to adopt that method where everybody has comprehensive medical care from cradle to the grave and so many in the population have doctors and nurses who monitor their health. If this is done, we will not have the whole country paralyzed by the cost of medical care. When we visit our constituencies, one of the greatest support that our constituents seek is money either for X-rays, health services, operations or medicine. Some of the ailments could have been prevented if they were detected early. I urge the Minister to also look into the issue of tracking the medicines once they reach the dispensaries, so that we do not have them leave to unauthorised places and end up in shops. The population will benefit if this is done. Whereas we have many dispensaries in some of our areas and people get diagnosis, they are unable to get the medicine. The perpetual answer is that there is no medicine in the dispensaries. I believe that in some of the cases it is issues of governance. I have heard the Minister, while moving this Motion, mention about the Government Chemist. I did not, however, hear any plan to modernise the Government Chemist. It is a shame that people have to go to South Africa and other private facilities for DNA and not rely on the Government Chemist. It is time we modernised the equipment and made them in line with the latest, so that we can enjoy that service. In all our dispensaries, if we were to adopt the Cuba model, we would be able to do regular pap smear and mammography tests for women and also have early detection of prostrate in men. We need advanced equipment for detection and preventive and reproductive health services and also for children, so that they can grow healthy. Mr. Temporary Deputy Speaker, Sir, in other words, what I am saying is that the efforts the Government is putting are not sufficient. With a more holistic approach, with the same money, even without increasing it, this Ministry could do more. Could the Minister relook at this, so that next year, same time, we see an improvement in the way we approach health issues. On the Kshs20 million per constituency for improving services, I want the Minister to consider engaging Members of Parliament and the leadership in those constituencies in prioritising what is to be done and enabling them to have oversight roles, so that this money is used efficiently. It is not enough to have Kshs20 million in the Budget and then, at the end of the day, find nothing of substance has been done. All

Thank you, Mr. Temporary Deputy Speaker, Sir. I also rise to support this Vote. I would like to say that this is a very important Ministry. If it takes care of its role very well, then this country will have very little problems in health care. In my contribution to this Vote, I want to focus on the provision of data and information on various diseases. If this Ministry has to reach out to the people, information is very important. In this regard, I would like to see this Ministry developing a comprehensive digital health database which is GIS-based, so that information on various diseases can be availed in a map form. We want information to be availed in a very simple way to the people in the local areas and students and pupils in schools. We already have technology that can create all this information very easily. This is one area that this Ministry should focus on in order to provide information to the people. This is an area that I wish to highlight. Mr. Temporary Deputy Speaker, Sir, the other area that I wish to highlight is public health. Most of the areas have public health officers. But because of lack transport and enabling environment, most of these officers cannot reach the people. So, you find that they are not able to reach areas to provide necessary information to the people regarding various diseases. This is an area again, I would like to see the Ministry providing, particularly transport to various public health officers, so that they can address various issues of sanitation.

Mr. Temporary Deputy Speaker, Sir, when it comes to the issue of distribution of drugs in the country, there should be a criterion on how they are distributed. The most logical way to distribute the drugs effectively is to, first of all, establish the disease prevalence in the country so that you know where particular diseases are very prevalent so that when you are distributing the drugs, you provide drugs according to areas that are more vulnerable. So, mapping of diseases of the country should be there. We need to see simple maps of the country showing the distribution of diseases so that when it comes to distribution of drugs, we know where to focus rather than just giving a blanket distribution criterion.

Mr. Temporary Deputy Speaker, Sir, one area where I want to highlight and which has not been given a lot of preference, although it is an area of great importance is the issue of jiggers. Jiggers are a major problem but unfortunately, we do not highlight it. I do not understand why. We need to have a clear policy on this major menace and disease called “jiggers” because they are all over. We do not have any serious policy or programme on this disease. I would like to see the Ministry coming up with a very serious programme on jiggers. For example, in Emuhaya Constituency, I have raised this issue with the Minister but so far, I have not received a very comprehensive programme on how to address the problem. The other issue that has been raised by various hon. Members is the issue of personnel. Most health centres that we have built using the Constituencies Development Fund are idle due to lack of personnel. In fact, most of them have closed down after completion. So, the Minister and the Ministry should work very fast and be able to recruit

Mr. Temporary Deputy Speaker, Sir, thank you for giving me this opportunity to air my observations on this very important Motion. First, let me thank the Minister for ably presenting her Ministerial estimates. Before I proceed, I would like to thank the Minister for her personal intervention when our nation was faced with H1N1 flu virus threat. She personally addressed the nation on the issue. That really gave the Kenyan people some kind of hope in the fight against that threat. I would also recommend that the nation should be updated not only on that threat but also on other emerging diseases that are likely to affect our nation. I also wish to thank the Director of Medical Services because time and again he has come out to give the Kenyan people some satisfactory information on emerging problems. I also wish to reckon that on the issue of contaminated maize, the Minister also came out very clearly to supervise the entire operation making sure that the contaminated maize is removed from the country. Nevertheless, the ship exporting the maize to the nation of origin developed some mechanical problems at the Port of Mombasa. I would urge the Minister to take further steps and make sure that the ship is repaired quickly and the maize removed from our waters. I Mr. Temporary Deputy Speaker, Sir, I also note that the Ministry is seriously under-funded to the tune of Kshs22 billion. If this money was released by the Ministry, it would have gone a long way in discharging effective service to our people. I wish to note that in our country, we have seen some private hospitals being allowed to run and at times, they have become the centres of abortion in our nation. The Ministry should take a keener role as to what is happening in these private hospitals because we have lost innocent lives and the perpetrators or the people who have been involved in this vice should be arrested and prosecuted. If found guilty, they should be dealt with according to the law so that, that threat to our women is also done away with.

Regarding the establishment of the health facilities in every constituency, this is a very welcome move. I would urge from the outset that contractors and quantity surveyors should be involved so that the facilities that we are going to develop will be for now and the future. It is, therefore, important that this Budget should be given a faster speedier approval so that the money could also come to our constituencies. We remember in certain areas, we have been able to identify land for the construction of these facilities. Therefore, the sooner we have the money, the better.

Regarding our district hospitals, there are some which are running but do not have qualified personnel. We lack doctors, dentists and even ambulances. If we are caring for the health of our people, the people who are going to spur the growth of this nation, it is important that all these facilities must be made available. I would suggest that during the next Budget, the Minister for Finance in conjunction with the Ministry of Public Health and Sanitation should be able to see the need of increasing the Budget allocation.

Order, Mr. Njuguna! Your time is up!

Mr. Temporary Deputy Speaker, Sir, with those few remarks, I beg to support.

Thank you, Mr. Temporary Deputy Speaker, Sir. Finally your eyes were able to see.

Order, Mr. Affey! The Chair’s eyes saw even the previous speakers.

Mr. Temporary Deputy Speaker, Sir, I rise to support this important Vote. I begin by congratulating the Minister for Medical Services and also the Minister for Public Health and Sanitation since I have this combined opportunity to contribute. First of all, I think in terms of policy, this should have been one Ministry. This is my personal thinking and whoever decided that these Ministries be two needs to re-think the strategy because we need effective delivery of health services. For it to be effective, we need effective co-ordination at the top. The monies requested by the Ministry for Public Health and Sanitation, clearly, is not enough because this Ministry is responsible, basically, for a lot of the things that we need to be careful about in terms of our health status. I, therefore, would like to encourage the Minister and the Ministry’s staff to improve the surveillance of critical diseases that particularly can come to us from our border points. As the hon. Member for Turkana Central said before me, I would like the Minister to be careful about this long border. We have a long border with an unstable neighbour in Somalia and because of lack of clear health activities in that country; there is every possibility that a lot of the problems in that country can find their way into Kenya. Therefore, apart from the refugee camps, I think there is an important aspect of the general surveillance of our border, which is nearly 1,000 kilometres. If that is not done, I think we will be confronted with a more difficult situation once those diseases come and confront our population.

Mr. Temporary Deputy Speaker, Sir, the issue of basic sanitation cannot be overstated, particularly in a place called Wajir. I know the Minister had an opportunity to visit that place; it is the only part of this country where, 40 years down the road, the communities there continue to use bucket latrines in order to discharge their waste. Mr. Temporary Deputy Speaker, Sir, if the Ministry of Public Health and Sanitation does not take that particular district as a priority district in terms of engagement and investment, I think that the communities that live there will continue to be confronted with diseases that could, otherwise, have been managed, if the Ministry had invested much more. Together with the Ministry of Local Government, I think the Minister can do something to save the local populations there from any outbreaks that might be apparent.

Mr. Temporary Deputy Speaker, Sir, I think the HIV/AIDS programme has substantially been successful, particularly in the North East. But it requires to be re- doubled because that part of the country continues to attract many Kenyans from many

Order, hon. Affey! Your time is up.

Mr. Temporary Deputy Speaker, Sir, I beg to support.

Proceed, hon. Kabando wa Kabando!

Thank you, Mr. Temporary Deputy Speaker, Sir, for giving me this opportunity to contribute to this Motion. On the outset, I would like to note that although this Motion is about the Ministry of Public Health and Sanitation, it is still in tandem with that of the Ministry of Medical Services because the two Ministries are closely correlated. The sort of competition between the two Ministries has brought the best in Beth and Peter. This is because each one of them and their bureaucrats have attempted to do the best in the circumstances in order to appear to be doing the best. In the process, I believe they have done the best.

Mr. Temporary Deputy Speaker, Sir, many areas have been covered with regard to allocation of money for this Ministry. However, I would like to note a few areas that, perhaps, would be considered in future for prioritization in order to achieve a clearer placement and resourcing. There is devolution in many sectors in the Budget by the Ministry of Finance. One of those aspects include creation of markets in every constituency. The Deputy Prime Minister and Minister for Finance allocated Kshs10 million for every constituency. This means more trade. It means more formalization of business at the grassroot level. At the same time, it also provides a challenge in terms of sanitation and basic health. This means congregating a lot of people in the 210 constituencies on market days. It also means a lot of commodities and, therefore, hygiene issues arise. This does not prevent livestock mixing with people in those markets. Therefore, there is need for the Ministry of Public Health and Sanitation to consider a

Order, Mr. Kabando wa Kabando! Time up!

Thank you, Mr. Temporary Deputy Speaker, Sir, for your patience.\

I beg to support.

Thank you, Mr. Temporary Deputy Speaker, Sir, for giving me the chance to contribute to this very important Vote. From the outset, I want to congratulate the two Ministers for working very hard under very difficult circumstances and with limited resources. I also want to congratulate the Ministries for devolving their resources to the constituency level. This is a step towards the right direction. Some of us have always complained about public resources being shared amongst powerful people. This time round, resources are going to the constituency level and we appreciate that development.

The proposal to recruit 20 nurses for each constituency is a step towards the right direction. Bicycles and motorcycles might be seen as a small thing by some people but we, the women of this country, see this as a big thing, because the motorcycles and bicycles will be used for community outreach programmes, which will serve the women and children of this country. So, we thank and congratulate the Ministries for that development.

Mr. Temporary Deputy Speaker, Sir, healthcare is a key issue in relation to the well-being of our country and society. I feel that the Budget that was presented to us in this House provides very limited resources. The Ministries have not reached the international healthcare targets, to which requirement Kenya is a signatory, so that we could get proper health facilities and management.

Order, Mrs. Noor! Your time is up!

Mr. Temporary Deputy Speaker, Sir, with those remarks, I beg to support.

Thank you, Mr. Temporary Deputy Speaker, Sir for giving me the chance to contribute. I want to begin by supporting the Motion on behalf of this Ministry. I also want to comment, particularly with regard to the proposal for allocating Kshs20 million per constituency to spend on a public health facility. My concern here is that the decision to make this contribution per constituency does not appear to have considered the health needs per constituency. There has not been clear assessment of what would be in the best interests of advancing the health services per constituency. So, this looks like a decision that has been made in an office. Surely, it is a bottom down approach. It is not a proper strategy for properly putting resources into use.

In my constituency, for example, we are asking ourselves where we can get a five acre plot to put up a health facility of this kind. The problem I have is that I cannot get five acre plot anywhere in my constituency. The parcels of land are so small. A five acre

Order, Mr. Baiya! Your time is up!

With those few remarks, I beg to support.

Order, hon. Members! Since apparently there are no more Members who wish to contribute to this Motion, I will ask the Minister to respond. Madam Minister, please, proceed!

Mr. Temporary Deputy Speaker, Sir, let me thank all the hon. Members who contributed to this Motion for their comments. I have taken note of all their concerns and I want to assure you that my Ministry will be keen to see that we incorporate them in our implementation as much as we can.

Mr. Temporary Deputy Chairman, Sir, I beg to move:-

THAT, a sum not exceeding Kshs11,860,549,000 be issued from the Consolidated Fund to complete the sum necessary to meet the expenditure during the year ending 30th June, 2010 in respect of:-

Vote 11 – The Ministry of Medical Services

VOTE R11 – RECURRENT EXPENDITURE

SUB-VOTE 110 – GENERAL ADMINISTRATION AND PLANNING

SUB-VOTE 111 – CURATIVE HEALTH

(Heads 294, 316, 317, 318, 320, 321 and 351 agreed to)

(Sub-Vote 111 agreed to)

Hon. Members, we will now move on to Development Vote on page 305

Hon. Members, we have completed Vote 11 and now we move to Vote 49 – Ministry of Public Health and Sanitation.

Vote 49 –Ministry of Public Health and Sanitation

Mr. Temporary Deputy Chairman, Sir, I beg to move:-

THAT a sum not exceeding Kshs8,090,220,000 be issued from the Consolidated Fund to complete the sum necessary to meet the expenditure during the year ending 30th June, 2010 in respect of:-

Vote 49 – Ministry of Public Health and Sanitation

VOTE R49 – MINISTRY OF PUBLIC HEALTH AND SANITATION

Thank you, Mr. Temporary Deputy Chairman, Sir. I know you are surprised as to why I have stood up when we were going so smoothly. The reason is that we all got confused at the beginning and we were not able to debate the Vote of the Ministry of Public Health and Sanitation. So, I am going to take this opportunity while supporting that Vote Head, to mention that, the fact that we are building one health centre in every constituency is---

Order! Dr. Eseli, you can only seek a clarification!

That is what I am seeking, Mr. Temporary Deputy Chairman, Sir.

A clarification?

Yes.

Something is not clear?

Yes. Now that we are building those health centres in every constituency, what criteria was used to decide that it would be one per constituency? Was it population? Was it the size of the constituency? What criteria was used to decide that there was going to be one per constituency?

Order, Minister! Dr. Eseli, for this particular Head, Head 335--- Are you there with me? What part of that Head do you not understand? Are you seeking additional information or clarification under this particular Head? That is because we have voted on the rest.

Mr. Temporary Deputy Chairman, Sir, I have said that I am in agreement with the figures, but I just want to know the criteria---

Which Vote are you dealing with?

Is it Head 335 - Rural Health Centres and Dispensaries?

Head 335?

Yes, Mr. Temporary Deputy Chairman, Sir.

Okay. Thank you. Madam Minister, are you able to shed more light on that particular Head?

Mr. Temporary Deputy Speaker, Sir, this was---

It is Mr. Temporary Deputy Chairman!

Mr. Temporary Deputy Chairman, Sir, that was an exercise by the Treasury. That is part of the surplus package. I believe the idea is to devolve funds to the units which have governance. At the moment, the unit which has the governance is the constituency. I believe the committee that is doing the realignment of boundaries will see what the constituency means as far as the population is concerned. At the moment, that is the unit that the Government can use to devolve funds.

All right. Dr. Eseli, your constituency is also included. I think he is satisfied, Madam Minister! Thank you.

Mr. Temporary Deputy Speaker, Sir, I am directed to report that the Committee of Supply has considered the resolution that a sum not exceeding Kshs11,860,549,000 be issued from the Consolidated Fund to complete the sum necessary to meet the expenditure during the year ending 30th June, 2010 in respect of Vote 11 – Ministry of Medical Services and has approved the same without amendment.

Mr. Temporary Deputy Speaker, Sir, I beg to move that the House doth agree with the Committee in the said Resolution.

(Mrs. Mugo) seconded.

VOTE 49 – MINISTRY OF PUBLIC HEALTH AND SANITATION

Mr. Temporary Deputy Speaker, Sir, I am directed to report that the Committee of Supply has considered the resolution that a sum not exceeding Kshs8,090,220,000 be issued from the Consolidated Fund to complete the sum necessary to meet the expenditure during the year ending 30th June, 2010 in respect of Vote 49 – Ministry of Public Health and Sanitation and has approved the same without amendment.

Mr. Temporary Deputy Speaker, Sir, I beg to move that the House doth agree with the Committee in the said Resolution.

(Prof. Anyang’-Nyong’o) seconded.

Hon. Members, we have come to the end of today’s sitting. Therefore, the House stands adjourned until tomorrow, Wednesday, 29th July, 2009, at 9.00 a.m.

The House rose at 7.30 p.m.