(Hon. Cheboi)

On a point of order, hon. Temporary Deputy Speaker, Sir. Thank you hon. Temporary Deputy Speaker, Sir. I met hon. Ochieng some few minutes ago and he has just rushed to pick some documents, so that he can come and move the Motion.

What did you say? This is before us now. Give us a more definite explanation. You have said he has rushed to where? We had made a decision a little bit earlier, but now that hon. Njuki is in, and he has explained why he was a bit late, I think he can give his notice of motion and use the Dispatch Box.

Hon. Speaker, Sir, I beg to give notice of the following Motion:-

THAT, aware that smallholder farmers living in the buffer zone around the Mt. Kenya National Park and Forest Reserve have struggled for years with elephants that invade their land and destroy their crops, which is a costly affair for these smallholder farmers, whose livelihoods are often lost in a single night; concerned that hardly a day goes without an incident occurring between the farmers and the elephants in the area; noting that the elephants from the park easily stray outside its perimeters and cause damage to crops, domestic animals and homes and even injury and death; and further aware that the Kenya Wildlife Service (KWS) compensation mechanism is wanting and unsatisfactory, giving only Ksh200,000 for death and Ksh50,000 for injury and nothing for crops or property damaged; this house urges the Government to enhance the claim for the people killed from the current Ksh200,000 to Ksh 1,000,000, and those

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Hon. Cheboi): Hon. Bett, you can also give your notice of motion.

Thank you, hon. Temporary Deputy Speaker, Sir. Pursuant to Standing Order 44(2) (c), I would like to also ask the Chair of the Committee on Education, Science and Technology one, whether the Government is aware that book sellers collude with pirates to sell counterfeit books.

Hon. Cheboi): Excuse me hon. Bett. Are you requesting for a notice of motion or Statement?

A Statement

Hon. Cheboi): Well, proceed and ask for it.

Is the Government aware that book sellers collude with pirates to sell counterfeit books to parents and students, a fraud that is costing billions of shillings to unsuspecting parents and students? Two, could the Government confirm that over 50,000 copies of pirated copies of textbooks were discovered in the year 2012, and if that trend is not checked, it is bound to go up? Three, why has the Government not implemented the Copyright Act of 2001 that requires review to be aligned with the new Constitution as well as Vision 2030, so that piracy of text books could be elevated to the level of economic crime? Lastly, we would like the Committee on Education, Research and Technology to tell us how many culprits have been brought to book, and how the Government intends to clean its system of these pirated materials Thank you.

Hon. Cheboi): That definitely goes to the Committee on Education, Research and Technology; I can see the Chair walking in. What amount of time do you require to give the Statement, Chairlady of the Departmental Committee on Education, Research and Technology?

Hon. Temporary Deputy Speaker, Sir, I request for a period of three weeks, so that I can bring an answer.

What do you have to say, hon. Bett?

Hon. Speaker, Sir, two weeks is okay with me.

Hon. Bett, the Chairperson of the Committee has asked for three weeks. Did you say three weeks or two weeks, Chairlady?

I mentioned three weeks.

Three weeks is okay, hon. Temporary Deputy Speaker, Sir.

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That is okay but, hon. Members, it is good practice that whenever you are going to ask for Statements you mention the same to the Chairpersons of the particular Committees in advance. It will be easier that way.

Hon. Members, we now proceed to the next Order which is the Motion by hon. Ochieng. Hon. Members, please, note that this is a party sponsored Motion. That is why it has taken precedence over another Motion which has already been debated halfway.

Hon. Ochieng, please, proceed and prosecute your Motion.

Hon. Temporary Deputy Speaker, Sir, I beg to move the following Motion:- THAT, aware that there is an acute and gross shortage of clinical officers and nurses in our hospitals, health centres and dispensaries, which in turn is severely limiting access by Kenyans to basic health care; deeply concerned that most Kenyans continue losing their lives to curable and easily manageable ailments; further concerned that public resources, especially the CDF, have been used to develop a number of facilities which remain non-operational due to lack of personnel; taking into account the need to meet the constitutional right of every Kenyan citizen to adequate health care; further noting that public resources have been used to train more than 15,000 clinical officers and 20,000 nurses who remain idle and unemployed; aware that the Government has just adopted a policy on free maternity services and in order to promote prevention and early detection of disease risks at household levels through closer and constant disease surveillance; knowing that the clinical officers and the nurses are the ones who operate most health facilities in most parts of the rural Kenya due to shortage of doctors, this House urges the Government to immediately recruit and deploy at least 4,000 clinical officers and 5,000 nurses and a further 3,000 clinical officers and 3,000 nurses annually and deploy them equitably to the counties to alleviate the suffering of the citizens and to help provide curative and preventive health care services to the people of Kenya.

Hon. Temporary Deputy Speaker, Sir, Kenya is one of the 57 countries globally, and 36 in sub-Saharan African, with critical shortage of health workers. For every 1,500 citizens in this country, there are only 2.5 clinical officers and 2.5 nurses. This is a dire situation in respect of which this House must take serious action to ensure that it is addressed. Records show that Kenya has 1.12 nurses per 1,000 people and 0.85 active nurses for every 1,000 people. That means for every 1,000 people, there is no nurse because 0.85 nurses is not a nurse. So, looking at these statistics, it means that we immediately need 55,000 clinical officers, 45,000 nurses and 30,000 laboratory technicians to be able to barely make our people survive as far as provision of health services is concerned.

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Hon. Temporary Deputy Speaker, Sir, thank you for this opportunity to second this Motion. The issue of healthcare in Kenya is a major one. I know we have made efforts but I am also certain that we have not made adequate efforts. The most important aspect of healthcare is health human resource. You could be digital but in the healthcare, a lot of work is still done by human hands and human skill. In this country, the funding of healthcare has not really met the needs of the population. The proportion of the Budget that goes to health has remained low. What had been agreed to in the Abuja Declaration is that we set aside for heath 15 per cent of our budgets. This year, the Budget we have passed sets aside for health only 7 per cent. I know there was a time when we set aside almost 9 per cent, but I do not know what has happened. We have gone backwards and now we are again at 7 per cent and the impact of this is clear. The infant mortality rate in this country was over 120 per cent in 2003. In some places it was as high as 200 per cent. That is the number of children who die out of 1,000 that were born within one year. The under five years mortality rate was also over 100 per cent. With the increase in funding over that period of time, we managed to reduce the infant mortality rate to 70 per cent and the under five mortality rate to 50 per cent. This was very good progress. We have again started going backwards because these indexes are going up.

Hon. Temporary Deputy Speaker, Sir, we have just declared ourselves a country that we will have free maternal care. That should have happened many years back. I have always pushed for better funding in health, but we respond a little and then go backwards. It is perhaps not easy for us to realize that you cannot calculate in financial terms the benefits of good health. However, the economists here will tell you that the economy grows with better improvement of the health of the population. So, we must really look into this area of our social sector.

I know that the Chair of the Departmental Committee on Health is very uncomfortable with the current Budget because large allocations were required in the health sector. The Budget deficit for the Recurrent Expenditure in the Ministry of Health was over Kshs40 billion. This is the case, yet we need a lot of money for the free maternal services and to employ more medical personnel to man the facilities that we have put up using the Constituencies Development Fund (CDF). Many facilities have been put up but they are lying idle. What is the point of constructing a building and nobody works in it?

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Thank you, hon. Temporary Deputy Speaker, Sir. My name is Elisha Busienei Kipkorir, Member of Parliament for Turbo Constituency. I rise to support this Motion. Before I support the Motion, may I thank the Mover for bringing this Motion at the right time?

Just a moment. Do we have a point of order from hon. Bishop Mutua?

No!

Okay; proceed.

Thank you, hon. Temporary Deputy Speaker. As the Mover of the Motion has said, we have shortage of nurses and clinical officers in this country. In my constituency, Turbo, we have quite a number of facilities built using the Constituencies Development Fund, but up to today they are not operational, because there is lack of enough personnel to serve those facilities. As the Government provides free maternity services, there is a problem; I believe most expectant mothers used to deliver at their homes, but now that there is free maternity service offered by the Government. It means most expectant mothers will be going to dispensaries, but we do not have enough personnel to provide the service. Thank you, hon. Temporary Deputy Speaker, I support the Motion.

Thank you, hon. Speaker. I rise to support this Motion by my good friend, hon. Ochieng. The shortage of nurses in our hospitals and dispensaries cannot be overemphasized. In all our respective constituencies, you can attest to this; there is a problem which is affecting all of us here. Arising from this, most of our constituents have resorted to miti ni dawa. The disadvantages of miti ni dawa are that there is no prescription, no scientific proof; you are just given a gallon of miti ni dawa to take in the belief that it will cure 40 or 90 diseases. Hon. Temporary Deputy Speaker, Sir, hon. Ochieng should have put a sentence in this Motion that, at least, we should have mobile clinics in each constituency, so that in the absence of the clinical officers, as it is now, the mobile clinics assist constituents instead of moving from one part of the constituency to the other in search of health services. Also, this Motion should have been brought much earlier before the Budget Estimates were presented to this House; this would have done a lot of good to us, as a House and as Kenyans.

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Very well. I can see the Chairperson of the Committee on Health. I am wondering why you want to contribute now. I think it would be proper if you got an opportunity towards the tail-end, after you have heard sentiments from hon. Members. Let me give this chance to hon. King’ola.

Thank hon. Temporary Deputy Speaker. I stand to support this Motion by my friend hon. Ochieng. It is quite disappointing when I realize how many nurses and clinical officers this country has trained, yet they all end up going out of this country to USA, Europe, South Africa and South America to work as maids or at old age institutions. Hon. Temporary Deputy Speaker, Sir, I thank the Jubilee Government. In their nine pillars, they emphasized on health. I am sure that on the basis of their promises, we can set aside money to employ nurses and clinical officers, who are otherwise unemployed, to serve in the dispensaries that have been constructed using CDF money, and our people will get healthcare. I would urge this august House that now that we are at the Budget approving stage - I saw that they have said that we sneaked in about Kshs1.3 billion for the CDF. Under the guidelines of CDF, a percentage should be given to employ nurses and clinical officers. This will help equip the already constructed CDF health facilities in various constituencies, rather than relying on the Government or even pushing the agenda to the county governments. I still do not believe that the county governments have what it takes to employ these health officers; the National Assembly should approve some funds to this end. Hon. Temporary Deputy Speaker, Sir, a healthy nation needs healthy people. This nation cannot move to the next stage of development unless we make our citizens healthy. I know that in my constituency--- Mlolongo has a population of about 150,000 people and there is only one CDF constructed dispensary that serves all those residents. If you go to Athi River, we only have one dispensary that is run by Mavoko Town Council and takes care of about 125,000 people. If the nurses and clinical officers who are idle are engaged or employed by the Government, I will be smiling. As the hon. Member suggested, we might think about mobile clinics. But, who will be manning them unless we have nurses paid by the Government? We should engage them and even look into the option of having mobile clinics going to places where there are no health facilities. Hon. Temporary Deputy Speaker, this Motion has come at a time when every hon. Member here does not understand how a free maternity service has been introduced; our people have got no facility to help them deliver babies. As Prof. Nyikal has said, the most important thing in the world is to have a baby. I wonder what will happen to the barren ones. I think this is an opportune moment for this Motion to be passed and a Bill enacted, so that the Government can absorb all the idle nurses and clinical officers. I beg to support the Motion. Thank you.

Thank you very much hon. Temporary Deputy Speaker, Sir. I rise to support this Motion. Kenyans voted for the Constitution in 2010 and one of the reasons why most Kenyans voted for it was because it did give them various rights. Article 43 of the Constitution guarantees the right to have medical care. That simply means that as a

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Hon. Temporary Deputy Speaker, Sir, I rise to support this Motion by my good friend, hon. Ochieng. It has come at the right time. In my constituency, the situation is pathetic. We have a sub-district hospital, namely Kilungu Sub-district Hospital, which is in a pathetic situation. Kilungu Sub-district Hospital serves the people of Kaiti and Kilome constituencies, which have a population of about--- Kaiti has 120,000 people and Kilome has 87,000 people. It is manned by two doctors and four nurses. Two doctors manning such a facility is a big joke because the inflow of patients per day ranges between about 100 and 120 people in a day. The doctors are overwhelmed. The nurses are so few that they cannot handle such a large number of patients. The most pathetic part is that the pediatrician serves about 60 children in a day. I visited the hospital last Monday, and saw that the situation there is very pathetic. So, I support this Motion and agree with my friend that the Government should recruit more clinical officers and nurses, so that this situation can be brought to a manageable level. We have other facilities in my constituency which are grossly under equipped. Sometimes the doctors in the sub-district hospital threaten to move to other hospitals because of lack of equipment. We do not have a theatre, a well equipped laboratory and other important facilities. Sometimes the doctors say that they do not know what to do because there are no facilities. I urge the Government to deploy more nurses to Kilungu Sub-district Hospital, which also serves the Nairobi-Mombasa Highway, which passes through the two constituencies. I beg to support the Motion.

Hon. Temporary Deputy Speaker, Sir, I rise to support the Motion passionately because I understand the need for us to have more nurses in this country. Technically, we have a shortage of 36,000 nurses in this country. The unfortunate thing about it is that we have 35,000 trained but unemployment nurses. I am very concerned that we spend a lot of money training nurses, who benefit the First World countries. We have spent quite a lot of money in constructing dispensaries and health centres in our constituencies using the CDF money. Almost 90 per cent of those health facilities are under-utilized. In Aldai Constituency, we do not even have a single doctor. We have only two clinical officers, yet there are so many unemployed clinical officers on the streets. If we are serious and want to take care of our own, we should employ health personnel as quickly as possible. If the Budget and Appropriations Committee did not consider having

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Hon. Kathuri Murungi.

Thank you, hon. Temporary Deputy Speaker, Sir. I rise to support this Motion by my good friend, hon. Ochieng, because in my constituency, to start with, my predecessor really worked very hard and made sure that we have enough medical facilities like dispensaries. We have more than ten dispensaries, which to date have not opened their doors simply because we have no medical personnel in the constituency. Many people are dying each day because of simple ailments like elevated blood pressure and diabetes, because there are not enough personnel at least to help people manage these non-communicable diseases. Hon. Temporary Deputy Speaker, Sir, I am not aware whether the Budget has factored in the recruitment of personnel; if it has not, maybe this House will sit down and see whether we can have a supplementary budget to cater for these cases. I vividly remember that last year medics had a strike – the mother of all strikes – and one of the things they were agitating for was for the Government to hire more personnel. I think my friend, hon. (Prof.) Nyikal, was in the Ministry at the time. The Minister who was in charge did not actually take these medics seriously. I remember that he threatened them with sackings during that time. I know the Jubilee Government will take care of this need; in addition to having medics. I think hon. Ochieng can consider introducing some amendments because we also need enough medicine in dispensaries. We might get the personnel but drugs will not be enough for the dispensaries which will be opened. So, if possible he can make changes to this party-sponsored Motion. Besides the drugs and medical personnel, we need equipment in these dispensaries. In my district, or constituency, we have no CT scan machine. A patient must be brought all the way from Meru County to Nairobi, so that he or she can get a CT scan. So, I think I will consult hon. Ochieng to introduce amendments to this Motion. This time I will work with his party. This is a party-sponsored Motion. I will work with his party, so that we can have these amendments; there is no need of bringing this Motion and then again hon. Murungi brings another Motion requesting equipment, then in future

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Hon. Murungi, you are even free to bring an amendment yourself; but, as you say, it is much easier when it is done by the Mover of the Motion. Yes, Hon. Shariff Ali.

Ni

hukrani Bw. Naibu Spika wa Muda kwa kunipatia fursa hii ili niweze kuichangia Hoja hii. Kwa kweli Hoja hii imekuja wakati ambao ni muhimu sana kwa sisi kuijadili ili kutoa mwelekeo kulingana na hali ya kiafya ilivyo katika nchi yetu. Bw. Naibu Spika wa Muda Katiba ya Kenya katika Kipengele cha 43 kinasema: “Every person has the right to the highest attainable standard of health, which includes the right to healthcare services---” Wakenya walipitisha Katiba na ukweli ni kwamba ni haki ya kila mkenya kuhakikishiwa kwamba amepata huduma ya matibabu popote pale alipo; lakini ni masitiko makubwa---

Just a matter of advice without interrupting, we have Katiba also in Kiswahili. So, when you start with Kiswahili you must stick to that language. Next time take note of that.

Shukrani, Bw. Naibu Spika wa Muda. Masikitiko makubwa ni kwamba utapata sehemu nyingi za nchi yetu ya Kenya hazipati huduma za afya vile inavyopaswa. Nikizungumzia eneo Bunge langu la Lamu Mashariki, licha ya kwamba kupatikana madaktari ni vigumu, hata hospitali zenyewe, ama hata zahanati zenyewe, hazina madawa. Watu huenda na kurudi; hata ingawa hufika huko akiwa mgonjwa anaambiwa kwamba dawa hakuna. Kwa hiyo, mara kwa mara watu wamekuwa wakisumbuka au kuteseka. Hata huduma za X-ray hazipatikani. Leo Serikali imesema kwamba wanawake watajifungua bure, lakini utapata hakuna sehemu ya akina mama ama akina dada zetu ya kujifungulia katika eneo la Lamu Mashariki. Utapata kwamba madaktari ama wahudumu ambao wako pengine ni mmoja katika zahanati; ama pengine utapata siku ya kazi mtu anapaswa awepo kazini, lakini wagonjwa wanaenda hospitalini na kupata kwamba hata yule mmoja ambaye anapaswa awe pale hayupo. Bw. Naibu Spika wa Muda, ukweli ni kwamba sisi tunazungumza mambo haya lakini maeneo Bunge mengi yana matatizo hasa mashinani. Mimi naunga mkono Hoja hii na bali na kuiunga mkono, ningependa kupendekeza kwamba yote yatakayopitishwa katika Bunge hili kuhakikisha kwamba sio kwamba tumeyazungumza hapa Bungeni kwa sababu ya kuyazungumza, ama kwa sababu ni Hoja imeletwa--- Inafaa tuhakikishe kwamba mambo haya yameweza kuwasaidia ndugu zetu, ama jamii ambazo zimeweza kuteseka kwa muda mrefu. Hivi sasa wanahitaji kupata zile huduma ambazo Serikali hii imetuahidi. Tuna imani kubwa kwamba Serikali hii inaweza kuyatekeleza mambo mengi tukiwa tumekuwa kama kitu kimoja, na kuwa na ushirikiano katika kuendeleza mambo yetu. Mimi nataka niunge mkono Hoja hii na nashukuru kwa hayo ambayo nimechangia.

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Thank you very much, hon. Temporary Deputy Speaker, Sir. I want to begin by commending the Mover of the Motion. This is a very important Motion because it involves the health of our people. The Chairperson of the Departmental Committee on Health needs to take the sentiments of hon. Members very seriously because a healthy nation is a secure nation. Given the critical shortage of medical personnel, it means that this country is not secure. When you have a shortage of over 30,000 clinical officers and nurses, it means that the country is very unstable. It is a constitutional right of every citizen of this country to access adequate health care. If we do not achieve this, we are not meeting the constitutional requirement. Majority of our trained health personnel have gone to South Sudan and Southern Africa. I was in the United Kingdom (UK) a year ago where I met a nurse who told me that in the UK alone, there were 4,000 nurses from Kenya. That was because the Government then never used to employ nurses. I do not know if the Jubilee Government has gotten its priorities right. Instead of talking about providing laptop computers to children, we should be talking about employing nurses and teachers, so that we can meet the health needs of our people. Hon. Temporary Deputy Speaker, Sir, the Motion demands that 5,000 nurses and 3,000 clinical officers be employed this year, and that a similar number be employed annually. I would recommend the same. In fact, I agree with my colleague from Meru who said that we need to amend the Motion to demand that 10,000 nurses and more than 7,500 clinical officers be employed immediately in order for us to meet the health requirements of our people. Currently, deployment of medical personnel in this country is unbalanced. My friend, hon. Ochieng, alluded to that fact. There are some counties which have so many medical personnel while other counties do not have any. So, harmonising the deployment of the existing medical personnel in the country is very important as we wait for the employment of others, as demanded by the Motion. The main reason as to why I requested the Chairperson of the relevant Departmental Committee to be here, as we make this demand, is for him or her to go to the Cabinet Secretary concerned and demand that Parliament cannot be a talk shop. The resolutions of Parliament must be implemented. Therefore, this is a very important Motion which we should all support. We demand that the Governments meets the demands of this Motion. With those remarks, I beg to support.

Yes, hon. Abdi Dukicha.

Ahsante, Bw. Naibu Spika wa Muda. Nimesimama kuiunga mkono Hoja hii kwa sababu inaangazia suala muhimu sana. Ni kweli kwamba katika nchi hii kuna uhaba mkubwa wa madaktari na madawa. Uhaba wa madaktari umeathiri sana utoaji wa huduma za matibabu kwa jamii, na haswa katika sehemu ninakotoka ya Tana River. Katika sehemu yangu ya uwakilishi Bungeni ya Galole, kuna sehemu ambazo ziko umbali wa kilomita 200 kutoka mjini Hola, kama vile Waldena, Wayu, Chifiri na Haroresa. Katika sehemu hizo, kuna uhaba mkubwa wa madaktari na hospitali. Hakuna mabarabara katika maeneo hayo. Kukinyesha, wagonjwa husafirishwa kwa punda mpaka Hola. Hospital ya Hola ndiyo hospitali kubwa pekee katika kaunti, lakini haina vifaa muhimu kama vile chumba cha kuhifadhia maiti na mtambo wa kupigia picha za X-Ray. Madaktari pia ni haba. Madawa na vifaa vingine

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Hon. Temporary Deputy Speaker, Sir, from the outset, each time I have been trying to catch your eye but I have not been able. However, today is a good day. I want to thank you and the people of Matayos Constituency for electing me as their Member. This Motion could not have come at a better time. This House may go on record as the House that may have so many Motions brought in at the end of the day and what I would like to urge those concerned is that the Motions we are bringing should be taken seriously and implemented.

At Independence, one of the promises that this country was given was the issue of addressing disease and 50 years later, problems of health are still rampant in the whole country. The Mover of the Motion, Hon. Ochieng, brought it and we want to support it so that nurses and medics can be employed. If we have over 35,000 medics trained including nurses and clinical officers and yet they are unemployed, that is very sad. Our problem should not be having people who are trained but are not being useful. The problem should be that we do not have trained people. However, if they are trained and they are there, they should be trained and they should address the problems that are bedeviling the heath sector. Just recently, I went to Busia District Hospital as I had an ailment. When I went to the injection room, what surprised me is that the nurses who gave me the injection were the same nurses who were to go to the dressing room to dress the wound that I had. This was happening to me, a Member of Parliament of Matayos Constituency. I am surprised! In fact, I was ashamed and I told them that we would address this issue. So, we are

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I want to laud hon. Odanga because despite the fact that he was making his maiden speech, he has tried as much as possible to be relevant to the Motion.

Hon. Temporary Deputy Speaker, Sir, from the outset, I would like to thank you for giving me this opportunity. This is a very important Motion and I would like to thank the Mover thereof. It is a constitutional right for every citizen to access health facilities, treatment and all those things that pertain to it. It is also the constitutional obligation of the Government to ensure that the citizen accesses facilities. However, it is a shame that 50 years on, we are unable to take care of our health facilities or sector because of the negligence of the governments that were there before because I would say we are the best trainers of people who serve other countries. If you go to America today, the UK or our neighbouring countries like South Sudan, our trained personnel have benefited them because we have not been able to take care of these important personnel. The pertinent issue is that the Ministry concerned must allocate resources where it matters most because if we do not train these people or if we train them and we do not employ them, then we would have done zero work. The most important thing is that money must be poured into the personnel aspect of the Ministry’s activities. We must also ensure that once these people are employed, they must adhere to the contractual obligations that they entered into because you cannot train this number of people and they just run away. So we must ensure that they are not given the right to leave the country before they have done what they are supposed to do, otherwise we would be wasting a lot of our resources. The other thing is that we must look at progressive betterment of emoluments because they leave because they earn peanuts here. They do not have facilities like housing and lack many basic necessities which they find elsewhere. Unless we take care of their welfare from housing and facilities in hospitals, we cannot say they should be there. So, we must put our money there because as we all know, a lot of our resources are embezzled and once we tighten the nuts of corruption or of the gravy train, then I am sure we will have resources to train these people and ensure that they are employed. Lastly, we must ensure that our infrastructure is upgraded because you will find that many people due to lack of these facilities do not go to hospital because roads are

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Hon. Temporary Deputy Speaker, Sir, thank you for giving me this opportunity. I would like to support this Motion and thank the Mover, hon. Ochieng, for moving it. I would like to say that it has come at the right time because the Departmental Committee on Health, together with the Ministry of Health have been deliberating this matter. You will notice that the budget for the Committee is Kshs98 billion and this is quite a big reduction compared to the one of last year. The other matter that we realized as soon as we got this Budget is that about 65 per cent of it has been devolved to the counties. Looking at it, I would like to say that this is a serious anomaly and the ongoing debate of whether our counties are prepared to take up matters, especially those that were being handled at the national level, is also a big issue when it comes to health. Knowing very well that matters of health touch on people’s lives, this is a discussion that needs to be tackled very seriously.

I would like to support this Motion and say that the Ministry of Health has serious priority areas that were not funded. Some of them include recruitment of health workers including the absorption of intern doctors and Bachelor of Science and Diploma nurses. The deficit is Kshs1.5 billion. This is something that needs to be taken up quickly. We also have a shortfall on the provision of free maternal healthcare due the fact that the 2010 policy is being implemented in our clinics today. This creates a shortfall of Kshs3.7 billion in the Ministry of Health.

On the purchase of ambulances for constituencies, you have heard many Members of Parliament say that people in our constituencies cannot access health facilities. So, we have a Budget of Kshs830 billion. That money should be spent on purchase of ambulances so that our people can reach health facilities.

Hon. Temporary Deputy Speaker, Sir, we also have a deficit of Kshs500 million on training of health workers including post-graduate students. We also have a big deficit at the Kenya Medical Training College (KMTC), and this is the collective bargaining agreement of Kshs500 million. The question is: “Is this country ready for another strike by nurses?”

The Kenyatta National Hospital (KNH) has also a court award per year of Kshs750 million. This excludes arrears. This hospital has also a shortage of Kshs70 million for recruitment of additional nurses.

On the Moi Teaching and Referral Hospital, we also have a CBA deficit per year of Kshs624 million. This takes us back to the possibility of having another strike. In the Kenya Medical Research Institute (KEMRI), we have a CBA deficit of Kshs393 million per year. We also require Kshs614 million for additional medical commodities. If we have to achieve the provision of basic healthcare for our citizens, then we need to purchase the medical commodities that are required.

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Thank you, hon. Temporary Deputy Speaker, Sir. I rise to support this Motion by hon. David Ouma Ochieng. I come from Molo Constituency; where at this point in time people of Molo whose population is about 350,000 are still without good medical care. At this point in time, we are still having people of Molo Constituency dying because of small ailments like choking coupled with the fact that we do not have very good road networks and most of the people die on their way to hospital. One case study which I would like to put at this point in time is that we have facilities in Molo Constituency; we have a sub-district hospital at Elburgon which is splendid. What used to be called the Nyayo Wards has splendid structures. Hon. Temporary Deputy Speaker, Sir, sometimes when you visit these hospitals, you find that between shifts, we do not have staff and most of the time patients are having to queue and wait for the nurses and the only one doctor to come to the station. We also have a splendid structure called Mokorombosi Dispensary, built with CDF and which serves an area of over 25,000 people which has never been operational for the last ten years, simply because we do not have doctors or health personnel to man it.

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Thank you, hon. Temporary Deputy Speaker, Sir. I support this Motion very passionately. I would like to start from home by stating the challenges that we are facing in the health sector. That provides me with energy to be able to contribute to this kind of Motion in a way that comes right from my heart. Hon. Temporary Deputy Speaker, Sir, I live next to a dispensary, at about 200 meters away and I have witnessed needless deaths because of lack of attention from the nurses. Just last weekend, we buried somebody who had been injected by a guy who was only a watchman at the clinic and who is masquerading now a medical practitioner. The health sector is desperate. As I read this Motion, I begin to see light at the end of the tunnel. I think the issues relating to the capacity at the counties particularly the health sector, must not be exaggerated. Hon. Temporary Deputy Speaker, Sir, if you look at the Constitution, Article 189 (1) (a) and (b), it virtually obligates the two governments; the national Government and the county governments to consult and provide assistance to the level that requires it. It is incumbent upon the national Government to go out of its way to support county governments, if the implementation of an area as important as this one is compromised. If we do not start with health sector or even education, we cannot meet our 2030 Vision. We will not be a functioning nation if we cannot devote a significant amount of money that is required in this sector. Hon. Temporary Deputy Speaker, we have talked about the exodus of our nursing and, perhaps, clinical staff. Of course, it is not all a loss to the economy; there are very significant repatriates of funds back to this country that does many other things. If by investing in our nurses and clinical officers we train them very well so that other countries need them, let us continue doing so. Even if they leave the country, there are also benefits attached to it. Somebody said we should have had this Motion before the Budget was concluded and we could have all gone out in unison to vote for increased funding for the recruitment of the many nurses and clinical officers who have been trained in the private sector and are waiting for jobs, eager to work. I would say, for areas of expertise where we do not have enough, this is one area that we must open up our mind and allow inflows of others as well. The bottom line not being the employment of the people, but the provision of service that is so crucial to this economy.

Hon. Temporary Deputy Speaker, when we are asking for this increased recruitment, much as it creates incomes for those who are employed, the bigger picture is

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Thank you, hon. Temporary Deputy Speaker. I rise to support this Motion by the hon. David Ouma Ochieng. Health care in this country is a critical issue that should be put among the top priorities. When this nation got its Independence in 1963, the founding fathers of this country talked about three issues; health, ignorance and poverty. Fifty years down the road, health is not still a priority in this nation. As we saw in the Budget allocations, it was given 7 per cent, which is way below the WHO and the Abuja recommendations of 15 per cent. We are not doing well as a nation. More often, maybe if we look at it that the middle class and the upper class have access to health, but more than 50 per cent of Kenyans live below poverty line. These are people who are able to access health care within the dispensaries, health centres and district hospitals. If they have some little money, they go to what we used to call provincial hospitals. Hon. Temporary Deputy Speaker, Sir, there are issues that concern these more than 50 per cent of Kenyans who live below poverty line. I think the rest of the middle class and the upper class are not putting it as a priority. There are several issues in this country that are not done well. More often, when there is an emergency you ask the public to come and donate blood. Blood is a critical issue. How much have we given to the National Blood Transfusion Service? It is nil! National Blood Transfusion Service with all its seven centres distributed across the country, is donor dependent. That is why when we have an emergency we ask people to come and donate blood and after that emergency is over we wait for another emergency then we will ask the public to come and donate blood again.

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Order! Hon. Kipchoim, are you sure you have a point of order?

No, hon. Temporary Deputy Speaker, Sir.

Okay. Then proceed, hon. Pukose.

Hon. Temporary Deputy Speaker, Sir, when you talk about our rural facilities, for instance, in Endebess Constituency, we have a sub-district hospital, one health centre and three dispensaries which were built through the CDF, but are dysfunctional. If you go to a health centre or dispensary, you find only one staff. Recently, a recruitment exercise was carried out under the ESP programme when Members were busy campaigning. This was hurriedly done and I think it was not properly done because the Members were not involved. I urge the Members that when they go back to their constituencies, they should see that the facilities that have not been equipped are equipped and nurses or clinical officers are deployed from those areas to man those facilities. The other issue that needs to be brought to the attention of the Members is the issue of the Equalization Fund, which is a constitutional provision of Kshs3.4 billion. When you look at the way the CRA has itemized the money for the Equalization Fund, they are talking about vaccines, hygiene and preventive health. The Equalization Fund, as far as the Constitution is concerned, is for the infrastructure. So, if this money is given to your constituency to be used for vaccines and hygiene, yet the Constitution provides that it should be used for the infrastructure, you need to be on the watch out. We might lose the money and the areas which we thought would catch up with the other areas in terms of infrastructure will not catch up. The other issue that we also need to look at is in terms of staffing, which we have proposed. There are also other cadres of staff in the health sector. We are talking of laboratory technicians, pharmaceutical technicians, medical engineers and medical records officers and physiotherapists. These are cadres that have been trained and they are languishing out there when they are supposed to be providing key services to those facilities. Suppose you have a nurse and a clinical officer and you do not have a laboratory technician, how are you going to conduct even a simple blood slid? They cannot do it. I wish to ask the Mover to look at other areas, so that this Motion can be inclusive and so that we can get a good package for our health facilities. Lastly, it is the issue of where we have devolved functions, as my Chair talked about. Out of the Kshs210 billion that will go to the counties, Kshs64 billion came from the Ministry of Health. In the Committee, we asked ourselves whether the governors and their teams are going to make sure that the Kshs64 billion that came from the Ministry of Health is going to be put in heath issues. We are talking about vaccines, immunizations and ARVs. These are issues that need to be looked into critically. We need to address the

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Hon. Cheboi): We have an amendment to this Motion to be prosecuted by hon. Sang. Are you ready to proceed?

Hon. Temporary Deputy Speaker, Sir, before I prosecute the amendment, I want to thank the Mover of this Motion, hon. Ochieng for coming up with this very important Motion. Before I contribute, I beg to move that the Motion be amended as follows:- By deleting all the words after the words “at least”, appearing on the 15th line and inserting the following words in place thereof “that instead of at least 4,000 clinical officers, 5,000 nurses and further 3,000 clinical officers and 3,000 nurses annually, to deploy equitable to the counties to alleviate the suffering of the citizens and to help provide curative and preventive health care services to the people of Kenya---”

Hon. Sang, you simply read what you have proposed. The rest you can paraphrase when you are explaining.

Mr. Temporary Deputy Speaker, Sir, I beg to move that the Motion be amended as follows:- By deleting all the words after the words “at least” appearing on the 15th line and inserting the following words in place thereof “5,000 clinical officers, 5,000 nurses, 2,500 laboratory technicians and further 3,000 clinical officers and 3,000 nurses annually and provide enough resources for the supply of adequate medicine and equipment and to adequately remunerate the officers and further equitably deploy them to the counties to alleviate the suffering of the citizens and help provide curative and preventive health care services to the people of Kenya”.

I want to support the Motion as amended. I know we have a number of challenges. I want to thank and congratulate the Mover of this Motion for coming up with the Motion at this particular time when we have promised Kenyans a number of services.

Hon. Sang, you are doing very well. The Motion has not been amended. You are actually proposing the amendment. So, you should justify to the House why you want the Motion amended, namely, the justification really.

Hon. Temporary Deputy Speaker, Sir, I stand guided.

Hon. Temporary Deputy Speaker, Sir, I just wanted to support that.

Hon. Temporary Deputy Speaker, Sir, health care in this nation, as hon. Pukose has just said, is very critical but for a long time, we have had problems. I have produced clinical officers being a trainer in the Nakuru Kenya Medical Training College (KMTC) and lately at the Kapkatet Medical Training College before I was elected to this House. I want to assure this House that we have trained very competent clinical officers and nurses at the Kapkatet Medical Training College and I know they are offering services wherever they are.

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Proceed. Now, you might have to go to the Dispatch Box because your microphone is not working.

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Thank you, hon. Temporary Deputy Speaker, Sir. I rise to second the amendment by Mheshimiwa Sang. Indeed, what he has mentioned is very important; about the laboratory technicians. Laboratory technicians are very important especially when it comes to diagnosis of diseases. I want to give an example. About seven years ago, somewhere in Embu Provincial Hospital, there was an outbreak of malaria and at the same time we had typhoid and these two diseases in terms of their symptoms are similar. So, imagine that treatment was being done for typhoid and yet these people were dying of malaria. So, someone like a laboratory technician plays a very critical role when it comes to diagnosis of the diseases. In my constituency, I have also had a scenario whereby someone presented with the problem of malaria and the level of parasitemia was very high. Microscopy had not been done. So, he went there and was given first line management of malaria. So, this patient died because there was no laboratory technician to have done maybe diagnosis to determine the level of parasitemia so that the doctor could prescribe the right drug. So,

Sang, that is a very good amendment because diagnosis is very critical. A lot of drug resistance in this country is as a result of misdiagnosis and why we are having this misdiagnosis is because maybe we do not have a laboratory technician or we do not have the reagents to do proper diagnosis so that the doctor will be able to prescribe the right drug at the right time to be able to save the patient. Hon. Temporary Deputy Speaker, Sir, this Motion is very critical when you look at the Millennium Development Goals (MDGs). The United Nations (UN) came up with eight MDGs and out of these eight MDGs, three talk about health. For instance, MDG Number Four talks about reducing child mortality; MDG Number Five talks about improving maternal health; and MDG Number Six talks about combating HIV/AIDS, malaria and other diseases. So, that tells you the importance of health care in any economy and research has shown that there is a positive correlation between any healthy nation and its Gross Domestic Product (GDP) growth. So, indeed, for this country to grow its GDP, focus must be put on health care. Again, with His Excellency the President coming up with free maternity health care we ask ourselves: Have we increased the manpower? For this policy of free maternity health care to work, it is important that this Motion has come at the right time. Unfortunately, when you look at the Budget Estimates which we have just passed, the percentage that was given in terms of health care is way less than the Abuja Declaration’s recommendation. A times you wonder why our Government and country commits itself to some declarations and yet we cannot implement them. The Abuja Declaration was very key and it said countries or governments must be able to allocate at least its 50 per cent of the GDP to health care. Unfortunately, in this country the budget that was given to health care is well well less than what was required. So, to me, if this aspect of free maternity health care is going to succeed, it is important that the Government must focus and be able to prioritise health care.

Hon. Wamalwa, restrict yourself to the amendment. You are now going to the Motion and we really want to dispose of your amendment first.

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Thank you, hon. Temporary Deputy Speaker, Sir, for the correction. On this diagnosis, we are talking about the laboratory technicians. For laboratory technicians to come in, you will agree with me that it has a budget implication. So, hon. Temporary Deputy Speaker, Sir, I am here. I second the amendment to insert “laboratory technicians” because of their critical importance in diagnosis of diseases. Thank you and I second.

Hon. Members, we have to restrict ourselves to the amendment until it goes through or otherwise. So, I urge that those hon. Members who will be speaking from now onwards should restrict themselves to the amendment. Yes, hon. Susan Musyoka.

Thank you, hon. Temporary Deputy, Speaker, Sir. I stand to support the Motion as amended, even though I am not comfortable with the proposed number of nurses. I do not know how the Mover arrived at the figure of 5,000 nurses.

Hon. Susan Musyoka, you will be speaking to the amendment. So, if you are supporting, you should be supporting the amendment to the Motion and not the Motion. So, proceed. I think you are doing fine.

Hon. Temporary Deputy Speaker, Sir, I support the amendment as it is. That is why I am asking why the Mover has proposed 5,000 nurses instead of 10,000 nurses. I do not know whether I am in order to say so.

Hon. Susan Musyoka, you can either be supporting or opposing. So, if you have a different view, obviously, you would be opposing. If you think it is a good amendment, you would be supporting it.

Hon. Deputy Speaker, Sir, I am supporting the amendment with a proposal for addition to the number of nurses. Is that an additional amendment?

That would mean an amendment to an amendment. So, contribute one way or the other. If you are supporting, you say so and proceed. If you have an issue, later on, somebody else can move an amendment for you. You cannot move an amendment yourself. So, proceed.

Hon. Temporary Deputy Speaker, Sir, the demand for health care services in this country is so big that we need to increase the number of health personnel, especially nurses, clinical officers and laboratory technicians. We cannot provide meaningful health care services unless we can diagnose what we are treating. We have made big strides especially in malaria control. However, if we cannot have diagnostic capability, it will be difficult for us to achieve what we want to achieve. So, passing this Motion without providing for an appropriate number of personnel would be an effort in futility. That is because we will not achieve what we want to achieve. With those remarks, I beg to support the amendment and request for more nurses.

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Hon. Barchilei, I hope you will be contributing to the amendment to the Motion, and not the Motion. Let us be very clear on that one.

Thank you, hon. Temporary Deputy Speaker, Sir. I rise to support the amendment to the Motion. We all know that healthcare is very crucial and that it is an issue that should not be compromised. As it has been proposed, there is need for hiring of more nurses, clinical officers and laboratory technicians. That is because we have quite a number of health centres and dispensaries where patients cannot be attended to properly because there are no laboratory technicians to carry out tests. It is very important that we have laboratory technicians in all the dispensaries and health centres so that service can be complete. With those remarks, I beg to support.

Put the Question! Put the Question!

Hon. Members, I will now put the Question, so that we dispose of the amendment and go back to the main Motion.

Hon. Members, the Motion as amended reads as follows:- THAT, aware that there is an acute and gross shortage of clinical officers and nurses in our hospitals, health centres and dispensaries, which in turn is severely limiting access by Kenyans to basic health care; deeply concerned that most Kenyans continue to lose their lives to curable and easily manageable ailments; further concerned that public resources, especially the CDF, have been used to develop a number of facilities which remain non-operational due to lack of personnel; taking into account the need to meet the constitutional right of every Kenyan citizen to adequate health care; further noting that public resources have been used to train more than 15,000 clinical officers and 20,000 nurses who remain idle and unemployed; aware that the Government has just adopted a policy on free maternity services, and in order to promote the prevention and early detection of disease risks at household levels through closer and constant disease surveillance; knowing that clinical officers and nurses are the ones who operate most health facilities in most parts of rural Kenya due to shortage of doctors; this House urges the Government to immediately recruit and deploy at least 5,000 clinical officers, 5,000 nurses and 2,500 laboratory technicians; and further, 3,000 clinical

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Ahsante sana, mhe. Naibu Spika wa Muda. Nimesimama kuiunga mkono Hoja hii kuhusu wafanyikazi wa umma katika sekta ya afya, nikitathmini ya kwamba Wakenya wanaongezeka kwa idadi kubwa sana. Ripoti ya census ya mwaka wa 2009 inaonyesha kwamba Wakenya wanaongezeka kwa kiasi cha milioni moja kila mwaka. Hii inamaanisha kwamba vifaa vilivyoko kwenye mahospitali yetu haviwezi kukidhi mahitaji ya matibabu ya Wakenya. Kulikuwa na tetezi kwamba ni vizuri wauguzi wetu waende kufanya kazi katika nchi za nje kwa sababu watakuwa wanachangia kuleta fedha za kigeni na kuzisaidia jamii zao. Ningependa kusema kwamba jambo la muhimu ni kuhakikisha kwamba Wakenya wako na afya nzuri, ndiyo wasionekane kuwa watu wanaochangia tu kuongezeka kwa makadirio na matumizi ya Serikali bali pia wanaochangia kukua kwa uchumi.

Mhe. Naibu Spika wa Muda, ukiangalia vizuri ni kwa nini nchi za kigeni zinahitaji watabibu wetu na sisi wenyewe hatuwezi kuwaajiri? Ingekuwa ni vyema kama wale ambao tunasema waende kufanya kazi kule nje wangekuwa zaidi ya wale ambao tunaweza kufundisha hapa. Lakini kuwa na mikakati ambayo inaonyesha kwamba vijana wetu wanakwenda shuleni, wanapata masomo ya afya na uuguzi lakini hawawezi kupata kazi, basi ni kuonyesha kwamba tunatumia pesa za umma vibaya. Kwa hivyo, ni muhimu sana kuhakikisha kwamba kuna utangamano kati ya zile hospitali na zahanati tunatengeneza kutumia zile pesa za umma kama vile CDF na watu watakaoweza kuwahudumia Wakenya kwa ujumla.

Ukiangalia, kwa mfano, ugonjwa wa saratani, umeongezeka kama vile miaka inavyokwenda ilihali, ugonjwa huo unaweza kutibiwa ikiwa kiwango chake hakijaweza kukidhiri. Kwa hivyo, kama hizo zahanati na hospitali zitakuwa na watabibu na wauguzi, itakuwa ni jambo la muhimu kuhakikisha kwamba magonjwa hayo yametibiwa kwa kiwango cha chini. Utakuta kwamba tangu tuanze kuzungumzia maswala ya afya katika Bunge hili la Kumi na Moja, kumekuwa na Miswada minne iliyowasilishwa na Wabunge tofauti kuhusu afya. Tulikuwa na Mswada wa hela za NHIF, wa Emergency Treatment, wa Saratani na sasa huu. Hii inamaanisha kwamba sisi kama nchi tunafaa kufikiria kwa undani na kina na tuwe na motisha kuhakikisha kwamba tuna Mswada ambao utaletwa Bungeni kuhakikisha kwamba kila Mkenya anapata matibabu kwa kiwango kile kinafaa. Kwa sababu, inamaanisha watu wengi, kwa mfano, walio na ulemavu ambao unahitaji kila wakati kupata matibabu, wanaadhirika kwa sababu hospitali ni chache. Utakuta wanatembea kwa muda mrefu kutafuta matibabu ilihali tuna uwezo, nia na njia. Ukiangalia, kwa mfano, yale makadirio ya Bajeti tulipitisha jana, utakuta kwamba Serikali ya kitaifa ina aina nyingi ya matumizi ambayo yanaweza kukatwa kuhakikisha

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Hon. Temporary Deputy Speaker, Sir, I wish to support the Motion because there is a very serious shortage of health staff in this country, and we need to recruit more clinical officers, nurses and lab technicians. In my place, Habaswein District Hospital, which is level 4 – a sub-district hospital - is supposed to have, as per the standards of the Ministry of Health, up to 60 nurses. But, currently, it is manned by five members of staff. You can imagine a place that is supposed to have the standard 60 nurses and currently being manned by five nurses and one clinical officer. The shortage is very serious and, therefore, I support the Motion.

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Then bring in an amendment.

I am supporting the Motion but I may go for an amendment. I also wish to mention that wherever those clinical officers and nurses are posted, there is a very big problem because most of them engage in business. They open clinics and small nursing homes and most of them do not serve the district hospitals. Because of that, there is always a shortage. I would also like to mention the issue of rural clinics and hospitals. They do not have enough personnel and drugs. Therefore, I would like to support this Motion and I hope my colleagues will understand that these big numbers might not be realistic and so, we need to bring an amendment on that.

Thank you, hon. Temporary Deputy Speaker, for giving me this opportunity to also contribute to this Motion. First of all, let me thank hon. David Ouma for bringing this Motion to this House. I rise to support this Motion from the outset because it is very important to this country.

I also realize that this Motion is party-sponsored and we do not have problems with this because the number of clinical officers in this country is small. On Monday, I travelled with the County Women Representative, Hon.Tuya, to one of our remote areas called Shotan Sub-location. We saw one clinical officer who serves a dispensary. We were shocked that the officer works from 8.00 a.m up to almost 6.00 p.m. One wonders when he finishes attending to all the patients in the long queue at the dispensary. The dispensary does not have any staff other than the clinical officer.

I would like to say that we require many of those officers on the ground. The Government says that it will provide basic clinical services. I support this Motion because it will go a long way in helping our counties in that endeavour. I think the biggest problem that we have is the Budget.

I am a Member of the Budget and Appropriations Committee and we have realized that the health sector has not been allocated enough money. Once we pass this Motion, we must come up with a supplementary budget to allocate money to cater for the hiring of those clinical officers. Otherwise, we will wait until next year. We cannot wait until next year because we need those clinical officers and nurses now. This issue should be taken very seriously. I know many hon. Members have brought many Motions on how to help this country but, let us be very careful so that we do not just become like a baraza where people attend, discuss very pertinent issues and then it ends there. I think it is time that this august House made sure that whatever we pass is implemented to the letter. Otherwise, five years will end and nothing will happen. Unless we do this, we might as well leave those Motions.

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Hon. Temporary Deputy Speaker, I would like to support the Motion which has been moved by my colleague, hon. Ochieng. I think this Motion has come at the right time because, as a country, we need to look into our health sector. The citizens’ health is a very important aspect in development.

I come from a county where health facilities exist but with an acute shortage of clinical officers, nurses and medicine. Our people walk into a clinic and they are told to go to a chemist to buy medicine. Therefore, that is a daily expense just like food.

I would like to request the Government to employ the human resource that is needed in our health facilities. The Government should not only do that, but also provide medicine in those health centres. I have realized again that some of the health centres which were constructed a long time ago are not upgraded according to the population that they serve. I have a case in Kitengela where a health centre which serves a very big population has not been upgraded to the status of a district hospital so that it can have enough clinical officers. I think a lot needs to be done in our health sector.

An audit of staff should be done so that we can know the number of staff who serve in our counties. We need to know how many clinical officers and nurses we have. That will also help us.

Hon. Temporary Deputy Speaker, I rise to support this Motion which has come at the right time. Thank you.

Ahsante sana Bi. Naibu Spika wa Muda. Nasimama kuunga mkono Hoja hii kwa sababu ni moja kati ya zile nguzo ambazo zinasimamia taifa hili katika upande wa afya.

Kusema ukweli, tuna upungufu mkubwa sana katika nchi hii. Nikiongea hususan katika upande wa Pwani, kuna masikitiko makubwa sana wakati akina mama wanatembea zaidi ya kilomita ishirini kutafuta matibabu. Hata wakifika huko wanapata kwamba huduma ni duni kwa sababu hatuna wauguzi wa kutosha, maabara hayana wasimamizi wa kutosha na hata hakuna vifaa vya kutosha. Bi. Naibu Spika wa Muda, pia ningependa ieleweke vizuri sana kwamba ijapokuwa tunapigania hao watu waajiriwe ili tupata hiyo huduma, kuna upendeleo katika uajiri. Tarehe nne mwezi wa nne hadi tarehe kumi na sita, watu walikuwa wakisajiriwa ili waweze kupata ajira katika sekta ya afya.

Bi. Naibu Spika wa Muda, ni ajabu kwamba tuna majimbo lakini watu wanaitwa Nairobi kuja kuhojiwa. Kwa nini hiyo huduma haiwezi kufanyika katika makao makuu

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Thank you, hon. Temporary Deputy Speaker. I want to support the Motion as amended. While supporting this Motion, allow me, first of all, to say that after food, the most important human need is health. Health is a very important requirement in human life. As a country, we must put it ahead of everything else.

Hon. Temporary Deputy Speaker, when I took over as a Member of Parliament for what used to be called Gwassi Constituency and now is Suba Constituency more than five years ago, I had an intention of having, at least, one health facility per sub-location. That is because our people die of diseases and sickness which can be cured very easily because health facilities are spread far apart. Many people take time before they seek small medical attention. Therefore, in the past five years, I had put up eight health facilities and all of them lack medical personnel. I have had constant discussions with the Medical Officer of Health and I realized that they are also helpless. We have gone ahead to expand the infrastructure for the health facilities but we have not realized an expansion in terms of employment of the required personnel.

Hon. Temporary Deputy Speaker, hon. David Ochieng, the Member of Parliament for Ugenya, has brought a timely Motion. I have heard my colleagues say that he should have brought this Motion before the Budget. But this is not the end of Budget process! We still have many budgets that this House will transact. I want also to put it clear that this House is not helpless. As opposed to the previous Houses, this House has the capacity and it is not a Budget approving House, but a Budget making House. Therefore, it is within our mandate and responsibility to redirect resources to the needy areas. I have in mind not only health, but also education. We need to increase the number of teachers in our primary and secondary schools. We need to implement some of the agreements that were made to the teachers so that we can have a motivated workforce.

Hon. Temporary Deputy Speaker, with regard to the Motion before the House, I have heard the Chair of the Health Committee complain about having devolved Kshs64 billion out of the total Kshs98 billion allocated to the Ministry Health for obvious reasons. The people of Kenya decided to devolve the function of health. If you read the

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Thank you, hon. Temporary Deputy Speaker. I stand to support the Motion particularly on the issue of implementation. I want to thank this august House for the effort of coming up with Bills which make this country develop. But, I am particularly concerned about the way we implement things in this House.

We pass Bills here but when it comes to implementation, there is a problem. I must applaud our Government and the private hospitals for the training opportunities for our children. But when it comes to employment of the same trained people, it becomes a problem. So, we are not really saying that we are lacking staff. The issue is where the funds are to employ them.

Hon. Temporary Deputy Speaker, at the constituency level, there are so many health facilities and if we ask every hon. Member to enumerate them, they will name so many. But the problem is not that they are lacking personnel. No! What we are lacking are the funds. At times, I feel that whoever is apportioning this Budget appears not to have the country at heart because we have so many students who have qualified from all those training institutions and they are idle. I think what we need to do right now is to ensure that we pass this Motion to enable us have more trained personnel to serve in our constituencies.

Hon. Temporary Deputy Speaker, I recall last week we lost a pregnant woman at Kabianga Health Centre simply because there was no qualified personnel to assist her.

Secondly, there was no vehicle to take her to Kericho District Hospital, a distance of about 21 kilometres away. That is a better environment considering that we still have ASAL areas. The area is not far from the road and the road may be a bit better. What about ASAL areas which have poor infrastructure?

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Hon. Temporary Deputy Speaker, I rise to support the Motion, one, because we have facilities out there built through CDF. In fact, I do not know what to do with them because we do not have personnel to man those facilities in my constituency. They are very good facilities, three of them, complete and furnished, but I do not have the personnel. That is why I support this Motion. I support the Motion because I want the Government to immediately, as requested by hon. Ochieng, employ nurses and clinical officers who are out there. I know for sure that in all our respective places, we have young men and women who are not employed and yet, we have facilities that are yearning for those kind of services. The major reason is because of poor deployment of staff. As the Mover mentioned - and I agree with him - we have cases where we have more than 600 nurses in one county and yet, in his Siaya County, he has only 165 nurses. The neighbouring Bungoma County has over 600 nurses. The Government should go back to the drawing board and deploy those officers to the needy areas, particularly, Kwanza Constituency where I have three well furnished health facilities, but nobody mans them. The other day, we lost an old lady because there was nobody in one of the facilities. From there, you go as far as Kitale, which is almost 50 kilometres away. That is not possible at night and so, we lost that life. I know for sure that the problem that we have in this country is that we train our nurses, clinical officers and doctors and they leave the country. I went to Namibia three years ago and I was surprised that there is a package there to woo our nurses. I was surprised to find over 110 nurses from Kenya working there. That is because they have better facilities. They have very good benefits. So, much as we also want to have our Government employing more medical personnel, we should also look at their benefits. They are poorly remunerated. The other thing is that we have facilities out there and as the amendment was moved this morning, we also need laboratory technicians. Patients go to clinics and they cannot be diagnosed to find out what illness they are suffering from. I want to support the fact that laboratory technicians should be employed. There is no need to take somebody to a dispensary who is suffering from Malaria and he is given the wrong prescription. One Member mentioned a case where a patient was given the wrong prescription. That is because the few who are there are frustrated. They work for 24 hours and they are likely to give the wrong prescriptions. It is high time the Government got its priorities right. I support the amendment. Instead of spending money on laptops and irrigation - and the

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Thank you, hon. Temporary Deputy Speaker, for giving me this opportunity. First, I stand to support the Motion, especially because it touches majorly on an area which is very dear to all of us in this country. I also support the Motion as amended majorly because the Mover had indicated quite a number of clinical officers and nurses, but the amendment by hon. Sang’ has created a situation where we can have additional nurses and clinical officers. As I speak, in many parts of this country, there is a huge shortage of medical personnel. There is a shortage of nurses, clinical officers and laboratory technicians. In most of our counties, we have facilities, but in others, we do not have enough facilities. There is a rise in diseases in most of the areas and most of those diseases need serious diagnosis. Now that we lack enough laboratory technicians who are supposed to diagnose those diseases, we find it hard to cure those diseases.

Hon. Temporary Deputy Speaker, most health centres are poorly staffed. Many health facilities have less than one clinical officer and,, in some areas, especially a case of my constituency, we have only five trained clinical officers who are not employed. So, you realise this is a crisis that needs to be seriously looked into by the Government.

Secondly, we also need to have additional health facilities so that when we are looking at how much money we are putting in the counties, and especially on the amendment by hon. Sang, we need to have enough resources. Those resources will not only cater for the recruitment and employment of those health nurses or clinical officers, but we should also look at how we equip those facilities so that the facilities that we have in those particular constituencies are properly equipped. Some of them are not functioning because they are not equipped. Some of them are functioning but do not have enough drugs. Some of them are functioning but they do not have equipment. So, I support this Motion by saying that we need also to have enough funds so that we can equip those particular hospitals.

Hon. Temporary Deputy Speaker, although we said that some of the facilities that we have were built through Constituencies Development Fund (CDF), there are so many of them that are not operational and that is because we lack nurses and clinical officers. So, I believe this Motion will go a long way to help us have all those clinical officers in our areas. You also realise that Kenya is not lacking in trained clinical officers. We have enough and that is why most hon. Members have been talking about migration by qualified clinical officers and nurses to other countries. The reason why we have the migration is because those that we have cannot be employed and even if we employ them, we are not giving them good salaries. We are not actually allowing them to make use of the training they have acquired from our institutions.

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(Hon. (Ms.) Mbalu): Hon. Members, the time for ventilation to this Motion is over. Therefore, I now call upon the Mover, hon. Ochieng, to reply.

Hon. Temporary Deputy Speaker, I would like to donate a minute each to hon. Munuve and the hon. Member over there; a minute to that hon. Member, a minute to that other hon. Member and a minute to hon. Mule.

(Hon. (Ms.) Mbalu): Very well. Let us start with hon. Munuve.

Hon. Temporary Deputy Speaker, I rise to support the Motion.

My constituency, for which hon. Ochieng could be speaking to, is one which may not enjoy what His Excellency the President generously gave to Kenyan women, to give birth without being charged. We have many clinics constructed through the CDF but which are without health officers. Therefore, I implore hon. Members to pass this Motion, so that women in my constituency can also enjoy these facilities.

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Mhe. Naibu Spika wa muda, vile vile nasimama kuunga mkono Hoja hii. Hoja hii inalingana na jukumu la Bunge kuwa itaweza kujadili na kutatua matatizo ambayo yanahusiana na wananchi kama inavyosema Katika katiba Kifungo cha 95(2). Pia, naunga mkono Hoja hii ambayo inaungwa mkono na Katiba katika Kifungo cha 19(2) na 20(2) ambayo imezungumzia kuhusu haki za raia ambazo zatakiwa watu wafaidike kwa kikamilifu. Tukiangalia katika Kifungo cha 43(1)(a) ambacho kinazungumzia haki za afya za wananchi, yatakiwa wananchi wapate huduma kwa hali ya juu kabisa. Tukimalizia, watu wazima ama wale ambao ni wazee, Katiba vile vile katika Kifungo cha 57(b) inasema wanatakiwa wapate huduma bora kutoka kwa watu wao na Serikali.

Tukiangalia hayo yote, tunaona Katiba ya nchi yetu inatilia mkazo mambo ya afya. Tukiangalia katika historia, nchi yetu ya Kenya iko nyuma katika mambo yote yalioahidiwa wananchi wakati wa Uhuru. Kwa ufupi, tungependelea hata ikiwa hili Bunge linaweza kukubali mambo ya laptop na maziwa ya bure yaondolewe ili tuweze kuhudumia wananchi wetu katika mambo muhimu ya elimu, afya na mishahara ya waalimu, ili tusiwe na mizozo siku za karibuni wananchi, waalimu na madaktari wakiomba mishahara na tushindwe kuwahudumia wananchi wetu. Kwa hivyo, kwa ufupi hata mimi ningeongezea kusema kwamba community health workers wafikiriwe kwa maana wanafanya kazi muhimu katika jamii zetu. Mwisho, kuna mahosipitali ambayo yako kwenye barabara zetu muhimu kama vile Voi na zinginezo. Zingefaa zipatiwe wahudumu wengi kwa sababu ajali nyingi zikitokea kupeleka watu Mombasa ama Nairobi huwa inapoteza wakati mwingi na wengi wanakufa kwa sababu ya ukosefu wa huduma za haraka.

Kwa hayo machache, naunga mkono.

Hon. Temporary Deputy Speaker, I am sorry to my colleagues who may not have contributed to this Motion. Hon. Members have contributed to this Motion for the last three hours and it is not possible for everyone to contribute to it even with the ten minutes I have donated. However, I want to thank every Member of this Parliament who has supported it. The Constitution provides the right to health. I want to make it very clear that the Constitution that we have now does not bar the national Government from employing health officers. In fact, there is nothing like mutual exclusivity in terms of the roles of the county governments and the national Government. There is nothing legally, morally or technically wrong in the national Government employing nurses.

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(Hon. (Ms.) Mbalu): Next Order!

(Hon. (Ms.) Mbalu): Hon. Members, we are on the Motion by hon. Mburu Stephen Kinyanjui. We had two hours and every Member had contributed. There was no hon. Member who had remaining minutes to contribute. So, any hon. Member can contribute. Hon. Joseph Muthari, you have the Floor.

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Hon. Temporary Deputy Speaker, I rise to support this Motion. While aware that transport is very crucial, it is important that the Government puts in place mechanisms that will ensure every part of each constituency has good roads of bitumen standards. in my Igembe North Constituency, we have some places that are inaccessible. Hon. Temporary Deputy Speaker, Igembe North neighbours Isiolo Town which is proposed in Vision 2030 to become a resort city and as that takes place, I would urge that roads in my constituency be constructed, especially the one from Mwelendungo-Lare through Ndomolu to Isiolo. If that is done, the communities in that place will enjoy the facilities and have the benefits of Vision 2030. Hon. Temporary Deputy Speaker, we know the importance of roads infrastructure. Having a roads infrastructure can enhance the movement of goods and services to market centres. So, I would urge the House to take this Motion seriously. There has been all that talk within the country for a while. There is also the debate about the monies between the county governments and the national Government. I think it is important that, that is taken into consideration, especially on the part of infrastructure. There is a problem in our country every time, even in this House, when we are talking about spending. Nobody talks about how we can create money. You cannot spend what you do not have! So, I am sure if we improve the infrastructure like roads, it can improve the economy through developing regions in the country. If the economy improves, then there is also a possibility of creating wealth. Hon. Temporary Deputy Speaker, then the communities can assess the markets and exchange their goods and services, and we can move forward. If we have this kind of possibility like in my constituency, then we can have those priority roads like the one from Kamweri-ini up to Kasuru, and connecting to the great North Road. This would improve the movement of people and goods and enable us to trade with our neighbours. We should also open up some of the roads that could improve security. Where there are good roads, security also improves. Where there are challenges, for instance cattle rustling in my constituency--- When the raiders attack, there are no roads for the security officers to go and help communities in distress. So, having proper road infrastructure is going to be a great opportunity for all of us. It will enhance the development of the various sectors in the country. If this Motion is passed, as a country, we are going to have the possibility of development in all the sectors. Development will not be based on whether you are close to power or not; there will be development in the entire Republic as it happens through the CDF. Then we will have constituency roads connecting to other major centres. This kind of connection will stimulate trade and enhance development. I support the Motion.

Thank you, hon. Temporary Deputy Speaker. I want to commend the Mover of the Motion, hon. Kinyanjui. I agree with him that there is need for us to improve our road infrastructure network. As much as I agree with him that there is need for each constituency to have a certain percentage of tarmac road, I beg to differ in certain aspects. First and foremost, if we look at the cost of doing 20 kilometres of tarmac at an estimated cost of Kshs80 million per kilometre, multiplied by the number of

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(Hon. (Ms) Mbalu): Hon. Members, it is now time for the interruption of business. This House is, therefore, adjourned until this afternoon at 2.30 p.m.

The House rose at 12.30 p.m.

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