Order, Hon. Members! Those making your way in, kindly take your seats. Hon. Members, I wish to introduce to the House a delegation of the Committee on Rural Economy, Agriculture, Environment and Natural Resources of the Pan-African Parliament which is seated in the Speaker’s Row. The delegation comprises of the following Members:- 1. The Hon. Abdoulie K. Jalwa - Leader of the delegation 2. The Hon. Roy Banda 3. The Hon. Abdallah Ibrahim 4. The Hon. Bekeyi Sogoyou 5. The Hon. Mamedi Sidibe 6. The Hon. Eugene Kparkar 7. The Hon. Suliaman Sisay 8. The Hon. Patrick Mayombe 9. The Hon. Aminata Niang 10. The Hon. Goodness Khanyisile 11. The Hon. David Moyenga 12. The Hon. Rethabile Marumo 13. The Hon. Mokhtar Zerouali 14. The Hon. Saloun Cisse 15. The Hon. Faycal Tebbin, and 16. The Hon. Rabiya Binegde
The delegation is accompanied by the Committee Clerk, Mr. Galal. They are in the country to attend the Second Pan-African Parliamentary Summit on Climate Policy to be held from 10th to 13th November, 2015 in Kenya. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
On my own behalf and that of the House, I wish to welcome them to the National Assembly and thank them for finding time to attend that conference. Our very own Hon. (Dr.) Wilber Ottichilo will be actively participating in the conference. I thank you. Next Order.
Hon. Speaker, I beg to lay the following Papers on the Table of the House today Tuesday, 10th November, 2015:- The Budget Review and Outlook Paper, 2015 for the Financial Year 2016/2017 and 2018/2019 Mid-Term Expenditure Framework. The Reports of the Auditor-General on the Financial Statements of the Constituencies Development Fund (CDF) for the year ended 30th June, 2014 and the Certificate therein in respect of Mathioya Constituency, Kiharu Constituency, Narok South Constituency, Gem Constituency, Muhoroni Constituency, Kisumu East Constituency, Kisumu West Constituency, Bondo Constituency, Rarieda Constituency, Homa Bay Town Constituency, Garissa Township Constituency, Chepalungu Constituency, Kajiado North Constituency and Kathiani Constituency Thank you.
Hon. Members, the Budget Review and Outlook Paper, 2015 for the Financial Year 2016/2017 and 2018/2019 Mid-Term Expenditure Framework are referred to the Budget and Appropriations Committee. Let us now have the Chairperson, Departmental Committee on Energy, Communication and Information.
Thank you, Hon. Speaker. I beg to lay the following Paper on the Table of the House today Tuesday, 10th November, 2015:- The Report of the Departmental Committee on Energy, Communication and Information on its consideration of the Energy Bill, 2015. I thank you.
Let us have the Chairperson, Departmental Committee on Transport, Public Works and Housing who has a series of Papers to lay.
Thank you, Hon. Speaker. I beg to lay the following Papers on the Table of the House today Tuesday, 10th November, 2015:- The Report of the Departmental Committee on Transport, Public Works and Housing on a study visit to Kuwait from 30th January to 6th February 2015. The Report of the Departmental Committee on Transport, Public Works and Housing on a study visit to South Africa from 31st January to 7th February 2015.
The Report of the Departmental Committee on Transport, Public Works and Housing on the consideration of a public petition by long distance truck drivers and allied workers union on corruption allegations at weighbridges in the country.
Obviously, Hon. Members, without any point of order, I can allow some few comments especially now that it is about weighbridges. Many of you may be passing through them. I am sure you may wish to make some comments. I do not know how you pass there but it may be of interest to some people to make comments about weighbridges. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Hon. Speaker, I can read some of the recommendations of the Committee so that I can guide the Members. One of the recommendations is that corruption at the weighbridges needs to be reported to the Ethics and Anti-Corruption Commission (EACC) so that it can take action. Secondly, when police officers are transferred from weighbridges these days they do not move out. They opt to retire than being transferred. That shows that there is rampant corruption among police officers. The Committee is recommending that a police officer should not serve at any weighbridge for more than one year. We have also realised, as a Committee, that even Members of this House in a way are not living to the rules they make in this House. You saw sometimes back how some officers were harassed by our colleagues in this House. So, the Committee felt that it is good that we behave as Members of this House.
Are you through? Ignore all those things.
I am not through, Hon. Speaker.
Make it brief. At this juncture, I will allow other Members---
Have you read your Standing Orders?
Hon. Onyonka, you cannot just stand and claim to be rising on a point of order. Under what Standing Order are you rising?
Hon. Onyonka, you did not catch my eye. You appear to have caught my ear instead. Under the new dispensation, you are only supposed to catch my eye through placement of an intervention. I do not see your name here. I can see the names of Hon. Gichigi, Hon. Kombe, Hon. Midiwo and Hon. Chepkong’a. I am told you are the last one. This machine does not lie. Yes, Hon. Harrison Kombe.
Thank you, Hon. Speaker. On the issue of weighbridges, we have one at Sabaki which is doing a terrible job. The workers are paid by the county government and yet the weighbridge owners are collecting 70 per cent of the revenue and keeping it. Something should be done about the weighbridges. Thank you.
Yes, Hon. Samuel Gichigi.
Ahsante sana Mhe. Spika. Hata mimi ningependa kuchangia kwa kusema kuwa ule ufisadi ambao tumekuwa tukiona katika sehemu hizo--- Kama tume ya kupigana na ufisadi na Mkuu wa Mashtaka katika nchi hii hajui hali ilivyo, inaamanisha kuwa tuna vyombo kadhaa vya Serikali ambavyo vimelala. Mahakama pia inachangia ufisadi katika nchi hii. Si vyema kama mfanyakazi anaenda mahakamani na kupata amri ya kutotii kuhamishwa kwake. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Akiambiwa aondoke katika hivyo vipimo vya uzani vya magari anakataa kuondoka kisha anaenda mahakamani na mahakama inasema aendelee kukaa hapo. Mahakama pia inachangia ufisadi. Kwa hivyo, Mkuu wa Mashtaka, tume ya kupigana na ufisadi na mahakama zetu zimesaidia sana kuongeza huo ufisadi. Ahsante sana.
Let us have Hon. Midiwo.
Thank you, Hon. Speaker. I rose on intervention because it seemed the Hon. Member who tabled the report was trying to debate his own report. I thought it was out of order. Nonetheless, I was also tickled when Hon. Kamanda was jittery in mentioning the word “corruption”. He tried to bring out the word “corruption” very many times and it was not coming out. He seems to be contradicting himself. In yesterday and today’s daily newspapers, he seems to take a very tribal angle with people who are condemning corruption. It is ironical that Hon. Kamanda can treat the nation and Parliament to a subject on corruption this afternoon. If police officers are corrupt, you know who else is corrupt. I want to plead with the Committee to look at the law properly on the issue of traffic police before it tables a report. At the end of the term of the last Parliament, we outlawed the so-called traffic police. There is nobody called “Traffic Police” in law. From the Floor of this House, I would even encourage Kenyans to ignore them because there is nobody called “Traffic Police” in law. It is just a corruption ring in the Police Department. So, this Committee can help this House by doing a proper report and letting Kenyans know that we are dealing with a rogue police department which is a creation of somebody in the police force. As it were, there is no Traffic Department. Thank you.
Thank you, Hon. Speaker. I have just listened very keenly to the Chairman of the Departmental Committee on Transport, Public Works and Housing make his presentation with respect to the petition that was made by long distance truck drivers. This is a very serious matter. The EACC, in its quarterly report, made a report to this House to take action with respect to this question of weighbridges. I would have expected one of the recommendations to be directed to Hon. Asman Kamama’s Departmental Committee on Administration and National Security so that they can deal conclusively with this question of corruption at weighbridges. As it is, the recommendation from the Committee is to the EACC and yet the EACC has made conclusive findings that weighbridges are full of very corrupt people. It is incumbent upon the Departmental Committee on Transport, Public Works and Housing to come up with stringent recommendations that can be implemented by the Ministry of Roads and Infrastructure to ensure that those people who are manning weighbridges are not there for more than one year. I agree with Hon. Jakoyo Midiwo that there is no one called “Traffic Police”. All of them are policemen. On the second limb of his assertion that people should ignore policemen, of course he is uttering unlawful words. He knows he can be arrested for ignoring lawful instructions from police. It is incumbent upon this House to come up with legislation to regulate weighbridges to ensure that persons who are deployed to these weighbridges are not there on a permanent basis because these have become dens of corruption. We need to get rid of corruption but we cannot get rid of it if we allow people to go to court when they are transferred. The Judiciary is also to blame. The Judiciary should not be entertaining every application and granting injunctions. If you grant an injunction for an officer to be transferred from one place to another, that is The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
indiscipline on the part of the Judiciary. That is misuse and abuse of power which the Judiciary has been granted. They cannot use it to stop lawful instructions which have been issued to officers. We should have seen a recommendation against the Judiciary here and it should have come to our Committee, so that we can also take action with regard to the Judiciary. Certain orders that are being issued, including the ones gagging Parliament from exercising its diplomatic right of freedom of speech, are wrong. We are told that when matters come before us we cannot discuss them. That is a rogue institution. We cannot be gagged from discussing any issue. We should be allowed freedom of expression just like they are also allowed freedom of expression. Although I agree with the recommendation from the Chair, we should make proposals to amend the Traffic Act to ensure that we move officers, in particular those who are manning weighbridges.
Thank you, Hon. Speaker. The reason I was trying to raise a point of order was that the Chairman, a man whom many of us respect highly, had actually decided to mention a matter which affects a colleague in this House. Since the case is in court, that would have been sub judice . I was trying to caution the Chairman that he should have left out that because the case is in court. Even when that is the case, in the 9th and 10th Parliaments, the issue of weighbridges was discussed and recommendations made. I hope he will include in his report what came out from the 9th and 10th Parliaments and what he has done now, so that this House can come up with a solution once and for all.
I know the Government is now using X-Ray machines at the Port of Mombasa, there is a tracking system. Maybe there is a possibility we do not need the weighbridges at all. That is something we will have to look at when we start debating the matter.
Very well. The last one on this is from Hon. Florence Kajuju. Hon. Members, this is not debate. It is just a few comments. The point raised by Hon. Richard Onyonka goes to our own Standing Order No.89 on matters that are res-sub judice, but we are not yet there since this is just about corruption on weighbridges. I do not think there was any reference to any specific matter that is before court. No reference was made, but I think you only made the observation and thought that we may be straying that way.
Thank you, Hon. Speaker. This report is very important. We have been speaking about integration and free movement of goods and services. At our weighbridges, there is no free movement of goods and services. A lot of time is wasted at the weighbridges.
As we discuss this report, we should look at instances where trade has been hindered. We cannot speak about integration when a lot of time is wasted at the weighbridges. We have also been talking about non-tariff barriers. These are issues that we need to address. If corruption at our weighbridges is addressed, this will be the best way to go. Even as we move on to deal with issues of the Customs Union, the Monetary Union and the Common Market Protocol, this is going to help us. Along the Thika Superhighway, there is a weighbridge and a lot of time is wasted. This has been the nest of corruption. Just as the Chief Justice has introduced the payment of fines on our roads, the Ethics and Anti-Corruption Commission officers should ensure that people are fined on the spot, so that we can discourage this vice.
Finally, this refers to something that Hon. Kamama may have an interest in because of his Committee. Let us have him.
Thank you, Hon. Speaker. I agree entirely with the recommendations submitted by the Chair of the Committee on Transport, Public Works and Housing and I wish to The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
recommend that we need to have radical reforms within our weighbridges. Most Kenyans do not believe that we can tackle corruption within the weighbridges. It has been an issue and even as a Committee, we have suggested that if it is possible, we privatise all our weighbridges. That is where corruption is so live that it is an eyesore to this country.
Officers at weighbridges are not willing to even take promotions. If you transfer an officer or promote him or her to the position of Corporal and post them to, maybe Garissa or Kacheliba, they do not want that promotion. They do not want that promotion because they get better returns at the weighbridges. To the extent that officers are refusing to be promoted because they are getting money at the weighbridges, we need radical reforms. We need to benchmark with Rwanda. If you give money to an officer in Rwanda you will be arrested. Why are our officers taking bribes in the open? It has become advanced that they now use M-pesa . They make calls from Mariakani to Athi River and the M-pesa system is used to network issues of corruption. I want to sit with my colleague, Hon. Kamanda, and come up with radical reforms. It is no longer business as usual. I am not even sure whether the EACC has the capacity to deal with this problem. That is why police officers are always number one every year when it comes to corruption. We must kill this thing and decide this year and not next year.
. Next Order!
Hon. Speaker, I beg to give notice of the following Motion:-
THAT, aware that Article 21(3) of the Constitution mandates state organs to address the needs of persons with disabilities; noting that this vulnerable group continues to face numerous challenges in getting access to the Uwezo Fund, the Youth Enterprise Development Fund and the Women Enterprise Development Fund; deeply concerned that there is no clear mechanism to ensure that persons with disabilities get their share of the funds; this House resolves that 30 per cent of each of these funds be channeled through the Economic Empowerment Fund under the National Council for Persons with Disabilities.
At this point, for the purposes of drawing the House’s attention to a function happening in the country, I want to invite Hon. Amina Abdalla, the Chairperson of the Departmental Committee on Environment and Natural Resources to make an announcement.
Thank you, Hon. Speaker. The National Assembly in partnership with the Pan-African Network on Climate Justice, United Nations Development Programme (UNDP), Oxfam and the African Union (AU) will be holding the second Pan-African Parliamentarians Summit on Climate Change tomorrow and Thursday, at the Safari Park Hotel. The Summit is intended to acquaint African parliamentarians on the landscape of negotiations under the United Nations Framework on Climate Change and to create awareness among parliamentarians on Africa’s common position on climate change before we head to Paris in December to negotiate the new universal framework for climate change. His Excellency the President will open this meeting tomorrow. The Pan-African Parliament (PAP) is well represented. The meeting will be closed by the Deputy President (DP) The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
on Thursday afternoon. Members are welcome to join us at the Safari Park Hotel for this very important meeting. Thank you.
It is assumed that everybody is listening. Let us proceed. Next Order.
Hon. Members, debate on this Bill was concluded.
Hon. Geni, just freeze. What remains is for the Question to be put. I hereby proceed to do so.
Hon. Members, once again, debate on this Bill was concluded and what remains is for me to put the Question, which I proceed to do.
The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Hon. Members, debate on this Bill proceeded up to the point where the Mover, Hon. Naomi Shaban and the seconder, Hon. Robert Pukose, had spoken and the Question was proposed. Therefore, the Bill is open for debate by any other Member apart from those two. The Leader of the Majority Party.
Thank you, Hon. Speaker. I beg to contribute to the Health Bill, 2015 as the Member for Garissa Township. The purpose of this Bill is to provide a mechanism on how the national health policy shall be formulated, implemented and coordinated between the two levels of Government. More significantly, this Bill deals with areas of coordination and how technology can positively contribute to better management of health services while curbing negative development. The aim of this Bill is to establish national health systems whose main purpose will be to afford an enabling environment to progressively realise the right to the highest attainable standard of health to citizens. This includes the right to healthcare services within the framework of reproductive health. This Bill aims to recognise the role of the statutory health regulatory bodies, but it distinguishes between regulatory bodies and bodies which have policy functions at the national Government level. Clause 7 of the Bill gives effect to the right to emergency medical treatment. The clause makes it an offence for any medical institution or healthcare provider to deny any person emergency medical treatment when it has the capacity to do so. You remember the story of Alex Madaga, a young Kenyan who had an accident and was taken to five hospitals, which all denied him emergency medical treatment because they valued money. The hospitals pegged emergency medical treatment to payment of money. So, this Bill sets the stage right. The clause says the right to emergency medical treatment is the right of every person in this country, only subject to capacity. I am sure that when we get to the Committee of the whole House, we will remove the condition of “subject to capacity”. As we progressively move towards making sure that citizens enjoy universal healthcare through the National Hospital Insurance Fund (NHIF), I think the right to emergency medical treatment is a right to every citizen. Clause 8 of the Bill makes it mandatory for every healthcare provider to inform the user or, where the user of the information is a minor or incapacitated, inform the guardian other things including the user’s health status except in circumstances where there is substantial evidence that the disclosure of the user’s health status could be contrary to the best interest of the user. The clause deals with how far one can go in making full disclosure of a patient’s health status. It will no longer be at the discretion of medical doctors. Let us look at Clauses 16 and 17 of this Bill. This Bill creates directorates within the Ministry of Health, which are to be led by a Director-General and who is the technical adviser to the Cabinet Secretary (CS) on all matters relating to health. The Director-General will be The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
responsible for preventing and guarding against the introduction of infectious diseases. This is part of streamlining the many directorates that are found within the Ministry of Health. Hon. Speaker, Clause 27 establishes the Kenya Health Professionals Oversight Authority (KHPOA). Its function is to oversee the regulatory functions of all national health systems, both private and public and to ensure that adequate coordination is done for the joint activities of these bodies. Clause 48 outlaws human organs transplantation except in a manner provided for. It is streamlining how you can transplant different organs between different bodies and patients. That was not the case before. A framework has been put in place. Clause 32 creates the establishments of a single regulatory body for the regulation of health products and technologies and by a separate Act of Parliament. This is a very condensed health policy and I am sure there are a number of other small Bills that we need to bring on board. Clause 54 deals with matters relating to health financing and Clause 56 provides that the Cabinet Secretary (CS) shall pursue strategies. Finally, before I give a chance to my colleagues, I want to go on record that I have nothing against county governments. There are only two things that made me support the Constitutional Referendum in 2010, namely, devolution and the Kadhis’ Courts. Those were very fundamental issues in the Kenyan Constitution in 2010. Among the many things that I supported in the Constitution, from the Bill of Rights, my irreducible minimum was the introduction of a devolved system of Government and the retention of the Kadhis’ Court, being a person who professes the Muslims’ faith. However, three years down the line I am a very worried man in as far as devolution of the healthcare system is concerned. My constituency is one of the very few constituencies that enjoy the services of a Level 5 hospital. In the last Parliament, Garissa Provincial General Hospital was one of the best healthcare institutions in the north. It used to serve, not only the North Eastern Province but counties like Lamu, Tana River, Isiolo and the whole of Kitui County. At the advent of devolution, the Garissa Level 5 Hospital fell under the County Government of Garissa. The last job I will seek in this country is governorship. I have no intention of seeking to be a governor and I want to be on record that I do not want to become a governor. From where I sit, the best job is being a Member of Parliament. There was a surgeon in Garissa Level 5 Hospital between 2007 and 2013 who did not even come from northern Kenya. He was from Kibra and was a respected surgeon. When we introduced devolution, all the doctors were removed and, of course, regional and ethnic issues came up. Today, if the Committee on Health walked to that hospital, it would be shocked to find that there is no water. Our women, wives and daughters access maternity services without water. Theatres have collapsed and healthcare workers have not been paid. You cannot imagine the status. When Prof. Nyikal looks at me from where he is sitting, being a former Director of Medical Services and at one time a Permanent Secretary (PS), Ministry of Public Health, he has visited Garissa General Hospital more than thrice. He is now a Member of the Committee on Health. I have said that I have no interest in being a governor and my interest is the people I represent. Today, that hospital has been reduced to a health centre. I am not saying it should be returned to the national Government. It should still be with the county government, but somebody somewhere must not ethinicise or politicise the health care system. My family is privileged to have one or two doctors working in the private sector or the NGO world. You can The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Hon. Nyikal, it just happened that your name is number one on the list.
Thank you, Hon. Speaker. It has come at no better time than now. That health services in this country are in a sorry state is public knowledge. Newspapers and the Press have highlighted it. At least, in this, they said the truth. That something needs to be done urgently is just common sense. Health services have suffered for many years merely because every time we have a transition that intends to make health services better, we fail to manage the transition. Sometimes we then blame the transition whereas the failure is in the management of transition. Let me give an analogy. Pregnancy is a good thing. The baby inside is good. When the baby is delivered safely, it is a great thing, but if the delivery of that baby is mismanaged, you will have a dead baby. You cannot, therefore, blame the pregnancy and the baby inside. We must blame the management of the labour. This is where we are in this country. From 2003 when we had one of the major transitions in this country in terms of change of Government, there was hope and a lot of changes were put in place. Health indices between 2003 and 2008 attest to that. The rate of infant mortality dropped considerably. The under-five mortality rate dropped. The use of contraceptives dropped. The only thing that did not change; and we know why, is actually the maternal mortality. This is because it is a systems issue.
In 2008, we split the Ministry of Health. I was involved. This was not desirable but at least it improved the funding to the Department of Public Health. Again, after that, we did not manage it very well. All the same, there was indication that there was improvement. We may want to blame devolution but we must distinguish the principle from the process. What has not been right is the process which we have gone through. It is not only in health. If you go to the Ministry of Environment, Water and Natural Resource and the Ministry of Agriculture, Livestock and Fisheries, you will see the same thing. It is not that devolution is not good; devolution is the best thing, but we hurried it. In fact, the Transition Authority should have been an independent constitutional commission and should not have been under a ministry. In my view, that is where we went wrong.
If you look at the health legal framework, you will realise that we still have the Public Health Act which was promulgated in the 1930s and we have about 32 or so other Acts that go with it. The many Acts have been useful in a way, but the Public Health Act was just that. It did not take into consideration very much the provision of medical or clinical services. These other Acts actually attempted to do that. We must now look at the socio-economic, political and legal situation in which we are running our health services now. The most important thing is the Constitution. Article 43 (1)(a) starts with nothing other than the right to health of all the social-economic rights. I agree. All The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Can you warn the Member for Kaiti. You do not just walk across like that. This is the National Assembly. Do not cross over like you are in a farm. Proceed, Hon. (Prof.) Nyikal.
At least every month we have a Bill brought in this House about the health sector. All these Bills stand singularly on their own. It is important that we have an overarching law that will actually oversee all of them. I am sure that is what this Bill is seeking to achieve. I have said something about devolution. Health has many systems that are in one: The human resource system, the commodity and supply system, the infrastructure and equipment system and the health financing system. All these systems have to be harmonised. It is not because of devolution that we have not been able to do this, it is because of the way we have implemented it. If we had gone the way we put in the law, we would have managed it. Hon. Speaker, if you look at the human resource system, no sector has so many cadres of human resource like health. No sector has so many commodities and supplies like the health sector. Each one is technically peculiar on its own. No sector has so many equipment which are so sensitive in terms of application to human health like the health sector. No system requires better and properly organised financing like the health sector. We, therefore, need policies, standards and co-ordination that must be adhered to the letter of the law. We are politicians and sometimes we think that where the majority are that is where the truth is. I dare say that in health, even if only one person is right, it is that one person whose idea will be taken. In the health sector, the law that the majority will have their way and the minority will have their say does not apply. Therefore, this Bill seeks to address how policy will be applied in a devolved system, how to come up with standards and ensure they are adhered to, and how to co-ordinate the system. This is something we must support. There are many other parts that we will have to look at during the Third Reading stage. I will give a few examples. The Bill has provided for the Health Professionals Oversight Authority in Part IV, Clause 27. If it was my wish we would have had a Health Services Commission, but given the way the Constitution is currently that is not possible. I think within the law and the framework of Intergovernmental Relations Act, we can still have these things. The Health Professionals Oversight Authority takes care of the Medical Practitioners and Dentists Board, the Nursing Council, the public health officers, the occupational therapists and others. We can put them together under that. It also seeks to establish a single Health Technology and Products Authority. Again, we have had issues between the Nursing Council and the Pharmacy and Poisons Board. That is something we will have to look at. It seeks to establish a Health Research Committee. We need that because although medicine is universal, there are peculiarities that research will bring within our local environment. We need something that will bring information that is relevant to us. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Hon. Nyikal, proceed. I have given you an extra 10 minutes already. You are doing very well, and you leave it to my judgment because it is not just for purposes of Bonga points. Debate here must also inform the public. Proceed.
Hon. Speaker, sometimes when hospitals claim they have no Intensive Care Unit (ICU) beds they are scared of taking in the patient. Emergency cases are extremely expensive. Within an hour, you will probably spend Kshs100,000 because of the equipment and drugs you are using. So, they are scared of who will pay for that. However, if they leave it at the constitutional level and say it is a right which must be provided, what are we doing to the facilities that are providing it and the healthcare providers? We must make provisions. I am happy that there is an attempt to do that under Clause 54(i)(e) where we are going to make provisions. We must make those provisions as a country so that people who take care of emergencies are reimbursed. They will not take all those expensive equipment from somebody in industrial area and say: “You know, I offer emergency services and I am going to treat people free of charge and I am not going to pay”. It cannot happen and yet it is a constitutional right. The constitutional obligation does not extend to the man in industrial area who manufactures the equipment. So, that is something we must do. I thank you for the indulgence but these are issues that we must look at as a country. Processes must not be confused with principles. Devolution is good. It is the process that we have not done properly, and that is what we need to do. Emergency care must be given, but somebody must pay for it. We must have a social healthcare insurance so that the monies of people who are wealthy do not end up in the pockets of insurance companies but are used to treat those who cannot afford. With those few remarks, I support.
Well spoken, Hon. Prof. Nyikal. As well, you might have noted that the Hon. Speaker appreciated what you were saying. Those reading the HANSARD should see that before this Bill became law, there was serious thinking that went to it. They can only see that from such contributions. Thank you very much. Let us have the Chairperson. Hon. Rachael Nyamai.
Thank you, Hon. Speaker for giving me this opportunity to support this important Bill that the House has been asking for. I would like to thank the Members The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Thank you, Hon. Speaker. I rise to support this very important Bill. The Constitution is clear about citizen’s right to health. This Article has been referred to by all those who have spoken ahead of me. Since it is in the Constitution, I would also like to start my contribution from there. Article 43(1)(a) of the Constitution provides that every citizen has a right to the highest level of healthcare available. This Bill will come in handy to try and realise or attain that expectation by the Constitution. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Thank you, Hon. Speaker. This is a very important Bill because one of the fundamental aspects of the Constitution is to provide protection to sick people. But the problem is that these rights which have been provided for by the Constitution have actually addressed one aspect. You are provided with a right which is health, education and security but specifically on health, it has not addressed the question of how. Therefore, it becomes a right on paper. At least, on the right to education, we have seen a lot of effort being put by the Government to provide free primary education and subsidised secondary education, but in terms of health there are many problems. If you go to our counties - someone had mentioned during the making of the Constitution that if we are not careful, this Constitution is going to make or break the country. I am worried that if the health sector is not well regulated, the country will be balkanized. The fact that you come from a certain county does not mean that you have to seek treatment in your county. Why am I saying this? We have seen a precedent being set where when our people go to certain hospitals, they get different treatment. For example, if you come from Nyanza and seek treatment in Samburu, the treatment you will get will be different. Therefore, this Bill has come at the right time. I hope the policies or the thinking and the provisions which have been provided for in this Bill are going to be implemented to ensure first, that there is universal healthcare available for every citizen of this country. Last month, I had a situation where I had to ask many questions. Due to bad luck, three of my constituents who reside in a place called “Kedowa” were involved in an accident around Machakos. Unfortunately, they were admitted to Machakos Hospital, but they were not treated for one month. They were supposed to be operated on but they were taken round in circles. I used all the means I had at my disposal to address that issue, including communicating with the county government. The assurance that they would be treated was given but they were not treated until they were transferred to Kapkatet District Hospital in Kericho. I asked myself whether we are in Kenya. That is the reality on the ground because people are not being treated equally. It depends on where you come from. Another example is a complex issue touching on Level 5 hospitals. There is a silent war among the counties on who should meet the cost of treating referral cases – people from one county who are referred to a Level 5 hospital in another county. We have tried in this House to allocate money to Level 5 hospitals differently, but there is still that perception that Level 5 hospitals belong to certain counties and not the country. Therefore, when we enact a law such as this, to bring together all the issues affecting health, we should ensure that we coordinate properly. We should ensure that county governments understand the difference between policy, standardisation and control. When this Bill was introduced, some people asked why we are legislating on health and yet the health sector is a devolved function. We must make Kenyans appreciate that whereas the health sector has been devolved, the policy has not. Once county governments appreciate the importance of following policy and law, they will offer the services required by the people. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Thank you, Hon. Speaker for giving me a chance to contribute to this debate. What a good debate this is. It reminds me of how Parliament used to be. The debate used to be sweet and all Members were relevant. Looking at the Bill, and listening to the contributions by my colleague Hon. Prof. Nyikal, this Bill is moving in the right direction. But it is not going far enough to do what our country needs. I want to plead with this House that this Bill must not be looked at as a Government Bill, but as a Kenyan Bill. This country needs this Bill. I was here when Parliament tried to implement universal healthcare, but there were too many interests outside Parliament that shot it down. I disagree with Clause 24 of the Bill which wants to keep the national Government involved in healthcare. The involvement of the national Government should only be in the higher level hospitals and in policy. This Committee should have looked at some of the areas where our country has not done well. You cannot promise people compulsory or universal healthcare without doctors and nurses. You cannot expect doctors in a hospital in my village. First of all, doctors are not churned out in enough numbers. The conditions of living are not good enough for any doctor to stay in that village. The Constitution calls for one thing, but this House must make it possible. That is why this is a very difficult Article of the Constitution to occasion. This House must think outside the box. The other day, I was in Indonesia at a conference against corruption. I felt unwell as though I had malaria. I decided to walk into a public hospital so that I could be tested and know if I was really sick. It turned out that I was generally fatigued. I did not see anything magical. In fact, they did not have all these computers they talk about. I looked for a doctor who could The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Very well, as the Leader of the Majority Party.
Hon. Speaker, as the Leader of the Minority Party, but I can do the Majority because I am going to be very soon.
You have equal speaking time. There is no problem.
Hon. Speaker, by thinking about this Bill, the Government has done its best, but this House must do better because we represent people. Anything that annoys our people when they seek medical services must be put in law, so that once and for all, we have a law that people fear. When nurses are absent in hospitals and workers are rude to patients who is to help our patients? We want to do a law as the people’s representatives. It is a requirement of the Constitution. I want to plead with this Committee that before we go to the Third Reading, let us do what is required of us, which is policy. We are the national Government. Let us set the pace for that Committee. I disagree with this Bill because it wants to create somebody called “Director-General” as spoken by my medical expert, Dr. Nyikal, that can be advisor to the President. No! The President has an advisor because he appoints his Minister for Health. That is the work of that person. This other office that we are creating---
The Minister is a banker!
I agree, but he may be a very good person. He does not have to be a doctor because it is about policy. He should propose policy and bring it here so that Dr. Eseli can say that he has thought like a banker, but this is a good policy. You cannot say that you create many jobs in the counties and there is somebody who has a Masters degree. That is also not good policy. The people that are employed at the county or suggestion of people to be employed by the county cannot be policy. We are expanding the wage bill again and yet we are crying about lack of money. That body cannot and should not pass here. Let us pass laws that provide the consequences of a patient missing drugs or dying at the dispensary. Let us give our courts laws to deal squarely and adequately with people who do not care, but are supposed to care for our patients. As I wind up, the attempt to nationalise healthcare in a failed system which we were trying to cure is one which I am going to oppose vehemently. The fact that the counties are dysfunctional in terms of health does not mean future counties will be dysfunctional. Let us empower the counties. Let us look at why they are dysfunctional. Like I have said, in our next Budget, we must earmark which money should go to health. With enough supply of money and proper laws, there will be no reason for us not to treat our people. However, I disagree with taking away power and giving it to somebody else apart from Government Ministries. In any case, we are saying that in future, the Cabinet Secretaries (CS) should be in this House so that we can interrogate them on policy. That way, we will do well.
Hon. Speaker, having said all that, I support this Bill. We will bring some amendments. I thank you. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
You actually stuck to your permitted time of 15 minutes. Hon. Joyce Akai.
Thank you, Hon. Speaker for giving me this chance. I rise to support this Bill. Even as I support the Bill, I would like to pick from where Hon. Jakoyo has left. I look at counties like Turkana, Samburu and others that are lacking in so many things.
Before we even talk of the right to receive emergency medical treatment, in some areas, medical facilities are lacking. The doctor/patient ratio in Turkana is 1:1,000. The nurse/patient ratio is 1:5,000, which is really impossible. Medical facilities are also non-existent. People have to trek for kilometres. We are not even talking about affordability - it is accessibility. We are actually talking of the basics where physical structures are. We do not have medicine and vehicles. For some areas, we should be talking about the basics.
The Constitution provides for the right to the highest attainable standards of health. I support this Bill because it ensures the right to health services, healthcare, reproductive health in terms of accessibility, affordability and access to information, the right to preventive services, curative and rehabilitative services. I would like to concentrate on Part II of the Bill, which talks about rights. Further to the protection of rights, the Bill protects and promotes the rights of children to basic nutrition and healthcare as stipulated in the Constitution - Articles 43 and 53. It is about the rights of the vulnerable groups which include women, the elderly, people living with disabilities, children, youth and minorities to health facilities.
The Bill further establishes a regulatory body which ensures that health products and technologies are accessed. It also ensures safe medication. Quacks will not have space in the medical facilities. We will not have cases like that of “Dr. Mugo”. It also controls clinical trials and ensures that manufacturers and distributors are genuine.
Hon. Speaker, I would like to reiterate the issue of emergency medical treatment. That is because many people have spoken about it. It has also happened to many people. The sad story of Alex Madaga is just a representation of thousands of Kenyans who die outside medical facilities and are not able to receive emergency treatment which includes pre-hospital care, stabilizing the patients before they are transferred and even arranging for referrals where medical facilities are unable to help.
This Bill stipulates that any service provider, be it an individual or an institution, who denies medical service while in a position to help, will be committing an offence and will attract a hefty penalty.
Hon. Temporary Deputy Speaker, the National Health System in this Bill streamlines and defines respective functions between the counties, national Government and other actors and gives adequate and comprehensive information to those players in terms of the roles and functions they play. The Bill is also in sync with advanced global technology through provision of e-health and use of technology. The establishment of the National Blood Transfusion Service is a good thing and will save lives. We know of many mothers who have lost blood in the The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): You support the Bill. The Hon. Member for Tongaren, Hon. Eseli Simiyu
Thank you, Hon. Temporary Deputy Speaker for giving me this opportunity. I have been sitting here patiently waiting for this opportunity to contribute to this Bill. At the outset, I want to say that this Bill is long overdue because health was precipitately devolved after the last elections. I believe this happened after the governors blackmailed or arm- twisted the Executive to devolve it at ago. Given that, the Health Bill should have come much earlier, in my view, within six months. In fact, this House should be informed that the Departmental Committee on Health has fought a serious war with the Ministry of Health to bring this Bill here, to the extent that we threatened to bring our own Bill. That is when the Ministry succumbed and brought this Bill in April this year.
The mismanagement of healthcare in Kenya is not just a preserve of the county governments. The national Government is in the game too and it has turned everything upside down. In nations where healthcare is fairly advanced, they lease high-end equipment and buy low-end equipment. In our situation, we have turned it over its head and we are leasing low-end equipment and buying high-end equipment - which forms part of mismanagement of healthcare.
The county governments are equally mismanaging healthcare to the extent where when a county buys drugs worth Kshs70 million, it calls the Press and takes a photo as they set off the truck to go and deliver the drugs. Before I came to Parliament, I was in private practice. There was somebody who was doing a study on the cost of healthcare in Kenya and picked my clinic as one of his study centres. When he went through my patient records, it came to transpire that in a year, my clinic, which was a one-man show, was prescribing drugs and medical commodities worth Kshs30 million. So, when a governor buys drugs worth Kshs70 million and goes to the Press with that, you can just see the shallow thinking at the county level. They imagine that drugs worth Kshs70 million are a lot. It can be very few drugs. Healthcare is the most devolved function and most of the money that is sent to the counties should be in the healthcare sector. But the governors are mishandling it. There is some serious propaganda which, unfortunately, even some Members of this House have bought, that this Bill seeks to return healthcare to the national Government from the county governments. That is far from the truth. This Bill seeks to deal with just the constitutional mandate of the national Government. The national Government is supposed to take care of national referral services. The Constitution does not say that national referral services are restricted to the Kenya National Hospital (KNH) and the Moi Teaching and Referral Hospital (MTRH) only. National referral services should be available to all citizens of Kenya. That means that the national Government must get closer to the citizens of Kenya. That means that it must have presence even in the counties to offer the national referral services. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
On a point of order.
(Hon. (Ms.) Mbalu): There is a point of order, Hon. Simiyu.
You spoke without interruption. So, I do not know why you are interrupting.
On a point of order, Hon. Temporary Deputy Speaker. Just tell my colleague to relax. I am not interrupting in a bad way. I would want him to explain to the House. He is a Member of the Committee and so, he needs to seduce us to support their proposal. He should then be kind enough to explain to the House what Clause 24 of the Bill means. Maybe, my understanding is different, but I am not a propagandist.
(Hon. (Ms.) Mbalu): Is he out of order? Hon. Midiwo, did you want some clarification?
He wants me to explain. That is what I was trying to do. Unfortunately, he did not pay attention from the word go. I said and I repeat it, we do not want to revert healthcare to the national Government. We want the national Government, which is mandated by the Constitution, to extend national referral services to the nearest points. Otherwise, we are implying that the national referral services will only be at KNH and MTRH, which are not accessible to all Kenyans and yet, all Kenyans have a right to national referral services. Most facilities and trained personnel are found at the national referral facilities. The other problem is that we come up with ideas which we fail to implement. If you look at the National Hospital Insurance Fund (NHIF), people have come from other countries, studied it and gone ahead to implement their national social health insurance funds. An example is Ghana. For us here, we start and leave it. The only way we will implement the clause that The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Your time is over, but I will give you one minute.
Hon. Temporary Deputy Speaker, I think I lost track. I still believe that the Health Services Commission is doable, but there is no political will and there is antagonism towards it. This Bill had too much input from non-medical people, including lawyers and very little input from serious health thinkers. That is why we are having that problem, where there is an excuse that you cannot have a Health Services Commission and yet, there is a body being formulated. The Council of Governors fears the establishment of a Health Services Commission because they have been mishandling health professionals. They fear that if there was a Health Services Commission, they will not mishandle them. That fear has permeated to everybody and they say that we cannot have a Health Services Commission in this Bill. There is a lot more to say to this, but suffice to say that, I support it. But serious amendments must be brought to this Bill.
(Hon. (Ms.) Mbalu): Thank you. Well spoken
. The Member for Ndhiwa, Hon. Aghostinho Neto.
Thank you, Hon. Temporary Deputy Speaker. I would like to start from the point at which Hon. Simiyu was trying to explain to Hon. Jakoyo. I think Hon. Jakoyo would better listen to me because I would like to give him some legal understanding of what Hon. Simiyu was trying to say. I have listened to the first two doctors speak very well and they have spoken to serious issues medical, but what they have refused to understand or speak to are serious issues legal. Hon. Eseli Simiyu speaks to Clause 24 of this Bill. What they are trying to do in Clause 24 cannot be done in law simply because if you look at the Sixth Schedule, Clause 15 that they are trying to refer to, it speaks to three years after an election has been done. So, you are phasing them out in a manner that anticipates that these things are not yet devolved. That devolution was supposed to have been happening in phases, and that has not happened. So, you cannot then have a claw-back clause in the manner of Clause 24 of the Bill.
On a point of information.
I am happy to be informed, but at this point--- The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Hon. Agostinho Neto, are you ready to be informed?
I do not want to be informed by Hon. Nyikal. I said that I want tell him things legal because he has spoken things medical.
(Hon. (Ms.) Mbalu): Hon. Neto, it does not matter whether you do not want to be informed, but you should also let the Speaker rule on that. So, allow me to report that you do not want to be informed. Hon. Nyikal, Hon. Agostinho Neto, does not need your information.
Thank you very much, Hon. Temporary Deputy Speaker. What is bothering members of the Departmental Committee on Health is what is bothering all Members of Parliament. What is bothering all of us is that the health function is not going on very well in the counties. As Members of Parliament, we cannot sit here and constantly cry that things are not going on well without doing anything. However, the provision to work with is not Section 15 of the Sixth Schedule of the Constitution. What ought to help us is the provision of Article 187 of the Constitution. The provision allows the national Government and the county governments to discuss what roles they can exchange and the manner in which they want to exchange those roles. However, to try to have a claw-back to the provisions of the Constitution in the manner Clause 24 of this Bill proposes is not tenable. So, re-look at the provisions of Article 187 of the Constitution. The second thing is that I appreciate the fact that Hon. (Prof.) Nyikal is in love with equipment. They want doctors to be compensated and they want people not to be given free emergency medical treatment. However, Article 43(2) of the Constitution is very express. It says emergency medical treatment shall be given. To have a claw-back in the manner the Committee is trying to do in this Bill is a negation of that constitutional right. As a student of law, I know for a fact that you cannot use the provisions of a single legislation like this to take away constitutional provisions. The best they ought to do---
On a point of order, Hon. Temporary Deputy Speaker.
(Hon. (Ms.) Mbalu): There is a point of order by Hon. Eseli. What is out of order?
Is the Member in order to imply that Hon. (Prof.) Nyikal and I do not want Kenyans to receive emergency care? What we have said is that Kenyans should receive emergency care, but there should be fair compensation. That is what we have said.
(Hon. (Ms.) Mbalu): Hon. Agostinho, as you make your contribution, clarify to him whether that is exactly what you have said.
Thank you, Hon. Temporary Deputy Speaker. I have listened to a lot of medical language today and I appreciate the gentlemen. However, they must appreciate what is legal and what is medical. What we are talking about in terms of emergency healthcare is legal. Article 43(2) of the Constitution is very express that emergency medical treatment shall be accorded. You cannot put a condition in the manner you are trying to do in Clause 7(2) by subjecting this right to progressive realisation as per the provisions of Clause 54(2). That cannot happen. It is not the business of a patient to see who is being compensated and how. A patient’s business is that the right to emergency medical treatment is a constitutional right, which must be guaranteed. How you provide for it is not by negating the right as the Bill seeks to do. The third thing I would like to speak to is the constant use of the word “progressive” in this Bill; progressive realisation of the right to health, progressive realisation of economic social The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): The Member for Isiolo County, Hon. Tiya Galgalo.
Thank you, Hon. Temporary Deputy Speaker. I stand to support this Bill. Health is a very sensitive issue. The county governments have been ill-prepared to take over the health services. Quite a number of counties do not have proper facilities to handle some of the emergencies that occur in their respective areas. Some hospitals in the counties lack medical personnel, equipment and facilities that can help communities. Quite a number of areas, especially rural and remote areas like Isiolo do not even have proper hospitals. The Level 4 hospital we have was run down a long time ago. Even after the County Government of Isiolo took over, much of the support patients require has not been fully actualised. After devolution, most of the health personnel are so demoralised. Many of them have not been paid for several months. Many of them who were there before were not promoted. The new ones who were recruited were given very high positions. So, those who have been there have been demoralised and they are not able to work as required of them. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): The Hon. Member for Bondo, Hon. Gideon Ochanda.
Hon. Temporary Deputy Speaker, I do not know whether I will move this “informal House” away from my front. Definitely, there is quite a bit of logic in terms of what has been brought out. The Bill is fairly reactionary. To the extent it tries to respond to the operational failures that are evident in the country, particularly in the health sector, it is predominantly ignoring very serious aspects of the Constitution. I want to believe that if we go at this rate, if we cannot handle it in the House, there are chances that it is going to be challenged in a court of law like some of the Bills that we have had before. Our Constitution generally provides for what needs to happen. Many things did not happen the way they were supposed to happen. First, we did not need to have global transfer of functions the way we did in the first six months. That was the first problem that we had as a country. Secondly, there needed to be assessment of capacities before a function is transferred. If we are transferring a health function to a county government, the question would be: Are they ready? Nobody did this! We transferred functions to county governments that were not ready to The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Member for Kwanza, Hon. Ferdinand Wanyonyi.
Hon. Temporary Deputy Speaker, thank you for giving me the opportunity to contribute to the Bill. I also support the Bill. As it has been said, this Bill should have come much earlier at the time when we were actually devolving.
Hon. Temporary Deputy Speaker, can you save me from my colleagues here?
(Hon. (Ms.) Mbalu): Hon. Members, can we save Hon. Ferdinand Wanyonyi together? You are saved.
Thank you, Hon. Temporary Deputy Speaker for helping me because there was a heated argument here. Before the doctor disappears, I want to say that we The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
On a point of information, Hon. Temporary Deputy Speaker.
(Hon. (Ms.) Mbalu): Order, Hon. Wanyonyi! There is an intervention by Hon. Nyikal. What is your intervention?
I know what I am talking about.
(Hon. (Ms.) Mbalu): Order, Hon. Member! You are getting out of order. Hon. Nyikal, what is your intervention?
It is a point of information.
(Hon. (Ms.) Mbalu): Let me get to understand whether Hon. Wanyonyi needs it. Hon. Wanyonyi, Member for Kwanza, are you ready for his information?
I do not need his information because I know.
(Hon. (Ms.) Mbalu): So, Hon. Nyikal, he does not need your information.
Hon. Temporary Deputy Speaker, they are distracting my discussion. If they listen to me---
On a point of order, Hon. Temporary Deputy Speaker.
(Hon. (Ms.) Mbalu): You would rather state what is out of order.
Thank you, Hon. Temporary Deputy Speaker. My point of order is a very serious matter.
(Hon. (Ms.) Mbalu): What is out of order?
It is a matter bordering on the integrity of this House. Our Standing Orders do not allow a police officer or anybody to come and arrest anybody within the precincts of Parliament. I do not under-value what the Member of Parliament for Kwanza is saying, but I thought that this is a very serious matter. The Criminal Investigation Department (CID) officers-- -
(Hon. (Ms.) Mbalu): Do you have any information to that effect?
The CID officers have invaded Parliament and arrested one of the journalists in the precincts of Parliament. I have no problem with journalists being arrested---
(Hon. (Ms.) Mbalu): Order! Thank you, Member for Suba. That is relevant, but you know in which office to do it. As a House, we have already heard it.
Hon. Temporary Deputy Speaker, I just want to bring it to the attention of the Chair. This is a very serious matter.
(Hon. (Ms.) Mbalu): Yes, the message has been passed. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
We do not want to go back to the periods when the late Martin Shikuku was arrested.
(Hon. (Ms.) Mbalu): Though it is irrelevant to the discussion ongoing, you have already passed your message.
The House is under siege---
(Hon. (Ms.) Mbalu): You have already passed your message even though it is a bit irrelevant. It will be handled in the right manner. Actually, it is not Hon. Wanyonyi who was out of order. So, Hon. Wanyonyi, you are protected. There was nothing out of order as far as your contribution was concerned. Carry on. For this matter, I will add two more minutes.
Thank you, Hon. Temporary Deputy Speaker. You have always been kind. What he is saying is important. During emergency cases, this Bill says that the first hospital you get to is the first contact that should stabilise the condition of patients. That dispensary or hospital will take care of that person as one awaits medical help. It is wrong for institutions to insist that they must be paid first before that help is given to a patient. This clause is very clear. Our brothers in the health services are saying that one must pay because one will be depriving that particular hospital or institution the right to get money. That is the point we are coming from. We have cases where Kenyans die because when they are taken to the nearest dispensary or hospital, they are first asked if they have money. I have a case where a lady almost died when she wanted to deliver. The first thing she was asked was to make a deposit. This is not medically ethical. It is true that it is business. Recently, I travelled to India, which is actually the second most populous country in the world. They have facilities that we actually admire. I was so impressed when I went to a hospital called Apollo. I am sure Hon. (Dr.) Nyikal knows about it. I was surprised one of the patients there comes from my constituency – and I pray that she gets better. I saw about 10 other Kenyan patients when I was in India two weeks ago. All of them were looking for medical services that could actually be provided here - only that our medical services are not subsidised. Therefore, you will find people leaving this country for other countries to look for medical care. India, which has billions of people, is able to provide social health services where health services are actually subsidised. We should do the same. This Bill should have come much earlier so that we lessen the burden being borne by our people. Our people are suffering and I think this Bill is going to cure that. Hon. (Dr.) Nyikal actually mentioned that devolution of the health services was done prematurely. We should have taken time to determine whether the county governments were prepared to take over that function. I can tell you for a fact that in my county, medical facilities are wanting. They are in a very bad state. For example, the situation is bad in a case where a patient lives far away from a referral hospital. As recent as two days ago, I had to transport a patient from Kitale, which is almost 70 kilometres away, to Moi Teaching and Referral Hospital in Eldoret. The poor child died on the way. I am sure that could have been prevented if Level 5 hospitals were working. Emergency cases such as what I am talking about would have been handled at a Level 5 hospital in my county. So, those services were prematurely devolved. They would have taken time and the process would have been done gradually. If the counties were ready to have the services, we would have devolved those functions.
My county was not prepared because it cannot even pay the personnel. In fact, people are resisting getting employed in hospitals in my place just because they were not prepared. A The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
You will have two more minutes because of the interruption that you had.
The 65 year olds should be given the National Hospital Insurance Card. When we come to the Third Reading, we will bring that amendment so that 65 year old Kenyans are given National Hospital Insurance Cards so that they can access hospital facilities as required. There are cases where a patient is taken to a Government hospital and incurs very heavy expenses. The fellow dies at the end of the day and the next of kin are forced to pay the bills. Something should be done about that. I have had so many such requests. They tell you: “So and so has passed away. Hon. Member, assist us to clear hospital Bill”. It becomes very expensive. One of my constituents died in Eldoret and I am now required to pay Kshs720,000. Where do I get it from? My salary is barely more than Ksh200,000. We should come up with an amendment at the Third Reading to take care of those who die while under Government and county institutions and the relatives are unable to clear medical bills. I support the Bill. It has come too late. It should have been there at the time we were devolving those services to the county governments. I support.
Hon. Members, I want to refer you to Standing Order No. 83 on points of order, information and on intervention to any discussion or any message to the House. This matter is on points of order. Let me read for you parts (1) and (2) so that when a Member is contributing, it is important that we raise a point of order or point of information at the right time. We allow interventions, if you want to make an intervention. It is also good to indicate that we have the clerks at the Hon. Speaker’s desk. At your seat, you can indicate on intervention so that we do not interrupt Members’ contribution, if there is something out of order. Standing Order No. 83. (1) reads as follows:- “ (1) Any Member may raise a point of order at any time during the speech of another Member, stating that the Member rises on a point of order and that Member shall be required to indicate the Standing Order upon which the point of order is based. (2) When a Member raises a point of order during the speech of another Member, the Member who was speaking shall thereupon resume his or her seat and the Member raising the point of order shall do likewise when he or she has The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Thank you very much, Hon. Temporary Deputy Speaker, for giving me this opportunity to contribute to this very important Bill. We are discussing the Health Bill. This Bill has been very long in coming. We have waited for it for a long time. At some point, we heard that it was lost and nobody could trace it. As days went by, more and more confusion prevailed in the health sector in this country. So, we are very happy to have the Health Bill being debated on the Floor of this House. A nation can only prosper if its people are healthy. So, as the representatives of the people, it is incumbent upon us to ensure this. Key challenges face the health sector. There is low access, prohibitive costs and poor quality healthcare. As a health management professional, I know that the first step is a health policy. This is what we are doing through this Bill. Then we look at the issue of health financing, health access and quality. Before I get into the Bill, I must say that it should disturb us that today this country spends less on healthcare as a percentage of our Gross Domestic Product (GDP) than we did in the year 2001 or 2002. It must disturb us. The distance we are from the Abuja Declaration is long. We are at 5 per cent and yet, the Abuja Declaration is at 15 per cent. The global average spending on healthcare is 9 per cent. These are the issues that we must be thinking about as we debate the Health Bill. The issue of health financing, particularly, must be looked at seriously and whether the National Hospital insurance Fund (NHIF) as it is currently constituted is what is going to take us to the universal health coverage that we require. We must look at how efficient the NHIF is. It is now spending much more on administration. Financial sustainability of NHIF itself is wanting. For us to pay for healthcare in this country, we must take bold steps. What the Health Committee must lead us in reflecting on is this: Is it going to be this Parliament that takes that bold step? Are we going to leave it to a future Parliament? There must be radical steps in any breakthrough. Therefore, the decision is upon us whether we will be taking radical step or we will leave it to another Parliament. I am happy that the Bill makes progress in actualising the right to reproductive health and emergency treatment.
Recently, we had a very serious accident at Homa Bay County. I must thank the administration of St. Camillus Mission Hospital in Migori because when several accident victims were taken there, they took immediate steps by treating them. By the time we came in, they had already had emergency care. We finally paid for it but they were taken in at that point when they did not have money. So, private hospitals must look at paying for emergency treatment as part of their corporate social responsibility. The issue of compensation must be looked at. The sustainability of compensating hospitals that provide emergency care to patients is an issue that must be looked at seriously.
(Hon. (Ms.) Mbalu): Hon. Gladys Wanga, there is an intervention or a point of information from Hon. James Nyikal. Is it true that it is a point of information? The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Hon. Temporary Deputy Speaker, I am happy to receive information from our healthcare guru .
(Hon. (Ms.) Mbalu): Let him say it for the sake of us. I should not assume that it is a point of information.
Hon. Member, are you ready for information?
Yes. I am ready to receive information.
(Hon. (Ms.) Mbalu): You can inform Hon. (Ms.) Wanga.
Thank you, Hon. Temporary Deputy Speaker. This is in relation to emergency care and treatment for it. Several Members have taken it that when we say that we must pay, we are saying that patients must pay before they get emergency care. What is proposed in the Bill and what we would want to say is that we must have a social health insurance that ensures universal access to treatment. It is through social health insurance and public funding that we will arrange for payment or compensation for emergency care, but not by the patient. The Committee believes that it is this House that must take the bold step in that direction.
(Hon. (Ms.) Mbalu): I can see her nodding.
I thank Dr. Nyikal for that information. With that kind of set up, it will be a very useful move. That is well clarified. Hon. Temporary Deputy Speaker, I hope you will add me two minutes on the basis of that point of information.
I am also happy with Section 8 of this Bill that speaks to access to health information. Many times, you can go through the health system, particularly in our villages. Somebody can be treated from the beginning to the end and given prescription without them even knowing what they are suffering from. Some things will be scribbled. You will be told to go for a test and come back. Then you are told go and buy some drugs. At the end of the day, you will not have a proper understanding of what your illness is. This is a very important part of this Bill. It ensures that you are given information regarding your own health. It would be important to have that information when you want to seek a second opinion.
There is need to define “specialised health activities”. There is a section of the Bill that speaks on the issue of specialised health activities being done by the national Government. If this is not defined, it is likely to cause confusion at the end of the day. So, in the definitions, we need to say what exactly specialised health activities are, and which ones qualify in this section.
The creation of the authority is very useful. As part of its responsibilities, it should also look at the issue of licensing. We have been treated to the theatre of the absurd by people like Mugo wa Wairimu and others operating clinics without proper licences. People are going to many quacks in town. Coordination and licensing must be looked at seriously by the authority. It must also look closely at the issues of continuous medical training. I know that, currently, there is continuous medical training and points that are awarded. However, when you look at the cases of misdiagnosis that happen, you are left with the question of who exactly is responsible for ensuring that our health providers are continuously updated and trained to a point that they are up to date to deal with the issues that come up now, like emerging illnesses.
People have canvassed the issue of sufficient personnel. It is a very serious issue because when we talk about the Health Bill and healthcare, we cannot speak about it in isolation of the issue of sufficient personnel within our facilities. I am particularly concerned with personnel that is specialised in illness such as cancer and other chronic illnesses. When you go through cancer The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Your time is over. Today, I am at my best philanthropic level. I can add you one more minute as you requested.
Give her two minutes.
(Hon. (Ms.) Mbalu): There should not be a lot of lobbying. Give her just one minute. Put an intervention.
Thank you very much, Hon. Temporary Deputy Speaker for adding me that minute. I was contributing to the issue of having clinical officers in charge of health centres. Nurses should also be allowed there so that we are not restrictive.
As I finish, there are very disturbing news that has been brought here, that a journalist has been arrested in the precincts of Parliament. That sets us back as far as the freedom of Press and information is concerned. We must condemn that seriously. You cannot arrest a journalist within the precincts of Parliament. I speak to that as the Chair of Information and Public Communication of the Parliamentary Service Commission.
(Hon. (Ms.) Mbalu): Well spoken. Your one minute was not over. Hon. Priscillah Nyokabi, Member for Nyeri County.
Thank you, Hon. Temporary Deputy Speaker. I thank all hon. Members who have contributed before on the Health Bill.
I want to start by asserting that I support this Bill. I support the enactment of the Health Bill, 2015. I also want to congratulate the Ministry of Health and the Departmental Committee on Health here for being able to get to this step. It has been a long story. It has been many steps. The country has waited for this law. It does not matter how long we have waited. Now that we are here, it is good that the Committee has completed. It is good that the Ministry of Health has been able to bring this particular piece of legislation before the House so that we can debate and pass it. I hope that even as we improve the Bill and put in amendments, this is one of the laws that we will ensure sees the light of the day. We should ensure that we finish our part. It is a constitutional Bill which will go to Senate. They can finish their part as soon as they can. By the year 2016, we will have a regulatory framework for healthcare in our country. Hon. Temporary Deputy Speaker, I would like to start with the constitutional framework, Article 43 in particular, and celebrate that the right to healthcare was included in our very progressive Constitution. It states that every Kenyan has a right to healthcare, including emergency treatment. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Very well spoken. Member for Vihiga.
Thank you, Hon. Temporary Deputy Speaker, for giving me the opportunity to support this Bill. This Bill touches on what is so close to our lives - health. All the successive campaign manifestos have talked about health. That is eradication of disease, poverty and illiteracy. However, we are still grappling the three. When the new Constitution came in place we thought we had found a solution. The Constitution did not envisage the kind of political competition we have today. There are a lot of conflicting issues when it comes to health matters in this country. The county governments have abdicated their roles and they are hanging in between. Any law that can help us to operationalise or to clarify what the Constitution intended is very important as far as I am concerned. It may not be perfect but if it can help us take some step towards making The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
Hon. (Ms.) Mbalu): The Member for Maragwa, Hon. Peter Mwangi.
(Hon. (Ms.) Mbalu): Hon. Peter Mwangi, Member for Maragwa, for you to be properly on record and for the sake of the HANSARD, you need to change your microphone. You cannot be captured on the HANSARD from that microphone. Just put your card in the intervention slot. We can hear you now.
Hon. Temporary Deputy Speaker, as I was saying, do I need to repeat everything I have said?
(Hon. (Ms.) Mbalu): No, just carry on.
Hon. Temporary Deputy Speaker, I was talking about a lady teacher from my constituency who had a mental problem and was taken to Mathari Mental Hospital. While there, her eyes were gouged out by the other patients. It took a lot of time for Mathari Mental Hospital to take responsibility. Let those people be treated equally as normal people. Let them be given the protection that they deserve. The issue here is about taking responsibility. We have seen many people in this country being given wrong diagnosis. I remember my father who was being treated for stomach ulcers in a certain hospital in Thika. When we took him to Kenyatta National Hospital, it was realised too late that he was suffering from cancer. It was too late for us to start giving him proper medication which he needed at that time. This Bill is very good because one can now question doctors who give wrong diagnosis. I urge Members of this House to support it. The other issue is that we should start looking at how we can give our people a social medical fund where all Kenyans, and especially the senior citizens of this country, are given proper medication. It becomes very hard once a person retires to get proper medical care. That is why if one retires to the rural areas at the age of 60, he will not live beyond the age of 65. This is due to lack of proper medical care. That is why it is good to have one social medical fund which will give equal services to all the citizens of this country. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Hon. Member for Ol Jorok Constituency, Hon. John Waiganjo.
Thank you very much, Hon. Temporary Deputy Speaker. I rise to support the Health Bill. We have been expecting this Bill for a long time. It has now come at the right time when our country is experiencing a lot of issues concerning health, particularly when the two levels of government are grappling with issue of devolution. The transfer of functions from the national Government to the county government was done under pressure. I am aware that the devolution of the health function was called for by the Council of Governors. They were really passionate about that function. Therefore, the national Government gave in to pressure and released that function to the counties. The problems we find ourselves in today are political problems, in the first instance, because had the national Government insisted on retaining the health function at the national level, we would not be having those problems. This is a good Bill. The only problem with this Bill is that it has certain provisions that appear to contradict the express provisions of the Constitution. Therefore, even as we pass this Bill, we need to be fully aware that it requires certain amendments so that it does not contradict the Constitution. We have many other sectors that would have been devolved as functions, and particularly this one. There was a way that the function of health would have been partially devolved. For instance, they would have devolved certain functions that do not necessarily require heavy equipment and retain others at the national level. We probably would have waited to build more hospitals, particularly Level 4 and Level 5 hospitals. We needed to train more personnel. We also needed to consult healthcare professionals, including doctors before we devolved those functions. The other egocentric mentality is that the governors themselves do not want to concede that some of their counties are not able to handle healthcare. It is very easy. It is in the Constitution that as a county, you can revert some of the functions back to the national Government. Similarly, you can choose which ones to retain and which ones to revert back to the national Government. However, this stand-off between the national Government and the county government does not really help. At the end of the day, it is Kenyans who are suffering. We have seen many deaths. The ones we are talking about here are the ones that have been captured by the media. We obviously know that other than road accidents which occur frequently in this country, we have many other medical conditions that go unnoticed, particularly with regard to child-birth. We know of mothers who have no access to free public facilities. They end up getting their babies at home. In the end mothers lose their babies or both lose their lives. Our private practitioners do not take in patients who do not pay. There are two ways of looking at this - and this is why this Bill is very important. We would want to see a situation where this law also proposes serious fines and sanctions to private practitioners who refuse to give first-aid for instance, to accident victims or expectant mothers. You cannot put commercial interests first and avoid responsibility. Of course, there is what you can call the duty of care, which is not necessarily mandated by law. If you refuse to exercise the duty of care, it does not necessarily mean that you have broken the law. For instance, if you are passing by a dam and somebody is drowning, the law does not compel you to save that person, but it is upon you to exercise the duty of care to save that person. So, morality and law do not necessarily go pari passu . However, we want to penalise public and private institutions which refuse to exercise the duty of care regardless of whether the patient has money or not. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Order! Order, Hon. Member! You have only one minute. Hon. Sunjeev, I can see you on intervention.
On a point of order, Hon. Temporary Deputy Speaker. Is the Member in order to suggest that contraceptives cause serious mood swings in women? Is this out The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): The Member for Ol Jorok, the Nominated Member wants you to substantiate whether you have proof that contraceptives cause mood swings in women?
Hon. Sunjeev Birdi, I have first-hand experience and, secondly, my wife stopped using contraceptives because of those mood swings. I am not talking about things that I am not fully aware of, and I am sure most other men live under such conditions. They have to contain their women when they suddenly take those pills.
(Hon. (Ms.) Mbalu): There is a point of intervention. The Member for Lugari, you are not a woman and I wonder whether you have the same intervention. What is out of order or you want to inform Hon. Waiganjo?
On a point of order, Hon. Temporary Deputy Speaker. I was just seeking your guidance. The Standing Orders dictate that before you contribute on such a Motion, if you have a personal interest, you have to declare your interest before you start contributing. He has personal interest involving the wife.
(Hon. (Ms.) Mbalu): Hon. Member for Ol Jorok, Hon. Savula wants your declaration of your interest. Of course, this was a clarification. It was a point of order. Hon. Birdi wanted you to substantiate whether you can prove scientifically that contraceptives cause mood swings in women.
Hon. Temporary Deputy Speaker, this debate is supposed to help the Kenyan women and men at the same time. I have informed the House that I am fully aware that those pills cause mood swings in women and my wife got those mood swings and we do not use those contraceptives any more. We plan our family without necessarily using those contraceptives. That is the long and short of it. I want to tell the Kenyan women that if they have those pills and they are not on prescription, they should throw them away and get babies if they may.
(Hon. (Ms.) Mbalu): Your one minute is over, so that you do not get your mood swings. The Member for Rangwe!
Thank you, Hon. Temporary Deputy Speaker. I did not know that contraceptives do what my colleague has said. This time round, I will be watching to ensure that those mood swings I see at home are not related to those other things. However, this is a very important Bill for us at this stage as a country when we are implementing the Constitution, 2010. This Bill is arriving at a time that, as legislators, we can respond to the crisis that is affecting the health sector in this country. The state of health care in this country has deteriorated to an extent that it is becoming a crisis. The other day, my wife was telling me that there was a news item on television of a lady in Kakamega who was begging nurses to help her in a maternity case. The nurse derisively told her that her time of duty was over and she had to go home. She left and that lady died. Those things are horrendous. As Parliament, having this Bill before us, we must take time and completely respond to the crisis affecting the country now. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): You promise is to bring amendments. That will be welcome as per our House procedures. Hon. Member for Kibra. It is a coincidence you are sitting next to each other.
Hon. Temporary Deputy Speaker, I also want to say it is a timely matter to have this Bill before this House but, due to the limited time, I would like to be brief in my remarks and contribution. The first thing that I will point out is that Kenya has international obligations which we have signed up to. I had the privilege to participate in the African Commission on Human and People’s Rights, 57th Session in Banjul, Gambia and Kenya presented its report on human rights. When we think about economic and social rights that are guaranteed under Article 43 of our Constitution, access to health rights is so important, including emergency healthcare and also the highest standard of healthcare which includes reproductive health rights. This is an opportune time for us to discuss our obligations under international commitments that our Government has made, and which this House has the capacity to oversee. I hope that the Departmental Committee on Health and the Departmental Committee on Justice and Legal Affairs will find ways to bring the report that was submitted in Banjul, Gambia for thorough investigation by this House to see where the gaps are and what this House can do. I will give you two examples of a particular concern. The first one is on the issue of reproductive healthcare. Under the Maputo Protocol, women have a right to access quality, safe and legal options for abortion among many other issues in reproductive healthcare. You will notice that in Kenya, we have this mentioned in our Constitution that abortion is legal in cases where, in the judgment of a healthcare provider or professional, it is meant to save the life of the mother. But the Ministry of Health has taken away the guidelines that are supposed to guide healthcare providers in this country in understanding their duty, care and responsibility to make sure that, where an abortion is necessary, it can be provided in a legal and safe manner to the women of Kenya. It is not happening because the guidelines were withdrawn since 2011. It is a high time this House and the Departmental Committee on Health held the Cabinet Secretary (CS) accountable to bring those regulations back. It is a commitment under the Maputo Protocol and our Constitution. There is no reason why we should put that aside. Regardless of our religious affiliations, the lives of women and mothers of this country are under jeopardy. The second issue is the Abuja Protocol. Kenya is a signatory to it and we have ratified it. It requires that we put in 15 per cent of our national spending into healthcare. Imagine that! Fifteen per cent will transform healthcare in this country. Every little village will have a clinic. Every little clinic and dispensary will have the capacity to refer, including an ambulance. Countries like Ghana have done this. They have put aside 10 per cent. They have not even reached the 15 per cent. They have put 10 per cent in education and 10 per cent in healthcare. Healthcare and education systems in those countries have been transformed. So, we do not have to go far to look for good examples. I would like to see whether this House can make history by making a provision in this Bill to ensure that Kenyan’s spending on healthcare moves from the measly 6 per cent that we are currently at to 15 per cent. It will be the best investment we will have done to our people. Next will be security. A healthy nation is a productive nation. So, I The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor.
(Hon. (Ms.) Mbalu): Order, Member for Kibra! You still have more time but since time does not allow, you will have your six minutes to contribute unless you are through with your contribution.
Not yet! I will gladly take my six minutes to give more details to the House.
(Hon. (Ms.) Mbalu): You will have your six minutes in the next sitting. Hon. Members, I must appreciate the interest. We have more requests including Hon. Joseph Kiuna, Member for Njoro, Hon. Kimani Njuguna, Member for Gatanga, Hon. Ayub Savula, Member for Lugari, and Nominated Member, Hon. Mwaura, amongst others. Hon. Members, this debate will continue. This is a House of rules and procedures. The time being 6.30 p.m. the House stands adjourned until tomorrow, Wednesday, 11th November 2015 at 9.30 a.m.
The House rose at 6.30 p.m.