By Dr Robert Armstrong
Dean of Medical College, East Africa
In Kenya we are seeing a complete health care paralysis involving both doctors and our political leaders. It has been disheartening to witness patients not receive critical care when care should have been available. Patients are being the victims of salary negotiations or demands for health systems improvement. This is wrong. It destroys the doctor-patient relationship and will cause irreparable harm and significant delay in achieving real improvements in health care delivery.As a university that provides patient care, we are committed to place the patient first. We train health professionals and want them to focus on the best interests of their patients. This drives our commitment to achieving international accreditation of our hospital, to a physician credentialing structure that ensures qualifications are real and sustained, and a quality improvement system that ensures evidence-based care. The current dispute between doctors and the government does not place the patient first. Indeed, the patient is sacrificed to the mission of the “greater good,” whether that is a fair wage or an improved health system. There are mechanisms for legitimate job action, balanced against the commitment to ensure that essential services are maintained. Doctors deserve fair compensation based on the trust that the doctor is always acting in the best interest of their patients. Break that trust and you compromise this fundamental relationship.Health care systems around the world are complex. Improvements cannot be negotiated through the lens of a labour dispute. What is required is leadership that creates a vision and framework to work continuously to improve health systems to deliver good quality care. Achieving such improvements depends on a committed workforce that is valued, and that delivers value.As a University we want our faculty, staff and students to find constructive and innovative ways to model patient-first principles while they positively impact health care delivery. We believe that resolving the compensation issues must be separated from the health care system issues and that responsible leaders must commit to set real targets, focus on health system improvement and achieve real change in healthcare for all Kenyan citizens. We urge the parties to sit and negotiate in good faith as it is only through dialogue that the matter will be resolved. We hope for a speedy and equitable resolution so that Kenyans are able to access the healthcare they need and deserve.