GOVERNMENTS HAVE NO MORAL AUTHORITY TO HOLD HEALTH WORKERS ACCOUNTABLE TO CONSUMERS

By Tracy Liloe

Let’s face it, the country has doubts on the ethics, competencies and attitudes of a section of health workers and by extension hospitals. Gory stories and videos, some uninformed, have washed social media platforms. The general perception of the public has thus morphed from misdiagnosis and negligence to ‘cyber bullying’ of health workers by persons allegedly being commissioned by third party competitors.

The trust bestowed on health workers by the consumer public is one of the most powerful indicators of the health of the healthcare system. The public verdict, going by the perception on health workers, is that the health sector is pathetic and the health workers have a similar verdict. But the story doesn’t end there. The public sector is nearly dead in our country. Education, agriculture, civil service, name it! In fact, in comparison, the health sector is stellar functional miles ahead of other sectors in terms of response to the needs of Kenyans but suffers a deadly rebuttal given the high expectations. The rebuttal is genuine and warranted because health services are a matter of life and death and unlike the judicial system which has appeal mechanisms, there are no appeals for loss of life.

However, the poor public perceptions on the health providers and attacks on health workers are engineered by those in authority, if the recent storming of Pumwani Hospital is to be interrogated. This is a scape goat mechanism that allows leaders to avoid being accountable to the public on mismanagement of the health sector and covers the leaders’ loss of moral authority to bring order to the sector. Eventually, the public has been hoodwinked to misdirect their anger to helpless health workers.

Research has brought little evidence on how health providers can be held accountable to consumers with mixed intervention results. Determinants of provider accountability relate to healthcare system management, resource allocation, oversight on health workers, consumer power which is a direct product of awareness and the health worker beliefs. Of these factors, the most powerful change tool is the government oversight on health workers. Government here being represented by Ministry of Health and it’s over 10 regulatory agencies. Tellingly, regulation of health sector is extremely weak. Herbalists have several hours a day on Television misleading the same complaining public while the regulators are busy extorting the qualified, well trained but underpaid health workers in exorbitant annual retention fees and other unnecessary licenses. The public, aided by mass media, for example, kept referring to the quack Mugo wa Wairimu as a doctor even after evidence showed he never stepped into any medical school. Such misreporting has power to impart negative perceptions.

Social influencers, particularly social media cyber bullying of health workers is gaining trend in Kenya and health providers are being overly exploited in retention fee payments by regulatory boards without commensurate professional protection and advancement. The regulatory boards have not only failed to bring accountability to the consumer but also created animosity between the public and the health workers. In set ups where health workers and consumers have public interaction mechanisms, health providers are much more accountable. In such participation, the ‘googling public’ are informed on health seeking behavior and attitudes to allay their ‘internet found fears’.

Developing countries still have a heavy reliance on government control of the health sector and health workers must follow the same route to deliver accountability. Citizens abusing and ridiculing doctors will only serve to widen the enemy’s gap and lead to poorer services.

Unfortunately, Government and agents of government have advantageously fueled this health worker cyber and media directed labeling so as to transfer the burden of providing health services to the same workers it mistreats by denying allowances, paying poorly and not offering adequate tools of trade. The false narrative is that health workers are under oath. But isn’t the president or the cabinet secretaries under oath too? For a reminder, Hippocrates, whom doctors are profoundly proud of and take his oath was the richest man in his time. He certainly would not prescribe an oath that would compel doctors to sleep hungry and be evicted by landlords as they do now when salaries aren’t paid or too low. Consequently, the government and its regulators lost the moral standing to provide the much lacking oversight on health workers without which accountability to consumers can’t be achieved.

The Kenyan citizen must realize now that shifting blame from the health provider to the government that they pay taxes to is the effective means to hold both health workers and hospitals accountable to patients. Such action must begin by the public collaboratively compelling government to improve its moral status among the health workers by treating them and paying them appropriately.

 

Tracy Liloe is a Human Resources Manager who roams the corridors of healthcare.

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