Bill seeking new health regulator sparks concern over role overlap

The Kenya Kwanza administration is yet again under scrutiny over the perceived duplication of roles within government institutions.

In a development that has triggered debate over the regime’s efficiency, the administration has introduced a Bill that seeks to establish an agency which will licence hospitals, accredit facilities, inspect and audit, and enforce compliance to set health regulations.

This is despite similar roles already being performed by bodies such as the Kenya Health Professions Oversight Authority (KHPOA), Kenya Medical Practioners and Dentists Council (KMPDC) and the Ministry of Health.

The Quality Healthcare and Patient Safety Bill, 2025, that is currently before the National Assembly, also seeks to provide for the responsibility of the national and county governments in the realisation of quality of healthcare for patients and to set and provide for implementation of standards for quality of healthcare.

Legal framework

“The principal object of this Bill is to establish a comprehensive legal framework to promote the improvement of the quality of healthcare in Kenya by establishing standards, accreditation mechanisms and ensuring the protection and promotion of patient rights,’’ the Bill reads.

To ensure the administration of healthcare in the country, the Bill proposes for the establishment of an Authority to be known as the Quality Health Care and Patient Safety Authority (QHPSA).

Its functions will be to regulate and guide the development of health facilities’ infrastructure; register, license and accredit health facilities; regulate the conduct of health facilities; inspect health facilities for compliance with quality of healthcare standards and inspect and accredit health facilities for purposes of internship and training.

Others include establishing and implementing a system of accreditation of health facilities for quality of healthcare; accredit health facilities for purposes of empanelment and contracting under section 33 and 34 of the Social Health Insurance Act, enforce compliance with quality of healthcare standards and promote public awareness on quality of healthcare including on patient rights among others.

The Authority will be headed by a board which will have sweeping powers to enter, inspect and search any health facility and one where an offence is being committed or is suspected to have been committed. With the approval of the National Treasury Cabinet Secretary, the Authority will invest any surplus funds not immediately required.

The board will also be at liberty to levy or charge fees for the services rendered by the Authority and to further receive gifts, grants, donations or endowments and make legitimate disbursements therefrom.

Pundits, however, argue that while the Bill promises to reduce fraud and improve care, it not only risks centralising too much power, creating a duplication of roles.

Fears have been espoused that should the Bill get the nod from lawmakers as currently is, it would lead to an overlapping of mandates between authorities such as KHPOA, KMPDC and the Ministry of Health.

This premised on the fact that the agencies and other regulatory councils are already performing the roles to be taken up by the new Authority and the new Bill does not provide for their scrapping.

Notably, functions of KHPOA include training, registration and licensing of health professionals; coordinating joint health inspections; receiving and facilitating resolution of complaints and arbitration of disputes and conflicts; ensuring compliance of health professionals standards and monitor execution of respective mandates and functions of health regulatory bodies.

KMPDC is mandated with regulating the training, practice and licensing of medicine and dentistry, and healthcare institutions that include private and mission hospitals, medical, dental centres and clinics, nursing and maternity homes and standalone funeral homes.

Healthcare standards

On the flipside, the Kenya Medical Association, the umbrella professional association for doctors in Kenya, supports the Bill, noting that it would transform Kenya’s healthcare landscape and advance healthcare standards in Kenya.

“Kenya Medical Association (KMA) supports the Bill’s provisions on: patient rights because the Bill has comprehensively defined patient rights, including informed consent, dignity, and access to qualified professionals elements that represent essential standards in patient care which require clear operational guidelines and consistent enforcement,” reads a statement from KMA which was submitted to Parliament at the public participation stage. “The inclusion of quality assurance mechanisms, rightly mandating safety protocols, risk management, and continuous professional development, reflects an attempt to address existing systemic gaps. Considerations for standardised regulation through the establishment of a dedicated Authority for oversight, accreditation, and enforcement is necessary for national coherence,” it adds.

Current regime

Notably, the Bill is not the first time to elicit debate, as the administration is facing over a duplication of roles by the current regime.

Last year, the courts slammed the brakes on a multi-agency task force to fight graft formed by President William Ruto, arguing that it was a duplication of roles already vested in existing independent institutions such as the Ethics and Anti-Corruption Commission.

A broader look at other offices and ministries in the public sector also reveals overlapping roles.

For instance, the Ministry of Public Service, the Office of the Head of Public Service, and the Public Service Commission have similar roles.

While Public Service CS is responsible for the general public service docket, supporting and facilitating performance management for effective service delivery, the Public Service Commission also promotes good governance and ensures efficiency in public service.

Head of Public Service Felix Koskei, also has duties that include promoting ethics, good governance, efficiency, and effectiveness in public service.

The duplication of roles now casts a dark shadow over the administration’s promise to reduce public expenditure in light of the country’s ballooning wage bill.