Mixed reactions emerge over Duale's appointment as Health CS

Fresh changes have once again been reported at the Ministry of Health, with Adan Duale appointed as the Cabinet Secretary.

Duale becomes the third Cabinet Secretary to be appointed at the Ministry in less than two and a half years of the Kenya Kwanza administration.

He takes over from Dr Deborah Barasa, who was appointed CS in August last year.

Barasa took over from Susan Nakhumicha, who served as Health Cabinet Secretary from 2022.

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“We are not happy. You cannot keep destabilising the sector and expect smooth operations. Duale could not work with military, but shall he work smoothly in health that require technical understanding,” questioned Miskelleh.

Apart from the shake-up in CS positions, the sector has also had changes at the two state departments within the ministry- Medical Services and Public Health.

President William Ruto established two arms in the ministry to streamline healthcare governance and spearhead sector reforms.

Peter Tum was appointed as Principal Secretary (PS) for Medical Services, while Josephine Mburu was assigned the Public Health docket.

However, a procurement scandal at the Kenya Medical Supplies Authority (Kemsa) involving donor-funded mosquito nets valued at Sh3.7 billion led to their removal—Mburu was dismissed, while Tum was reassigned.

In came Harry Kimtai, who replaced Tum as Medical Services PS, while Mary Muthoni took charge of Public Health and Professional Standards.

In last week’s reshuffle, Kimtai was moved to the Ministry of Mining, with former Kenya Medical Practitioners and Dentists Union (KMPDU) Secretary-General Fredrick Ouma Oluga appointed as PS for Medical Services.

Muthoni, who retained her position, continues to champion the preventive and promotive health agenda under the primary healthcare pillar, where community health promoters play a crucial role.

Before Ruto’s administration assumed office in 2022, the Health ministry operated under a single state department, overseen by PS Susan Mochache.

Duale, according to the union is a politician.

In an interview with The Standard, Miskellah said the sector does not need a politician.

“The sector needs someone who embraces policies; for example, if we say SHA is not working, he should get solutions to fix it, If there is an issue with interns, they should fix it. No politics, this is in black and white,” said Miskellah. “What value is Duale coming to add in healthcare, honestly?"

Duale said he will be required to learn how many cadres the health care has, laws that govern the sector, and also balance with Governors.

“Will Duale come to the sector and say he is coming in as a friend to the president, because health needs a balance of 47 governors with ego, with unions, with patients who know their rights. I do dot know the value, but we are very disappointed," he said.

Miskellah said that with the appointment of Oluga to take over Medical services, with Muthoni running preventive and promotive health, the sector was stable.

“What value is Barasa going to add to the environment? Do we need healthcare to work? Do we want SHA to work?” posed the unionist.

“I am still waiting to see the value Duale will add. But as a union, we are saying if he comes ready to listen to us and make changes, we shall agree to that, but if he comes and bully us around, we shall just go on strike.”

Miskellah maintained that doctors will be looking for implementation of their 2017 CBA and actualisation of the healthcare system.

Respective CS according to the union have been coming up with respective agendas. For example, Nakhumicha pushed for policy formation. Whereas Barasa was for healthcare

Contrary to doctors, Kenya Union of Clinical Officers (KUCO) Secretary General Georeg Gibore applauded the changes, saying the ministry needs a manager and not necessarily a trained doctor.

“It is a better change. We want leadership, not just the name of a medic. Someone who can understand policy and how it should be implemented. I want to believe Duale can do better than Dr Barasa,” said Gibore.

The union representative observed that the Ministry of Health is broad and has many stakeholders who should all be engaged in decision-making for quality access to healthcare by all Kenyans.

Dr Barasa claimed that she was not able to make decisions on her own and did not understand what was to be done.

“We want to see someone who is listening and working with people,” added Gibore. “We want to see someone who is inclusive, engaging everyone, not representing their cadres. I want to see active CS and not passive ones, a CS who can make decisions and stand by them.