Connect with us

News & Analysis

Hakijamii Finds Privatization of Healthcare is Undermining Right to Health in Kenya

HakiJamii and CHRGJ report titled “Wrong Prescription: The Impact of Privatizing Healthcare in Kenya” concludes that privatizing healthcare has proven costly, led to the neglect of public health priorities, contributed to the rise of low-quality, low-cost providers that offer inadequate and unsafe care, and resulted in severe human rights problems including exclusion and denial of service.

Published

on

HakiJamii, a national human rights organization that supports marginalized groups to claim their economic and socio-cultural rights, has described the influx and rapid growth of for-profit actors in health in Kenya over the past decade which has left the private sector now constituting the majority part of Kenya’s healthcare system as amounting to de facto privatization of healthcare in the country. This according to a report released in November 2021 by Economic & Social Rights Centre-HakiJamii and the New York University (NYU) School of Law’s Center for Human Rights and Global Justice (CHRGJ) the explores how privatizing healthcare, defined as increasing the role of the for-profit, private sector, has failed many Kenyans, undermined the right to health and set back the goal of universal health coverage.

HakiJamii and CHRGJ report titled “Wrong Prescription: The Impact of Privatizing Healthcare in Kenya” concludes that privatizing healthcare has proven costly, led to the neglect of public health priorities, contributed to the rise of low-quality, low-cost providers that offer inadequate and unsafe care, and resulted in severe human rights problems including exclusion and denial of service. The report condemns as wrong prescription the practice, in recent years, where policymakers in Kenya have sought to expand access to healthcare by embracing the private sector, undertaking a wide range of reforms and initiatives to encourage private actors to get into the business of healthcare.

“The private healthcare sector in Kenya has generally failed to deliver on many of its proponents’ promises about value for money and access to quality and affordable healthcare. The results have been disastrous for many, especially for poor, vulnerable, and historically marginalized communities. We found that privatization makes healthcare more expensive for individuals and the government, and it is bad value for money. Private providers need to extract profits, face higher borrowing costs than the public sector, and often charge patients overwhelmingly more than public providers,” HakiJamii Executive Director Dr. Nicholas Orago told The Lawyer Africa.

HakiJamii and CHRGJ interviewed Community members including residents of informal settlements in Mombasa and Nairobi, as well as rural areas in Isiolo, in compiling the report. They reported facing excessively high fees at private health facilities, where treatment can cost in excess of twelve times more than the public sector. As a result, out-of-pocket healthcare spending in Kenya has risen 53 percent per capita between 2013 and 2018 as the role of private facilities has increased. In addition, the study found that privatization of healthcare in Kenya has also significantly increased the burden on public coffers.

According to the Report, while private sector involvement in healthcare in Kenya is often promoted as a solution when public resources are scarce, research shows that its growth has been highly dependent on the commitment of major resources from the Kenyan government. HakiJamii findings show that the government now transfers tens of billions of shillings to the private sector annually to contract with private facilities, subsidize access to private care, and pay for secretive public-private partnerships with global corporations. Far from simply filling a gap left by an insufficient public health system, the private sector has been intentionally invited in, and rewarded handsomely by the government and development actors for showing up.

In terms of what is wrong with privatization of healthcare in Kenya, the HakiJamii report notes: “Private providers’ focus is on making a profit, not providing a strong healthcare system that meets national objectives. Because of these misaligned incentives, the private sector neglects important public health priorities. Instead, it is heavily concentrated in the most profitable forms of care, and has spurned less commercially viable areas, patients, and services—including important preventative and family planning services. Healthcare workers described having to meet patient “targets” as well as enduring workplace conditions inferior to those in the public sector. Additionally, private providers, who are insulated from democratic processes, operate with significantly less transparency and accountability.”

HakiJamii concludes that the de facto privatization of healthcare is impacting human rights severely as private sector routinely excludes and denies access to those who cannot afford their services, while driving others into poverty and debt due to the high cost of care. Many people interviewed for this report described facing immense hardships to pay for private care, including selling important assets, like land, and forgoing educational and livelihood opportunities. Others described severe problems resulting from poor quality care at private providers, including unnecessary deaths and disabilities. The negative impact has been especially severe for women and people who are poor and low income, live in rural areas, and have disabilities.

Founded in 2004 and registered in 2007, Hakijamii is a premier national human rights organization at the forefront in supporting marginalized groups to claim and accesss their economic and socio-cultural rights. With a secretariat in Nairobi, it has strategic community partners in Nairobi, Kisumu, Garissa, Isiolo, Kakamega, Kwale and Mombasa and works with governments, CSOs, CBOs, FBOs, and the private sector to jointly create effective engagement platforms, strengthen capacities and link policy implementation to budgetary allocation towards the realization of economic, social and cultural rights.

Hakijamii and CHRGJ recommend that the regulatory framework that applies to private providers should be significantly strengthened and beer enforced. Further, hey call for radical reshaping of the relationship between NHIF and private healthcare providers. The need to refocus health policy and expenditure o prioritize the public healthcare system is also highlighted. “The public health system is far better positioned to deliver on public goals than the private sector. Health policy and expenditure should prioritize the public system. National and county governments should work together to ensure the public healthcare system provides accessible, affordable, quality care for all Kenyans, and that healthcare workers enjoy dignified working conditions. Greater transparency and access to information relating to the private sector’s role in healthcare is also sorely needed,” concludes the Report.

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

News & Analysis

Brief History of the Permanent Court of Arbitration (PCA)

Published

on

By

By Dr. Kariuki Muigua, PhD, C.Arb, Current Member of Permanent Court of Arbitration (PCA) Representing the Republic of Kenya.

The Permanent Court of Arbitration (PCA) is a 124 Years Old Intergovernmental Organization currently with 122 contracting states. It was established at the turn of 20th Century during the first Hague Peace Conference held between 18th May and 29th July 1899. The conference was an initiative of then Russian Czar Nicholas II to discuss peace and disarmament and specifically with the object of “seeking the most effective means of ensuring to all peoples the benefits of a real and lasting peace, and, above all, of limiting the progressive development of existing armaments.” The culmination of the conference was the adoption of a Convention on the Pacific Settlement of International Disputes, which dealt not only with arbitration but also with other methods of pacific settlement, such as good offices and mediation.

The aim of the conference was to “strengthen systems of international dispute resolution” especially international arbitration which in the last century had proven effective for the purpose with number of successful international arbitrations being concluded among Nations. The Alabama arbitration of 1871-1872 between the United Kingdom (UK) and the United States (US) under the Treaty of Washington of 1871 culminating in the arbitral tribunal’s award that the UK pay the US compensation for breach of neutrality during American Civil War which it did had demonstrated the effectiveness of arbitration in settling of international disputes and piqued interest of many practitioners in it as a mode of dispute resolution during the latter years of the nineteenth century.

The Institut de Droit International adopted a code of procedure for arbitration in 1875 to answer the need for a general law of arbitration governing for countries and parties wishing to have recourse to international arbitration. The growth of arbitration as a mode of international dispute resolution formed the background of the 1899 conference and informed its most enduring achievement, namely, the establishment of the PCA as the first global mechanism for the settlement of disputes between states. Article 16 of the 1899 Convention recognized that “in questions of a legal nature, and especially in the interpretation or application of International Conventions” arbitration is the “most effective, and at the same time the most equitable, means of settling disputes which diplomacy has failed to settle.”

In turn, the 1899 Convention provided for the creation of permanent machinery to enable the setting up of arbitral tribunals as necessary and to facilitate their work under the auspices of the institution it named as the Permanent Court of Arbitration (PCA). In particular, Article 20 of the 1899 Convention stated that “[w]ith the object of facilitating an immediate recourse to arbitration for international differences which it has not been possible to settle by diplomacy, the signatory Powers undertake to organize a Permanent Court of Arbitration, accessible at all times and operating, unless otherwise stipulated by the parties, in accordance with the rules of procedure inserted in the present Convention.” In effect, the Convention set up a permanent system of international arbitration and institutionalized the law and practice of arbitration in a definite and acceptable way.

As a result, the Permanent Court of Arbitration (PCA) was established in 1900 and began operating in 1902. The PCA as established consisted of a panel of jurists designated by each country acceding to the Convention with each country being entitled to designate up to four from among whom the members of each arbitral tribunal might be chosen. In addition, the Convention created a permanent Bureau, located in The Hague, with functions similar to those of a court registry or secretariat. The 1899 Convention also laid down a set of rules of procedure to govern the conduct of arbitrations under the PCA framework.

The second Hague Peace Conference in 1907 saw a revision of the 1899 Convention and improvement of the rules governing arbitral proceedings. Today, the PCA has developed into a modern, multi-faceted arbitral institution perfectly situated to meet the evolving dispute resolution needs of the international community. The Permanent Court of Arbitration has also diversified its service offering alongside those contemplated by the Conventions. For instance, today the International Bureau of the Permanent Court of Arbitration serves as a registry in important international arbitrations. In 1993, the Permanent Court of Arbitration adopted new “Optional Rules for Arbitrating Disputes between Two Parties of Which Only One Is a State” and, in 2001, “Optional Rules for Arbitration of Disputes Relating to Natural Resources and/or the Environment”.

Reference

PCA Website: https://pca-cpa.org/en/about/introduction/history/ (accessed on 25th May 2023).

Continue Reading

News & Analysis

Former KCB Company Secretary Sues Over Unlawful Dismissal

Published

on

By

Former KCB Group Company Secretary Joseph Kamau Kania who has sued the Bank for Unlawful Dismissal

Former KCB Group Company Secretary Joseph Kamau Kania has sued the lender seeking reinstatement or be compensated for illegal sacking almost three years ago. Lawyer Kania was the KCB Group company secretary until restructuring of the lender in 2021 that saw some senior executives dropped.

Through the firm of Senior Counsel Wilfred Nderitu, Kamau wants the court to order KCB Group to unconditionally reinstate him to employment without altering any of the contractual terms until his retirement in December 2025.

In his court documents filed before Employment and Labour Relations Court, the career law banker seeks the court to declare the reorganization of the company structure a nullity and amounted to a violation of his fundamental right to fair labour practices as guaranteed in Article 41(1) of the Constitution. He further wants the court to declare that the position of Group Company Secretary did not at any time cease to exist within the KCB Group structure.

He further urged the Employment Court to declare that the recruitment and appointment of Bonnie Okumu, his former assistant, as the Group Company Secretary, in relation to the contemporaneous termination of his employment, was unprocedural, insufficient and inappropriate to infer a lawful termination of his employment.

“A declaration that the factual and legal circumstances of the Petitioner’s termination of employment were insufficient and inappropriate to infer a redundancy against him, and that any redundancy declared by the KCB Group in relation to him was therefore null, void and of no legal effect and amounted to a violation of his fundamental right to fair labour practices as guaranteed in Article 41(1) of the Constitution,” seeks lawyer Kamau.

Kamau says he was subjected to discriminatory practices by the KCB Bank Group in violation of his fundamental right to equality and freedom from discrimination as guaranteed in Article 27 of the Constitution and the termination of his employment was unfair, unjustified, illegal, null and void.

Lawyer Kamau further seeks the court to declare that the Non-Compete Clause in the 2016 Contract is unenforceable by the KCB Group as against him and is voidable by him as against the Bank ab initio, byreason of the termination of the Petitioner’s employment having been a violation of Articles 41(1) and 47(1) and (2) of the Constitution, and of the Employment Act.

He also wants the Employment Court to find that finding that KCB’s group legal representation by Messrs of Mohammed Muigai LLP Advocates law firm in respect of his claim for unlawful termination of employment resulted in a clear conflict of interest by reason of the fact that a Founding and Senior Partner at the said firm lawyer Mohammed Nyaoga is also the Chairman of the CBK’s Board of Directors.

“A Declaration that the circumstances of KCB’s legal representation by Messrs. Mohammed Muigai LLP Advocates resulted in a violation of the Petitioner’s fundamental right to have the employment dispute decided independently and impartially, as guaranteed in Article 50(1) of the Constitution,” seeks lawyer Kamau.

Kamau is seeking damages against both KCB Group and Central Bank of Kenya jointly and severally for the violation of his constitutional and fundamental right to fair labour practices.

He wants  further wants court to declare that CBK is liable to petitioner on account of its breach of statutory duty to effectively regulate KCB Group to ensure that KCB complied with the Central Bank of Kenya Prudential Guidelines and all other Laws, Rules, Codes and Standards, and that, as an issuer of securities, it complied with capital markets legislation.

Kamau through his lawyer Nderitu told the court that he was involved in Shareholder engagement in introducing the Group aide-mémoire that significantly improved the management of the Annual General Meetings, including obtaining approval without voting through the Memorandum and Articles of Association of Kenya Commercial Bank Limited among others.

He said that during his employment at KCB Bank Kenya and with the KCB Group, he initially worked well with former KCB CEO Joseph Oigara until 2016 when the CEO allegedly started sidelining him by removing the legal function from his reporting line.

He further claims he was transferred from the Group’s offices at Kencom House to its offices Upper Hill under the guise that the Petitioner was merely to support the KCB Group Board.

He adds that at that point his roles were given to Okumu for reasons that were not related to work demands.  He stated that Oigara at one time proposed that he should leave his role in the KCB Group and go and serve as the Company Secretary of the National Bank of Kenya Limited, a subsidiary of the Group, a suggestion which he disagreed with to Oigara’s utter annoyance.

Kamau stated that his work was thenceforth unfairly discredited, leading to his being taken through a disciplinary process whose intended outcome failed miserably, and the Petitioner was vindicated.

“More specifically, the Petitioner contends that the purported creation of a new organizational structure towards the end of 2020 was in fact Oigara’s orchestration targeted to remove certain individuals by requiring them to undergo interviews in the pretext that new roles were created, and amounted to a further violation of the Petitioner’s fundamental right to fair labour practices under Article 41(1) of the Constitution,” said in his court documents.

He further adds that this sham reorganization demonstrates how the role of the KCB Group Company Secretary purportedly ceased to be and was then very briefly replaced with a new role of the KCB Group General Counsel. The role of KCB Group Company Secretary then ‘resurfaced’ immediately thereafter, in total violation of legal and regulatory requirements.

Continue Reading

News & Analysis

Court of Appeal Upholds Eviction of Radcliffes from Karen Land

Published

on

By

Adrian Radcliffe, the Expatriate Squatter, Evicted from Karen Property by Innocent Purchaser for Value

The Court of Appeal has stayed the decision of the Environment and Land Court purporting to reinstate Adrian Radcliffe into possession of the 5.7 Acre Karen Land by Kena Properties Ltd after eviction by the lawful owners in February 2022. Adrian Radcliffe who was evicted by Kena Properties Ltd, the innocent purchaser of the Land for value.

Before his eviction, Mr. Radcliffe had been living on the land as a squatter expatriate for 33 years without paying any rent. Since he moved into the property as a tenant, he only paid deposit for the land in August 1989 despite corresponding severally with the owner of the land. His attempt to acquire the land by adverse possession claim filed in 2005 was dismissed by Court in 2011 on the basis that he has engaged with the owner of the land July 1997 and agreed to buy the land which he failed to do. The High Court [Justice Kalpana Rawal as she then was] concluded that:

“His [Mr. Adrian Radcliffe] averments that he did not have any idea of the whereabouts of the Defendant and that he could possibly be not alive, were not only very sad but mala fide in view of the correspondence on record addressed by him to the Defendant’s wife. I would thus find that the averments made by him to the contrary are untrue looking to the facts of this case.”

On 10th March 2022, Mr. Adrian Radcliffe and Family purported to obtain court orders for reinstatement into the land. However, the Court of Appeal issued an interim stay of execution of the said orders. The Court of Appeal has now granted the application of Kena Properties Ltd and stayed the execution of the Environment and Land Court Order pending the hearing and determination of the Appeal.

The Court also stayed the proceedings at the Environment and Land Court on the matter during the pendency of the Appeal. In effect, the eviction orders issued by the Chief Magistrate Court for eviction of Mr. Adrian Radcliffe in favour of Kena Properties as the purchaser of the property for value were upheld and the company now enjoys unfettered ownership and possession of the suit property until the conclusion of the Appeal.

The Court of Appeal in granting the orders sought by Kena Properties Ltd concurred with Kena Properties Ltd that as the property owner it had an arguable appeal with a high probability of success which would be rendered nugatory if Adrian Radcliffe a trespasser was to resume his unlawful possession of the suit property, erect structures thereon, recklessly use or abuse the said suit property as he deems fit. In any case, that is bound to fundamentally alter the state of the suit property and render it unusable by Kena Properties Ltd as the property owner.

At the same time, the Appellate Court rubbished the argument of Adrian Radcliffe in opposition to the application for stay that he has been in occupation of the suit property for more than 30 years and that he and his family were unlawfully evicted from the suit property on 4th February, 2022. The Court also rejected Radcliffe’s claim that Kena Properties Ltd has no valid title to the suit property and held that as the purchaser, the company was entitled to enjoy ownership and possession of their property during the pendency of the appeal.

The Court dismissed claims of Mr. Adrian Radcliffe that Kena Properties Ltd as the property owner acquired title to the suit property illegally and unprocedurally finding to the contrary. Further, it rejected Adrian Radcliffe’s claim that Kena Properties as the purchaser cannot evict a legal occupier of a property putting paid to the claim that he was a legal occupier at the time of eviction.

As a matter of fact, Mr. Adrian Radcliffe cannot claim to be the legal occupier of the property having attempted to acquire it by adverse possession before the High Court thwarted his fraudulent scheme on 28th February 2011. Mr. Radcliffe did not appeal the 2011 High Court decision meaning it is still the law that he is not the owner of the land nor the legal occupier of the land having attempted to adversely acquire against the interests of the lawful owner who sold it to Kena Properties.

Mr. Adrian Radcliffe is a well-to-do Water, Sanitation and Hygiene (WaSH) UNICEF consultant and former UN employee (who has been earning hefty House Allowance). Many have wondered why he has been defaulting in paying rent for 33 years on the prime plot of land in Karen while living large and taking his kids to most expensive schools in Kenya. No question, a local Kenyan could never have gotten away with such selfish impunity.

Continue Reading

Trending