NAIROBI, Kenya – The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has warned of possible industrial and legal action over a proposal by Health Cabinet Secretary Aden Duale to bar doctors from pre-authorising insurance claims during official working hours.
The union says the move, which would limit such approvals to outside the 8 a.m. to 5 p.m. window, risks disrupting service delivery and was developed without consultations with organised labour.
The proposal follows remarks by CS Duale earlier this week in which he accused some doctors of juggling multiple jobs and allegedly referring patients from public hospitals to private clinics.
Speaking during the commissioning of a new ICU and amenity wing at Chuka Level 5 Hospital in Tharaka Nithi County, Duale said the government was keen to curb conflicts of interest, protect public resources and rein in rising insurance costs.
He also pointed to what he described as inefficiencies in some public facilities, including Kenyatta National Hospital, and said the ministry would deploy digital tools such as the Afya Yangu app to monitor services and verify insurance claims.
But in a statement issued on Wednesday, KMPDU rejected the plan as “operationally unrealistic” and “administratively arbitrary,” arguing that it fails to reflect the realities of Kenya’s overstretched public health system.
“The proposed mechanism has not undergone formal consultation with organised labour or other key stakeholders in the health sector,” the union said, calling for the suspension of any unilateral implementation pending structured engagement.
KMPDU said it will seek urgent talks with the Ministry of Health, the Social Health Authority (SHA) and the Directorate of Health Assurance (DHA) to formally present its position.
It warned that it would consider “appropriate industrial, legal or advocacy action” if the policy is enforced in a manner that undermines labour rights or compromises patient care.
The union noted that rigid time-based restrictions overlook high doctor-patient ratios, extended shifts, emergency duties and the blurred lines between on-duty and off-duty hours in public hospitals.
It defended dual practice as a survival strategy in the face of staff shortages, delayed pay, heavy workloads and limited incentives for exclusive public service.
While acknowledging the government’s concerns around accountability and prudent use of public and insurance funds, KMPDU insisted that any policy affecting doctors’ terms and scope of practice must comply with the Constitution, existing collective bargaining agreements and fair labour standards.
As an alternative, the union proposed reforms such as structured dual-practice frameworks, roster-based or facility-verified authorisation systems, incentives for exclusive public service, and faster recruitment to ease pressure on public hospitals.
“KMPDU remains committed to strengthening public healthcare delivery and safeguarding patient welfare,” the statement said.
The National Executive Committee statement was signed by National Chairman Dr Abdi Mwachi, Secretary General Dr Davji Atellah and National Treasurer Dr Mercy Nabwire, underscoring what the union described as a united position as discussions with government authorities continue.
