Health Unions Statement on Healthcare and Patient Safety Bill, 20205

We, the Unions and Associations in health sector are concerned with the nature in which the MOH continues to develop legislations and policies without involving the relevant stakeholders especially those who represent the implementors.

The WHO defines quality health services as those that are effective, safe, people-centered, timely, equitable, integrated, and efficient. These characteristics are often assessed using quality indicators, which are standardized, evidence-based measures that help monitor and track healthcare performance and outcomes. These includes:

• Effectiveness: Providing services based on scientific knowledge to all who could benefit. E.g. Maternal health indicators (rates of severe maternal morbidity and mortality)

• Safety: Avoiding harm to patients from the care provided. E.g. Hospital-acquired infections, Adverse drug events among others

• People-centeredness: Providing care that respects individual patient preferences, needs, and values. E.g. Patient satisfaction with care, Involvement of patients in treatment decisions and Availability of patient education and support.

• Timeliness: Reducing waits and delays for both patients and providers. E.g. Time to treatment initiation and Availability of services outside of regular business hours among others

• Equity: Providing care that does not vary in quality due to factors like location or socioeconomic status. E.g. Disparities in access to care based on location and Disparities in outcomes based on socioeconomic status among others

• Efficiency: Avoiding waste of resources. E.g. Appropriate use of resources

• Integration: Providing coordinated and continuous care. E.g. Communication and coordination between different healthcare providers, Continuity of care between different settings (e.g., hospital to home) and Availability of electronic health records and information sharing.

We observe that almost 80% of contents in Quality of Healthcare and Patient Safety Bill 2025 are already provided for in other legislations and policies within the ministry including: Health Act 2017, National Policy on Patient Safety, Health Worker Safety and Quality of Care, Public Health Act, Clinical Officers Act, Medical Practitioners and Dentists Act, Nurses Act, Kenya Quality Model of Health (KQMH) policy, Medical Laboratory Technicians and Technologists Act, Nutrition and Dieticians Act, PHOCT Act, Pharmacy and Poisons Act, among others.

The Judgement by Judge Wesley Korir of September 2022 directed for amendment of Health Act 2017, which provides a shorter and cost-effective route for its improvement, if need be, without reproducing and duplicating laws that provide for health.

Management and continuous monitoring of Quality of Healthcare is already provided for in several legislations and policies as indicated above, meaning this bill will not change anything as far as quality of healthcare is concerned.

We have identified the following issues with the bill:

1. Duplication and Confusion.

   • The bill will create confusion and duplication of roles by replicating other acts E.g. rights and duties under Health Act and Public Health Act provisions among many others.

2. Weak Quality Assurance Framework.

   • The biggest problem that has affected quality of care with regard to health facilities has been the wrong designation of health facilities due to weak quality assurance mechanism which does not provide for verification.
   • This bill still retains this problem where one entity registers, licenses and accredits facilities which has led to corruption and the consequent poor quality of health. This is because facilities were allocated erroneous levels that neither matched their resources nor capacity due to lack of an independent verification system.
   • A strong and progressive Quality Assurance Mechanism should have two tier accreditation system, where the relevant regulatory body registers and licenses and then an independent body verifies and accredits.

3. Interference with development of Scopes of Practice.

   • Transfer of Mandate on development of Scopes of Practice from regulatory bodies to Director General is retrogressive and will negatively affect quality of health.
   • Councils and Boards are better placed to continue with this function since they have diversity of members representing various fields including trainers, regulators, legal practitioners and practitioners in the relevant field, which provides a better and informed forum for development of progressive Scopes of Practice.

4. Duplication of Roles.

   • The Judgement of September 2022 on Health Act interpreted KHPOA to be the ultimate body responsible for Quality of Healthcare in Kenya. There is therefore no need to bring in another SAGA when KHPOA can be improved to serve its purpose. Lack of operationalization of