The Kenya Medical Practitioners, Pharmacists, and Dentists’ Union (KMPDU) has opposed the government’s proposed time-based restrictions on insurance claim pre-authorisation for public sector doctors, calling the plan “operationally unrealistic” and “administratively arbitrary.”
The union says the policy, which would block claims approved by doctors between 8 pm and 5 pm does not reflect the realities of public hospitals and could disrupt service delivery.
In a statement released on December 17, 2025, KMPDU acknowledged that while the government aims “to reduce conflict of interest, prevent diversion of public service time into private practice, and control rising insurance costs,” the approach ignores ongoing workforce shortages.
“The public health system continues to operate under severe and chronic health workforce shortages, with doctor-patient ratios falling far below internationally accepted standards, leading to extended working hours, emergency call duties, and blurred distinctions between ‘on-duty’ and ‘off-duty’ times,” the union said.
The union noted that many doctors rely on dual practice to cope with insufficient staffing, delayed pay, and heavy workloads.
KMPDU warned that enforcing fixed office hours for claim approvals is “disconnected from clinical and workforce realities” and could result in “workforce attrition and disruption of service.”
KMPDU stressed that any policy affecting doctors must “respect constitutional guarantees of fair labour practices, be consistent with existing Collective Bargaining Agreements, and be developed through meaningful consultation with recognised health sector unions.”
The union urged the Ministry of Health, SHA, and DHA to explore alternatives, including “structured and transparent dual-practice frameworks; roster-based or facility-verified authorisation mechanisms; incentivised exclusivity; and accelerated recruitment, retention, and workload rationalisation within public facilities.”
The union also stated it will seek “urgent engagement with the Ministry of Health, SHA, and DHA” and called for suspension of any unilateral implementation of the proposed rule.
KMPDU warned it could take industrial, legal, or advocacy action if the policy is enforced in ways that undermine service delivery or violate doctors’ rights.
The union concluded by reaffirming its commitment to public healthcare, saying: “The Union remains committed to strengthening public healthcare delivery and protecting patient welfare, and sustainable reform must address systemic constraints rather than individualise structural failures.”
