THE HEALTH (AMENDMENT) BILL, 2024
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Establishment of Health Facilities by Gazette Charter
Under the new Section 21B, the Cabinet Secretary for Health is empowered to establish teaching, referral, and research health facilities as body corporates with perpetual succession and common seals through a Charter published in the Gazette. These facilities are categorized into:
- National referral facilities;
- Specialized facilities;
- Level 5 secondary facilities;
- Level 6 tertiary facilities; and
- Centres of excellence.
New Governance Structures via Governing Boards
Each chartered facility will be overseen by a Governing Board (Section 21F) consisting of:
- A Chairperson appointed by the President;
- The Principal Secretary for Health (or a representative);
- The Principal Secretary for the National Treasury (or a representative);
- The Attorney-General (or a representative);
- A representative from a public university with a medical school collaborating with the facility;
- Three independent members appointed by the Cabinet Secretary; and
- The Chief Executive Officer as an ex-officio member.
Competitively Recruited CEOs and Corporation Secretaries
The Bill mandates competitive, transparent recruitment processes for key executive roles:
- Chief Executive Officer (Section 21M): Must hold a postgraduate degree and have at least ten years of professional experience in medicine, healthcare, finance, or public administration. The CEO serves as the accounting officer for a five-year term, renewable once.
- Corporation Secretary (Section 21N): Must be an Advocate of the High Court, a Certified Public Secretary, and have at least five years of experience in governance matters.
Penalties of up to KSh 1 Million for Breaches
The Bill introduces strict penal liabilities (Section 21X):
- Facility staff or agents who willfully or negligently cause harm to patients, impersonate healthcare professionals, or disclose confidential information commit an offence. Conviction carries a fine not exceeding KSh 1 million, imprisonment up to two years, or both.
- Governing Board members who fail to disclose conflicts of interest face a fine not exceeding KSh 1 million, imprisonment up to six months, or both (Fifth Schedule, Para 3(3)).
Bill No.
No. 54 of 2024
Gazette No.
Supplement No. 214
Sponsor
Robert Pukose
Background
Teaching, referral, and research hospitals in Kenya currently operate under various legal frameworks, such as individual Legal Notices, which have been deemed inadequate and lacking in regulatory uniformity. The Health (Amendment) Bill, 2024 redresses this by introducing a standardized legal framework directly under the Health Act, Cap. 241, to govern the establishment, administration, and financial management of these specialized institutions.
Key Amendments
- Insertion of Part IIIA: Introduces a comprehensive section dedicated to the "Establishment of Teaching, Referral and Research Health Facilities" (Sections 21A to 21Y).
- Categorization (Section 21A): Organizes specialized facilities into distinct levels including national referral, level 5 secondary, level 6 tertiary, and centres of excellence.
- Corporate Status (Section 21B): Declares each chartered facility a body corporate, granting it the power to sue, purchase or dispose of property, borrow or invest money, and enter into contracts.
- Powers of the Board (Section 21D): Empowers the Governing Board to set up satellite facilities, manage assets in compliance with the Public Procurement and Asset Disposal Act, levy fees for services rendered, and invest surplus funds with National Treasury approval.
New Obligations
- Charter Compliance: The Cabinet Secretary must ensure a facility complies with the Health Act before granting a Charter (Section 21B(5)).
- Financial Reporting and Auditing: Governing Boards are required to keep proper books of accounts and submit annual financial statements within three months after the end of each financial year to the Auditor-General (Section 21U). Audits will be conducted in accordance with the Public Finance Management Act and the Public Audit Act.
- Code of Conduct: Board members and staff must subscribe to and sign the "Code of Conduct for the Teaching, Referral and Research Facility" outlined in the Sixth Schedule, which mandates transparency, conflict-of-interest registers, and fair handling of disputes.
Penalties
- Patient Harm and Negligence (Section 21X): Any staff or agent who willfully or through negligence causes harm to a patient, or releases unauthorized confidential information, faces a fine of up to KSh 1 million, a prison term of up to two years, or both.
- Conflict of Interest (Fifth Schedule, Para 3(3)): Board members who do not declare direct or indirect private interests in matters being decided by the board commit an offence liable to a fine not exceeding KSh 1 million, a prison term of up to six months, or both.
Transitional Provisions
- Protection of Existing Hospitals (Section 21Y): Five existing hospitals in operation on or before 24th January, 2024, are preserved and will continue to operate as if approved under this amendment. These are:
- Kenyatta National Hospital;
- Moi Teaching and Referral Hospital;
- Kenyatta University Teaching and Referral Hospital;
- Mathari National Teaching and Referral Hospital; and
- National Spinal Injury Hospital.
- Transfer of Assets and Liabilities: All rights, duties, assets, and liabilities of these existing institutions will automatically transfer to their respective newly chartered corporate entities.
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