Governors clash with KMPDC over mandatory ambulance registration

A Growing Conflict over Ambulance Regulation

A clash has emerged between the Council of Governors (CoG) and the Kenya Medical Practitioners and Dentists Council (KMPDC) regarding the mandatory registration of ambulances and emergency care personnel. The dispute stems from a directive by the KMPDC requiring all ambulances and pre-hospital care providers to register with the council. 🚨

The CoG, however, has advised county governments to disregard the directive, leading to a significant standoff that exposes a deeper conflict over the management and regulation of health services in Kenya.

The Core of the Conflict

The primary reason for the clash is the perceived duplication of roles and the encroachment on devolved functions. Governors argue that the KMPDC’s directive undermines the constitutional mandate of county governments, which are responsible for providing ambulance services under the Fourth Schedule of the Constitution of Kenya. The CoG’s chairperson has publicly stated that the directive disregards a long-standing agreement on consultations and cooperation between the Ministry of Health and county governments.

Here are the key points of contention:

• Devolution vs. Centralization: The CoG maintains that ambulance services are a fully devolved function. Counties have already invested heavily in and established their own ambulance services and referral systems over the past decade. The KMPDC’s move is seen as an attempt by a national body to exert control over a function that falls under county jurisdiction.
• Legal Mandate: Governors challenge the KMPDC’s legal authority to regulate county-owned ambulances. They argue that the KMPDC Act does not grant the council the power to impose sanctions or prohibitions on county governments that are performing their constitutional duties.
• Financial and Operational Inefficiencies: County officials have voiced concerns that creating parallel regulatory and operational systems would lead to financial waste and operational inefficiencies. They argue that a single, coordinated system under county management is more effective.
• Lack of Consultation: The CoG accuses the KMPDC of bypassing the agreed-upon consultation process. The health executives from the counties had previously rejected the KMPDC’s draft standards for emergency medical care, insisting that any new framework must be aligned with the existing county-managed systems.

KMPDC’s Position

The KMPDC, on the other hand, maintains that its directive is aimed at standardizing and improving the quality of emergency care across the country. The council, which is mandated by the Health Act, 2017, and the Medical Practitioners and Dentists Act (Cap 253), asserts its role in regulating all health facilities and personnel.

The council’s position is based on the following:

• Quality Assurance: The KMPDC believes that mandatory registration is crucial for ensuring that all ambulances and emergency care providers meet the necessary standards for equipment, personnel qualifications, and overall service delivery.
• Patient Safety: The council argues that unregulated ambulance services pose a significant risk to patient safety. Registration and licensing are vital for ensuring that only qualified and properly equipped providers are allowed to operate.
• National Oversight: As the primary regulator of medical practice in Kenya, the KMPDC sees ambulance services as an integral part of the healthcare system that requires national oversight to ensure uniformity and high standards.

What’s Next?

The standoff between the CoG and KMPDC highlights the broader challenges of intergovernmental relations and the implementation of devolution in the health sector. While the KMPDC’s goal of improving emergency medical care is valid, the governors’ concerns about constitutional mandates and the potential for a return to centralized control cannot be ignored. The conflict calls for a collaborative solution that respects the devolved structure while ensuring a unified, high-quality emergency response system for all Kenyans. 🇰🇪