Kenya Medical Practitioners and Dentists Council has embarked on automation of Kenya’s licensing processes of medical doctors and dentists, oral health practitioners and health institutions. This has gone a long way in conforming to its ease-of doing business in leveraging on the benefits of technology in its business processes.

According to KMPDC’s ICT Manager Duncan Mwai, all medical and dental practitioners, oral health officers and health institutions applying for renewal of their annual practice licenses are all required to apply online through osp.kmpdc.go.ke.

“Automation is aimed at making the registration and licensing system transparent, robust and easy-to-use for medical, dental practitioners and health institutions, by reducing the turnaround time therefore improving efficiency and creating more time in patient care other than queuing for license application,” Mwai said.

He further added that this has also improved revenue to the Council and increased compliance since members of the public can verify the authenticity of the practitioners and health institutions on the publicly available registers.

“Having integrating payments via M-Pesa and bank payments, the license application process is now seamless,” says Mwai.

All registration and licensing, previously done manually, required all medical and dental practitioners to physically visit the KMPDC headquarters. Today however, only the first-time registration is done manually with the subsequent renewal of licenses all done online the OSP portal.

This move has greatly reduced the number of people visiting the Council for the service, greatly contributing to physical and social distancing measures implemented to curb the spread of COVID-19.

After the online application has been done, Mwai adds, the various registers are made available on the Council’s website on this link https://kmpdc.go.ke/registers-practitioners-php, making it easier for interested members of the public to check up and verify the practitioners’ and health institutions’ licensure status. This has also helped deal with quacks because the public can easily check and see if one is indeed a doctor or a quack.

Once the license application has been made, it becomes available on one’s online services portal, where it can be downloaded at one’s convenience.

“The licenses provided by the Council have a Quick Response (QR) Code, which can be used to verify the authenticity and validity. On verification, name of the holder, registration number, license number, a photo, practice type, qualifications and specialty are displayed” Mwai said.

“This, we hope, will help us in weeding out quacks and those operating in the country illegally,” he said, “we believe in ensuring quality healthcare for patients, and one way we do this is by protecting them patients through ensuring all medical and dental practitioners are registered and duly licensed before being allowed to practice in Kenya.”

One of the Council’s functions is to keep a practitioners’ and health facilities’ register. The register contains a list of medical and dental practitioners and health institutions and further shows their registration status, training and specialty. It helps the Council keep a record of the actual number of practitioners and health institutions and the list of specialists practicing in the country.

The register is broken down to general/dental practitioners register, senior registrar register, specialists register, register of community oral health workers, register of interns foreign practitioners register, health facilities register and medical camp register.

All practitioners are also required to enroll into integrated continuing professional development (CPD) platform and submit their CPD points online. They are required to attain a minimum of 50 CPD points per CPD calendar year (1st January to 31st December) to qualify for retention in the annual register.

The Council’s Registration and Licensing system also addresses registration of institutions; both medical training institutions, hospitals, clinics, dispensaries and health centers, licensing of interns, accreditation of internship centers, CPD Providers and virtual services providers.

“As Kenya is pursuing Universal Health Coverage by 2022 where healthcare services are going to be paid for by Insurance, the health facilities registry will also help National Health Insurance Fund (NHIF) to establish the veracity of the claims as NHIF will only empanel health facilities and practitioners registered and licensed by KMPDC. These licenses are shared with NHIF on real-time basis” Mwai explained. KMPDC is also working on a solution to map all healthcare facilities in Kenya and services they offer. The mapping will be done using geo-coordinates.

The number of cases of alleged medical malpractice lodged at the Kenya Medical Practitioners and Dentists Council in 2020 dropped to 79, the frst decrease in fve years.

In 2019, the Council registered 110 cases, the highest number of complaints ever received since the establishment of KMPDC in 1978.

The mandate of the Council is to regulate health training, practice of medicine and dentistry as well as regulate healthcare standards in hospitals, medical centers and clinics.

One has the right to lodge a complaint with the Council if they feel that they did not receive quality healthcare. The Council, through the Disciplinary and Ethics Committee (DEC) then conducts inquiries on professional misconduct, medical/dental malpractice, overcharging, patient mismanagement, patient abandonment among others.

Dr. Mohamed Abdi who chairs the committee says that so far, the Council has cumulatively received a total of 1,239 complaints, since the first case was reported to the Council in 1997. About 1,060 cases have been concluded while only a paltry 147 cases are under investigation.

“Once the Council’s Legal Department receives a complaint from a patient, a patient’s relative or caregiver, the Office of the Ombudsman or even the media, the complaint is shared with the practitioner or health institution being accused, to give them a chance to respond to the allegations. The complaint and the response are then tabled before the DEC for discussion in their next scheduled meeting,” said Dr. Abdi.

Except for 2020, there has been a rise in the number of medical malpractice cases lodged at the Council for the past five years. The KMPDC Legal Services Manager Eunice Muriithi however says the rise in cases may not be an indicator of increased medical malpractices.

“Today, more than ever before, there is increased public awareness on patient rights. Furthermore, patients know that they can always report to the Council should they feel that their rights have been violated while receiving treatment,” said Ms. Muriithi.

KMPDC has also installed an open system where aggrieved patients or family members can lodge complaints.

Furthermore, to make it easier for a complainant, one can easily download the complaint form from the Council’s website www.kmpdc.go.ke on the “PUBLIC” tab, which also explains the procedure of lodging such complaints.

Once the form is filled, the same can be sent to the Council together with documents indicated in the complaint form to the email, legal@kmpdc.go.ke.

Cases of professional practice in medicine can usually come from; mis-diagnosis, wrong treatment, errors in emergency care, failure to diagnose and even lack of informed consent from patients among others.

Professional negligence is defined as “an act or omission of a health care provider in which the treatment provided falls below the accepted standards of practice in the medical community and causes injury or death to the patient”.

The rise in litigation for medical malpractice cases has seen the government step up measures to cushion health workers and institutions.

The Health Laws Amendments Act of May 2019 makes it mandatory for medical and dental practitioners in Kenya to take an annual professional indemnity cover. A professional indemnity insurance covers the costs of a lawsuit and compensation claims associated with a legal matter.

While KMPDC encourages members of the public to lodge cases for resolution, it urges medical and dental practitioners and health facilities to initiate dialogue with the patients and their relatives for speedy resolutions.

From the 2021-2022 Financial Year, KMPDC will receive funding from the National Treasury for the very first time in over four decades.

This is after the Council was categorized by the government as a semi-autonomous government agency (SAGA). According to the KMPDC Finance Manger CPA Phillip Ole Kamwaro, the revenue model will make the regulator financially stable, enabling the organization to focus on its core mandate including regular inspections of health facilities, medical and dental schools and internship training centers in the country. The Council will further strengthen its inspections of health facilities and step up systems in determining cases of alleged medical malpractice all over Kenya.

“The funding from Treasury couldn’t have come at a better time. The government has already rolled out Universal Health Coverage (UHC), and KMPDC plays a critical role in UHC,” said Kamwaro. “As we speak now, the State Corporations Advisory Committee has already ratified the KMPDC organizational structure and we are now awaiting its approval.”

The Finance Manager further says that the government funding will accelerate the rate at which the Council plans to implement technology based regulatory services to enhance efficiency and access of services by clients. “We generate revenue from the fees we levy.

The model does not generate enough revenues needed for KMPDC’s optimal performance and at the right time required,” Kamwaro explains. For optimal regulatory services, Kamwaro opines, there is need to devolve KMPDC services as directed by the Senate to the Counties.

“We are planning to have eight devolved KMPDC units; this will help us appropriately cover the entire country,” he reveals. All the eight offices will “require funding for operation, to buy furniture, equipment, vehicles and even salaries.” The existing revenue falls short of the sum required to finance such operations.

Among other things, Kamwaro foresees smooth operations at the Council in the future. He says the government funding will enable KMPDC meet financial obligations including procuring an enterprise resources management system.

 “We are planning to embark on cost-cutting strategies. With enough income from the National Treasury, we foresee a time when KMPDC will accumulate a reserve fund to cater for any eventualities/risks,” the Finance Manager says. Kamwaro, who says the Council has cleared all pending bills, adds that the new revenue model will come with additional requirements on financial reporting.

“But we are equal to the task,” he says. According to the State Corporations Act, “no state corporation shall, without the prior approval in writing of the Minister and the Treasury, incur any expenditure for which provision has not been made in an annual estimate.”

The Act also requires every state corporation to keep “proper books recording all the property, undertakings, funds, activities, contracts, transactions and other business of the state corporation.”

However, funding from government comes with new requirements. The Council has already ceased collecting fees from all public health facilities. This will account for 60% drop in the income. “The government has scrapped the fees public health facilities have been paying including inspection and license fees. KMPDC will, however, still continue offering services to the institutions,” revealed Kamwaro.

He however adds that the Council will continue collecting fees from private health facilities as well as fees from medical and dental practitioners and community oral health officers.

KMPDC conducted Internship Qualifying and Pre-Registration Examinations in September 2020 at the Kenya Medical Training College, Nairobi Campus. The examinations, which lasted three days, were conducted in accordance to Section 11 (1) (a) of the Medical Practitioners and Dentists Act (CAP 253) and Rule 18 of the Medical Practitioners and Dentists (Training Assessment and Registration) Rules.

The rules state that “Any person who has qualified outside Kenya shall be required to engage in internship and, unless exempted under rule 23, shall be required to pass an internship qualifying examination.”

An Internship Qualifying Examination (IQE), is a written or oral examination or both which determines the suitability of foreign trained graduates who hold a degree recognized by the Council to undergo internship training in Kenya.

On the other hand, a Pre-Registration Examination is a written or oral examination or both which determines the suitability for registration of a foreign trained student (Kenyan or non-Kenyan), as a practitioner in Kenya.

The examinations are held three times every year that is January, April and September. Unlike previous years, the 2020 examinations were conducted in the midst of the COVID-19 pandemic.

Graduates from the East African Partner States (EAC) who qualify from approved medical and dental schools are however exempted from Board exams under EAC Boards/Councils Reciprocal Recognition.