A new fight has broken out between Kenya’s governors and the country’s medical regulator over who should control ambulances and emergency services.
The Kenya Medical Practitioners and Dentists Council (KMPDC) has directed that all ambulances, paramedics, and emergency staff register with the council by Monday, September 15. Any that fail to comply, it warned, risk being barred from operating.
But governors have pushed back, saying the order undermines the Constitution and county authority.
Council of Governors (CoG) chairperson Ahmed Abdullahi said the directive was issued without proper consultation. “The KMPDC Act does not confer any functions to any level of government. Accordingly, the threatened consequences of non-compliance with the notice are of no effect to counties performing their constitutional mandates,” he wrote in a letter to governors dated September 9.
He added that ambulance services, under Article 186 and the Fourth Schedule of the Constitution, are expressly assigned to county governments. “Counties have invested heavily in ambulance services over the past 12 years and established functional referral systems,” he said.
The standoff reflects wider tensions between national health agencies and devolved units. Governors argue that creating parallel systems risks duplication and could stretch already limited health budgets.
County health executives also rejected KMPDC’s draft standards on emergency care at a meeting in Mombasa earlier this month. They insisted that any new framework must fit within existing county-run dispatch systems.
Mr Abdullahi accused the Ministry of Health and its agencies of walking back on earlier resolutions to work with counties. “The Ministry of Health and its semi-autonomous institutions have reneged on resolutions made towards cooperation and consultation,” he said. “We therefore advise county governments to disregard the public notice and treat it with the contempt it deserves.”
The KMPDC has not responded publicly to the governors’ pushback. The Ministry of Health has also yet to comment.
For now, the dispute leaves ambulance operators in limbo, caught between two levels of government each claiming control over who should regulate their work.
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