Nairobi Hospital 'not for profit'?

I always find Sunny Bindra’s articles in the Sunday Nation and the Business Daily well written and from an astute mind. That, coupled with his optimism of Kenya’s future makes him a must read for me. In fact, I rarely miss his pieces and always look forward to them. However, his latest article about the ‘not for profit’ organizations in Kenya makes me wonder whether, indeed, he very well knows the institutions he wrote about.

There seem to be some glaring contradictions in his piece that I wish to point out. Sunny wrote, “They are clocking up impressive financial results”, whereas the topic was about the ‘not for profits’ in Kenya. Now, I ask myself, if these institutions are indeed what he says they are, where are the profits coming from? Isn’t someone somewhere duping us? ‘Not for profits’ making profits? Come-on!

Anyway, I have had the privilege of working for one of the institutions he wrote about. I worked for the Nairobi Hospital for three years, between 2005 and 2008. Thus, I could be privy to some information that he has probably never known. The good thing with this hospital is that, in trying to mask the profit they make, they conveniently term it as surpluses. Actually, there is no problem with such a “premier” institution to post some positive financial results. However, some of the methods with which they achieve the surpluses are almost unethical. I agree, ethics can be relative but, still, that doesn’t let them off the hook, at least here.

Ideally, you would expect an institution of that calibre to take good care of its staffs. However, nothing could be further from the truth.

While working for this hospital, I came to the sad realization that the much despised Kenyatta National Hospital (KNH) was in fact a better employer. My contemporaries in KNH were surprisingly paid better, worked less hours per week and had a more relaxed shift than us at the Nairobi Hospital. I acknowledge, though, the two hospitals played in different leagues.

Whereas one was an excellent medical institution, the other exemplified ineptness and corruption. Thus, you may think that I am not justified in comparing the two. However, the question I always asked myself, while working there, was; why should employees at the Nairobi Hospital work so hard yet be woefully compensated for their time and efforts? And, why should Kenyans, on the other hand, be paying taxing for such mediocre services at KNH when in fact most of their staffs, barring the doctors, were better paid than staffs at the elitist Nairobi Hospital?

The answers boil down to the key objective of the latter’s mission. The Nairobi Hospital, to me, was for one and one thing only; to make surpluses. It didn’t matter at whose expense.

The hospital, just like other ‘for profit’ institutions, had a board and ‘shareholders’. The ‘shareholders’ in this instance being members of the Kenya Hospital Association. Nonetheless, other than the discounts they get on services received, they ordinarily do not receive any dividends, as do normal shareholders. It always seemed to me that whatever the CEO did was just to please these two groups.

It was because of some of these policies that many employees left the hospital for greener pastures. In trying to reverse the huge staff turnover at the hospital, the management came up with a decision to review the salaries of all staffs. Sadly, their recommendation was not fair at all. Employees were compartmentalised into ‘surpluses making’ and ‘expending only’ departments. Thus, only the staffs who were working in the units that were deemed to be making money for the hospital were thought of being worthy of a pay rise. The rest were probably seen as some burden on the institution.

Thus, Sunny’s praise for this particular organization becomes questionable. On what merit do they deserve such accolades? And, can a great leader, actually, reward only a section of his subjects and still expect to get positive results for a long time? How, for example, will such a policy affect teamwork in the long run? And, what would be the implications of such short-sightedness to the performance of the organization? In my not so schooled mind, I believe even the junior-most staff of an organization is a valuable resource and should be treated as such. Otherwise, they wouldn’t have been employed in the first place.

The irony of working for such a revered institution was that most staffs could not afford the very services they offered. Contrast that with my friend who works for Emirates Airlines. Even though his is a ‘for profit’ organization they still grant their employees highly discounted tickets. Indeed, he pays for only a tiny fraction of the actual ticket’s cost. And, in Kenya, you have an institution where almost all the female staffs prefer to deliver at other cheaper hospitals, rather than pay exorbitantly for services they gladly offer to Nairobi Hospital’s clients.

Which makes me ask why they don’t provide comprehensive insurance covers for their employees? The cover we had while working there was so insufficient that it was not uncommon to see staffs enduring deductions for several months for some excess accrued, mostly due to emergency medical services. Of course, a good cover would affect the surpluses.

Despite this, I acknowledge Nairobi Hospital is a great institution that I can easily trust myself with, if, God forbid, I had to seek medical services somewhere. I wrote this knowing very well the difficulties with which some of my friends, who still work there, work under. I guess this would be for their good. Not that anyone has asked me to. I left the hospital out of my own accord. I thus have no bones to pick with anyone. I however, wish they improved on some of these things.