Bill proposes to bring optometrists under Kenya Medical Practitioners and Dentists Council.
The proposed amendments to the Medical Practitioners and Dentists Act, which are being framed as a step toward strengthening healthcare regulation in Kenya, should concern us all.
Effective legislation must be grounded in clearly defined system failures. Yet, the amendment Bill does not identify gaps in the current law, nor does it demonstrate how patient outcomes are being compromised under the existing framework.
A closer reading of the Medical Practitioners and Dentists (Amendment) Bill, 2026 exposes the dangers it poses to Kenyans. The Kenya Medical Practitioners and Dentists Council, the regulatory body for doctors and dentists, is now being expanded to regulate optometrists, dental technologists and community oral health officers within the same legal and regulatory framework as medical doctors and dentists. In doing so, the Bill risks creating a false equivalence in competence, both within the health system and in the eyes of the public.
The danger in this expansion is that it shifts, for example, optometry (the examination of eyes and testing of vision), which is primarily a corrective and screening role, into full clinical decision-making without guaranteeing training equivalent to that of an ophthalmologist (a doctor who specialises in diagnosing, treating and performing surgery on diseases of the eye).
A patient with glaucoma, for example, may initially present with poor vision and eye pain, which can slowly progress into permanent visual loss. Similarly, retinal diseases linked to diabetes or hypertension require systemic understanding and timely referral. Expanding “diagnosis and treatment” without tightly defined limits increases the risk that complex cases are managed beyond competence, especially in settings where referral systems are weak.
Team-based model
Kenya’s healthcare system is designed as a team-based model, where doctors provide clinical leadership and other cadres operate under structured supervision. The Bill does not strengthen or clarify these supervision requirements. Instead, by creating regulatory parity across cadres, it risks weakening accountability. In practice, particularly in our resource-limited setting, supervision may become nominal rather than functional.
Another concern is how the Bill approaches registration and licensing. It introduces new pathways for registering these additional cadres, including degree and diploma holders, without establishing a robust framework for standardising training quality across institutions.
It is a fact that there have been numerous concerns about medical practitioners and dentists who are graduates of newly mushrooming universities because of the poor quality of training.
Even with the introduction of a pre-registration examination for these cadres, which is presented as a safeguard, without clarity on its rigour, scope and enforcement, it may function more as a procedural requirement than a meaningful quality control mechanism. A single examination cannot substitute for years of structured clinical training and supervised practise.
Another dangerous amendment is the transitional provision that allows these individuals to continue practising in these roles for up to one year without a licence.
It effectively permits continued practise outside a fully regulated framework, increasing the risk of unqualified or inadequately supervised care, delayed accountability for malpractice, and preventable harm to patients, particularly in a system where oversight capacity is already strained.
The Bill also risks entrenching inequality within the health system. It creates the conditions in which wealthier populations continue to access doctor-led care, while lower-income populations rely on mid-level cadres operating with expanded but insufficiently supported roles.
One of the more subtle but significant changes is the removal and alteration of key definitions, including the deletion of the definition of “private practice”. Removing that definition introduces uncertainty about who is authorised to practise independently and what regulatory safeguards should apply.
Enforce standards
In practical terms, this ambiguity weakens accountability. Providers and facilities may operate within grey areas, making it difficult for regulators to enforce standards and for courts to apply the law consistently. Patients may also be unable to distinguish whether they are receiving care in a properly regulated setting or from a provider authorised to practise independently.
But not all is bad. The Bill introduces provisions for temporary licensing, including for foreign practitioners and students undertaking specific work in Kenya, which is a welcome step.
It allows the health system to respond more flexibly to workforce gaps, supports skills transfer and enables controlled exposure to international expertise. If properly implemented with clear supervision requirements, it can strengthen service delivery in underserved areas and enhance training opportunities.
The introduction of mandatory professional indemnity requirements for practitioners and health institutions is another important reform. It strengthens accountability and ensures that patients have avenues for redress in cases of harm. The creation of new offences and penalties, including sanctions for fraudulent registration and criminal liability for detaining patients over unpaid bills, is also necessary.
In its current form, the Bill introduces significant changes without sufficient safeguards.
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Dr Bosire is a medical doctor and lawyer. stebosi51@gmail.com.
