Governors have objected to the format of talks to resolve the strike by doctors.
They also refused to pay doctors more saying they are already the best-paid professionals in the counties.
The governors said the “Whole of Nation approach Committee” constituted by the Labour Court to resolve doctors' grievances cannot make decisions for the 47 counties.
Council of Governors chair Anne Waiguru said they might not participate in the talks under such a format.
“The Council of Governors appreciates the whole of nation approach directive by the court whose aim is to have a long lasting solution to the perennial industrial unrest in the health sector. However, this is not tenable as both the national and county governments are independent and distinct employers,” Waiguru said on Tuesday.
The chairperson was speaking after an extraordinary council meeting at COG head offices in Nairobi attended by at least 26 county chiefs.
On March 13, Justice Byram Ongaya declared the doctors strike illegal and ordered the committee to discuss the grievances.
The committee includes doctors representatives, the Ministry of Health, Council of Governors, Public Service Commission, Salaries and Remuneration Commission, ministries of Labour and Social Protection, National Treasury, and the Head of Civil Service.
However, the Kenya Medical Practitioners Pharmacists Dentists Union defied the court order and its members went on strike on March 14.
They are demanding the posting of interns; payment of fees for doctors on postgraduate training; extension of contracts for UHC staff; payment of arrears of basic salaries as per the 2017 CBA and provision of comprehensive medical insurance.
The CoG termed these demands as untenable, noting that on average, a senior medical officer in the counties earns Sh479,000 every month.
This is “double the amount that is paid to non health workers in the public service and other doctors in the private sector”.
In Nairobi, the 2017 CBA shows an intern is paid about Sh206,000. The lowest paid junior doctor in the county earns a maximum Sh291,000 and the highest paid doctor about Sh512,000 every month.
Waiguru, who read a statement on behalf of the governors, also said action will be taken against doctors who have downed tools for five weeks now.
“It is noted that health workers have absconded duty contrary to the court directive and therefore County Governments will institute disciplinary action against them,” she said.
Attempts to pay medics more will prompt the government to raise basic salaries of all civil servants, which requires additional allocation of resources to all counties.
The CoG also fought off claims that medics are not being released to go for post-graduate degrees and fellowships, saying 890 of the doctors have gone for further studies away from their duty stations.
Most of these studies take about two years and the medics are still paid full salaries, Waiguru said.
“This situation deprives counties of substantial amount of resources which could otherwise be used to recruit more doctors to handle patients while the rest are on post graduate training,” she said.
“To this effect, County Governments will undertake the costing of Doctors on post graduate studies for purposes of allocation of the resources for recruitment to fill the gaps and offer services during this training period.”
The governors also said health services have improved after devolution.
In 2012, Kenya had only 8,466 health facilities which increased to 10,032 in 2016, then to 16,655 in 2024.
In 2013, counties found 874 doctors and 6,620 nurses and by 2016, there were 1,302 doctors and 8,903 nurses in the facilities. Currently, there are 4,398 doctors and 31,923 nurses in health facilities, the chairperson said.
“Further, there is 89 per cent utilisation of skilled birth deliveries by women of reproductive age. This is a 13% improvement from the 2014 KDHS reported skilled birth deliveries.”