Escaping the realities of the health care system – at your expense.

There’s nothing like allowances for representatives of national assemblies to really get people fired up. Annoyed as people get about MPs salaries, it’s the perks that lurk below the headline wage that cause righteous spluttering and indignation. The UK’s parliamentary expenses scandal that erupted in 2009 resulted in resignations, de-selections, and even jail sentences for those MPs unable to come up with even the barest semblance of a plausible reason as to why they should pay rent to their partner, have their hedges trimmed, or buy new toilet seats or duck houses with public money (OK, the duck house claim was actually rejected – but the picture of some hapless MP trying to argue it was legitimate is too good not to mention).

The salaries and benefits of MPs in Tanzania and Kenya have in recent years come under fire. In Tanzania, reports over the past few months – denied by government – that MPs have received increases to their salaries and benefits (including a grant of $98,000 when they leave parliament, and a 285% increase in sitting allowances) has caused a scandal. In Kenya, Kibaki may have vetoed a planned pay rise that would have made Kenyan MPs the highest paid in the world, but in 2012 MPs quietly voted substantial increases in benefits packages.

But it’s not all about the monetary benefits. Less often commented upon, but equally (or perhaps even more) pernicious, are the health benefits that accrue to those with power. For legislators, it seems, health care in Europe’s finest hospitals and clinics is one such perk. In Tanzania, MPs, their spouse and up to four children under the age of 18 are provided with medical insurance that will cover ‘treatment within the United Republic and abroad‘ (my emphasis). Up until last year, Kenya was more generous in the scope of its coverage, allowing for up to two spouses and eight children. Changes in 2013 mean one spouse and four children up to the age of twenty-five can be treated in US or European hospitals, as well as in private wards of local hospitals, with cover worth up to $115,000 for in-patient procedures (as well as support for outpatient treatment, maternity, dental and optical support).

Now there’s nothing wrong with the principle that health insurance should be part of the benefits package of MPs. But paying for treatment abroad might be. Isn’t it a bit of a problem if they don’t have to come into contact with the same conditions politicians are ultimately responsible for ensuring government provide to the rest of their compatriots? If MPs are not subject to the same problems, delays and difficulties in accessing decent health care, where is their incentive to improve it (or their ability to really understand the nature of the challenges?).

In the UK, the annual September hunt for the cabinet minister who sends their child to a private school is a long tradition. What kind of vote of confidence is it, critics ask, if government members won’t send their kids to the type of establishment the rest of us use for ours? The difference is that this is not subsidised by the public purse: if you think your child will only reach their potential in the rarefied corridors of Eton or St Paul’s, you have to pay from your own salary. Similarly, if you want to be treated by a Harley Street doctor rather than go to the local NHS hospital, you need to fork out yourself.

Of course, one could hope that MPs can and will champion issues they have no direct experience of. You don’t have to have been a victim of domestic violence to realise its horrific impact and push for reforms to end it and provide support for those in fear. And, in Tanzania and Kenya as elsewhere, many do act on such principles. But giving people the opportunity to escape from the realities of poorly functioning services can have dangerous consequences. There’s nothing like knowing your health and wellbeing depends on a broken system to provide an incentive to make sure it is fixed. And if the state cannot stop the rich escaping such perennial pressures of everyday life, it certainly should not be subsidising them. If the elite want to make use of the private clinics of Europe, North America and elsewhere, let them pay for it themselves out of their (already generous) salaries.

An aside: Tellingly, perhaps, the Tanzanian act, outlining the benefits package to MPs, writes of the “Member of Parliament … [and] his family”. I haven’t read through the entire text of the Kenyan equivalent, but on first glance couldn’t see any similar assumptions as to the sex of the MP.


About Mike Jennings

I am Reader in International Development and Head of the Department of Development Studies at the SOAS, University of London. I research, teach and write on Africa, and the history and politics of international development in sub-Saharan Africa. Research areas include: - The history of development in Africa, from the late nineteenth century to the current day - Politics of East Africa (Kenya, Tanzania and Uganda) - the role of non-state providers (NGOs, FBOs and self-help groups) in welfare service provision - Social aspects of health, including HIV and AIDS, and malaria
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3 Responses to Escaping the realities of the health care system – at your expense.

  1. I enjoyed reading your article. Would you mind if I post it in my blog ( with full credit? Thanks, Shaaban

  2. Reblogged this on and commented:
    Here is an article from the blog entitled “Africa Development Politics” by Mike Jennings that touches on MP salaries and the perks that goes along with it. In addition to their exorbitant salaries, they also have perks for medical treatment abroad on tax-payers money. For more information, read Mike Jennings article below.

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