Report On Consideration Of The Presidential Memorandum Of Referral On The Cancer Prevention And Control (amendment) (no. 2) Bill

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THIRTEENTHPARLIAMENT-FOURTHSESSION-2025

DIRECTORATEOFDEPARTMENTALCOMMITTEES

DEPARTMENTALCOMMITTEEONHEALTH

REPORTONTHEPRESIDENTIALMEMORANDUMOFREFERRALONTHE CANCERPREVENTIONANDCONTROL(AMENDMENT)(NO.2)BILL,2022 (NATIONALASSEMBLY BILL NO.45 OF 2022).

Published by: TheDirectorateofDepartmental Committees Clerk's Chambers Parliament Buildings NAIROBI

TABLEOFCONTENTS

| CHAIRPERSON'SFOREWORD | CHAIRPERSON'SFOREWORD | | |----------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------|----| | CHAPTER ONE | CHAPTER ONE | | | 1.0PREFACE | 1.0PREFACE | | | 1.1EstablishmentandMandateoftheCommittee | 1.1EstablishmentandMandateoftheCommittee | | | 1.2 Subjects under the Committee. | 1.2 Subjects under the Committee. | | | 1.3 Oversight. | 1.3 Oversight. | | | 1.4CommitteeMembership | 1.4CommitteeMembership | | | CHAPTERTWO. | CHAPTERTWO. | | | 2.0 PRESIDENTIALMEMORANDAOFREFERRALTOTHECANCER PREVENTION AND CONTROL (AMENDMENT) (NO. 2) BILL, 2022 (NATIONAL ASSEMBLY BILL NO.45 OF 2022). | 2.0 PRESIDENTIALMEMORANDAOFREFERRALTOTHECANCER PREVENTION AND CONTROL (AMENDMENT) (NO. 2) BILL, 2022 (NATIONAL ASSEMBLY BILL NO.45 OF 2022). | | | 2.1 Background | 2.1 Background | | | 2.2 Legislative Process.. | 2.2 Legislative Process.. | | | 2.3LegislativeFramework | 2.3LegislativeFramework | | | CHAPTERTHREE. | CHAPTERTHREE. | | | 2.4AnalysisofthePresidential MemorandumofReferral | 2.4AnalysisofthePresidential MemorandumofReferral | | | CHAPTERFOUR | CHAPTERFOUR | | | 4.0 | COMMITTEEOBSERVATIONS | 9 | | CHAPTERFIVE | CHAPTERFIVE | 10 | | 5.0 | COMMITTEERECOMMENDATIONS | 10 |

LISTOFANNEXURES

ANNEXUREI

Adoption List

ANNEXURE1I

Minutes

ANNEXUREIHI

Presidential Memoranda of Referral on the Bill

ANNEXUREIV

Message by the Hon.Speaker on the Presidential Memoranda of Referral

CHAIRPERSON'SFOREWORD

This Report contains a detailed analysis of the Presidential Memorandum of Referral on the Cancer Prevention and Control (Amendment)(No. 2) Bill, 2022 (National Assembly Bill No. 45 of 2022). On Tuesday,1*t July, 2025, the Rt. Hon.Speaker conveyed a message from His Excellency the President, referring to the Cancer Prevention and Control (Amendment) (No. 2) Bill, 2022 (National Assembly Bill No. 45 of 2022), accompanied by a memorandum to the Departmental Committee on Health.

The messagefrom His Excellency the President, dated 26th June, 2025 notes that His ExcellencythePresidentdeclinedtoassent to theCancerPreventionandControl (Amendment) (No. 2) Bill, 2022 (National Assembly Bill No. 45 of 2022) and attached memorandumof referral detailing the reasons for declining to assent,in exercise of the powers conferred on him by Article 115(1) (b) of the Constitution.

The Cancer Prevention and Control (Amendment) (No. 2) Bill (National Assembly Bill No. 45 of 2022)was published on 26th October 2022 vide Kenya GazetteSupplement No.170 of 28th October 2022 and was read a First Time on 15th February 2023. The Bill was sponsored by Hon. Rahim Dawood. The Bill was passed, with amendments, by the National Assembly on Tuesday, 15th April 2025.

It is upon this premise, that the National Assembly Departmental Committee on Health convened to deliberateon thePresidential Memorandum of Referral in accordance toArticle 115 of the Constitution which provides that the President may refer a Bill back for reconsideration toParliament toamend theBill inlight of thereservations ofthePresident; orpass theBill asecond timewithoutamendment.

I take this opportunity to thank and commend Committee Membersfor their devotion and commitment to duty, the Speaker and the Clerk of the National Assembly for providing leadership and direction and finally, the Committee Secretariat for their exemplary

On behalf of the Departmental Committee on Health and pursuant to provisions of Standing Order 216 (5)(g),it is my pleasant privilege and honor to present the Report ofthe Committee onitsconsiderationofthePresidentialMemorandumofReferralontheCancerPrevention and Control (Amendment) (No. 2) Bill, 2022 (National Assembly Bill No. 45 of 2022) with the recommendation that the House agrees with His Excellency the President's eo ()() (a))i n d sod s ss

HON.DR.NYIKALJAMESWAMBURA,CBS,MP. CHAIRPERSON,DEPARTMENTALCOMMITTEEONHEALTH

1.0PREFACE

1.1EstablishmentandMandateoftheCommittee

1. TheDepartmental CommitteeonHealthis one oftheDepartmental Committees of theNationalAssemblyestablishedunderStandingOrder216whosemandates pursuant to theStanding Order 216(5) are as follows: 1. To investigate, inquire into, and report on all matters relating to the mandate, management, activities, administration, operations and estimates of the assigned ministries and departments;

• ii. To study the programme and policy objectives of ministries and departments and the effectiveness of theimplementation;

4. i1i. on a quarterly basis,monitor and report on the implementation ofthe national budget in respect of its mandate;

• iv. To study and review all legislation referred to it;

6. To study, assess and analyse the relative success of the ministries and departments as measured by the results obtained as compared with their stated objectives; 7. Vi. To investigate and inquire into all matters relating to the assigned ministries and departments as they may deem necessary,and as maybe referred to them by the House;

• vii. Tovet and report on all appointments where the Constitution or any law requires the National Assembly to approve, except those under Standing Order 204 (Committee on Appointments);
• viii. To examine treaties, agreements and conventions;
• ix. Tomake reports and recommendations to the House as often as possible, including recommendations of proposed legislation;
• X. Toconsiderreportsof Commissions andIndependentOfficessubmittedtothe House pursuant to the provisions of Article 254 of the Constitution; and
• xi. To examine any questions raised by Members on a matter within its mandate.

CHAPTERONE

1.2 Subjects under the Committee

2. In accordance with the Second Schedule of the Standing Orders, the Committee is mandated toconsider mattersrelated tohealth,medical care andhealthinsurance,includinguniversal health coverage.

1.3 Oversight

3. In executing its mandate, the Committee on Health oversees the:

• i. StateDepartmentforMedicalServices
• ii. StateDepartmentforPublicHealth andProfessional Standards.

1.4 Committee Membership

4. The Departmental Committee on Health was constituted by the House on 27th October 2022and comprises thefollowingMembers:

Chairperson

Hon. Dr. Nyikal James Wambura, MP Seme Constituency ODM Party

Vice-Chairperson

UDA Party

Hon. Ntwiga, Patrick Munene MP Chuka/Igambang'ombe Constituency

Hon. Owino Martin Peters, MP

Ndhiwa Constituency ODM Party

Hon. Muge Cynthia Jepkosgei, MP Nandi (CWR)

UDA Party

Hon. Wanyonyi Martin Pepela, MP Webuye East Constituency

Ford Kenya Party

Hon. Kipng'ok Reuben Kiborek , MP Mogotio Constituency UDA Party

Hon. (Dr) Robert Pukose, MP Endebess Constituency

UDA Party

Hon. Kibagendi Antoney, MP Kitutu ChacheSouth Constituency ODM Party

Hon. Julius Ole Sunkuli Lekakeny, MP Kilgoris Constituency KANU

Hon. Maingi Mary, MP Mwea Constituency UDA Party

Hon.Mathenge Duncan Maina,MP Nyeri Town Constituency

UDA Party

Hon.Lenguris Pauline, MP Samburu (CWR)

UDA Party

Hon. Oron Joshua Odongo, MP Kisumu Central Constituency ODM Party

Hon. (Prof.) Jaldesa Guyo Waqo, MP Moyale Constituency

UPIA Party

Hon.MukhwanaTitusKhamala,MP Lurambi Constituency

ODM Party

1.5CommitteeSecretariat

• The Committee is facilitated by the following staff secretariat:

Mr.HassanAbdullahiArale ClerkAssistantI/HeadofSecretariat

Mr.TimothyKimathi Samson

ClerkAssistantIII

Ms. Gladys Jepkoech Kiprotich ClerkAssistantIII

| Ms. Marlene Ayiro | Ms.Sheila Chebotibin | |---------------------------|---------------------------| | Principal Legal Counsel I | SeniorSerjeant-At-Arms | | Ms. Faith Chepkemoi | Ms. Abigel Muinde | | Legal Counsel II | Research Officer III | | Mr.Hiram Kimuhu | Ms.Rahab Chepkilim | | Fiscal Analyst III | AudioRecording Officer II | | Mr Eric Lungai | Mr.Hillary Mageka | | Hansard Reporter I | MediaRelationsOfficerIII |

CHAPTERTWO

• 2.0PRESIDENTIALMEMORANDAOFREFERRALTOTHECANCER PREVENTION AND CONTROL (AMENDMENT)(NO.2)BILL,2022 (NATIONALASSEMBLY BILL NO.45 OF2022).

2.1 Background

6. On Tuesday, 1st July, 2025, the Rt. Hon. Speaker conveyed a message from His Excellency,the President,referring to the Cancer Prevention and Control (Amendment)(No.2)Bill,2022 (National Assembly Bill No.45 of 2022) accompanied by a memorandum to the Departmental Committee on Health. 7. The message from His Excellency the President, is dated 26th June, 2025, states that His Excellency the President declined to assent the Cancer Prevention and Control(Amendment)(No.2) Bill, 2022 (National Assembly Bill No. 45 of 2022) and attached memorandum of referral detailing the reasons for declining to assent, in exercise of the powers conferred to him by Article 115(1)(b) of the Constitution.

2.2LegislativeProcess

8. The Cancer Prevention and Control (Amendment) (No. 2) Bill (National.Assembly Bill No. 45 of 2022)waspublished on 26th October 2022videKenya GazetteSupplement No.170 of 28th October 2022 and was read a First Time on 15th February 2023.The Bill was sponsored 2. by Hon.Rahim Dawood. The Bill was passed, with amendments, by the National Assembly on Tuesday,15thApril2025.

2.3LegislativeFramework

• 9.Article 115 of the Constitution makes provision on Presidential assent and referral. Article115(1)ofthe Constitution provides that withinfourteen days after receipt of a Bill,thePresident shall assenttotheBill,orrefertheBillback toParliament for reconsideration by Parliament, noting any reservations that the President has concerning the Bill.
• 10.Article 115(2) of the Constitution provides that if the President refers a Bill back for President;orpass theBill a second timewithout amendment.

11. Article 115(3) of the Constitution provides that if Parliament amends the Bill fully accommodating the reservations of the President, the Speaker shall re-submit the Bill to thePresidentfor assent. 12. Article 115(4) of the Constitution provides that Parliament, may pass the Bill a second time, without amendment, or with amendments that do not fully accommodate the reservations from the President,by avote supported by two-thirds of members of theNational Assembly.

CHAPTERTHREE

2.4AnalysisofthePresidentialMemorandumofReferral

13. Attached below is a Matrix containing an analysis of the memorandum of referral on the Cancer Prevention and Control (Amendment) (No.2) Bill,2022 (National Assembly Bill No. 45 of 2022) detailing the reasons by His Excellency the President for declining to assent to theBill —

| Clause | Provision | Recommendation by H.E. the President | Reason | Departmental Committee on Health's Resolution | |----------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------| | 2 | The clauseproposes to introduce the definitions of the terms “e-health" and “telemedicine"to the Cancer Prevention and ControlAct. | Deletion of clause 2. | The two terms are already defined in the Digital Health Act. The Bill may cross- reference the terms as defined inthe Digital Health Act. | Agreed to | | 3 | The clause seeks to amendsection5ofthe principal Act by inserting new paragraphs on the functions of the National Cancer Institute (NCI) as | Deletion of clause 3. | The two insertions are already covered under section3on the objects of the Digital Health Act. | Agreed to | | | follows: Promoting the use ofe-health and telemedicine for the prevention and management of persons with cancer; and Promoting the treatment of persons of cancer as a component of primary healthcare. | | | |

| 4 | The clause proposes to amendsection31of the principal Act by inserting a new subsectiont thatthe NCI shallcollaborate with national government departments responsibleforhealth to promote the training ofhuman resource on oncology services. | Deletion of clause 4. | Under Executive Order No. 1 of 2025 on the Organization of Government, theNCIisa government agency under the Ministry of Health, State Department for Medical Services. Nothing bars the NCI from collaborating with national government departments to promote oncology training. | Agreed to. | |-----|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|

CHAPTERFOUR

4.0COMMITTEEOBSERVATIONS

14. The Committee observed that the principal object of the Cancer Prevention and Control (Amendment)(No.2) Bill, 2022 (National Assembly Bill No. 45 of2022) was to amend the provisions of the Cancer Prevention and Control Act, No. 15 of 2012, to provide for training of health cadres in the specialized medical field of oncology, toinclude cancer treatment aspart oftheprovisionofprimaryhealthcare and to incorporate the use ofe-health and telemedicinein the prevention and management ofcancer. 15. In considering the reservations by His Excellency the President, the Committee observed that the amendments in relation to the use of technology in the managementof cancer are adequately addressed through the Digital Health Act, No. 15 of 2025 and that theNational CancerInstitute already has the general power to collaborate with any national government department in furtherance ofits functions including in promoting oncology training.

CHAPTERFIVE

5.0COMMITTEERECOMMENDATIONS

• 16.Article 115 ofthe Constitution provides that Parliament (a) mayamend theBill fully accommodating the reservations of the President or (b) may pass the Bill a second time,without amendment,orwith amendments thatdonotfullyaccommodate the reservationsfrom thePresident.

17. Pursuant to Article 115 of the Constitution, the Committee may consider the reservations and recommend that the National Assembly: (a) amends the Bill fully accommodatingthereservations ofthePresidentor(b) passes theBilla second time, withorwithoutamendmentsthataccommodatethereservationsfromthePresident.

• 18.Pursuant toArticle 115of the Constitution,the Committee resolves to amend the Bill fully accommodating the reservations of the President relating to the Cancer Prevention and Control (Amendment) (No.2) Bill, 2022 (National Assembly Bill No. 45 of 2022) by :
• (a) Deleting Clause 2 of the Bill;
• (b) Deleting Clause 3 of the Bill; and
• (c) Deleting Clause 4 of the Bill.
• 19.The Committee having considered the Presidential Memorandum of Referral on the Cancer Prevention and Control (Amendment)(No. 2) Bill, 2022 (National Assembly Bill No.45 of 2022) recommends that the House agrees with His Excellency the President, pursuant to Article 115(1)(b) and (2)(a) of the Constitution.

..DATE..22S

SIGNED..

HON.DR.JAMES NYIKAL WAMBURA, CBS,M.P. CHAIRPERSON,DEPARTMENTALCOMMITTEEONHEALTH

THENATIONALASSEMBLY

13THPARLIAMENT-FOURTHSESSION(2025) DIRECTORATEOFDEPARTMENTALCOMMITTEES

DEPARTMENTALCOMMITTEEONHEALTH

REPORTONTHEPRESIDENTIALMEMORANDUMOFREFERRALONTHE (NATIONAL ASSEMBLY BILL NO. 45 OF 2022).

We, the undersigned Members of the Departmental Committee on Health do hereby append our signatures to adopt this Report Date:\_ 171202S

| NO | NAME | SIGNATURE | |------|-----------------------------------------------------|-------------| | 1. | The Hon.Dr.Nyikal James Wambura,CBS,MP- Chairperson | | | 2. | The Hon.Ntwiga Patrick Munene,MP-Vice- Chairperson. | | | 3. | TheHon.Dr.Pukose Robert,CBS,MP | | | 4. | The Hon.Titus Khamala,MP | | | 5. | TheHon.Sunkuli JuliusLekakeny Ole,EGH,EBS,MP | | | 6. | The Hon.Prof.Jaldesa GuyoWaqo,MP | | | 7. | TheHon.OwinoMartinPeters,MP | | | 8. | The Hon. Wanyonyi Martin Pepela, MP | | | 9. | The Hon.Lenguris Pauline, MP | @ | | 10. | The Hon. Mary Maingi, MP | | | 11. | The Hon. Muge Cynthia Jepkosgei, MP | | | 12. | The Hon. Oron Joshua Odongo,MP | | | 13. | The Hon.Kibagendi Antony,MP | | | 14. | The Hon.Mathenge Duncan Maina, MP | | | 15. | The Hon. Kipngor Reuben Kiborek, MP | |