Court dismisses Joy Nursing Home's application to lift suspension of its licenses

The Joy Nursing Home and Maternity has lost a suit where it had taken to court the National Hospital Insurance Fund (NHIF), Kenya Medical Practitioners and Dentists Council (KMPDC) and the Ministry of Health for closing its operations.

The hospital had sued to have its operational licenses reinstated pending a hearing and determination of a matter where it had challenged the withdrawal of the licenses by the Ministry of Health and KMPDC.

The hospital wanted the court to quash the decisions of the KMPDC and the Ministry of Health to suspend its licences arguing that due process was not followed including, according to the hospital, an opportunity to be heard before the administrative actions were taken.

But Justice Jairus Ngaah dismissed the suit for lack of merits because there is evidence that there were inquiries and disciplinary proceedings by the KMPDC before the suspension of the licenses.

Justice Ngaah said none of the prayers sought can be granted because there is evidence of an inquiry before the suspension of the licenses.

He said the hospital has not provided any proof of the grounds of illegality and procedural impropriety which are the only two grounds upon which judicial review reliefs are sought.

The procedural impropriety which was the hospital's ground was meant to point out that the two failed to observe basic rules of natural justice to act with procedural fairness towards it while it was likely to be affected by the decisions.

But Ngaah said the KMPDC had defended its decision to suspend the license of the hospital and the license has also expired therefore no need to lift the suspension of an expired license.

"As for KMPDC, the Medical Practitioners and Dentist Act (lnquiry and Disciplinary Proceedings) Rules, 2022 were cited as having been the basis upon which the KMPDC acted in suspending the (hospital's) licence and suspending it in the manner it did. This has not been disputed," the judge stated.

"But it has been noted that even assuming the suspension of the licence was procedurally improper, the lifting of that suspension would be of no consequence because the licence has since expired. For the reasons I have given, I am not satisfied that the applicant's (hospital's) application has any merits."

The hospital wanted the high court to quash the decision by the NHIF to shut down the Health Insurance Claim System and to suspend the hospital's operations with it.

It also wanted to be allowed to operate and to carry on with its business as usual.

The hospital had a contract with NHIF to provide health care services to beneficiaries of NHIF cover in which the state health insurance provider was to pay the hospital and the petitioner argued that they had provided the health services as agreed with the NHIF.

However, on June 18, 2023, the NTV aired an expose showing how certain healthcare facilities, including the Joy Nursing Home and Maternity, were scamming vulnerable Kenyans, misusing public resources and providing what has been described as "injurious healthcare services to patients."

These facilities were said to be preying on the elderly and, in particular, the Joy Maternity and Nursing Home is said to have taken advantage of the elderly and vulnerable citizens in need of medical attention, with a view to fraudulently claiming reimbursement from the NHIF for procedures or services that were never provided.

Following this expose`, the Cabinet Secretary for the Ministry of Health directed the NHIF to suspend all those health facilities that had been named by the NTV expose`.

The hospital - Joy Nursing Home and Maternity - which sued had received over Sh225,000,000 as payment for medical services and procedures allegedly offered to the NHIF beneficiaries between July 2022 and June 2023.

And the KMPDC on June 19, 2023, cancelled the hospital's licence by invoking provisions of section 15(9) of the Medical Practitioners and Dentist Act and suspended the proprietor's license to operate a health facility pending the hearing and determination of the matter.