Nairobi unveils Bill to give public hospitals more autonomy and improve service delivery
The Nairobi City County Health Services Bill, 2025, seeks to address delays in service delivery and financial access that have long affected the county’s healthcare system.
Nairobi County Assembly is proposing changes to the management of public hospitals through a new bill intended to hand health facilities more power and autonomy.
The Nairobi City County Health Services Bill, 2025, seeks to address delays in service delivery and financial access that have long affected the county’s healthcare system.
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Minority Whip Moses Ogeto outlined the urgent need for the changes, citing critical issues faced by both workers and patients in public clinics.
Ogeto said many hospitals operate with limited staff and underpaid workers, making it hard for residents to receive timely care.
“You see, they are unable to access public clinics simply because these public clinics don’t even have the staff,” Ogeto said.
The Bill proposes to allow hospitals, especially smaller clinics, to take full charge of their finances and operations.
A key element is the retention of all money collected at the facility level, instead of being directed to the County Treasury’s Consolidated Fund Services account.
Even small fees like Sh100 will remain at the clinic to support its services.
“We want to decentralise the management of the hospitals, especially when the budgets have been approved,” Ogeto stated.
He noted that even after a budget is passed by the assembly, clinics face unnecessary delays due to additional approvals from treasury officials.
This, he said, is one of the main reasons hospitals struggle to function effectively.
To deal with these setbacks, the proposed law will create strong hospital boards responsible for overseeing performance.
These boards will be required to meet every quarter and work closely with newly introduced internal boards that will handle daily hospital affairs.
For the first time, members of the County Assembly will be officially included in the boards, giving them a platform to monitor how budgets are spent within hospitals.
The reform is seen as a way to bring greater transparency and accountability at the facility level.
Another major goal of the Bill is to formalise the position of hospital CEOs. Ogeto explained that many of them currently operate without a legal framework backing their authority.
“We want to strengthen the CEO position; currently, they are there illegally, so we want to make them legal,” he said. The new law will grant them full powers similar to those of executives running private hospitals.
If enacted, the legislation is expected to ease long-standing bureaucratic pressure on health facilities and allow them to respond faster and more efficiently to patient needs across Nairobi.
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