Duale: SHA will expose NHIF fraud, lead to private clinics closures
PS Kimtai accused private healthcare providers of attempting to blackmail both the government and the public by withholding services.
Health Cabinet Secretary Aden Duale has cautioned that a large number of private clinics operating in residential estates will shut down once the newly introduced Social Health Authority (SHA) becomes fully operational.
He argued that many of these facilities have survived due to fraudulent dealings under the National Health Insurance Fund (NHIF), which the SHA system aims to eliminate.
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Speaking on Thursday, Duale insisted that the transition to SHA would expose malpractices in the sector, leading to the closure of clinics that had been taking advantage of NHIF weaknesses.
"I'm telling you; mark my words today, the day the Social Health Authority (SHA) takes root, 60 percent of the many clinics you see in the estates will close. Most hospitals that you thought were doing good work were open because of the fraud that was taking place in NHIF," he stated.
At the same time, outgoing Health Principal Secretary Harry Kimtai accused private healthcare providers of attempting to blackmail both the government and the public by withholding services.
Speaking on Monday, Kimtai warned that hospitals failing to comply with the constitutional obligation to provide healthcare services could face serious consequences, including difficulties in license renewals.
"From the statistics and data we have seen, we have realized that most of the private facilities are not participating in outpatient services, which is primary healthcare funding," he said.
Denied registration
He further indicated that hospitals that do not adhere to the new structure could be denied registration and potentially shut down.
The Ministry of Health has shared data with private hospitals in an attempt to understand their reluctance to participate in the SHA model.
The government and private hospitals have been in a prolonged dispute over the scheme, with the Rural and Urban Private Hospitals Association (RUPHA) announcing a suspension of SHA services in February.
However, this decision was later reversed following intervention from the president.
One of the primary concerns raised by private hospitals is the issue of unpaid debts, some of which date back to 2017.
RUPHA Chairperson Brian Lishenga highlighted that these outstanding payments have led to financial struggles, including bank defaults and shortages of essential medicines.
Under the SHA framework, outpatient services are capped at Sh2,000 per visit, with each beneficiary limited to four visits per year in Level 2, 3, and 4 primary healthcare referral facilities.
Private hospitals argue that this model is unsustainable and could further strain service delivery.
As the transition to SHA progresses, the government maintains that the new system will promote efficiency and eliminate fraudulent activities.
However, private healthcare providers continue to raise concerns about its feasibility and financial impact on their operations.
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