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Archbishop Anthony Muheria on SHA non-payment: When our payments are held back, we are risking the lives of patients. It’s not a favour the government tis doing to the faith-based hospitals; it’s a right to the patient being treated. The money owed is almost Ksh.5B #CitizenExplainer

Citizen TV Kenya

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Mr. President, Please Seek the Truth on the Ground About SHA H.E. the President, Kenyans need to tell you the truth about what is happening on the ground with the Social Health Authority (SHA). SHA was launched with good intentions, and many Kenyans welcomed the transition from NHIF to a system intended to provide accessible healthcare to all. However, there are growing concerns that implementation challenges, administrative failures and possible malpractice in some facilities may be undermining the programme and creating the impression that SHA is not working. There are reports and concerns from patients that when a patient is referred from a Level 4 facility to a Level 5 or Level 6 hospital because of the seriousness of their condition, they may be asked to pay cash before admission, despite being under SHA. This is especially concerning because ordinary Kenyans were led to believe that they would be able to access covered healthcare without being required to make such payments. Another major problem occurs when the SHA system is unavailable or experiencing technical or administrative difficulties. Patients can find themselves unable to receive treatment unless they pay cash. A system failure should not become a reason for a sick person to be denied urgent medical care. There are also concerns that some hospitals may submit claims to SHA while simultaneously asking patients to make additional payments for services they believe should be covered. These allegations need to be independently investigated rather than dismissed. There are further concerns that individuals who previously benefited from fraudulent or questionable NHIF claims may have interests within the new system, and that some people within SHA or hospital management could be contributing to its problems. These are serious allegations and should not be treated as facts without evidence. However, they are important enough to warrant an independent investigation. Mr. President, please do not rely only on reports from officials within the system. Commission an independent, transparent assessment of SHA implementation across the country, particularly in public hospitals and among ordinary citizens who depend on public healthcare. The investigation should establish: 1.Whether hospitals are demanding cash payments for services covered by SHA. 2.Whether hospitals are submitting SHA claims while also charging patients for the same services. often system failures prevent patients from accessing treatment. 4.Whether public hospitals are receiving SHA reimbursements on time and whether those payments are reaching the intended services. 5.Whether there is fraud, abuse or conflict of interest within the SHA claims and payment system. 6.Why patients referred to higher-level hospitals are sometimes facing difficulties accessing care. 7.Whether the experience of ordinary Kenyans differs significantly from that of civil servants or other groups with easier access to healthcare services. The President should hear directly from patients, doctors, nurses, hospital administrators and independent healthcare experts not only from officials responsible for implementing SHA. If SHA is being sabotaged or poorly implemented, those responsible should be identified and held accountable. If the problems are caused by weaknesses in the system, those weaknesses should be corrected. Kenyans do not want SHA to fail. They want it to work. Mr. President, please obtain an independent report on what is actually happening in hospitals across the country and correct the mistakes before public confidence in SHA is lost. The success of universal healthcare should not be determined by reports on paper; it should be measured by whether an ordinary Kenyan can walk into a hospital when sick and receive the care they need without being forced to pay cash because of failures within the system.

Mr. President, Please Seek the Truth on the Ground About SHA H.E. the President, Kenyans need to tell you the truth about what is happening on the ground with the Social Health Authority (SHA). SHA was launched with good intentions, and many Kenyans welcomed the transition from NHIF to a system intended to provide accessible healthcare to all. However, there are growing concerns that implementation challenges, administrative failures and possible malpractice in some facilities may be undermining the programme and creating the impression that SHA is not working. There are reports and concerns from patients that when a patient is referred from a Level 4 facility to a Level 5 or Level 6 hospital because of the seriousness of their condition, they may be asked to pay cash before admission, despite being under SHA. This is especially concerning because ordinary Kenyans were led to believe that they would be able to access covered healthcare without being required to make such payments. Another major problem occurs when the SHA system is unavailable or experiencing technical or administrative difficulties. Patients can find themselves unable to receive treatment unless they pay cash. A system failure should not become a reason for a sick person to be denied urgent medical care. There are also concerns that some hospitals may submit claims to SHA while simultaneously asking patients to make additional payments for services they believe should be covered. These allegations need to be independently investigated rather than dismissed. There are further concerns that individuals who previously benefited from fraudulent or questionable NHIF claims may have interests within the new system, and that some people within SHA or hospital management could be contributing to its problems. These are serious allegations and should not be treated as facts without evidence. However, they are important enough to warrant an independent investigation. Mr. President, please do not rely only on reports from officials within the system. Commission an independent, transparent assessment of SHA implementation across the country, particularly in public hospitals and among ordinary citizens who depend on public healthcare. The investigation should establish: 1.Whether hospitals are demanding cash payments for services covered by SHA. 2.Whether hospitals are submitting SHA claims while also charging patients for the same services. often system failures prevent patients from accessing treatment. 4.Whether public hospitals are receiving SHA reimbursements on time and whether those payments are reaching the intended services. 5.Whether there is fraud, abuse or conflict of interest within the SHA claims and payment system. 6.Why patients referred to higher-level hospitals are sometimes facing difficulties accessing care. 7.Whether the experience of ordinary Kenyans differs significantly from that of civil servants or other groups with easier access to healthcare services. The President should hear directly from patients, doctors, nurses, hospital administrators and independent healthcare experts not only from officials responsible for implementing SHA. If SHA is being sabotaged or poorly implemented, those responsible should be identified and held accountable. If the problems are caused by weaknesses in the system, those weaknesses should be corrected. Kenyans do not want SHA to fail. They want it to work. Mr. President, please obtain an independent report on what is actually happening in hospitals across the country and correct the mistakes before public confidence in SHA is lost. The success of universal healthcare should not be determined by reports on paper; it should be measured by whether an ordinary Kenyan can walk into a hospital when sick and receive the care they need without being forced to pay cash because of failures within the system.

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