The government has finally given in to pressure to reinstate a discontinued comprehensive medical insurance scheme for civil servants and public officers.

The scheme will now run alongside the Social Health Insurance Fund (SHIF), sparking mixed reactions from civil servants amid fears that more money will be deducted from their payslips.

The proposed scheme will be operated by funds appropriated by the Treasury and money paid out to civil servants as medical allowances, according to draft regulations published by the ministry last week.

These rules have raised fears that a new set of deductions from civil servants’ pay cheques will be introduced.

Kenyans have until November 18 to submit their views on the draft regulations on the Public Officers Medical Scheme Fund.

A notice from Treasury Cabinet Secretary John Mbadi said a team composed of public officers from several government departments had “finalised preparing the draft Public Finance Management (Public Officers Medical Scheme Fund) Regulations, 2024”.

The proposed scheme will include civil servants and other qualifying categories of workers. Beneficiaries will only turn to it once they have  exhausted their SHIF accounts.

“This means that the limits provided under [SHIF] will have to be exhausted by a member or qualifying dependent first before the limits under the Public Officers Medical Scheme are considered,” Mbadi says in his memo.

The proposed scheme will replace the defunct NHIF comprehensive scheme that provided healthcare for principal members and six dependants under a package that included outpatient and inpatient care.

Overseas treatment

NHIF, discontinued when SHIF was introduced, also had other services such as dental and optical, annual medical checkups, road ambulance, emergency air rescue, overseas treatment, and a group life and last rites expenses cover.

“For civil servants to continue receiving this benefit from the scheme as part of their remunerations, a fund is proposed to enable civil servants first to receive the comprehensive range of quality health services from the Social Health Authority,” Mbadi writes.

Once this is exhausted, “proceed with the limits provided for under the comprehensive medical insurance scheme for civil servants and disciplined services (renamed Public Officers Medical Scheme).

Civil servants are apprehensive that the proposed scheme may come with new deductions alongside a 2.75 percent contribution from their gross pay for SHIF.

But the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has welcomed the move, saying this was one of their demands.

“To actualise the establishment of this fund, the joint government and public sector unions came up with regulations that have been released for public participation by the National Treasury,” the union’s secretary general Dr Davji Bhimji Atellah said yesterday.

“We therefore implore all our members to interact with the regulations and provide their inputs to our email for onward submissions of [the] KMPDU stand.”

Atellah said a committee comprising representatives from several government departments and public-sector unions was discussing how the proposed medical scheme would work.

But he said the new scheme will not come with new deductions as the government will fund it.

Initial capital

The scheme’s initial capital will be financed with money appropriated by the National Assembly and contributions from the ministry responsible for public service and any other employer who opts to contribute to it using money payable to public officers as medical benefits, per the proposed regulations.

The fund will be administered by the CEO of the Social Health Authority (SHA), the agency that administers SHIF. Staff from SHA will also be deployed to support the scheme’s functions.

The introduction of a third medical fund for teachers could be a ploy by the government to introduce other deductions from their payslips, said Kuppet Vihiga branch executive secretary Sabala Inyeni.

Teachers, he said, already have SHIF and a Minet medical scheme under the Teachers Service Commission.

Bureaucratic delays

He added that teachers have been complaining that health facilities under Minet take up to four days to discharge patients, unlike under other schemes. He also claimed they cannot access health services again within seven days after treatment.

“Already the two covers have issues that we are complaining about. Why introduce a third cover instead of ensuring that those already in existence work efficiently?” Inyeni said.

“We are not going to allow any more deduction [from] teachers’ payslips, which are already overstretched.”

SHIF has it own issues, he added. He cited bureaucratic delays in pre-authorising procedures, long chains of referrals from Level One to Level Six and system failures.

“Our members on the ground do not even understand how they should benefit from this [SHIF] due to the manner in which it has been set up,” he said.