Duale warns health facilities against charging for outpatient services
By Faith Lagat, August 12, 2025Health Cabinet Secretary Aden Duale has issued a stern warning to health facilities that defy the presidential directive to provide free outpatient services, saying they will be treated as crime scenes and face severe legal consequences.
The directive, announced by President William Ruto during the burial of Phoebe Asiyo in Homa Bay on August 8, 2025, seeks to ensure all Kenyans can access essential healthcare without financial barriers at public hospitals from Level 1 to Level 4.
Presidential call for accountability
President Ruto, in his address, condemned attempts to impose charges on outpatients, citing a case in Rachuonyo.
“Public funds are for development, not personal use. Any hospital that will steal money from the citizens will face my wrath,” he warned.
He stressed that adequate resources have been allocated to sustain free treatment services and that patients at Level 1 to Level 4 hospitals should be treated promptly, given prescribed medicines, and not asked for any payment.
The President’s remarks were part of a broader push to strengthen universal health coverage (UHC) and eliminate cost barriers that prevent Kenyans from seeking timely medical care.
Govt’s tough stance
Duale reinforced the President’s message, framing non-compliance as a violation of public trust and an infringement on Kenyans’ right to affordable healthcare.
“Such actions will attract immediate legal consequences and be deemed an offence against both public trust and the right of every Kenyan to accessible and affordable healthcare,” he said.
His statement reflects the government’s intention to apply strict enforcement measures to any facility found flouting the directive, with violations treated as criminal acts. The approach underscores the administration’s determination to make UHC a tangible reality rather than a policy promise.
Progress under the SHA
The directive’s rollout is supported by progress made under the Social Health Authority (SHA) programme, with Homa Bay County emerging as a leading example. According to Ruto, approximately 533,000 residents in the county are registered under SHA, placing it thirteenth nationally.
The President urged counties to accelerate registration drives, stressing that the initiative is not exclusive to the wealthy or well-connected. “It is a fundamental entitlement for every Kenyan,” he said, adding that the programme aims to ensure healthcare is treated as a right, not a privilege.
The policy builds on earlier health reforms, such as the 2013 abolition of delivery fees, and represents a major step towards equitable healthcare access. Its success will depend on rigorous enforcement, transparent administration, and public participation to ensure that no Kenyan is denied treatment due to inability to pay.