Health ministry suffers Sh219b cuts in budget

President William Ruto’s flagship project of the Social Insurance Fund (SHF) could run into headwinds after the National Treasury cut the budgetary allocation to the Ministry of Health by a whooping  Sh219 billion.

The recently signed return-to-work agreement between the government and the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) is also lying on shaky grounds after the National Treasury failed to allocate it any money. Instead, the Ministry says it would bring an addendum to the budget to factor in the allocation for the same.

Besides SHF and the doctors’-return-to-work deal, other sectors set to suffer as a result of the budget cuts in the 2024/2025 vote to the health sector include procurement of HIV/AIDs, family planning and vaccines commodities as well as free maternity services.

The Ministry of Health had requested Sh319.4 billion but was instead allocated a paltry Sh100 billion, a deficit of Sh219.4 billion.

Out of the Sh100 billion, Sh 60.5 billion is for recurrent expenditure and only  Sh 39.5 billion has been set aside  for development.

Lawmakers who sit in the Health committee chaired by Endebess MP Robert Pukose were shocked to learn that the Ministry of Health had suffered huge cuts that will  have a negative impact on the delivery of services to Kenyans.

Budgetary allocations

Nyeri Town MP Duncan Mathenge said that based on the budgetary allocation,  it is clear that the government is not interested in implementing the new health scheme.

 “What are we telling Kenyans about this? Is the amount left really able to fund this? We have been telling Kenyans about this and we have even gone ahead and deducted money from salaries,” he said.

Seme MP Dr James Nyikal, who is a former Director of Medical Services questioned how the fund will work following the deduction of the said vote by more than Sh100 billion.

 “I am wondering how this social insurance fund will work. Kenya Kwanza came up with this model and we need to be told how to move because as of now it leaves us not sure about what is going to happen in future,” Dr Nyikal, a medical practitioner observed.

Nandi Woman Representative Cynthia Muge sought to know whether the government was deliberating  killing the Social Health Insurance Fund following the huge cuts on the Ministry’s budget.

She also questioned what the reduction of the  monies meant for maternal health sector  after the Ministry said that not all pregnant mothers will be covered by the insurance fund as beneficiaries are only the indigents.

Their sentiments came after Medical Services Principal Secretary Harry Kimtai tabled documents indicating the various critical sectors that have suffered as a result of the budget cuts .

 “The resource allocation in the proposed annual estimates shows a significant deviation of the annual budget estimates allocation from the 2024 Budget Policy Statement ceiling,” Kimtai’s statement read.

 The documents show that implementation of Social Insurance Fund had been reduced by Sh 94.9billion out of which 45.9 billion has been slashed from Primary Health Care which was only allocated Sh 4.1billion while the Emergency, Chronic and Critical Illness Fund has lost Sh49 billion after  it was only allocated Sh500 million.

Vaccines

The procurement of HIV, family planning and vaccines commodities has lost the entire Sh14.1 billion that the department had requested.

Semi-Autonomous Government Agencies (SAGAs) under the Ministry  have lost Sh 2.8 billion while the fight against cancer has been affected after the National Cancer Institute was allocated Sh170 million out of a budgetary request of Sh 800 million.

Among the SAGAs that have been affected include Kenyatta National Hospital (KNH)  and satellite hospitals (Mwai Kibaki Hospital and Mama Margaret Uhuru Hospital)  which has lost Sh 804 million meant for the implementation of the Affordable Housing Levy (AHL) , National Social Security Fund (NSSF) contributions  and reviewed contributions and staff mortgage scheme.

 Moi Teaching and Referral Hospital (MTRH) has lost Sh 944.1 million that was meant to cater for unpaid salary obligations and staff pension scheme.

The Kenya Medical Research Institute (KEMRI)  has lost Sh1 billion that was meant for AHL, pensions benefits scheme and pending court order claims.

 “Personal Emolument has been a perennial problem that has occasionally caused disruptions in provisions of services in key Referral Hospitals such as KNH, MTRH, satellite hospitals such as Othaya Hospital, KEMRI and other saga,” Kimtai said.

Free maternity services will also be affected as the budget for the said vote has been reduced from Sh 4 Billion to Sh 2 Billion.

Kimtai in his submissions appealed to the committee to reinstate the said monies to avoid critical services from being affected.

He said that  monies that had been  earmarked for scaling up of Social Health Insurance Fund, implementation of Social Health Insurance Act 2023, Primary Health Care act and Digital Health Act 2023 which were recently enacted had been slashed.

“The state department requests the committee to consider the above additional requests to ensure Kenyans get specialised healthcare services, avoid stalling of ongoing projects and ensure Kenyans get return on investment in the health sector through better service’s provision,” the PS implored.

Health coverage

He added : “The deviation in allocation will significantly affect the implementation of the Universal Health Coverage which requires funding of the Primary Health Care Fund, Critical Illness and Emergency Funds, operationalization of Social Health Authority and the operations of the day to day running of the state department.

On procurement of HIV, family planning and vaccines, he regretted that there has been a perpetual rationalization of the said funds over the years during supplementary estimates. e further regretted that there has been a steady reduction in donor funding for the said programs and called on the government to increase its counterpart funding to offset the deficit especially for the said commodities.

“ The state department further requests that these funds be ring fenced in the financial year 2024/2025 and the Medium Term and further be exempted from any budgetary cuts in supplementary estimates,” the PS noted.