Various hospitals yesterday claimed that the Social Health Insurance Fund (SHIF) will collapse in the next 12 months if the current challenges affecting the implementation process are not addressed.

This came on the day lawmakers allied to ousted Deputy President Rigathi Gachagua demanded that the government comes clean on how it procured the Sh104.8 billion Social Health Authority (SHA) system following revelations that the State has no control over the Fund.

The hospitals under the Kenya Healthcare Federation (KHF), Rural Urban Private Hospital Association (RUPHA), Kenya Association of Private Hospitals (KAPH) and the faith-based hospitals told lawmakers that if the funding to the primary healthcare fund, which takes care of outpatient services where 91 per cent of all Kenyans are, is not enhanced then the fund will not be sustainable.

The hospitals further raised concerns that the capitation of Sh900 allocated to families per year to take care of outpatient services is inadequate as compared to the capping that had been provided for under the defunct National Hospital Insurance Fund (NHIF), which was Sh1,000 that had been allocated for Level I and Level II hospitals.

Appearing before the Departmental Committee on Health, the hospitals further told lawmakers that the issues facing the contributions being made by those in the informal sector ought to be addressed as so far only a handful of them are contributing to the fund.

Inconsistent payment

KHF chairman Kanyenje Gakombe, who disclosed that the government owes them Sh30 billion, regretted that non-salaried Kenyans only pay for SHIF whenever they fall sick and visit hospitals and once treated, they never make further contributions to the fund, a move he said is likely to affect running of the fund.

“If we do not address how non-salaried people should make their contributions because they only pay when they fall sick, this SHIF will become very untenable,” he warned.

The chairperson of KAPH, Eric Musau, said they have issues with the sustainability of the fund as only about four million non-salaried Kenyans, translating to 21 per cent out of the total registered members, are contributing.

“More than 80 per cent of those living in the informal sector are registering as members, they have done that when they need services. Someone comes to the hospital, pays Sh800, gets a benefit of Sh1.8 million and then after treatment it ends at that. If we do not follow up on this issue, we do not see how this fund will survive beyond 12 months,” he said.

RUPHA chairperson Brian Lishenga said the fund had become extremely unpopular as its highest rating record, as per a recent survey, is at 37 per cent.

“Out of 20 million registered persons only about four million people in the informal sector are contributing yet the Primary Health Care is supposed to support even those that are not contributing. This fund can only survive for the next 12 months because even the funding the vote was allocated is Sh4.2 billion to cover 20 million Kenyans yet the budget required is Sh18billion,” he said.

Irregular procurement

The sentiments by the hospitals came on the day 10 lawmakers allied to Gachagua told Ruto to admit that he engaged in an irregular deal when he procured the SHA system following revelation by Auditor General Nancy Gathungu that the government has no ownership of the system.

Kajiado North MP Onesmus Ngogoyo said it is clear that SHA is not working because Ruto engaged in a raw deal.

“SHA is not working because the President did an irregular procurement. We were very surprised. President William Ruto oversaw an irregular procurement.”

Naivasha Town MP Jane Kihara told Ruto to refund Kenyans their hard-earned money owing to the fact that the SHA system is not working.

She said:

“It is now clear that there is corruption in these SHA things and the money is going to the pockets of a few. The money is just being taken. Ruto should tell us when he will refund us this money. This is money being deducted using corrupt ways.,” she said.

According to Tetu MP Geoffrey Wandeto, whereas the State has been collecting money for SHA, it was all a plan to swindle money from Kenyans- not to help them.

“The Auditor General has said no tender was done, no specification was issued and no one knows what this thing is. This thing the country could only have spent Sh4 billion, and not the Sh100 billion, which we believe was used for corruption,” he explained.

In her latest report, the Auditor General Nancy Gathungu pointed out that several laws were flouted in the procurement of the system, saying there was no value for money. She raised concerns that the system was acquired through an uncompetitive procurement procedure where they single-sourced for the service provider contrary to Section 114 of the Public Procurement and Asset Disposal Act.

“The system was procured at a cost Sh104,808,136,478 through Specially Permitted Procurement Procedure but was not included in the procurement plan nor the medium-term budgetary expenditure framework,” the report reads, adding that ownership of the system, system components and all intellectual property rights remain in the ownership of the consortium except for the infrastructure which is to be transferred to the procurement.