The Kenya Medical Practitioners and Dentist Union (KMPDU) to come up with mechanisms to protect whistleblowers of medical fraud.

In a statement on Tuesday, June 20, 2023, KMA Secretary General Diana Marion stated that the move will encourage more people to expose practitioners acting unethically.

This follows recent revelations that hospitals have been stealing from Kenyans by inflating bills, which they then charge to the National Hospital Insurance Fund (NHIF).

KMA urged the Kenya Medical Practitioners and Dentists Council (KMPDC) and NHIF to investigate those linked with medical fraud.

“KMA calls upon the Kenya Medical Practitioners and Dentists Council and NHIF to take immediate and decisive action to investigate the cases of medical fraud. We further call upon KMPDC to implement mechanisms to protect whistleblowers who report fraud and encourage individuals with knowledge of unethical practices to come forward,” Marion stated.

According to KMA, the medical scandal proves that the medical regulator and the professional associations must work together to come up with structures that will encourage self-regulation.

“We note that medical ethics and standards are threatened when there is no proper and standardized coordination between the regulator and professional associations. There is an urgent need for the establishment of well-defined structures to support self-regulation of the medical profession. KMA is ready to work collaboratively with KMPDC to make self-regulation a reality in Kenya,” Marion added.

“We also call upon the public to remain vigilant and report any suspected cases of medical fraud to the
appropriate authorities. Patients and their families play a crucial role in identifying and exposing such
fraudulent activities, ensuring that the healthcare system remains transparent and trustworthy.”

Medical regulatory bodies

KMA urged the government through the Ministry of Health to strengthen medical bodies by providing the regulatory bodies with adequate resources, which will in extension allow the bodies to conduct audits, investigations and inspections.

“We believe in upholding the highest standards of medical ethics and professionalism as evidenced by our Code of Conduct, which our members are bound by KMA will be looking into cases involving any of their members and will take necessary action. It is imperative that those found guilty of fraudulent activities are held accountable and face appropriate legal consequences,” Marion added.

Health Ministry action

In a statement on Monday, Health Cabinet Secretary Susan Nakhumicha condemned the malpractice and announced the suspension of NHIF managers of all the affected areas.

She also stated that the facilities mentioned in the scandal will be under investigation and inspection by KMPDU.

The mentioned facilities were also given 48 hours to evacuate and transfer their inpatients, to pave way for the inspection. Additionally, the Health CS said that all NHIF staff will undergo a lifestyle audit to explain their wealth in relation to their earnings.

She added that the audit will be conducted until the end of December.