MPs call for end to Minet teachers' medical scheme

The suffering of teachers seeking medical services is set to persist because of the incapacity and 'exorbitant' insurance cover pricing by the Social Health Authority (SHA), Teachers Service Commission (TSC) disclosed yesterday.

At the same time, Parliament now wants TSC to terminate its contract with Minet Insurance brokers and a consortium of underwriters for the provision of medical cover services to teachers, terming the arrangement an "amorphous structure".

A parliamentary team yesterday heard that TSC settled on renewing the contract for the provision of a comprehensive teachers’ medical cover with Minet Kenya Insurance brokers Ltd, which is currently grappling with operational challenges that have hindered teachers’ access to healthcare, due to SHA's lack of structures to accommodate and cover the huge number of teachers. 

TSC Chief Executive Officer Nancy Macharia submitted before the National Assembly Education Committee that the Commission had approached SHA for the provision of a medical scheme to teachers but the authority confessed to having inefficient structures to undertake the venture. 

Macharia also revealed that SHA was demanding Sh37 billion to onboard teachers to its medical scheme, which was a far cry from the current Sh20 billion allocated towards the scheme. 

"Last year, we did have a meeting with SHA but they said they did not have the structures to undertake the scheme. They were also asking for Sh37 billion to onboard teachers to SHA but even then they said they were not ready to take up the teachers this year, "said Macharia. 

She explained that TSC had entered into a three-year contract with Minet in 2015 and had tendered for it twice to date, but at some point sought to terminate the same following complaints from teachers over delayed insurance payment approvals, prohibitive pre-authorisation requirements at health facilities and teachers who were seeking treatment at hospitals being turned away. 

To this end, she said, the Commission had sought to place teachers in a public medical scheme. 

"We have only tendered for this scheme under Minet Insurance twice. Previously, we had also sought to use the defunct NHIF but the figure that they quoted was too high to fund. I later wrote to Treasury to increase the funding we get so we could take up the cover but there were no funds, and that is how we ended up with Minet Insurance, and the consortium," added Macharia. 

The CEO's sentiments were in response to concerns expressed by the Education Committee which had poked holes exposing the inefficiencies in the medical scheme available for teachers and sought to know whether there were any plans to onboard teachers onto SHA. 

"There are issues about the inefficiencies of the medical scheme that teachers have raised. I am aware of a case of a teacher who was held in solitary confinement at the Upperhill Hospital for three months on basis that the facility was not pre-authorised to offer the medical services she had received," said committee chair Julius Melly. 

"We had to intervene to secure her release," he said.

Kibra MP Peter Orero disclosed that teachers had submitted complaints that whenever they visited the consortium-approved hospitals, they were not given medicine and were required to go and buy the drugs elsewhere out of pocket. 

Orero also majority of teachers were being turned away from health facilities and told they had not been registered under the medical system. 

"Why not have linkages with hospitals so that, with the click of a button, it shows TSC teachers who are scheme members?" posed the legislators. 

Macharia explained that the lack of timely monetary disbursement by the government had made the situation worse.

"We have teething problems with Minet, but if our teachers were to get premium services, they should be fully insured. But we do not have the resources to do that," she said. 

This, however, only invited more scrutiny on the medical scheme from the members.

"We know that Minet is a brokerage insurance firm which deals with eight other insurance firms under a consortium. Given all these underwriters and delays in approval, who is in charge of the approvals?" posed committee vice chair Eve Obara.

Efforts by the Commission's lawyer to explain that the contract with the consortium would come to an end in November this year and a decision on whether teachers would be onboarded to the "enhanced" SHA system would be decided then, were, however, met with criticism and calls to terminate the contract before then. 

 “What kind of insurance cover is this? It is a mongrel. It has no head or tail. You are getting an insurer, a lead consortium, as an administrator and a capitator. Very funny type of insurance. You must get out of this thing’’ said Melly.

"We can not do things the same way and expect different results. The consortium is an amorphous structure that does not offer services," said Luanda MP Dick Maungu.

Baringo North MP Joseph Makilap proposed for banding of teachers so they can access premium healthcare. 

"As TSC terminates this contract in the next six months, teachers will suffer. I propose that we divide them in lots and get them good insurance covers or we bundle them to SHA and God help us all," Makilap remarked. 

The Committee consequently invited the leadership of Minet Insurance Medical Association of Kenya, Blis Hospitals and all members of the consortium to appear before it.