Plan to move teachers' Sh20b medical cover to SHA sparks storm

A fresh storm is brewing over the Sh20 billion teachers’ medical scheme as the government plans to migrate all tutors to the newly established Social Health Authority (SHA) by 1 December.

This means that the Teachers Service Commission (TSC) has about 72 days to roll out plans for moving all teachers to the new plan.

Sources in government told The Standard that the directive, issued by President William Ruto, is irreversible, even as teachers’ unions have today been invited to a meeting with the employer.

It emerged that during the State House meeting, Ruto hinted at the looming shift to SHA at a meeting also attended by union leaders.

“The President said that based on calculations, public servants had higher access to medical cover of 17 per cent. While teachers only had access of seven per cent, which the Head of State said was very low,” said a senior government official who attended the State House meeting.

However, teachers’ unions opposed the move, terming it premature, as SHA lacks the capacity to provide the comprehensive medical services they enjoyed under the Minet cover.

Appearing before the National Assembly Education Committee, chaired by Julius Melly (Tinderet), acting TSC chief executive Evaleen Mitei said consultations are ongoing to develop the necessary framework that will enable a smooth transition of teachers’ medical care.

“There are ongoing consultations (with the Head of Public Service) that will enable a smooth transition of teachers’ medical cover to SHA. Once the technical issues are complete, the Commission will engage all the stakeholders before the scheme is rolled out,” Mitei said on Thursday.

Mitei said that consultations will end on 30 September.

The government official, speaking to The Standard, said unions were aware of the planned shift to SHA.

“The unions can therefore not feign ignorance because the President was clear in the communication and even promised the teachers that the medical scheme would be reviewed to serve them better.”

On Thursday, Mitei told the National Assembly Education Committee that consultations are ongoing to ensure a smooth transition.

“It is proposed that all teachers will be onboarded with the Public Officers’ Medical Fund under SHA from 1 December 2025, and the Commission is working round the clock to complete the initial framework on or before 30 September,” Mitei said.

Under the new arrangement, teachers will be enrolled in the Public Service Medical Fund, which will cater to their healthcare needs.

A fresh storm, however, is brewing over the medical insurance of more than 460,000 teachers, as the plan has already drawn sharp opposition from unions and MPs, who raised fears of a looming crisis.

After a decade of dalliance with private providers, the TSC announced on Wednesday that teachers will be onboarded to the Public Service Medical Fund under SHA by 1 December 2025.

The move will mark the end of the current scheme run by Minet, which expires on November 30 this year.

“The government must learn from past mistakes. Imposing a new scheme without consultation is bound to fail and will only invite court battles,” KUPPET Secretary-General Akello Misori warned, adding that the single-sourcing of SHA raises transparency concerns.

However, Mitei said that under the new scheme, TSC will adopt the current structure of benefits as it stands.

“Teachers will not lose anything. In everything, we have realised that the other two schemes, civil service and police service, had some higher benefits, I think, in maternity and overseas education. As it stands, we are carrying our scheme as it is to SHA,” Mitei said.

She said that TSC is awaiting the allocation of money from the Treasury.

Kenya National Union of Teachers (KNUT) Secretary-General Collins Oyuu echoed the caution, saying that while universal health coverage is a noble idea, SHA is not ready to absorb teachers.

“We need at least two years before onboarding teachers to SHA. We don’t necessarily mean sticking with Minet, but we need a comprehensive cover that provides all the benefits teachers currently enjoy. As things stand, SHA cannot handle that,” Oyuu said.

Mitei said that TSC will on Friday engage KNUT and KUPPET over the proposal.

She assured MPs that teachers would retain their existing benefits under the new scheme.

“Teachers will not lose anything. We are carrying our scheme as it is to SHA,” Mitei said, adding that teachers will retain the freedom to access hospitals of their choice, including high-end facilities such as Nairobi Hospital.

She further noted that TSC has already reviewed SHA’s empanelled hospitals and found them satisfactory.

A final meeting with the Head of Public Service is scheduled for October to seal the transition modalities.

But the announcement sparked disquiet in Parliament and within teachers’ unions, who fear the young institution may not handle the complex demands of a scheme covering nearly half a million teachers and their dependants.

Mandera North MP Haro Mohamed warned that TSC had previously admitted SHA lacked the capacity to directly manage such a massive scheme when TSC first approached the Authority.

“This is a very expensive undertaking. Are we sure teachers will not lose critical benefits?” he asked.

Committee chair Julius Melly pressed TSC on whether it had adequately engaged unions and considered the “teething problems” SHA is already grappling with.

Kitutu Masaba MP Clive Gisairo went further, questioning whether a fallback plan exists in case SHA fails to deliver when Minet exits.

Beyond Parliament, dissenting voices are growing louder. On Thursday, the Kenya Union of Post-Primary Education Teachers (KUPPET) rejected the plan outright, branding it “ill-conceived and dismissive of teachers’ welfare.”

KUPPET officials argue that under Minet, teachers currently enjoy comprehensive cover, including overseas treatment options, group life insurance, and flexibility in hospital choice.

By January 2024, the teachers’ medical scheme under Minet covered about 1.3 million lives, including 360,000 teachers, 230,000 spouses, and 677,000 children.

The scheme provides both outpatient and inpatient services, with inpatient cover ranging between Sh750,000 and Sh2.5 million depending on the job group, while outpatient services are capped at between Sh100,000 and Sh375,000.

The cover also includes fertility treatment such as in vitro fertilisation (IVF), prosthetics, family planning and fertility tests, baby-friendly and travel vaccines, as well as alternative treatments like acupuncture and chiropractic services.

Teachers and their spouses are further cushioned with rehabilitation services for substance abuse, alcoholism, and gender-based violence, alongside four air evacuations annually.

The scheme also provides for optical and dental treatment, handling approximately 400 cases in each category daily.

The maternity package remains one of the busiest, with an average of 175 births recorded daily under the scheme, although it only covers the teacher and their spouse, excluding child dependants.

On average, the scheme attends to about 7,000 outpatient visits and 300 hospitalisations daily. Teachers also benefit from an overseas treatment package that offers Sh2 million for medical care abroad and Sh200,000 for travel expenses.

Teachers now fear that these gains could be eroded in the transition.

Despite admitting that the current cover by Minet had its limitations, Cavin Anyuor, Director of Legal at TSC, said that the scheme had performed very well.

“If I were to rate the outgoing cover out of five, I would score it at 3.5,” Anyuor said.