Legal battle looms over teachers' medical cover transfer to SHA

Teachers have vowed to stage a legal battle to safeguard their Sh20 billion medical cover following a proposal to move all teachers to the Social Health Authority scheme.

The Saturday Standard established that the two major unions, in a meeting with the employer and SHA staff, rejected the proposed shift, arguing it does not add value to their present benefits.

Kenya National Union of Teachers and the Kenya Union of Post-Primary Education Teachers were called to separate meetings to be sensitised on the new scheme, dubbed the Public Service Medical Fund.

Speaking in parliament on Thursday, TSC acting Chief Executive Evaleen Mitei said consultations are ongoing to migrate teachers to SHA by December 1.

However, union officials who attended the meeting said that the fight to retain their medical scheme could also include strike action that could potentially paralyse learning in third term and disrupt examinations.

The Saturday Standard also established that both unions— KNUT and KUPPET— raised fears of possible legal troubles over the decision to single-source the next insurer while TSC and SHA officials pitched the proposal.

“TSC did not respond to this matter(Single-sourced insurer), although we had brought it up, and this could be grounds for a legal challenge,” a source in the meeting told the Standard.

However, TSC, while responding, defended the cover, noting that it would provide better services as it is not profit-driven, unlike the current cover under MINET.

SHA official present also stated that the teachers will have a chance to choose from up to 9,800 health facilities, up from the current 1,000, currently under the MINET cover.

However, the unions reportedly asked the employer—TSC— to take the proposal to public participation for teachers to determine its fate.

But the biggest challenge yet, the sources indicate, is the possible legal battles over failure to follow the procurement procedures as stipulated by law, which could send the matter to court.

Education stakeholders now warn that the legal hiccups could expose teachers—especially those battling chronic illnesses—to gaps in care if court injunctions stall the scheme.

Teachers living with cancer, kidney disease, hypertension, and diabetes could face life-threatening consequences if there are gaps during the transition. Unions argue that, unlike routine healthcare, such conditions require uninterrupted treatment, something SHA’s teething problems may not guarantee. 

The switch-over date also coincides with the marking of Kenya Certificate of Secondary Education (KCSE) examinations, raising fears that teachers could use the critical tests as leverage in their protests.

At the heart of the controversy is the government’s decision to single-source SHA, sidelining the competitive tendering process that awarded Minet the scheme in 2015. 

The Kenya Union of Post-Primary Education Teachers (KUPPET) has threatened to move to court, arguing that the procurement process is opaque and dismissive of teachers’ welfare.

However, on Friday, Secretary General Akello Misori said the union is ready to give the new cover a chance if all underlying issues are addressed.

Misori said they will be keen to see health facilities that have been accredited to provide services under the scheme.

“They did not show us the list of institutions that will offer medical services under the comprehensive cover, and this is something we are keen on. We also want issues on pre-authorisation ironed out,” Misori told the Standard.

However, legal experts say the government’s approach could easily be struck down.

“Imposing a new scheme without open tendering violates procurement law and puts teachers at risk of losing access to treatment. We are ready to challenge this in court,” Wahome Thuku, an advocate, said.

He argued that such contracts must be subjected to open competition. 

“By single-sourcing SHA, the state risks violating the Public Procurement and Asset Disposal Act. If challenged, courts could issue injunctions, leaving teachers in limbo without an insurer once Minet’s contract lapses,” he added.

Education stakeholders warn that a standoff could destabilise schools and even threaten the administration of national exams if teachers escalate their pushback.

The migration to SHA is set for December 1, a timeline that coincides with the marking of the Kenya Certificate of Secondary Education (KCSE) exams. 

The Kenya Certificate of Secondary Education (KCSE) examinations for 2025 are scheduled to run from November 3 to November 21.

Education stakeholders now warn that a standoff over the replacement of the teachers’ medical scheme could see teachers use the marking of examinations as a bargaining tool.

“KNEC will be marking the KCSE examination papers when the change happens, and that could be used by teachers to arm-twist the government as they pursue better terms,” National Parents Association chairman Silas Obuhatsa said.

On Thursday, MPs and education stakeholders warned that the young health authority is ill-prepared to absorb such a massive scheme.

Acting TSC chief executive Evaleen Mitei assured MPs that teachers would not lose benefits and would retain access to top facilities.

She said consultations with the Head of Public Service are ongoing and that SHA has already provided an empanelment of hospitals for review.

But lawmakers on the National Assembly Education Committee voiced unease.

Chair Julius Melly questioned whether unions had been consulted, while Mandera South Constituency's Abdul Ebrahim Haro warned of the “very expensive” risks of placing teachers’ welfare in an untested system. 

Kitutu Masaba MP Clive Gisairo pressed TSC on whether a fallback plan exists in case SHA fails to deliver, especially with Minet exiting.