SHA threatens private hospitals for suspending services

Private hospitals are reporting threats and victimisation from the Social Health Authority (SHA) as they push for the settlement of a Sh30 billion debt owed by the defunct National Health Insurance Fund (NHIF).

The hospitals say they are being compelled to provide all health services or face withdrawal of SHA contracts.

The facilities have only been offering emergency treatment and pre-booked (elective) surgeries following the suspension of SHA services.

In a letter dated February 25 by the SHA Nyeri branch, the agency accuses hospitals of breaching their contracts.

.

Keep Reading business

•  Income problem with the State's housing agenda Premium
•  State hikes pest inspection charges at ports
•  Cooking gas consumption rises to reduce kerosene use by 32pc
•  Race for the skies as Nairobi okays 75-floor limit
•  City ready for skyscrapers but where's supporting infrastructure

“Contracted facilities must offer the full spectrum of services as stipulated in the contract throughout the entire contract period. Any variation from these terms constitutes a breach of contract and must be dealt with promptly and subsequent action taken in accordance with the provisions of the contract.”

Medical Services Principal Secretary Harry Kimtai is Thursday expected to lead a meeting to find a solution to the stalemate.

Rural and Urban Private Hospitals Association of Kenya (Rupha) Chairperson, Brian Lishenga, Wednesday dismissed the threats, saying such a move would not resolve the controversy.

“Our position is that healthcare facilities cannot be compelled to provide a full spectrum, or compelled to provide services. They have a choice to not offer services especially when there is a breach. We have told our members to ignore this. We cannot be compelled. It is impossible,” said Dr Lishenga.

He said the SHA contract does not compel any facility to provide full services, but rather a mechanism for hospitals to know which services are covered, and method of submission of claims.

In the new health scheme, more private hospitals have been onboarded compared to public ones. 

Data by SHA reveals that 3,993 hospitals have been contracted, among them 2, 244 private, 352 faith-based and 1,366 under the county governments.

Further, two are under the national government, 10 are run by NGOs, 12 are community facilities, 1 institutional, 4 rehabilitative with two are described as unknown.

As the tussle continues, patients seeking services in private hospitals continue to pay out of pocket despite the Kenya Kwanza administration continuing to promise affordable healthcare.

In Nairobi, facilities represented under the Kenya Association of Private Hospitals are “not accepting SHA services, apart from only critical services including dialysis, oncology and emergency”, according to Dr Erick Musau, association chairman.

SHA Chief Executive Officer, Robert Ingasira, has acknowledged that the scheme owes hospitals Sh10 billion in claims.