Duale: SHA Will Expose NHIF Fraud, Lead to Private Clinic Closures
Health Cabinet Secretary Aden Duale has warned that a significant number of private clinics operating in residential estates will shut down once the newly introduced Social Health Authority (SHA) becomes fully operational.
Duale claimed that many of these facilities have thrived due to fraudulent dealings under the National Health Insurance Fund (NHIF), which the SHA system aims to eliminate. Speaking on Thursday, he asserted that the transition to SHA would uncover malpractice in the sector, forcing clinics that exploited NHIF loopholes to close down.
“Mark my words today, the day the Social Health Authority (SHA) takes root, 60 percent of the many clinics you see in the estates will close. Most hospitals that you thought were doing good work were open because of the fraud that was taking place in NHIF,” he stated.
Government Clashes with Private Healthcare Providers
Outgoing Health Principal Secretary Harry Kimtai also accused private healthcare providers of attempting to blackmail both the government and the public by withholding services. He warned that hospitals failing to comply with their constitutional obligation to provide healthcare services could face serious consequences, including difficulties in license renewals.
“From the statistics and data we have seen, we have realized that most of the private facilities are not participating in outpatient services, which is primary healthcare funding,” Kimtai noted.
Hospitals that refuse to align with the new SHA structure could also face registration denials, further complicating their operations.
Dispute Over SHA Implementation
The Ministry of Health has engaged private hospitals to address concerns over the SHA model. However, the dispute between the government and private hospitals has been ongoing. In February, the Rural and Urban Private Hospitals Association (RUPHA) announced a suspension of SHA services, citing grievances over unpaid debts. The decision was later reversed following presidential intervention.
One of the primary concerns raised by private hospitals is the issue of outstanding payments, some of which date back to 2017. RUPHA Chairperson Brian Lishenga stated that these financial burdens have led to bank defaults and shortages of essential medicines.
Sustainability Concerns for Private Hospitals
Under the SHA framework, outpatient services are capped at Sh2,000 per visit, with each beneficiary limited to four visits per year at Level 2, 3, and 4 primary healthcare referral facilities. Private hospitals argue that this model is financially unsustainable and will further strain service delivery.
As the transition to SHA moves forward, the government maintains that the new system will promote efficiency and eliminate fraudulent activities. However, private healthcare providers continue to express concerns over the feasibility of the model and its financial impact on their operations.
The coming months will determine whether SHA will achieve its intended objectives or create further disruptions in Kenya’s healthcare sector.
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Duale: SHA Will Expose NHIF Fraud, Lead to Private Clinic Closures