
The entrance to the Kenyatta National Hospital’s Accident and Emergency Unit.
Kenya’s top six national referral hospitals are operating on the strength of gazette notices, exposing the facilities to run on weak legal and regulatory frameworks, a parliamentary committee has said.
The National Assembly’s Health committee says Kenyatta National Hospital (KNH), Moi Teaching and Referral Hospital (MTRH), Kenyatta University Teaching and Referral Hospital (KUTRH), and Mathari National Teaching and Referral Hospital are using separate gazette notices as their legal backing.
Other national health facilities operating on the legal notices are Othaya Teaching and Referral Hospital, and National Spinal Injury Referral Hospital.
“We now have a Bill that has been published by the Government Printer and I will be tabling it in the House for consideration,” Robert Pukose, who chairs the Health committee, said on Monday.
“It is unfortunate that referral facilities like Kenyatta and Moi Teaching and Referral hospitals which are parastatals have been operating on a weaker legal instrument as opposed to a proper Act of Parliament.”

Moi Teaching and Referral Hospital in Eldoret, Uasin Gishu County.
Mr Pukose said the National Referral Health Facilities Bill, 2025 which seeks to anchor the six-national referral facilities into law is set to be tabled in the National Assembly when lawmakers reconvene from the long Christmas recess on Tuesday, February 11.
The committee said the Bill provides sound legal backing for the running of the six national referral facilities.
The Presidential Task Force on Human Resources for Health (HRH) on Monday asked lawmakers to fast-track the passage of the Bill to anchor all the national referral hospitals in law.
Task force chairperson Khama Rogo told the committee that the largest referral facility, Kenyatta National Hospital, is operating on a legal notice which is not adequate to regulate the affairs of the biggest hospital in East Africa.
The National Assembly last August investigated the transfer of Kenyatta University Teaching, Research and Referral Hospital to the Health Ministry as a parastatal.
This is after former President Uhuru Kenyatta issued Legal Notice No 4 of 2019, which placed the Sh8.7 billion hospital under the Ministry of Health.
Kenyatta University, which constructed the facility, protested the decision, saying the move locked its teaching staff and students from accessing the health facility. The initial plan was to use the hospital for teaching, training and research.
Previous attempts by MPs to pass the National Referral Health Facilities Bill, 2020 failed to materialise after the term on the life of the 12th Parliament ended in June 2022.
The Bill sought to establish a national referral hospital in each of the 47 counties.
The Bill, then sponsored by Homa Bay Women Representative and now governor for Homa Bay County Gladys Wanga sought to upgrade all the current level five hospitals to referral facilities.
“The Bill generally aims at improving the management of the referral health facilities and also enhancing the healthcare facilities in the country,” reads the lapsed Bill.
Kenya has 11 level five hospitals. As of 2020, the Parliamentary Budget Office (PBO) estimated that if the Bill becomes law, it will cost taxpayers Sh236 billion to construct the 47 national referral hospitals.
Conditional grants
Currently, the national government transfers Sh4.3 billion annually as conditional grants to counties hosting referral hospitals to run operations of the facilities.
The rejected Bill proposed that the money from the national government be channelled directly to the hospitals’ accounts instead of county revenue bank accounts.
Ms Wanga argued that the passage of the Bill will reduce pressure and ease congestion at the busy Kenyatta National Hospital (KNH) leading to improved services.