Members of the National Assembly at the 2025 mid-term three-day retreat for legislators at Lake Naivasha Resort in Nakuru County on January 28, 2025.
Lawmakers have expressed frustrations about President William Ruto's new health system and called for its review.
The MPs questioned the operational failures of the multibillion-shilling Social Health Authority (SHA), which was intended to replace the defunct National Health Insurance Fund (NHIF).
During a Naivasha meeting with Medical Services Principal Secretary Harry Kimtai, SHA Acting Chief Executive Officer Robert Ingasira and Board Chairman Abdi Mohamed, the MPs raised concerns over the implementation of the health plan.
The MPs lamented the suffering of many patients turned away from hospitals despite being registered due to system downtimes and lengthy pre-approval processes.
They warned that delays in accessing care—sometimes lasting days—put patients in dangerous situations.
Additionally, the MPs demanded a full list of hospitals contracted under the SHA and a report on the feasibility study conducted before the system was introduced.
Suba North MP Millie Odhiambo has called for the case against Grace Njoki, one of the women who stormed Health Cabinet Secretary Deborah Barasa's press briefing at Afya House last week, to be dropped and for SHA officials to be arrested and prosecuted immediately.
They also sought explanations for the scheme's poor implementation, including delays in approving patient claims, and called for clarity on the specific services covered by SHA.
Lawmakers further pointed out that the new health insurance system is prone to failures and slow processing speeds and demanded that the ministry provide a report on possible remedies.
SHA was a creation of President William Ruto and was to have three health funds: the Social Health Insurance Fund (SHIF), Primary Healthcare Fund, and Emergency and Chronic Illnesses Fund.
Suba North MP Millie Odhiambo suggested that the government should give SHIF a six-month period, after which it should revert to NHIF if the system continues to exhibit the current failures.
"The PS has the vision but the implementation is a problem. My suggestion is that you give yourself six months so that if this SHIF fails, we go back to NHIF," said Ms Odhiambo.
"Again, why are 18 million people registered but only about four million are paying members? These things need to be addressed," she added.
Mumias East MP Peter Salasya has described the new scheme as a scam and questioned whether there was any public participation before it was introduced.
Mumias East MP Peter Salasya termed SHIF a 'scam' and questioned whether there was public participation in the first place before the scheme was rolled out.
"The scheme is susceptible to system failures and slow speed. SHA is just a scam that needs to be abolished completely. Cancer patients and others suffering from chronic illnesses are suffering across the country,” said the first-term MP.
Kabondo Kasipul MP Eva Obara said there was an urgent need to review the system, including the 2.75 per cent enhanced contributions salaried Kenyans make from their gross earnings.
"Having tested the system, we need to reduce the 2.75 per cent of gross earnings contribution because we have seen what it can do. People with pay slips are suffering. We cannot go on like this, we have to do something," said Dr Obara.
The new health plan requires salaried Kenyans to contribute 2.75 percent of their gross salary, up from a maximum of Sh1,700, while the unemployed must pay at least Sh300, while the government is expected to roll out a plan to cover indigent citizens.
Kitutu Chache South MP Anthony Kibagendi termed the presentation by the ministry officials as shallow, saying the new scheme was inferior to what the defunct NHIF was offering.
"A bulk of benefits in SHIF are inferior to what the defunct NHIF was offering. Again why can't you address the system challenges so that patients across the country can benefit from the scheme? Patients have been complaining that the system does not work properly. They have been forced to dig deep into their pockets to pay for their medical bills,” stated Mr Kibagendi.
Nyandarua Woman Representative Faith Gitau took issue with the long period it takes to get approvals from SHIF.
"You must address the delays experienced in making approvals for patient claims in SHIF. Two, how long does it take to reflect the data captured after registration? Why does it take so long for people before they start benefiting? ,” asked Ms Gitau.
During the meeting, which took place between 10 am and 2 pm, a presentation by SHA chairperson Abdi Mohamed angered MPs.
When asked to explain the specific areas covered by SHIF, Mr Mohamed casually responded that the information was available on the website, sparking uproar among legislators. They demanded to be addressed by the PS or the CEO, whom they felt had a better understanding of the scheme's implementation.
National Assembly Majority Leader Kimani Ichung’wah was among those angered by Mr Mohamed’s response.
"The presentation by Mr Abdi shows that either those implementing SHIF lack the capacity or are not qualified to run the scheme. The chairperson cannot simply tell us that the information is on the website. Why can’t you communicate effectively with the Kenyan people?" wondered Mr Ichung’wah.
Ruaraka MP TJ Kajwang’ added, "It seems the PS has better information than the chairman and the authority. The authority appears to have scanty information. Who will tell Kenyans which services and benefits SHA offers?"
There has been uproar from Kenyans over the implementation of the programme, most comparing the services under the defunct NHIF, the enhanced contributions they were making and questioning whether they were getting any value for money.
So bad was the situation that 59-year-old Grace Njoki Mulei, who lives with diabetes, hypertension, and heart issues, stormed a press conference by Health Cabinet Secretary Deborah Barasa, to demand answers on the failures of the new system.
Ms Njoki was a few days later arrested in Eastleigh when she had visited the facility to apply for a knee surgery.
On Thursday, the ministry officials bowed to pressure to drop the case against Ms Njoki.
Nyeri Town MP Duncan Mathenge leads other MPs in calling for the case against Grace Njoki, one of the women who stormed Health Cabinet Secretary Deborah Barasa's press briefing at Afya House last week, to be dropped and for SHA officials to be arrested and prosecuted immediately. This is during the mid-term retreat for Members of Parliament at the Lake Naivasha Resort on January 30, 2025.
Nyeri Town MP Duncan Maina Mathenge said the fate of those who cannot pay remains unclear in the new system.
"In the previous system, we had Kenyans who could not pay for NHIF but were registered as indigent. What is their status under SHA?” He asked.
Igembe South MP John Mwirigi expressed concern that even people who have registered are unable to access services in most hospitals.
This was echoed by Karachuonyo MP Adipo Okuome.
Busia County Woman Representative Catherine Omanyo said patients have been frustrated in hospitals while seeking treatment because their names are not found in hospitals despite registration.
“How long does it take for patients' information to be reflected in the system? Where do they have to go or what level of hospital do they have to visit to get their records updated?" asked Ms Omanyo.
Kabondo MP Eve Obara said: "SHIF is not working in my constituency. People are suffering. Can the ministry come up with a questionnaire to know where there are challenges to the proper implementation of SHIF, so that they can be addressed?"
When they spoke, the ministry officials defended the scheme and repeatedly reiterated its importance as one of President Ruto's flagship projects.
"I urge you to look at the bigger picture, which is the achievement of affordable, accessible, quality healthcare for all Kenyans, leaving no one behind. That is what we are pushing for and we are asking for your support," said Mr Kimtai.
Mr Kimtai while responding to the duration it takes for SHA to approve patient claims, said SHA has automated their systems to make it faster between 48 to 72 hours.
"We however need additional money to streamline the operations. We anticipated about Sh 60 billion but we got Sh 3 billion," he said.
Mr Ingasira also revealed that SHA was facing budget constraints.
"Our budget for communication and adverts was trimmed from Sh 400 million to Sh 50 million. We make monthly collections of Sh 6.7 billion and we are only allowed to use five percent of the amount for our administrative issues and operations. The amount is insufficient,” said Mr Ingasira, saying primary healthcare funds have now dropped from the planned Sh35 billion to just Sh4 billion.
Mr Kimtai gave an assurance that none of the formerly NHIF employees would lose their jobs.
"All employees of the defunct NHIF have been onboarded and deployed to support SHA rollout. Nobody will lose their job as all of them will be absorbed into public service,” stated PS Kimtai.
On the debts earlier owed by NHIF to health facilities, the PS revealed that the Ministry of Health has already paid Sh 10 billion and is committed to clearing the remaining Sh9 billion.
As of last year, NHIF owed health facilities a total of Sh19 billion, according to Mr Kimtai.
National Assembly Speaker Moses Wetang'ula directed the chairperson of the Health Committee, Robert Pukose, to meet with the Ministry of Health and representatives from the Social Health Authority next week, to receive comprehensive responses regarding concerns raised by MPs and thereafter issue a detailed response on February 11, 2025,, when the National Assembly resumes sittings.
"Based on the discussions there are two major issues with SHA: Poor public communication and inadequate service delivery,” said Mr Wetang'ula.
On those who cannot afford to pay, PS Harry Kimtai said the ministry has set aside funds to pay the indigent and this will be done after a mean test is done to confirm that they are indeed unable to pay.
The SHA scheme, which the Ruto administration is banking on to transform the country's health system, has been mired in controversy after the claims processing system failed.
Hospitals across the country have reported delays in getting pre-approvals for surgeries and other critical procedures, leaving many patients to seek treatment in pain or pay in cash.
Some health facilities have also pointed out that they are forced to wait weeks for claims to be processed.
