Private hospitals to suspend SHA services from Monday, cite system failures

Speaking to the press on Thursday, the association's chairperson Dr. Brian Lishenga stated that challenges surrounding the new healthcare system have been ignored, endangering the lives of patients.

He added that the debacle is threatening the survival of health facilities due to a weak service provision.

Dr. Lishenga intimated that only 54% of hospitals have not received payments from SHA, 89% of facilities have reported SHA portal failures, and 83% of hospitals have reported serious difficulties in verifying patient eligibility due to SHA's system glitches.

The most significant barriers include prolonged system downtime, delays in One-Time Password (OTP) verification, and an inability to track claim approvals—issues that have worsened over the past month. 

"We have unpaid debt dating back to 2017, hospitals are facing bank defaults, we have stock out of essential medicines and many consultants haven't been paid for years," he stated.

He therefore announced that RUPHA will no longer provide care under the medical administrator Medical Administrators Kenya Limited (MAKL) which handles medical schemes for police and teachers. 

"Without urgent intervention teachers and police officers will be left without quality healthcare service," he added.

RUPHA now wants the government to settle Ksh.30 billion debt in NHIF arrears in full payment, to revise and streamline the SHA outpatient reimbursement model and ensure fair and timely payment under MAKL.

Since its introduction in October 2024, the new healthcare scheme has been rocked with endless glitches as Kenyans complain of its inefficiency.

Clinical officers have been protesting being barred from offering services through SHA and a breach of last year’s return-to-work agreement which comprised a collective bargaining agreement, promotions, comprehensive medical cover and the confirmation of universal health coverage (UHC) clinical officers and those in short-term contractual employment into permanent and pensionable terms.

The clinical officers have been demanding immediate and unconditional recognition and empanelment of health providers and practitioners licensed by the Clinical Officers Council.

They also want the SHA board to reinstate pre-authorisation rights to clinical officers, including specialists.