MPs call for overhaul of NHIF to give all Kenyans affordable healthcare

MPs have proposed far-reaching changes to the country's law to make sure Kenyans have access to cheap treatment in hospitals.

They want a total overhaul of the National Hospital Insurance Fund (NHIF) to make sure that most of the money goes toward treating the members, and that all Kenyans have access to the Fund. NHIF currently serves 6.6 million members, including 2.8 million principal ones.

The MPs' move looks like a first step in the Government's undeclared bid to boost contribution to the fund for a second time, in an effort to make sure that more Kenyans have access to medical services.

The lawmakers are aware that for NHIF to thaw the resistance against increased premiums, it has to "re-engineer its image through reforms".

In a report tabled yesterday, the National Assembly's Committee on Health exposed the rot within NHIF, including a bloated workforce, unqualified managers, use of the bulk of the money on administrative costs and poor systems to manage the fund.

"Business processes at the NHIF are not transparent and both the board and the management of the fund lack fiduciary responsibility to its contributors," the MPs said in the report.

The MPs want at least 550 employees of NHIF sent home because they just increase the personnel costs yet "they do not contribute directly to the core business". The MPs also noted a curious trend where millions of shillings are spent on Information Technology infrastructure, yet there is no "corresponding decline in overall operating costs".

They have tasked Health Cabinet Secretary James Macharia to sit down with the committee and come up with a new law to create universal healthcare for all lawmakers. The current NHIF Act, they said, should be repealed. MPs also want Macharia ask Auditor General Edward Ouko to do a forensic and performance audit on the Fund, whose income is estimated at Sh12 billion annually.

Skills mismatch

The House team noted that most of the people in the Fund did not merit the jobs that they have. For instance, the branch manager for Eldoret "possesses a diploma in Animal Husbandry as the highest qualification".

"Senior managers holding key positions in specialised fields such as finance, operations, and quality assurance either lack minimum required academic and professional qualifications or are faced with skills mismatch," the House committee noted in the report.

They have also asked Macharia to make sure the law caps the administrative costs, it reworks the management structure, and makes public the financial health of the Fund. They said NHIF should also be regulated, just the same way other insurers were, through the Insurance Regulatory Authority (IRA).

The absence of IRA supervision, the committee noted in the report, had made it difficult for NHIF to focus on its core functions. On one hand, it accredits health institutions, but on the other, still buys health services.

The committee noted that while NHIF remains the "key vehicle" for universal health care in the country, as it is right now, it cannot cope.

NHIF has 1,665 employees, most of them in the lower cadre."The committee noted the need for rationalisation of the staff and leveraging in the use of information technology as critical to efficiency at the Fund."