Teachers protest, lay down their demands for SHA cover

Collins Oyuu speaks to journalists at Tom Mboya Labour College in Kisumu during KNUT elections. [Michael Mute, Standard]

Details have emerged over a heated exchange between the unions and the Teachers Service Commission (TSC) over the disputed Social Health Authority (SHA) medical cover.

In a meeting yesterday, the Kenya Union of Post-Primary Education Teachers (Kuppet) and the Kenya National Union of Teachers (Knut) raised frustrations among their members, citing bureaucratic delays in accessing treatment, poor service delivery, and the failure by the cover to provide key benefits as promised.

It emerged that the SHA cover has not been providing fertility treatment, last-expense cover, and overseas medical care despite all being listed as part of the package.

The unions also complained that some hospitals that provided decent services under the defunct Minet Kenya cover have not been enlisted despite offering good services.

Kuppet had threatened to paralyse the reopening of schools, piling pressure on TSC to scrap or overhaul the cover. 

The teachers complained  that pre-authorisation processes was taking up to three hours, and patients were being forced to begin treatment at lower-tier facilities, most of which are overcrowded public hospitals.

In some cases, hospitals demanded cash payments from teachers, citing delayed reimbursements by the scheme.

Unions also raised concerns over the drastic reduction in accessible facilities, claiming teachers can currently access only about 200 hospitals, far below the over 9,000 initially promised.

“Most of the institutions available for teachers are public hospitals and this leaves them queuing for long hours before they can get any medical assistance and when they finally do, they are required to go buy their medicine,” said Kuppet Deputy Secretary General Moses Nturima.

The union further criticised restrictions on outpatient care, where teachers are limited to one hospital visit per week with a cap of Sh1,200 per visit.

“If a teacher has to do a follow-up visit within the week, the cover does not cater for that, they are forced to pay out of pocket,” he added.

Despite the hardline stance, Knut Secretary General Collins Oyuu said the meeting yielded key resolutions, with a joint technical committee formed to address the grievances.

“A technical committee that brings together the unions, SHA and TSC will look into issues affecting the medical scheme within 21 days to address the issues,” he said.

Among the immediate concessions is the activation of fertility treatment, including IVF, which will now be offered at Nairobi West Hospital after emerging as the lowest bidder.

Oyuu also announced that overseas treatment has been reinstated, with the first patient set to be flown to India, while patients with chronic illnesses will now be allowed medication covering up to three months.

“Service providers claiming not to have been paid by SHA will be delisted—they have been hoodwinking teachers. Co-pay to stop immediately,” Oyuu stated.

Payment of last-expense benefits is also expected to begin next week.

However, Oyuu defended the controversial cap on outpatient visits, saying it was introduced to curb exploitation by some health facilities.

“A simple hospital visit would see teachers charged up to Sh10,000. We say that capping has to stay but practiced reasonably,” he said.

Under the SHA scheme, teachers are covered alongside their spouses and up to five dependants, with benefits such as Sh45,000 annual dental cover, Sh60,000 optical cover and inpatient limits ranging between Sh1 million and Sh3 million depending on job group.

Outpatient cover ranges between Sh150,000 and Sh450,000 annually, while all teachers are entitled to Sh2.2 million for overseas treatment and a Sh300,000 last-expense benefit.