Teachers strike a good deal with NHIF

By Moses NjagihKenya National Union of Teachers has secured Sh4.2 billion annual medical scheme for its 258,551 members to be administered by National Hospital Insurance Fund. The lucrative deal Knut struck with NHIF covers inpatient and outpatient treatment. The bumper and comprehensive medical package will serve all union members, permanent staff of the umbrella body, and employees of the Teachers Service Commission (TSC) as principal members, their spouses, and children.The medical scheme is a major boost for teachers who have been earning a marginal amount in medical allowance in their pay, making it hard for them to access enhanced health care for themselves and dependants. Under the scheme now, teachers will forfeit 50 per cent of the medical allowance, which will go towards the financing of the generous scheme. Under the plan they will walk into any public health facility and some accredited private hospitals for treatment.NHIF said that some faith-based hospitals would also be accredited to offer health care to teachers under the scheme.Patients seeking outpatient treatment through this cover will only be required to pay a gate-keeping fee of Sh100 at a Government health facility. Any visit to a private or faith-based institution will see them pay Sh200."This is to deter members from abusing the scheme. It will ensure that only those who are sick to a point they should seek treatment visit the health institutions," explained NHIF Strategy and Corporate Planning Manager Marwa Chacha. One spouseTeachers wishing to include more than one spouse under their cover would be allowed to do so with additional premium.Meanwhile, teachers who will retire as from October 1 after joining the scheme will also access a full post-retirement cover, with their spouses. But missing out on the comprehensive package arrived at after negotiation that began in November, last year, between NHIF and Knut, are members of the union who retired before the commissioning of the scheme. The teachers’ medical scheme comes only months after the Government rolled out a Sh4.3 billion ambitious medical scheme for civil servants and members of the disciplined forces to be implemented by the same provider – NHIF.Unlimited coverJust like the civil servants scheme, the teachers’ package provides unlimited inpatient and outpatient cover. This includes optical, dental care, and a comprehensive maternity and reproductive health cover in public health institutions and accredited private and faith-based hospitals. But unlike the civil servants’ scheme where the beneficiaries were clustered according to their job groups, the teachers’ cover is uniform for all Knut members and TSC employees."We do not expect teachers, their spouses, and children to pay anything. The cover is 100 per cent comprehensive, meeting all costs of consultation, laboratory investigations, drugs, admissions and also optical and dental care," announced NHIF Chief Executive Officer Richard Kerich. He spoke during the commissioning of the scheme at Afya House, which hosts the Ministry of Medical Services. To ensure the package is accessible to all members, health centres will be accredited and registered to especially offer outpatient cover, with referral hospitals restricted to inpatient treatment only. Kerich said NHIF would ensure different health providers offer the inpatient and outpatient covers. "We will not encourage referral hospitals to provide outpatient cover. The two covers may not be provided in the same facility, but this will come as we implement the scheme," explained Kerich. To ensure quality assurance and viability of the scheme, a quality advisory committee will be set up under the chairmanship of a Knut representative and an official from the NHIF, as the secretary.Other members of this committee will include representatives from the Ministry of Medical Services, private hospitals, faith-based organisations, and representative of Kenya Medical Supplies Agency. Pilot projectSpeaking at the function, Medical Services Minister Anyang’ Nyong’o said a successful pilot project was carried out last year to find out if NHIF, which has since inception in 1966 been offering inpatient care, could provide outpatient coverage.The minister called for the evaluation of the Fund, saying statistics show only 25 per cent of Kenyans sought inpatient care per year. This means majority of patients could not benefit from the outpatient care under the Fund.He said that with the commissioning of the teachers scheme, the challenge was now in ensuring that medical facilities are improved."We must improve our facilities, including their management. We should ensure that the diagnostic equipments in our health facilities meet their requirements," said Prof Nyong’o. Knut Secretary General David Okuta said teachers welcomed the medical scheme, since they were involved in the negotiations. He said the union had turned down another proposed medical scheme worked out by the Government as it felt it was being "rammed through our throats"."(Former Health minister Charity) Ngilu came up with a medical scheme, which had wiped out the medical allowances for teachers. To us it did not make any sense so we rejected it," said Okuta.He added: "Unless we feel that we are involved in negotiations, we do not accept imposed programmes. We want teachers to get proper medical care and we feel that we own this NHIF scheme." He said that teachers have been bearing the burden of seeking health care due to lack of a cover, but the situation has now changed.

Teachers strike a good deal with NHIF

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