Stakeholders demand SHA payment list

Health Cabinet Secretary Aden Duale addresses MPs in Naivasha. [Antony Gitonga, Standard] Medical experts and hospitals are demanding immediate publication of Social Health Authority (SHA) payments made by the government for scrutiny, transparency, and accountability. The stakeholders are also urging the Ministry of Health (MoH) to support indigents through predictable budgets, and not appealing through MPs for allocation. This follows a statement by Health Cabinet Secretary Aden Duale last week that a total of Sh130.4 billion has been collected, with at least Sh91.4 billion having been disbursed to hospitals. Addressing MPs during a retreat in Naivasha last week, Duale further promised to settle all unpaid claims. The statement has been criticised with many calling for all payments to be made public. Some hospitals have decried non-payment by SHA making operations hard to sustain. Rural-Urban and Private Hospitals Association (RUPHA) chairperson Brian Lishenga said SHA should resume publishing payment lists. "Payment transparency is the only way to show accountability, especially with the history of paying ghost hospitals," said Dr Lishenga. On her part, Beatrice Kairu, a health economist and policy expert, said the only way to avoid back and forth accusations on payment is to make the list public. "The ministry needs to make public the SHA payments they make to facilities. There is no transparency in this," Kairu told The Standard in an interview. In his address, Duale applauded the establishment saying it has achieved an average claims settlement rate of 73 per cent. "This (settlement of claims) means money is flowing to hospitals, ensuring facilities remain stocked and operational," maintained the CS. But investigations by The Standard across the country revealed a struggling health system with hospitals unable to purchase essential medical supplies because of financial crisis. A number of hospitals have been forced to suspend some services like laboratory for diagnostics, laying off staff, and a number fearing closure. Hospital proprietors complained of lack of information on payment despite being owed millions by the new social health scheme. "SHA lacks transparency in payment. Some hospitals have received all their SHA claims but some, like us, are left to follow-up with the system. We do not know when to receive payment as this remains a secret move by the entity," a facility owner in Mombasa, who asked to remain anonymous, said. Lishenga said putting the payments public will also eliminate "speculations and rumours." Payment of SHA claims, he said, is not being communicated as it was done earlier. "It is never clear when to expect SHA payment. Two weeks ago, for example, some payment was done, but again, we do not know the official state on the pending SHA claims and the paid ones," Lishenga said. SHA has only published payment lists three times since its establishment in October 2024. The last publication made in August last year attracted public uproar as some of the hospitals paid had been flagged as ghost whereas others were in deplorable state. The public demanded for further scrutiny into hospitals that had been paid. The cry attracted the attention of MoH and the National Assembly Committee on Health who visited a number of hospitals for a fact finding mission across the country. The committee established that a number of hospitals that had been paid taxpayers money were in a deplorable condition. Some facilities classified as Level 4, for instance, did not have a single inpatient bed while others operated from a single room, resembling a kiosk. Amid increased scrutiny from Kenyans and experts, however, the authority would pull down its portal, locking away the payment list and later disabled the Kenya Master Health Facility Registry (KMHFR). With the site disabled, it has become difficult for the public to verify hospital details and track payments. The KMHFR contains critical data on all health facilities, including their geographical location, bed capacities, and regulatory bodies.

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