The Ombudsman on Friday, February 21, demanded the Social Health Authority provide a detailed breakdown of outstanding payments to hospitals, including the reason for delays in the wake of a recent move by the Rural and Urban Private Hospitals Authority (RUPHA) to suspend healthcare services.
Through a statement, the Commission on Administrative Justice (CAJ) (Office of the Ombudsman) slapped SHA with four other demands, giving them seven days to comply with their orders.
The move by CAJ came after RUPHA decried the failure of SHA to remit funds owed to private healthcare providers for services rendered under government-sponsored health programs.
In their lamentations, RUPHA stated that the suspension that will take effect from Monday, February 24, came after a staggering accumulation of unpaid arrears by the now-defunct National Health Insurance Fund (NHIF) amounting to approximately Ksh30 billion. This is despite pledges made by the Ministry of Health and SHA to repay claims under the previous system.
To that effect, CAJ pressured SHA, led by Chief Executive Officer Robert Ingasira, to develop a remedial action plan outlining how the Authority intends to settle outstanding payments and prevent future delays.
Further, CAJ called for a transparent audit of SHA’s financial operations to ascertain the root cause of the funding shortfall. This is particularly significant as the government continually disburses funds worth billions in SHA payments.
According to CAJ, the audit would ensure accountability in the utilization of public resources, especially in the critical health sector.
The fourth demand by CAJ directed SHA to disclose what grievance resolution mechanisms they have put in place to resolve the looming countrywide crisis.
Justifying the looming health paralysis, RUPHA noted that members have had their hospitals auctioned, lost employees, and, as a result, some specialists have refused to offer services. Doctors under RUPHA are now saying they will not treat patients without paying cash.
CAJ’s final demand entailed the provision of evidence by SHA of consultations with RUPHA and other stakeholders to address the issue and mitigate the impact on service delivery.
To avert the devastation of RUPHA’s recent demands, the Ombudsman pressured SHA to prioritise the remittance of all outstanding funds to members of RUPHA to ensure the continuity of health services.
Meanwhile, Health Cabinet Secretary Debora Barasa acknowledged RUPHA’s demands, adding that the ministry would engage in consultative meetings to develop a way forward.
