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{
"id": 1412801,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412801/?format=api",
"text_counter": 227,
"type": "speech",
"speaker_name": "Ruiru, UDA",
"speaker_title": "Hon. Simon King’ara",
"speaker": null,
"content": "the high medical bills and considerable number of bodies are locked at the hospital’s mortuary? (c) Elaborate on measures by the Ministry to ensure affordability including offering of waivers for healthcare services within the facility, especially given the diverse income levels of the population in Ruiru and neighbouring constituencies that the facility serves? Thank you, Hon. Speaker."
},
{
"id": 1412802,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412802/?format=api",
"text_counter": 228,
"type": "speech",
"speaker_name": "Ms. Susan Nakhumicha",
"speaker_title": "The Cabinet Secretary, Ministry of Health",
"speaker": null,
"content": " Thank you, Hon. Speaker and Members. We need to clarify whether KUTRRH imposes high deposits before attending to patients and that the NHIF cover caters for very minimal amounts as compared to other facilities such as KNH and Kiambu Level 5 Hospital. KUTRRH does not impose high deposits before attending to patients. The hospital attends to all patients who come either through referral, specialized clinics, Outpatient Department (OPD) or the Accident and Emergency Department. The patients who come to this hospital are in most cases seeking highly specialized care since it is a referral hospital. At the Accident and Emergency Department, patients are normally stabilised even before they are asked to pay the consultant fee. At the OPD and specialised clinics, patients pay a minimal consultancy fee as prescribed by the consultants. Deposits are only asked for where the consultant determines that the patient needs admission for continuation of care as explained here after. The hospital admits patients through the referral, specialist clinic or on an emergency basis. The Hospital Admission Policy and Procedures (Section s 7.2.3 and 7.2.4) and the Hospital Referral Policy (Section 6.1.16 i.) are both informed and aligned to Article 43(2) of the Constitution which states that: ‘No person shall be denied emergency medical treatment.’ The Admission Policy and Procedure Section 7.2.3 states that: ‘KUTRRH will ensure that no patient shall be denied admission due to race, colour, religion, ancestry, financial class, nationality or any other form of discrimination.’ In the same policy, in cases of emergency, there will be no financial obligation. The Referral Policy 6.1.14 (i) states that: ‘All emergency referrals to be accepted without fail and unnecessary ‘‘shunting’’ of patients should be avoided.’ They will be given priority on arrival. On waived hospital bills, the hospital does not deny care to any patient who requires emergency care or admission on the basis of a deposit, despite the fact that the deposit is part of the overall cost of care. Majority of those patients get admitted without the deposit, but with a promise to pay upon discharge. However, some do not honour their promise because they are genuinely unable to cater for their treatment costs fully. Others are only able to pay partially for the services rendered. As a result, the hospital has unpaid bills of Ksh403,587,763 since the hospital began four years ago, and this has been requested in the budget for reimbursement. Regarding the NHIF cover, the hospital has a hybrid model that has both comprehensive and non-comprehensive covers. Patients admitted under the comprehensive cover do not top up for the cost of their care, including all required pharmaceuticals, diagnostic services, surgery and medication. For example, for all patients under the NHIF scheme access surgery purely under the comprehensive cover. Under NHIF non-comprehensive cover, patients co-pay as outlined in the contract for different services. This arrangement is actually the same with that of KNH. Patients at KUTRRH have access to a whole continuum of care with a rare need to access services like imaging, special laboratory works and specialized consultancy outside the hospital. This is unlike the lower-level hospitals where patients have to buy some items or seek services outside the facility, which translates to huge out-of-pocket costs despite the NHIF cover. Part two of the Question states that we provide details on the budgetary allocation that is provided to the hospital in the Financial Year 2023/2024, and further confirm that the Credit The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor"
},
{
"id": 1412803,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412803/?format=api",
"text_counter": 229,
"type": "speech",
"speaker_name": "Ms. Susan Nakhumicha",
"speaker_title": "The Cabinet Secretary, Ministry of Health",
"speaker": null,
"content": "Control Department holds numerous title deeds for patients who are unable to meet the high medical bills and considerable number of bodies are locked at the hospital mortuary. The Hospital Budgetary Allocation for the Financial Year 2023/2024 was Ksh5.886 billion; consisting of the Government of Kenya (GoK) grant of Ksh2.986 billion and A-in-A of Ksh2.9 billion. The development budget for the hospital is Ksh350 million. The actual expenditure for PE is Ksh3.988 billion against the GoK PE allocation of Ksh2.986 billion, hence a gap of Ksh1.002 billion, which the hospital struggles to meet despite it not having the required staff establishment for optimal service delivery. In the next Financial Year 2024/2025, the hospital will requires a PE allocation of Ksh4.072 billion from the Government. In the Department of Credit Control, the hospital's Credit Control Office plays a crucial role in assisting families facing financial difficulties by offering credit payment plans. This initiative benefits both the patients and the hospital in several ways. The benefit to the patient is that elimination of unnecessary hospital stay. On the prevention of accumulating and manageable bills, and by entering into a credit payment plan, patients can manage their medical expenses over time rather than facing a large immediate financial bill. Reduced risk of hospital- acquired infections due to the shorter hospital stay will decrease the likelihood of patients contracting infections during their time in the hospital. The benefit of this payment plan to the hospital is that there is availability of hospital space after the release of patients who settle their payment arrangement. This frees up space thus allowing the hospitals to accommodate other patients. With efficient resource allocation by recovering debts through credit payment plans, the hospital can allocate its resources more effectively thus ensuring that resources are available for patients who need them. The hospital mitigates budgetary limitations by managing outstanding debts. This helps them navigate the financial constraints they are experiencing. To secure those arrangements, title deeds are used solely as collateral for the commitments made by the patients or their families. Once the debts are fully recovered according to the agreed-upon terms, the title deeds are returned to their respective owners. This practice assures the hospital that debts will be repaid while also safeguarding the patients' assets or their families. Overall, this approach demonstrates a proactive effort by the hospital to address financial challenges that are faced by patients and their families. At the same time, it also ensures efficient operations of healthcare services within the constraints of budgetary limitations. On the issue of dead bodies being locked up at the hospital mortuaries, the hospital preserves dead bodies for relatives as they make funeral arrangements. Some bodies may stay longer in the morgue due to various factors. For example, some cases may arise from court disputes, which can prolong the stay of the body in the morgue until the issue is resolved. Some of the bodies in the hospital are unclaimed. We have delays from families as they fundraise and make funeral arrangements. Some families request to be allowed time to fundraise since once a burial is done, it becomes difficult for them to mobilise funds. When a family requests a waiver of a hospital bill, they wait for the outcome of the waiver process. The process involves socio-economic analysis and, at times, it involves a home visit to enable an objective determination of the request. Part (iii) of the question is to elaborate on measures by the Ministry to ensure affordability and offering of waivers for health care services within the facility, especially given the diverse income levels of the population in Ruiru and the neighbouring constituencies that the facility serves. The Ministry of Health is currently on course in the establishment of the Social Health Authority and the seamless transition from NHIF. The Social Health Authority (SHA) will provide social health insurance to up to 85 per cent of the population in the formal and informal sectors. The Government will continue paying for the indigent and vulnerable populations. These measures will ensure that most Kenyans, including the poor and The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor"
},
{
"id": 1412804,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412804/?format=api",
"text_counter": 230,
"type": "speech",
"speaker_name": "Ms. Susan Nakhumicha",
"speaker_title": "The Cabinet Secretary, Ministry of Health",
"speaker": null,
"content": "the vulnerable households, have a form of prepayment of health insurance any time they visit a facility, and they will not have to pay out of pocket. The Social Health Authority, together with the Ministry of Health, has developed a comprehensive health benefits package that is enough to cover, at least, 70 per cent of the prevalent conditions. The citizens of Ruiru and Kenyans at large will have to register and contribute to the SHIF depending on their ability to pay to access services not just at Kenyatta University Teaching and Referral Hospital (KUTRH), but within the other facilities. The Ministry of Health has also come up with a clear communication strategy for universal health coverage that will sensitise citizens on the need to enrol in social health insurance and to benefit from the expected benefits. Hon. Speaker and Hon. Members, I hereby submit. Thank you."
},
{
"id": 1412805,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412805/?format=api",
"text_counter": 231,
"type": "speech",
"speaker_name": "Hon. Speaker",
"speaker_title": "",
"speaker": null,
"content": "Member for Ruiru, are you satisfied? Give him the microphone."
},
{
"id": 1412806,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412806/?format=api",
"text_counter": 232,
"type": "speech",
"speaker_name": "Ruiru, UDA",
"speaker_title": "Hon. Simon King’ara",
"speaker": null,
"content": " Thank you, Hon. Speaker. The questions were as a result of the discomfort of the community. I might need some clarifications if you allow."
},
{
"id": 1412807,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412807/?format=api",
"text_counter": 233,
"type": "speech",
"speaker_name": "Hon. Speaker",
"speaker_title": "",
"speaker": null,
"content": "Just seek one clarification."
},
{
"id": 1412808,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412808/?format=api",
"text_counter": 234,
"type": "speech",
"speaker_name": "Ruiru, UDA",
"speaker_title": "Hon. Simon King’ara",
"speaker": null,
"content": " Hon. Speaker, in the last part of her response, the Cabinet Secretary has said that the bodies and documents are held in agreement with the families. However, I have evidence that that facility is holding documents for other reasons. How long can a facility hold documents for the concerned families and the deceased? How long can they also hold the bodies? I know of bodies that have been held there for many months or years."
},
{
"id": 1412809,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412809/?format=api",
"text_counter": 235,
"type": "speech",
"speaker_name": "Hon. Speaker",
"speaker_title": "",
"speaker": null,
"content": "Let us hear from Hon. (Dr) Makali Mulu."
},
{
"id": 1412810,
"url": "http://info.mzalendo.com/api/v0.1/hansard/entries/1412810/?format=api",
"text_counter": 236,
"type": "speech",
"speaker_name": "Kitui Central, WDM",
"speaker_title": "Hon. (Dr) Makali Mulu",
"speaker": null,
"content": " Thank you Hon. Speaker. I might have misplaced my card. My question is related to this issue. Although this question is specific to KUTRH, the bigger issue is the cost of treatment in this country, that is, medication, consultation and surgery."
}
]
}