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"id": 1557882,
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"content": "the county governments and leaders who sit in this august House. I urge the national Government, the county governments and Members of Parliament to identify the indigent in our communities using social protection data and pay for their SHA premiums because they are an important component of our society. That data can be found in the sponsors’ portal, which is available on our website. You can use the Afya Yangu portal or app to help the most vulnerable in society. Unlike the defunct NHIF, to which access to benefits was only granted after six months depending on who you knew, access to the SHA benefits is instant. You can choose to pay monthly and still access medical services unlike during the time of NHIF, when you had to wait for two months for your personal data to be incorporated into the system for you to access medical services. The SHA gives you instant access to healthcare coverage services. Hon. Speaker, the third question is on the nature of medical cover offered by the Authority at all levels. The SHA provides free primary healthcare services at all public health facilities from Levels 2 to 4 hospitals, and at contracted private and faith-based healthcare facilities. I thank the House for this because free primary healthcare is paid for by the government. It is budgeted for by this House. It had never existed in our country before. Once people register with SHA, they are eligible to visit Levels 2, 3 and 4 hospitals for healthcare services. These are Government dispensaries, health centres and sub-county hospitals, and their equivalent private and faith-based healthcare facilities. One can get free treatment and medicines, courtesy of the Government of Kenya. Additional services are available under the Social Health Insurance Fund (SHIF) to all paid up members at Levels 4, 5 and 6 hospitals and at contracted private and faith-based facilities. The SHIF also provides emergency services to all Kenyans. You do not need to register or pay in advance for any emergency. For example, if a boda boda rider is knocked down by a vehicle, if he is rushed to hospital, he will not be required to register or pay anything. No facility can deny him treatment. He will be treated and discharged to go home. That provision never existed before. It is now in the law. Article 43(2) of the Constitution on the Bill of Rights requires the Government to bear emergency healthcare services costs. Hon. Speaker, the last service we offer is chronic and critical illness services for all paid up members of SHA at Levels 5 and 6 hospitals. The details of the services that the Member has asked about have been set out in Legal Notice No.47. The NHIF was not required to publish them but this House allowed us to do so. You can access those services under that Legal Notice. The gazetted benefits are a big improvement from benefits previously offered by the defunct NHIF. They are aligned to the projected collections. We will continuously improve these benefits in tandem with available resources. For instance, this month, the SHA and the Ministry of Health enhanced the Intensive Care Unit (ICU) package from Ksh4,000 to Ksh28,000 per day. We have also increased the limit for all cancer patients to Ksh150,000 under Chronic and Critical Illness Services. The next question is about the referral system. There are three levels of healthcare service access in the referral system as shown in the document that I have given to the colleagues who asked this question. All registered SHA members can access outpatient services at primary healthcare facilities comprising Levels 2, 3 and 4 hospitals, through the Primary Healthcare Fund, which this House established. Registered SHA members can access healthcare services for free at those facilities. Secondly, all inpatient services can be accessed at secondary healthcare facilities comprising Levels 4, 5 and 6 hospitals. The Social Health Insurance Fund, which is the contributory arm of the UHC or the Taifa Care, allows one to access services at Levels 4, 5 and 6 public healthcare facilities and at contracted private and faith-based inpatient facilities. Indigents will be paid for by the Government, Members of Parliament through the NG-CDF, the county governments or good Samaritans and sponsors. 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": 1557883,
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"content": "Specialised services are accessed at public tertiary facilities comprising Levels 5 and 6 hospitals. Emergency, chronic and critical illness services are provided at these facilities, courtesy of this House. They are funded by the Government of Kenya. This referral system is aimed at decongesting specialised facilities to allow them focus on provision of specialised services as contemplated under the Health Act, 2017. Kenyans go to India and other countries looking for specialised facilities because our specialised facilities like Kenyatta National Hospital (KNH), Moi Teaching and Referral Hospital (MTRH), Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) are crowded by patients who can be attended to at Levels 2, 3 and 4 healthcare facilities. Somebody with a headache, malaria or a small scar from an accident goes to Kenyatta National Hospital. Our specialised facilities should be reserved for special cases. I ask this House to support me in this regard. Health practitioners in our specialised facilities should attend to patients who require specialised treatment and not ailments that can be treated at lower levels of our healthcare system. Hon. Speaker, the other question is on the empowerment of health facilities. How do we know that this is a health facility? How do we grade them? Unlike before, a facility must now be licensed by the Kenyan Medical Practitioners and Dentists Council, the Clinical Officers Council and all other regulatory bodies within the healthcare sector. They must tell us what level a facility is and whether it has all that is required to be part of Universal Health Care. The regulator audits these facilities and licenses them. If the regulator feels that a facility is fit to be Level 3 and not Level 4, it will advise SHA accordingly. The defunct NHIF used to accredit facilities and make them pay for em-paneling even after being licensed. This was done on the basis of who you know and how much money you paid for the defunct NHIF to accredit your facility. That has since changed. I have had a meeting with the Council of Governors and learned that we still have about 2,900 primary health facilities that have not been licensed. We asked them to give us the names of those facilities, which they have already done. The Kenya Medical Practitioners and Dentists Council and the other regulatory bodies within that sector will consider those facilities. Hon. Speaker, on the question of the approved SHA staff establishment, it is 815. In line with the First Schedule of the Social Health Insurance Act, SHA has advertised positions. The Act gives priority to employees of the defunct NHIF that SHA did not absorb. The number will reduce because SHA is technology-driven. The excess NHIF staff will be redeployed within public service. No one will lose their job. Let me do it with the rider that certificates must be genuine. If you were working at NHIF with a fake degree, we will not only terminate your service but we will also refer you to the relevant institutions within the criminal justice system for appropriate action to be taken against you. We have already found a number of them. Corruption has permeated our systems to a point that people do not want to go to university. They want to buy degrees. Many Members of Parliament have approached and told me that so-and-so is working somewhere. Before I deal with those cases, ask your constituents who worked at NHIF if their documents are in order. I am sure, they are watching me. Nobody will lose his or her job. However, do not wait for me if your documents are fake. You better resign now and go home because we will not carry you just because you joined NHIF. In fact, we will surcharge you all the salaries paid by the defunct NHIF. On provision of a detailed report on the current capital capitation, SHIF has not received any capitation from the Exchequer. As we said, there is a difference between SHA and SHIF. The SHIF is contributory and self-financing. If you allow me, Hon. Members, I have a table where this is explained very well. Hon. Speaker, the other question is on how monies have been utilised since the authorisation of the Fund. All monies collected so far have been used to settle verified claims. Let me stress the phrase “verified claims”. Some of the unpaid claims by the defunct NHIF are 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": 1557884,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557884/?format=api",
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"content": "with the Task Force of the former Auditor-General, Ouko. He is looking at the bigger picture of pending bills amounting to Ksh500 billion. I have set up a verification team for all pending bills accrued from July 2022, when we took over the administration of public affairs up to 30th September 2024, when SHA took over from the defunct NHIF. We have made a commitment and we will seek a budget. The Government of Kenya will pay anybody whose bills have been verified and are between zero and Ksh10 million. We will bring a budget funding request to the Budget and Appropriations Committee of this House for consideration. We have formed a committee for the rest. We have used all the money we have collected so far to settle verified claims. Hon. Speaker, it is good for the country to know that this House has capped the administration cost of SHA at 5 per cent. What was the administration cost of the defunct NHIF? It was at 40 per cent at one time. That is why many people were employed and money was everywhere. That is why there was fraud. By the time this administration came to office, the administrative cost of the defunct NHIF was at 17 per cent. Today, because of technology and by law, the administrative cost of SHA is at 5 per cent. Proper measures have been put in place to ensure proper verification of SHA claims. First, all patients are verified using the National Registration Bureau data identifying biometrics, which is paperless. The SHA will not give you a card like the NHIF card. You walk into hospital if you are registered. We have integrated with the National Registration Bureau. We pick your 10 fingerprints when you register with your ID. You present your 10 fingerprints. Thereafter, the system will show you. This is important because we want to identify persons. Hon. Speaker, you could go to hospitals that would scan seven of your fingerprints instead of scanning 10 fingerprints. The other three were used for fraud. For example, Hon. K.J would be seated in this House but somebody would be using his fingerprints to be admitted in hospital for five days and that healthcare facility would be paid. This system is integrated to the National Registration Bureau (NRB) data. Secondly, the Social Health Authority (SHA) system is integrated with the systems of all regulators: The Kenya Medical Practitioners and Dentists Council (KMPDC), the Nursing Council of Kenya (NCK) and the Clinical Officers Council (COC), among others. From the system, we can know the doctor who is treating a patient. There will be no “Dr Mugo” in this country. You all know what “Dr Mugo” did to many people. He is from Dagoretti as a Member said. We will even know the surgeons. Let me give you a good example of a crazy thing that we saw. For a surgeon to perform a hip replacement and there are doctors in this House, he needs eight to 12 hours. Under the defunct National Hospital Insurance Fund (NHIF), we had a facility that had a doctor who performed 10 hip replacements in a day. That must have been a very meticulous or magical doctor. Going forward, that will not happen because KMPDC - and Dr Golicha is a member - will be able to see who he has treated and if he has not, then that payment will not be made. From NCK, we shall know which nurse is treating patients. Also, from the COC database, we shall know which clinician is treating patients. If their license is cancelled because of malpractice, the system, through those bodies, will delete them. This will ensure the correctness of the facility and the doctor providing the service. The facilities are also identified by the regulators. A claim verification office with qualified doctors has been designated to undertake additional verification and settlement of claims. In fact, the head of the claims department - though I do not want to pre-empt when he or she is recruited - must be a medic. As I said earlier, all SHA claims are settled by the 14th day of every month. All claims status is available in our facility portal. Every facility and claim can be seen on the dashboard. The other question was on the current liabilities of the Fund by Hon Kawanjiku, who had many questions. The Ministry has appointed a verification committee to review the claims 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": 1557885,
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"content": "and make recommendation on the same to be settled within three months. I was very clear to the verification committee that if they allow and present a fictitious claim, they will be held responsible. On clarity on how SHA is enforcing the payment of contribution by employers, SHA sends SMS reminders every 15th and 30th of every month to employers and employees. It has also designated officers to follow up on the payment of the contribution. Finally, on the percentage of SHA funds that shall be paid to medical equipment suppliers vis-a-vis public health facility, the National Equipment Service Programme (NESP) is completely delinked from SHA. It is a different programme. It is a replacement of the old system known as Managed Equipment Services (MES). If you allow me, I am happy to engage the House and table a full report of NESP which is a joint venture between the National Government and county governments. So far, 45 counties have signed the Implementation Partner Agreements (IPAs) to join the programme. Only two have not and I am talking to them. I will update the House on this. That programme is not part of SHA; neither a partner. SHA and the Primary Health Care (PHC) only pay for their members when they fall sick, require surgery, want to deliver, have cancer or when there is an emergency. The last one was on the status of PHC Fund in relation to facilities improvement."
},
{
"id": 1557886,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557886/?format=api",
"text_counter": 235,
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"speaker_name": "Hon. Speaker",
"speaker_title": "",
"speaker": null,
"content": "Order, Cabinet Secretary. You have dealt with two questions by Hon. Kawanjiku. I will now allow Members to joyride on those before we go to the next question. Let us start with Hon. Oundo."
},
{
"id": 1557887,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557887/?format=api",
"text_counter": 236,
"type": "speech",
"speaker_name": "Funyula, ODM",
"speaker_title": "Hon. (Dr) Ojiambo Oundo",
"speaker": null,
"content": " Thank you, Hon. Speaker. I thank our former colleague for coming back here. Allow me to ask the Cabinet Secretary two very basic questions. I will ride on the first question by Hon. Kawanjiku, QPN 2/2025, on the issue of teenage mothers who do not have national identification documents (IDs). I come from a border county. In essence, there are quite a number of ladies from Uganda who get married to Kenyan men. For some strange reason, they do not get IDs, but they get pregnant. So, they have to go to hospital and deliver and yet, they have no IDs and so they cannot get into that programme. What measures is the Cabinet Secretary or the Government going to take to ensure that they are attended to just like any other person? Secondly, he has said that they will pay for the indigents. When will the Government pay because diseases cannot wait?"
},
{
"id": 1557888,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557888/?format=api",
"text_counter": 237,
"type": "speech",
"speaker_name": "Hon. Speaker",
"speaker_title": "",
"speaker": null,
"content": "Thank you. KJ."
},
{
"id": 1557889,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557889/?format=api",
"text_counter": 238,
"type": "speech",
"speaker_name": "Dagoretti South, UDA",
"speaker_title": "Hon. John Kiarie",
"speaker": null,
"content": " Thank you, Hon. Speaker. Thank you, also for admitting Waziri Duale to this House in an afternoon when we have been talking about experts. This is also to showcase that we also have experts from the United Democratic Alliance (UDA) Party and the Kenya Kwanza side of the House. This gentleman did an amazing job at the Ministry of Environment and Forestry. We were waiting to swim in the Nairobi River. As soon as he had set up the plan, he is now at the Ministry of Health and we hope he will clean up Afya House. Today, Hon. Duale has done a job of advocacy and sensitisation. We have also seen him on TV doing the same. As he speaks about SHA today, the story that is out there is about the teething problems. My concern is this: Does the ministry have tangible plans to conduct proper sensitisation and communication campaigns to allay the fears that Kenyans have? The questions which Hon. Kawanjiku asked are the same ones that Kenyans have. The information sits at the Ministry, but it does not trickle down to the people. As they invest in big plans at the Ministry, how will this message get down to Kenyans? Finally, there is a big monetary investment by Kenyans on making universal healthcare work. We are still very dependent on remedies, therapies and medicines from outside Kenya. We very well know from our traditional medicine and culture, we have therapies that are better than the medicine we import through the Kenya Medical Supplies Authority (KEMSA). Will 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": 1557890,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557890/?format=api",
"text_counter": 239,
"type": "speech",
"speaker_name": "Dagoretti South, UDA",
"speaker_title": "Hon. John Kiarie",
"speaker": null,
"content": "a component of the monies we are investing in go to research and development, so that we can develop our own naturally grown remedies and therapies in our country, instead of exporting all the monies we are raising through this very beautiful programme to international pharmaceutical companies. Thank you very much, Hon. Speaker."
},
{
"id": 1557891,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1557891/?format=api",
"text_counter": 240,
"type": "speech",
"speaker_name": "Hon. Speaker",
"speaker_title": "",
"speaker": null,
"content": "Thank you. Prof Jaldesa. Hon. Kawanjiku, I know I should have given you the first bite. I will come to you. The joyriders will only ask one question each."
}
]
}