{"count":1608389,"next":"http://info.mzalendo.com/api/v0.1/hansard/entries/?format=json&page=150269","previous":"http://info.mzalendo.com/api/v0.1/hansard/entries/?format=json&page=150267","results":[{"id":1520872,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520872/?format=json","text_counter":152,"type":"speech","speaker_name":"Sen. Wambua","speaker_title":"","speaker":{"id":13199,"legal_name":"Enoch Kiio Wambua","slug":"enoch-kiio-wambua"},"content":"Mr. Deputy Speaker, Sir, I will skip the tables and the figures because I have just received them. Since you have said there will be engagements going into the future, perhaps we can transact that business elsewhere. I will go straight to my two supplementary questions. Madam Cabinet Secretary, my appreciation of SHA and SHIF as a Kenyan and not as a Senator is that your Ministry is trying to climb a tree from the top. That is my honest response to SHA and SHIF. Why? This is because the Universal Health Care (UHC), which is not a Kenyan programme, but a global universal concept, is supposed to facilitate access to affordable, promotive, preventive, curative, rehabilitative and palliative care to patients when they need it. For that to happen, two things are important: The first one is infrastructure development in terms of physical facilities and equipment. The second one is personnel; doctors, nurses, clinicians and support staff. That will form the basis of rolling out the UHC. Madam Cabinet Secretary, I want you to tell this country, of those two important facets of the success of UHC, what did the Government do before rolling out the SHA to ensure that we have enough facilities, infrastructure and sufficient personnel to deal with the demands that come with the UHC? My second supplementary question is a live matter. Kenyans, you and I are aware that private and faith-based health facilities are withdrawing from the SHA for reasons of release of funds to the facilities. Yesterday, I saw the Chief Executive Officer (CEO) make a very irresponsible statement. He said that they are only 300 facilities so, even if they disappear, nothing will change. Madam Cabinet Secretary, Kenyans, you and I know that those 300 facilities could be the only facilities available to Kenyans, especially in far to reach areas. Therefore, the withdrawal of services by those facilities is a death sentence to millions of Kenyans. I had expected a rejoinder from you immediately to say that you care, if you do, on that statement coming from your CEO. What are you doing to win the confidence of the faith-based and private health facilities, to make sure they come back on board and continue to offer services to Kenyans, especially to reach far areas? I thank you."},{"id":1520873,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520873/?format=json","text_counter":153,"type":"speech","speaker_name":"Sen. Kathuri","speaker_title":"The Deputy Speaker","speaker":{"id":13590,"legal_name":"Murungi Kathuri","slug":"murungi-kathuri"},"content":" Madam Cabinet Secretary, answer the two supplementary questions."},{"id":1520874,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520874/?format=json","text_counter":154,"type":"speech","speaker_name":"Hon. Barasa","speaker_title":"The Cabinet Secretary for Health","speaker":{"id":1885,"legal_name":"Didmus Wekesa Barasa Mutua","slug":"didmus-wekesa-barasa-mutua"},"content":" Thank you very much, Hon. Deputy Speaker and Sen. Wambua. Affordable, accessible, quality care is indeed critical. The UHC and Taifa Care in our country has been implemented. It is part of the Sustainable Development Goals (SDGs) and Africa Union Agenda, 2063. We have had multiple guidelines on the implementation of the UHC from various bodies, including the World Health Organisation (WHO). Therefore, this is not something that the Ministry just sat behind the bench and looked into. We have reviewed data, publications, research and other implementations best practises from various The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."},{"id":1520875,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520875/?format=json","text_counter":155,"type":"speech","speaker_name":"Hon. Barasa","speaker_title":"The Cabinet Secretary for Health","speaker":{"id":1885,"legal_name":"Didmus Wekesa Barasa Mutua","slug":"didmus-wekesa-barasa-mutua"},"content":"countries, including Thailand, on how they were able to make UHC a success in their country. It is indeed critical for us. If you look at various countries, you observe that they raise concerns and grievances on the waiting time and system interruptions, so, this is a common issue. However, one thing that cuts across board on the UHC implementation, all the countries that have implemented say it is better than nothing. They know that if each person can access services, then the country will move forward and we will not have a catastrophic expenditure when it comes to health service delivery for our people. Indeed, it is critical for us to embrace UHC as a country and ensure that we are all in the same page. That is why we emphasise on collaboration with the Senate and other stakeholders to ensure that it is a success. We take note of the infrastructure and equipment. You will notice that part of the pillars of UHC is the health products and technology. In this, we have the National Equipment Support Programme (NESP) project, where we have had multiple counties sign the agreement. There are 45 out of the 47 counties that have signed the agreement. There are 36 counties that have listed down the equipment they need within the facilities. Therefore, this is an area we are looking into. Now, you will also observe that within our country, we are building infrastructure, but we do not have the needed services, human resources or health products. We need to balance, and that is why, as a Ministry, we went back and reviewed what is critical to ensure that human resources and health products are there for the patients. Those are really the critical components that we are looking into. We need some time to look at the comprehensive report and see how we are working together with the Kenya Medical Supplies Authority (KEMSA), to ensure that there is recapitalisation and that medicines are reaching the last mile because that has been a challenge. This is especially in Levels 2 and 3; the dispensaries and health centres, where you observe that there is no medicine. People are now moving towards higher levels of care where they need equipment and health products. This poses a challenge because these hospitals with equipment become congested and cannot run fully. Our health centres and dispensaries should have human resources and medications, so people can access services. This is why we need your support even moving forward. We will have a comprehensive report on health products. For infrastructure and equipment, we have the National Equipment Service Programme. Regarding human resources for health, we are looking towards having more human resources for health within the programme and ensuring that they are running and supporting this initiative. So, the personnel are not out of it; it is part of our action plan to ensure that the services continue. We continue to support the building of health centres and ensure their functioning as a country. You will notice even in our annual plan and our budget that we are supporting the development of health centres by emphasising that a health centre is not just a shell or a building. What we need is the services, and for the services to be there, we need health products and human resources. The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."},{"id":1520876,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520876/?format=json","text_counter":156,"type":"speech","speaker_name":"Hon. Barasa","speaker_title":"The Cabinet Secretary for Health","speaker":{"id":1885,"legal_name":"Didmus Wekesa Barasa Mutua","slug":"didmus-wekesa-barasa-mutua"},"content":"We acknowledge that private and faith-based organisations are critical pillars in ensuring that health services are delivered to all Kenyans, and so, we continue with our partnership with them. We have had routine meetings with them to ensure that they are supporting the implementation of Universal Health Coverage (UHC). So, what was critical with regard to the withdrawal of services was the National Health Insurance Fund (NHIF) debt. Together with the Social Health Authority team, we have routine meetings to see how we can have a payment plan for the NHIF debt. We are engaging the Treasury and various managing directors who were involved in the billing to ensure that there is payment. Our engagement is ongoing. However, as you can see, first, we are paying them on time. While we had talked about 90 days, we are paying them within 30 days. When you engage them further, the problem is not Social Health Authority; we are ensuring that the payment is made within the time limits. The challenge was the claims management, which has been addressed currently. Again, the challenge that we are facing is the NHIF debt. Once we have addressed that, I believe that we will be in a position to ensure that UHC is implemented. Number two was the Primary Health Care Fund, which some of them had not grasped the concept of global funding. We are meeting with them to explain to them and tabulate what it means for them in regard to the new form of the primary health care funding model. What you will see is of benefit to them. While previously NHIF only covered around seven to eight million Kenyans, we have universal coverage. So, we have more Kenyans on board. This means we are offering more services to Kenyans, and in turn, more revenue is collected. We are explaining to them how the calculation is done, so they understand that they are not going to lose but will get more through this system. We are reaching out to them to ensure that discussions are ongoing and that our partnership with the Ministry and the private and faith-based organisation continues because we really need to have their services, so that they can be accessible to all Kenyans. We will honour the pending bills; we acknowledge them and have a payment plan for NHIF."},{"id":1520877,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520877/?format=json","text_counter":157,"type":"speech","speaker_name":"Sen. Kathuri","speaker_title":"The Deputy Speaker","speaker":{"id":13590,"legal_name":"Murungi Kathuri","slug":"murungi-kathuri"},"content":" Next is Sen. Seki."},{"id":1520878,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520878/?format=json","text_counter":158,"type":"scene","speaker_name":"","speaker_title":"","speaker":null,"content":"(Sen. Wambua stood in his place)"},{"id":1520879,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520879/?format=json","text_counter":159,"type":"speech","speaker_name":"Sen. Kathuri","speaker_title":"The Deputy Speaker","speaker":{"id":13590,"legal_name":"Murungi Kathuri","slug":"murungi-kathuri"},"content":"Are you not satisfied? You had two supplementary questions, which she answered. If you are not satisfied, I will give you an opportunity to get clarification."},{"id":1520880,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520880/?format=json","text_counter":160,"type":"speech","speaker_name":"Sen. Wambua","speaker_title":"","speaker":{"id":13199,"legal_name":"Enoch Kiio Wambua","slug":"enoch-kiio-wambua"},"content":"Mr. Deputy Speaker, Sir, I am not satisfied with any of the responses that have been given. On the first Question, the Cabinet Secretary should go on record. This is the Senate. She should go on record and state that the Government was not ready for UHC. This is because, in so many words, that is what you are saying. You are saying, you do not have infrastructure and personnel. Go on record and say that we were not ready as a country for the rollout of UHC. You cannot tell a sick nation that you are putting money into building hospitals and recruiting staff. This should have happened before you rolled out UHC. The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."},{"id":1520881,"url":"http://info.mzalendo.com/api/v0.1/hansard/entries/1520881/?format=json","text_counter":161,"type":"speech","speaker_name":"Sen. Wambua","speaker_title":"","speaker":{"id":13199,"legal_name":"Enoch Kiio Wambua","slug":"enoch-kiio-wambua"},"content":"On the issue of faith-based facilities, what baffles many of us is that this is already realised revenue. It is not money that --- Cabinet Secretary, if you listen to the questions, you may---"}]}