Gachagua warned us, Omtatah sued, now account for SHA billions

When Rigathi Gachagua warned that the Social Health Authority could collapse within six months, President William Ruto dismissed his prediction with remarks invoking witchcraft and superstition. That response reduced a serious public concern to political ridicule.

Today, as healthcare facilities move from the SHA provider portal to a Health Management Information System, those warnings deserve examination rather than another presidential punchline. But accountability begins with accuracy. Closing or replacing a provider portal is not the same as abolishing SHA.

The government has announced a migration to HMIS and given some facilities more time to complete it, while assuring patients that services will continue. That evidence shows a technological transition, not closure of the authority.

The distinction matters because it prevents officials from escaping scrutiny by merely correcting an exaggerated accusation. The central question remains simple. What did Kenyans purchase, what has been delivered, and why is this transition necessary? The government describes HMIS as an integrated platform for patient verification, electronic claims, provider authentication, and information exchange. Those functions are important.

Their importance makes scrutiny more urgent. Healthcare financing cannot rest on assurances unsupported by accessible contracts, verified performance and clear explanations of what changes between the old portal and its successor.

Gachagua was not alone in raising concerns. Before the October 2024 rollout, Senator Okiya Omtatah, together with Eliud Matindi and Magare Gikenyi, went to court challenging implementation and the technology procurement. Their petition questioned the legality, contractual arrangements, and justification for the consortium deal. Those allegations required proof, but they also raised substantive questions about public administration. They could not honestly be answered by branding every critic an enemy of universal healthcare.

Omtatah’s intervention matters because it placed scrutiny ahead of celebration. A government introducing compulsory contributions and restructuring access to treatment should expect questions before implementation. Indeed, it should welcome them.

When citizens ask whether a system protects patients or creates lucrative opportunities for contractors, the proper response is documentary disclosure. Political confidence cannot replace procurement records, service standards or proof that patients can obtain care.

The Sh104.8 billion figure must also be explained honestly. Reporting describes a broader integrated healthcare technology programme, including information management, information exchange, telemedicine and pharmaceutical tracking. It is misleading to treat the entire amount as the price of one provider portal. Equally, the headline value is not proof that the full sum has already been paid or stolen. Because the commitment is enormous, every component deserves scrutiny.

Kenyans need a financial account. They need the original contract, amendments, financing arrangements, payment schedules, amounts disbursed and outstanding obligations. They need to know which deliverables passed independent acceptance tests. They need ownership and licensing terms for software, infrastructure and data. Above all, they need to know whether migration to HMIS fulfils the original bargain, corrects defective work or creates additional costs.

Health CS Aden Duale must answer these questions. He cannot defend the programme publicly and then treat its contractual foundations as somebody else’s concern. But demanding that he alone be liable would prematurely narrow accountability. Responsibility must follow the evidence through those who designed, approved, procured, signed, financed, implemented and supervised the project. Any official or contractor implicated in wrongdoing should face consequences proportionate to proven conduct.

An expensive digital programme can require improvement without being fraudulent. A portal migration, by itself, does not establish collapse, theft or abandonment of the whole technology investment. However, government cannot use the language of innovation to avoid explaining performance. If this was always planned, publish the timetable. If shortcomings forced changes, disclose them. If contractors failed obligations, explain the remedies and whether taxpayers are paying again.

For patients, these distinctions have immediate consequences. A rejected claim, delayed authorisation or interrupted treatment is not an abstract software problem. It can mean borrowing money, postponing surgery or going without medicine. Government assurances that migration will not interrupt treatment must be measured against what happens in hospitals.

Providers need practical support, reliable claims reconciliation, and clear responsibility when systems fail. Patients should never become collateral damage in a contractual dispute. Parliament should demand an independently verified account of expenditure and delivery. Auditors should examine value for money, contractual compliance and transition costs. Investigators should pursue any evidence of corruption. The public should receive findings detailed enough to distinguish genuine improvement from costly repair, and costly repair from misconduct. That is the minimum constitutional obligation now.

Gachagua’s deadline may prove wrong. Omtatah’s allegations must stand or fall on evidence. Neither point excuses secrecy. Kenyans deserve more than laughter followed by another launch. Account for every shilling committed, every payment made and every promise still undelivered. Healthcare reform must protect the sick, not protect officials from scrutiny.