NHIF accused of favouring two hospitals in new health cover

By Standard Team

Questions have been raised over the manner the National Hospital Insurance Fund (NHIF) is rolling out its medical scheme for civil servants.

A parliamentary committee is investigating how two "little known" private health providers were awarded the cover for over half of the members.

Only three months after the ambitious Sh 4.2 billion health cover, which also includes a cover for members of the disciplined forces was rolled out, the issue of transparency in the selection process has been brought to the limelight.

The NHIF board was on Wednesday grilled by Parliament’s Health Committee over how Meridian and Clinix got the cover of more than half of the civil servants.

The Dr Robert Monda-led committee took the NHIF board to task, questioning how other more established health institutions, and especially public hospitals which have a broader network, lost to Meridian and Clinix.

The questions arose after the NHIF board disclosed that the two private health institutions were paid more than half of what the fund has released to health providers for the scheme in the first quarter of its rolling out.

NHIF Chief Executive Officer Richard Kerich told the committee that out of the Sh600 million paid to institutions accredited to offer the cover for the first three months of the year, 18 outlets operating under Meridian were paid Sh116 million while those operating under Clinix earned Sh202 million.

MPs demanded to know how the two institutions were given the cover. Dr Eseli Simiyu asked if the two had lobbied within the civil service to win the support, given that they do not have a wide network.

pilot programme

NHIF board chairman Prof Richard Muga defended the deal, saying the two institutions could have been at an advantage as they had been picked for a pilot programme before the scheme was rolled out.

Muga and Kerich said that the civil servants had been granted to choose the provider of their choice, denying claims that they had allocated the covers to health institutions.

They said many had shunned public hospitals while making their choice.

"You will need to also consider the circumstances under which the scheme was rolled out. It came at a time when doctors in public hospital were on strike and therefore many civil servants opted to be covered by private institutions," explained Dr Kerich.

The two members of the board said many private health institutions had declined the deal with NHIF as they considered the capitation rate of Sh2,850 per head that the fund was giving as too low.

Meanwhile, Civil servants union officials in Nyanza want the new medical scheme administered by NHIF shelved until sticky issues are ironed out.

Union of Kenya Civil Servants (UKCS) officials drawn from Homa Bay, Kisii, Migori and Nyamira counties accused their national office of entering into agreements with the Government without consulting their branches.

Addressing the Press on the sidelines of a workshop organised in Kisii by NHIF to sensitise members on the new scheme, the officials lamented that services at public hospitals were yet to be standardised.

They also want the number of nominees to benefit from the scheme increased to five and their remissions to the scheme reflected in their pay slips monthly.

Elsewhere, Medical Services minister Anyang’ Nyong’o has appealed to Kenyans to give NHIF time to harmonise its activities to ensure the new scheme was successful.

Prof Nyong’o said the scheme would now provide universal health care, both for in and out patients.

"This is a good scheme. We are just appealing for Kenyans to give NHIF time. Let us have enough time for this scheme. This is a noble idea," he said in Kisumu.

— Reports by Moses Njagih, Kenan Miruka and Nicholas Anyuor