The Cabinet Secretary for Health Aden Duale has warned hospitals contracted under the Social Health Authority (SHA) against denying patients treatment claiming system downtime or non-payment by the government.
Duale explained that such actions put the health facilities at the risk of immediate suspension and possible termination of their contracts. He elaborated that any contracted facility that turns away patients citing technological challenges goes against the constitutional right of Kenyans to access healthcare.
The Cabinet Secretary was speaking during a meeting in Nairobi with a delegation from the Kenya Union of Post Primary Education Teachers (KUPPET), where they discussed the Public Officers Medical Cover after the transition of 413,577 teachers to the Social Health Authority (SHA) health insurance cover.
“There are certain facilities in our country that want to deny Kenyans to use their cover under SHA and they give a lot of reasons. Sometimes they say the system is down, sometimes they say we have a problem with payment… You are denying a patient who is sick, who can die at any time treatment. SHA will pay you in accordance with the law,” he stated.
Ensuring proper implementation
He directed contracted facilities to continue providing services even when technical challenges occur, adding that the government has personnel across the country to ensure Kenyans get the assistance they need at hospitals.
“To strengthen service delivery under the scheme, 425 senior officials have been appointed within SHA, with 367 deployed to counties to provide on the ground-support and assist teachers facing challenges at health facilities,” he explained.
Present at the meeting were the Principal Secretary for Medical Services Dr. Ouma Oluga, Director General for Health Dr. Patrick Amoth, SHA CEO Dr. Mercy Mwangangi, Digital Health Agency CEO Anthony Lenayara, KUPPET Secretary General Akelo Misori, and TSC Acting CEO Eveleen Mitei, alongside senior Ministry of Health officials.
Duale revealed that a dedicated 24-hour focal person had been assigned to handle urgent issues under the Mwalimu Medical Cover, while 47 County Joint Committees had been established to oversee the implementation of the Teachers Medical Scheme at the county level.
The committees are chaired by the Teachers Service Commission (TSC) County Directors and comprise SHA managers and union representatives who will meet quarterly to resolve operational issues and improve coordination.
Protecting teachers under SHA
Duale added that the interests of teachers remain protected in the government-run SHA scheme, which has seen the administration push for Kenyans of all calibers to join.
“The interest of workers remain protected within the governance structure of SHA. The Central Organization of Trade Unions (COTU) is represented on the Authority’s Board,” he elaborated
He also announced the activation of a 24-hour toll-free hotline 0800 720 601 and short code 147 to support teachers experiencing emergencies or administrative challenges while accessing care.
Furthermore, SHA, TSC, and KUPPET will roll out a nationwide education campaign to help teachers understand their benefits, access the patient portal, and navigate the scheme
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