The Social Health Authority (SHA), formerly National Health Insurance Fund (NHIF) board chaired by Abdi Mohamed has sent acting Chief Executive Officer (CEO) Elijah Wachira on a 90-day compulsory leave to allow further investigation into his professional conduct and performance.
Investigations by The Informer Media Group established that Wachira’s suspension was preceded by a stormy board meeting where insiders revealed that heaps of blames ranging from alleged diversion of funds, prioritising payments to private hospitals for services offered to SHA members at the expense of public hospitals and rising pending bills, which have forced hospitals to ask patients to pay cash among other claims.
The board also shifted blame on Wachira over the apparent ongoing chaotic transition from NHIF to SHA which has predisposed patients’ to untold agony, suffering and at times exposing them to unfortunate risk of death.
However, impeccable sources who spoke to us on condition of anonymity revealed that Wachira denied all accusations and said he is not aware of any diverted funds before he was axed.
Consequently, the board appointed Robert Ingasira, Director of Financial Services, as the acting CEO.
“This is to inform you of the resolution of the board to send you on compulsory leave effective immediately for a period of 90 days to allow for further investigations into your professional conduct and performance as Acting Chief Executive officer of Social Health Authority,” read the memo.
Abdi said that while on leave, Wachira will be entitled to all his current remuneration and benefits. The board partly attributed Wachira’s suspension to the challenges facing the SHA’s transition from the NHIF.
According to the minutes from Tuesday’s board meeting, the SHA leadership expressed concerns over rising unpaid bills, which have led hospitals to require cash payments from patients a situation the board says directly contradicts the SHA’s commitment to improving access to healthcare under Universal Health Coverage (UHC).
“As its first assignment towards UHC attainment, it has been critical to pursue the clearance of these pending bills as they also disburse claims on time to avoid payment backlogs. Fifty percent of the Sh19 billion pending bills have been cleared in just over one month, a historic feat since the advent of SHA.” Minutes from an internal board meeting read in part.
However, the board accused Wachira of diverting Sh1.6 billion intended for settling debts owed to public hospitals, reportedly prioritising payments to private facilities over public ones.
“It therefore comes as a concern when the Acting CEO, Elijah Wachira takes actions that not only go against this effort but put the delivery of healthcare services at risk despite the government’s best effort.” The board said.
The controversy surrounding Wachira marks the second major leadership shake-up at SHA since its establishment just two months ago.
The previous upheaval involved the removal of former board chairman Dr. Timothy Olweny shortly before SHA’s official launch.
Wachira was appointed NHIF CEO in October last year after a competitive selection process.
With a background as the former Managing Director of CIC General for four years, he is regarded as a seasoned professional in the insurance industry.
In 2022, CIC General Insurance Ltd, where Wachira previously worked, won a Sh8.7billion tender to provide the National Police Service (NPS) and the Kenya Prison Services (KPS) members medical cover.
The consortium also includes Britam General Insurance Company (K) Ltd and Old Mutual General Insurance Kenya Limited.
NHIF, which also made a bid, was disqualified for quoting way above the consortia with a Sh9.4billion.
