Patients’ agony, suffering and at times death to persist as Ruto adamant in SHA push despite system glitches

The agony, anguish and at times the unfortunate ultimate fate of death that the incessant system glitches of the Social Health Authority (SHA) has exposed suffering patients to is likely to persist until the controversial SHA system becomes efficient after President William Ruto said it may take some time but it will eventually work.

While addressing faithfuls during today’s Sunday service at Jesus Winner Ministry in Roysambu, Nairobi county, President Ruto adamantly pushed for the SHA project terming it as the biggest programme undertaken by the Kenya Kwanza administration.

However, he acknowledged SHA failures saying it might take some time but it will eventually work.

The president’s remarks come even as the Rural and Urban Private Hospitals Association of Kenya (RUPHA) announced an indefinite suspension of services under the SHA insurance scheme, the Social Hospital Insurance Fund (SHIF) starting February 24, 2025 citing unpaid claims and an unsustainable reimbursement model.

RUPHA, which represents private and faith-based hospitals, said the government’s failure to settle Sh30 billion in arrears and address operational concerns had made it impossible to continue offering services.

RUPHA has also demanded full disclosure of SHA hospital claims reimbursement formula.

“It is the biggest programme we have in the country. It may take time for things to align, but believe you me: It is going to work,” he said.

The president who donated Sh20million to the church was accompanied by Nairobi governor Johnson Sakaja and Members of Parliament (MPs).

“The continued failure to resolve critical challenges in the SHA transition is directly endangering patient care and hospital sustainability,” said RUPHA chairman Brian Lishenga.

“Hospitals have lost staff, defaulted on loans, and faced medicine shortages due to delayed payments,” he added.

Hospitals have struggled with unpaid National Health Insurance Fund (NHIF) claims dating back to 2017, pushing many to financial distress.

RUPHA noted that pharmaceutical suppliers had blacklisted hospitals, tax liabilities had mounted despite unpaid claims, and specialist doctors remained without pay for years. SHA, which replaced NHIF, has declined to take responsibility for pending payments, further straining the sector.

The latest SHA transition report found that 89 per cent of hospitals were unable to process reimbursements due to nonfunctional claims portals, while 54 per cent had not received payments since December.

Under SHA’s outpatient model, hospitals would receive less than Sh75 per patient per month. RUPHA called this “unrealistic,” saying it was impossible to pay staff, procure drugs, or maintain operations under such terms. “We refuse to put Kenyan lives at risk…The reimbursement model is financially unsustainable and threatens service delivery,” said Lishenga.

“If Kenya is well, everyone will be okay. If things go wrong, everyone will suffer,” she said.

RUPHA also withdrew from the Medical Administrator Kenya Limited (MAKL) scheme, which covers teachers and police officers, citing 11 months of unpaid claims, unexplained fee deductions, and preferential treatment of MAKL-owned clinics.

The association demanded that the government either settle NHIF arrears or provide a transparent payment plan, revise the SHA reimbursement model, and ensure timely MAKL payments.

Patients seeking treatment under SHA at private and faith-based hospitals will have to pay in cash starting 24 February 2025.

RUPHA expressed regret over the decision but said hospitals could not continue offering services without reforms.

“We stand ready to work with the government on real solutions,” said Lishenga.

“But hospitals cannot subsidise a broken system at the expense of patient safety,” he added.

On jobs, President Ruto said the government has put in place robust measures to create opportunities for young people. He cited the export of labour programme which, he said, is expanding horizons for many youths.

The president commended the leadership of Jesus Winner Ministry for securing employment opportunities abroad for its members, and asked other religious organisations to emulate such initiatives.

“Instead of engaging in blame games, we can work together to find solutions to our problems,” he added.

Among the MPs present were; John Kiarie (Dagoretti South), George Aladwa (Makadara), Simon Ng’ang’a King’ara (Ruiru), Anthony Oluoch (Mathare), Sabina Chege (Nominated MP), Beatrice Elachi (Dagoretti North), and Mark Mwenje (Embakasi West).

Oluoch said it was noble that President Ruto and Odinga are working together to bring Kenyans together. He pledged that he would not stand in the way of such progressive efforts.

“Should I help Raila to gather or to scatter?” he asked.

Elachi asked Kenyans to shun tribal politics, saying places such as Nairobi City are inhabited by Kenyans from every region.

Mwenje said even though they had opposed the president in the past, they had made a decision to come together for the sake of the country’s progress.

“There is a season for everything. We are now at the season of building the nation,” he said.

Aladwa commended President Ruto’s efforts to unite the country so that Kenyans can work together, terming it a bold vision.

King’ara asked Kenyans to always strive to portray the country’s image positively, noting that was the way to help will help unlock opportunities locally and abroad.

Chege reminded Kenyans of the shared responsibility for the country’s future, highlighting that the well-being of all citizens is tied to the nation’s success.