Private hospitals in Kenya are under increasing pressure to align with the regulatory framework set by the newly established Social Health Authority (SHA), with Medical Services Principal Secretary Harry Kimtai issuing a stern warning regarding the potential revocation of licenses for non-compliant facilities. This warning comes amidst ongoing friction between the government and private health providers, many of whom have suspended services under SHA due to outstanding payments from the now-defunct National Health Insurance Fund (NHIF). The standoff highlights the tension between the need for regulatory compliance and the financial sustainability of private healthcare providers who feel burdened by unsettled debts.
Speaking on Monday, PS Kimtai criticized private hospitals that have halted services, accusing them of attempting to manipulate the government by withdrawing essential health services from citizens. He emphasized that compliance with SHA regulations is not optional and that hospitals failing to meet the requirements could face license revocation. According to Kimtai, the suspension of services by some hospitals is a form of blackmail aimed at forcing the government’s hand in clearing pending NHIF arrears. He questioned the rationale behind these actions, noting that since 2016, the government has been open to negotiations and settlement discussions concerning outstanding bills, and hospitals should not use patients as leverage.
Kimtai made it clear that the government expects all licensed health facilities to operate within the law and to continue serving Kenyans without disruption. He asserted that failure to do so could lead to closure, warning that licenses are subject to renewal and can be revoked if facilities show unwillingness to comply with the new regulations. His remarks are seen as an attempt to assert government authority in the wake of increasing defiance from the private health sector.
Private hospitals, however, maintain that their actions are driven by financial strain. Through their representative bodies the Rural and Urban Private Hospitals Association of Kenya (RUPHA) and the Kenya Association of Private Hospitals (KAPH) these facilities have urged the government to prioritize the clearance of NHIF arrears before processing SHA claims. According to a joint report from RUPHA and KAPH, 55 percent of private hospitals want NHIF debts settled first, while 26 percent advocate for simultaneous processing of NHIF and SHA claims. A smaller segment, 19 percent, prefers that SHA payments take precedence, with NHIF arrears addressed later.
The report also noted that private facilities have a higher preference (61 percent) for NHIF arrears settlement compared to faith-based (51 percent) and public facilities (49 percent). It further revealed that while over half of the facilities 56 percent have reconciled their NHIF claims, many smaller and lower-level health providers are struggling due to limited awareness and access to the NHIF portal.
In an attempt to address the crisis, State House recently announced a plan to pay hospitals with NHIF claims of Sh10 million or less in full, covering approximately 91 percent of contracted facilities. The remaining nine percent, with claims exceeding Sh10 million, will be subjected to a verification process expected to last 90 days, after which a payment schedule will be agreed upon.
The dispute underscores the complex transition from NHIF to SHA, with financial, regulatory, and operational challenges affecting the provision of healthcare services. As the government pushes for compliance, private hospitals are calling for prompt settlement of past debts to sustain their operations. The coming weeks will likely determine whether the standoff eases or escalates into a wider healthcare crisis.
