A potential strike by public sector unions over the transition from the National Health Insurance Fund (NHIF) to the Social Health Authority (SHA) was called off after a crucial agreement was reached between the unions and the government. The agreement, signed on Wednesday, involved several Cabinet Secretaries, including Justin Muturi (Public Service), Alfred Mutua (Labour), and Debora Mulongo Barasa (Health), alongside union representatives. The signing ceremony took place at Harambee House in Nairobi.
Background of the Dispute
The dispute between public sector unions and the government centered on the government’s plan to transition from the NHIF to the SHA without guaranteeing comprehensive coverage for public servants. The shift also involved an increase in monthly contributions from public servants to 2.75% of their gross salary without any visible improvements in healthcare benefits. The unions further raised concerns over the unclear fate of NHIF employees and demanded clarity on job security and benefits.
The Union of Kenya Civil Servants, representing many public sector workers, along with other unions, had issued a 14-day strike notice on October 8, 2024. They planned to protest the government’s failure to provide clarity on the new health scheme, especially the lack of a comprehensive cover for public servants during the transition from NHIF to SHA. This caused significant anxiety among union members, who relied on NHIF for their health insurance needs.
Public sector unions emphasized that health insurance is critical to their members’ well-being, given the challenges faced by workers in accessing quality healthcare. With the rise in the cost of living and healthcare, the unions had hoped for better coverage under the SHA scheme, but the initial rollout left many dissatisfied. The strike was thus intended to push for improvements to the new health scheme and ensure the well-being of union members.
Key Issues Leading to the Strike
At the heart of the unions’ grievances was the concern over the increased monthly contribution to 2.75% of gross salary without corresponding improvements in benefits. Public servants felt that the government was placing an unfair financial burden on them without providing the healthcare services they deserved. This created tension between the unions and the government, with unions demanding immediate intervention.
Another critical issue was the fate of NHIF employees. With the transition to SHA, thousands of NHIF employees faced an uncertain future. The unions demanded job security guarantees for NHIF staff, fearing mass layoffs or adverse changes to their terms of employment. The lack of a clear transition plan exacerbated concerns among workers who had served the public health sector for years.
Furthermore, the unions were worried about the quality of services that public servants would receive under SHA. They feared that without sufficient oversight and a well-thought-out transition plan, public servants could face gaps in access to healthcare services. For this reason, they called for comprehensive dialogue with the government to address these issues before the transition was fully implemented.
Agreement with the Government
The signing of the agreement between the unions and the government signaled a significant breakthrough. The unions agreed to abandon their strike plans after the government responded to their concerns. During the signing ceremony, Union of Kenya Civil Servants Secretary-General Tom Odege stated that the unions had no interest in calling for strikes but did so to ensure that the government listened to their concerns.
“It is not in our interest to call strikes, but we do so to make the employer respond to our concerns. The government has now responded, and we are therefore calling off the strike,” Odege remarked.
The agreement addressed many of the key issues raised by the unions. One of the most significant elements was the government’s commitment to extend the comprehensive medical insurance scheme for public servants until November 21, 2024. This extension ensures that public servants will continue to have access to healthcare under the SHA during the transition phase.
Additionally, the agreement guarantees “seamless access” to benefits for all public servants beyond November 21, 2024. This assurance was a critical factor in the unions calling off their strike, as it provided public servants with much-needed peace of mind regarding their healthcare coverage.
The agreement also establishes an ad-hoc working committee to oversee the seamless transition of NHIF staff to SHA. This committee will ensure that the transition complies with the Social Health Insurance Act, 2023, the Employment Act, 2007, the Labour Relations Act, and relevant Collective Bargaining Agreements (CBAs). The unions and the government agreed that there would be no loss of jobs or benefits for NHIF employees, addressing one of the unions’ most pressing concerns.
The parties further committed to resolving any issues related to the transition in good faith, suspending any legal actions that may have been considered. This provision emphasized the importance of collaboration and communication between the unions and the government to ensure a smooth transition.
Government Response
During the signing ceremony, Cabinet Secretaries Justin Muturi, Alfred Mutua, and Debra Mulongo Barasa expressed their appreciation for the unions’ willingness to engage in dialogue and reach an amicable resolution. They emphasized the government’s commitment to ensuring that public servants receive the best possible healthcare services under SHA.
Public Service CS Justin Muturi thanked the union leaders for their understanding and efforts in facilitating the agreement. He reiterated the government’s commitment to providing civil servants with seamless healthcare services under the new SHA scheme.
“We will work with everyone involved to ensure that all civil servants, who are entitled to a medical cover, receive seamless delivery of services,” Muturi said.
Labour CS Alfred Mutua also called for an end to the confrontational approach between unions and the government, urging unions to declare disputes before resorting to strike actions. He stated that dialogue was a better way to resolve disputes and that the government would act as an intermediary between employers and employees to ensure fairness.
“Before calling a strike, I urge unions to declare a dispute before engaging in strike action. Matters can be better handled amicably. I will listen and will act as the intermediary between employers and employees,” Mutua emphasized.
Health CS Debra Mulongo Barasa assured Kenyans that the government was committed to providing affordable, efficient, and accessible healthcare for all through SHA. She acknowledged the challenges experienced during the transition but expressed confidence that the SHA would deliver high-quality healthcare services for public servants and all Kenyans.
SHA’s Role in Universal Healthcare
The Social Health Authority (SHA) was established to replace the NHIF under the Social Health Insurance Act, 2023. SHA is designed to deliver universal healthcare to all Kenyans, with a focus on promoting preventive, curative, rehabilitative, and palliative healthcare services.
The SHA scheme comprises three main funds: the Primary Health Care Fund, the Social Health Insurance Fund (SHIF), and the Emergency, Chronic and Critical Illness Fund. These funds aim to provide comprehensive coverage for both registered and paying members, ensuring that all Kenyans, including public servants, have access to essential healthcare services.
The Primary Health Care Fund ensures free medical treatment for patients registered under SHA at health centers and dispensaries. Paying members receive additional benefits, including outpatient, inpatient, and emergency care, as well as coverage for mental health, critical illnesses, and major surgeries.
The Emergency, Chronic and Critical Illness Fund covers serious health conditions such as cancer, kidney disease requiring dialysis, severe high blood pressure, and diabetes. This fund was established to alleviate the financial burden on individuals dealing with life-threatening health conditions.
Conclusion
The agreement between public sector unions and the government marks a positive step in resolving the concerns surrounding the transition from NHIF to SHA. The government’s commitment to extending the medical insurance scheme for public servants, ensuring job security for NHIF employees, and providing seamless healthcare services under SHA has brought relief to many union members.
As the transition continues, both parties will need to maintain open communication to address any challenges that arise. With SHA playing a key role in the government’s vision for universal healthcare, it is essential that all stakeholders work together to ensure that every Kenyan has access to high-quality healthcare services.
