Health Cabinet Secretary Aden Duale has issued a stern warning to hospitals across the country, saying any facility that refuses to treat patients covered under the Social Health Authority (SHA) will face serious consequences, including suspension from the programme and possible loss of its operating licence.
Speaking on Tuesday, the CS said some health facilities contracted under the scheme had begun turning away patients while citing system failures or payment disagreements with the authority. He said such conduct is unacceptable and violates the law because hospitals that signed agreements with SHA are required to provide services to patients under the programme.
“There are certain health facilities in our country that want to deny Kenyans to use their cover under SHA, and they give a lot of reasons,” Duale said.
“Sometimes they say the system is down. Sometimes they say we have a problem with the payments.”
The CS said once a facility signs a contract with the authority, it becomes legally bound to serve patients enrolled in the scheme and cannot refuse them care because of internal disputes or delays in reimbursements.
“You have signed a contract agreement by law with the Social Health Authority,” he said.
Duale said denying patients treatment under the programme goes against the constitutional right to healthcare and will not be tolerated by the government.
“If we find that you have denied a Kenyan his basic constitutional right to the attainment of health care, not only shall we suspend you from the portal of SHA, we will go further and deny you the licence to operate,” he said.
His remarks come at a time when concerns have been growing among the public after reports that some hospitals had declined to treat patients under the new system. In several cases, facilities reportedly cited system outages or unresolved reimbursement claims as reasons for refusing to offer services.
According to the CS, such actions place patients at risk, especially when they require urgent medical attention.
“You are denying a patient who is sick, who can die anytime because of your greed that SHA has not paid you,” he said.
Duale insisted that healthcare providers must continue serving patients as the authority processes payments in line with the law.
“SHA will pay you in accordance with the law,” he said.
The Social Health Authority was introduced as part of wider health financing reforms aimed at expanding universal health coverage in the country. The system replaced the former National Health Insurance Fund, with the government saying the new framework is meant to help more Kenyans access affordable treatment in both public and private hospitals.
The CS emphasised that hospitals that have joined the programme must place the wellbeing of patients first instead of allowing financial disagreements to interfere with treatment.
He warned that the ministry will closely watch facilities suspected of breaching their agreements with the authority and take action where necessary.
Duale said enforcement will be strict to ensure all contracted hospitals follow the terms of their agreements and that no patient is turned away unfairly.
“If we find that you have denied a Kenyan his basic constitutional right to the attainment of health care, not only shall we suspend you from the portal of SHA,” he said, reiterating the government’s position.
He added that stronger disciplinary measures could also be taken against facilities that continue denying patients services.
“We will go further and deny you the licence to operate,” he said.
Duale’s remarks signal a tougher approach by the government as it moves to enforce compliance with the new healthcare system and ensure that patients covered under the scheme are able to access treatment without barriers.
The Health CS said the government remains committed to protecting every Kenyan’s right to healthcare and urged hospitals participating in the programme to honour both their legal and ethical responsibilities.
“SHA will pay you in accordance with the law,” he said.
“But you cannot deny a patient who is sick and who can die anytime.”