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Where are the arrests? Hospitals challenge Duale to prosecute after Sh11bn fraud claims
Health Cabinet Secretary Aden Duale during an interview in Nairobi on January 26, 2026.
What you need to know:
- Health Cabinet Secretary Aden Duale vowed to recover the money from reimbursements meant for hospitals.
- In August last year, Duale said the government had flagged about 1,029 rogue hospitals that had attempted to defraud SHA.
Private hospitals are demanding greater transparency from the Health Ministry following an audit that links them to fraud within the Social Health Authority (SHA).
Health Cabinet Secretary Aden Duale told the Nation in an exclusive interview that between October 2024 and April last year, the country lost Sh11 billion to fraud. The CS vowed to recover the money from reimbursements meant for hospitals.
In August last year, Mr Duale said the government had flagged about 1,029 rogue hospitals that had attempted to defraud SHA, adding that detecting them in time saved the country about Sh10.6 billion in taxpayers' money.
"Since I took office on April 1, we have intensified the fight. Our comprehensive system was specifically designed to detect and eliminate the very vulnerabilities that plagued the defunct National Hospital Insurance Fund (NHIF)," he said at the time.
President William Ruto has also expressed confidence in the SHA system, describing it as a robust fraud detector.
"The theft that collapsed NHIF into Sh30 billion debt will not happen under SHA. The digitisation of SHA is what enables us to detect all fraudulent claims, all ghost hospitals, and all fake patients attempting to commit fraud," he said in August last year.
Kenya Healthcare Federation CEO Dr Tim Theuri.
Reacting to the allegations on behalf of the Kenya Healthcare Federation, its chief executive officer, Dr Tim Theuri, said the SHA system operated by the Digital Health Agency should have the capacity to list fraudulent transactions and identify those responsible.
"Blanket condemnation leads to bearish markets, and investor money leaves the sector because the majority of providers are acting in good faith," Dr Theuri said.
"What we want is transparency, not mere visibility. Publication of payment information should resume if the system is truly robust. What SHA collects and what it pays out should be public knowledge. Selective visibility is performative, not collaborative," he added.
A 2023 Kenya Health Facility Census conducted by the Health Ministry shows that about 46 per cent of healthcare services in the country are provided by private hospitals.
Sh10 billion debt owed to hospitals
Dr Theuri said this explains why the private sector accounts for the majority of claims, adding that it reflects Kenyans' trust in private care.
"We have repeatedly asked that fraudsters be weeded out to improve confidence in the sector. Ultimately, the top 50 providers account for 80 per cent of payments, and you will find that all government referral hospitals are among them. If the government is stealing from itself, then the problem is not the private sector," he said.
In December last year, a parliamentary committee on health recommended that the government settle within 90 days a Sh10 billion debt owed to hospitals from the transition from the defunct NHIF.
Dr Brian Lishenga, chairperson of the Rural and Urban Private Hospitals Association of Kenya (Rupha), also responded to the ministry's claims. He alleged a pattern in the healthcare system where hospitals' requests for payment are sidelined with new distractions.
"It is predictable that every time these calls rise, we see this kind of pushback. When you ask for settlement of valid claims, hospital bills, or NHIF arrears, you can expect that the immediate response will be allegations of fraud," Dr Lishenga said.
"We are shocked. If the Cabinet Secretary has evidence that Sh11 billion has been lost, we call immediately for prosecution — prosecution of SHA officials who authorised the payments, and arrest of hospital owners and chief executives who may have been involved," he added.
Dr Lishenga expressed concern that no one has been publicly prosecuted after the ministry delisted more than 1,000 hospitals for allegedly defrauding the system.
"We heard the ministry claim that Sh10.2 billion had been lost. That figure has now shifted to Sh11 billion. If this is indeed happening, we, on behalf of the people of Kenya, are requesting to see genuine efforts to recover these resources, because these are contributions by Kenyans," he said.
