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Duale: We will crack down on doctors over SHA claims

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Health CS Aden Duale at a past event. 

Photo credit: File

The Social Health Authority (SHA) will no longer pay claims from private facilities filed by doctors employed in public service during official working hours, Health Cabinet Secretary Aden Duale has said.

Mr Duale put doctors working in public hospitals on notice over what he termed chronic absenteeism, driven by the pursuit of extra income in private hospitals.

Speaking in Tharaka Nithi County on Tuesday while commissioning an Intensive Care Unit at Chuka Level Five Hospital, Mr Duale maintained that doctors employed by the government must operate from their workstations between 8am and 5pm.

“Recently, I met private and faith-based hospital owners. A private hospital owner confidently said that her doctors work in the county referral hospital. According to the healthcare workers’ rules, each is required to deliver full service to the person they have a contract with. You are paid to work from 8am to 5pm.”

“From January, the Digital Health Agency system will enforce the rule to ensure that SHA will only reimburse a claim where a doctor is properly employed at the facility. If you go to a private facility during official working hours, SHA won’t pay you,” Mr Duale said.

Diversion of patients

The CS said the practice has become widespread, with some doctors deliberately diverting patients from public facilities to private hospitals.

“It is unacceptable for a doctor to be on the government payroll and at the same time send patients away so they can make money elsewhere during working hours. Some doctors in public hospitals give far-off review dates but offer a closer appointment in a private facility. This is fraud, and it will not be tolerated,” he said.

The Health CS cited Kenyatta National Hospital as one of the hardest hit by specialists keen on earning more from locum work.

“Kenyatta National Hospital has 26 fully equipped theatres and highly qualified specialists, but patients are always in a queue. A patient is told to wait two months in a public hospital, only to be called later and offered treatment the next day in a private hospital. That is deliberate manipulation of the system,” he said.

The CS directed the Digital Health Authority to take firm action against health workers who make claims outside their registered public health facilities during official working hours.

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