Private hospitals must reduce health cost, CS Mutahi Kagwe says
Health Cabinet Secretary Mutahi Kagwe in Mombasa on January 4, 2022.
What you need to know:
- CS Kagwe maintains that the private sector must change its business model to reflect the current times.
- National Health Insurance Fund has in recent days threatened to turn away patients using their cards.
The Ministry of Health has said private hospitals must reduce the cost of healthcare as part of a deal to break their stalemate with the National Health Insurance Fund.
Talks between the private facilities and the national medical insurer on new contracts are on after they initially refused to renew contracts citing reduction in cash to be reimbursed by the insurer.
But Health Cabinet Secretary Mutahi Kagwe maintained that the private sector must change its business model to reflect the current times as the government’s objective is to bring down the cost of healthcare.
“There are some things that will not happen and must change. We will not go back to hospitals charging high prices for services. There is a procedure being charged Sh6,000 in public hospitals with better equipment than private hospitals who charge Sh60,000 for the same procedure,” he said.
He said a procedure costing Sh60,000 at Kenyatta National Hospital goes for Sh400,000 in a private hospital, yet all the fees are paid by the National Health Insurance Fund (NHIF).
“Is it just me who is not seeing the logic here? Something is not right and not attainable and cannot continue... Kenyans must not cough more money from their pockets to pay for health when they are already paying monthly contributions to the NHIF.”
Mr Kagwe said life is already tough for many people and costly healthcare is worsening the situation and amounts to exploitation.
Turn away patients
“When we have NHIF cards, whatever we agree as the government as the charge for a service is what will be paid by NHIF irrespective of the hospital. Patients should not add more money after the services are rendered.”
On Monday, Ministry officials and the private stakeholders met and agreed to deliberate on the findings after two months of engagement. They announced a five-month NHIF contract extension. The facilities had threatened to turn away patients using the NHIF cards.
“We held a meeting and decided that we continue with the old contract until we reach a consensus on the harmonisation of the contracts so that we avoid a situation where some hospitals charge exorbitantly,” the CS said.
“We don’t want a situation where we close private hospitals. We are working as partners, but we have conditions. We must give Kenyans quality and affordable healthcare.”
The key to the success of the changes is ensuring public hospitals are well equipped with infrastructure and personnel to provide a viable alternative to the private sector, he said.
“Unless this is done, Kenyans are going to be exploited and they will continue to suffer, but as long as the government and county hospitals are properly run and well equipped, the partnership between the private sector and the public sector will be on an equal basis. That’s why we must invest in equipping hospitals.”
The NHIF and the Kenya Association of Private Hospitals were for the last two weeks embroiled in a war of words, with the service providers saying they stop serving NHIF card patients.
The Fund, on the other hand, indicated that the facilities had to sign the contracts they were being given. It took the intervention of the government to bring them to a meeting. They agreed to work together for mutual benefits. The old contracts were extended until the end of June, with new contracts to be signed by July.
Government stand
However, there seems to be no end in sight to the impasse after Mr Kagwe, who was also part of the meeting, said Kenyans should not be subjected to costly healthcare, maintaining the initial government stand.
For her part, Dr Mercy Mwangangi, Chief Administrative Secretary, said one of the components of the meeting was to look at different prices and payment for different NHIF packages.
“We will review the current payment rates as we discuss how to ensure care is affordable and sustain for both private sector and Kenyans,” she said.
“The affordability is very important, particularly because we have a vision on ensuring we move towards the attainment of Universal Health Coverage. The Fund is an important player in ensuring care and service delivery is affordable to all Kenyans.”
The doctors had earlier protested that the new contracts were hurriedly executed, hence implementation would be counterproductive. They said they had not been given time to look at the contents and the input of private hospitals was not sought, save for a few providers. They added that the new fees for most services had been slashed and that would hurt their operations.
For instance, for appendectomy (removal of the appendix), the combined rate proposed by the NHIF suggests that doctors’ fees and hospital charges should not exceed Sh40,000. However, under KMPDC guidelines, doctors’ fees range from Sh60,000 to Sh120,000, while anaesthetists are allocated Sh20,000.
For haemorrhoid surgery (to remove swollen blood vessels inside or around the anus and rectum) KMPDC guidelines for doctors’ fees is from Sh70,000 to Sh150,000; but for NHIF, the services should not exceed Sh24,000.
He said the process of developing the contracts was unprocedural, lacking meaningful engagement, and Kenyans would be on their own.
Impoverished families
Meanwhile, Mombasa Governor Hassan Joho has joined Mr Kagwe in backing the NHIF reforms, saying it will cut of healthcare costs. The two said cancer burden has impoverished many families, forcing them to sell their property to get money for treatment of their members battling with the disease. They further urged Kenyans to enrol for NHIF cover.
“Under the Universal Health Coverage (UHC), the key facet is access, cost and standards of healthcare,” said the CS.
He spoke after opening the recently equipped Coast General Teaching and Referral Hospital (CGTRH) regional cancer treatment centre. It now has state-of-the-art treatment facilities, including radiotherapy machines.
Speaking on World Cancer Day, which was nationally marked at the CGTRH in Mombasa, Mr Kagwe warned politicians against politicising healthcare matters and urged to instead sensitise Kenyans to register as NHIF members.
“We are in an electioneering period. Let's pray the incoming government continues with the gains we have made and not destroy what we have built. Let’s never politicise healthcare; diseases do not discriminate.”
Governor Joho said: “Even as I leave office, I will stick to the national insurer due to its benefits. I have even forced my sons and daughters to enrol for NHIF. It is responsive and easily accessible."
The CS urged politicians to focus on the successes of President Uhuru Kenyatta in the health sector.
“If I look at the patients here, will I know the political party they support? I don’t know who is in Kenya Kwanza, Azimio la Umoja, or any other formation. Even as we focus on the political front, let’s never forget our hope and prayer that what is being done by the Head of State can continue, grow and improve,” he said.
