Teachers up in arms over medical scheme

They lamented that some of the hospitals listed by the scheme are inaccessible to patients on wheelchairs because they are located in tall buildings, while others are far from teachers’ locations.

They also complained that approvals for scans take too long, forcing the teachers to give up and seek services in unaccredited hospitals.

“The medical scheme has limited the number of days a teacher can visit a hospital to once every seven days, meaning that a teacher’s medical card cannot be used twice in a week. This means that once a teacher has gone to a hospital within a week, their dependants cannot access treatment within that week,” explained a teacher.

The Kenya National Teachers Pressure Group, a lobby comprising teachers in primary and secondary schools and teacher training colleges, is piling pressure on the Teachers Service Commission (TSC) to revoke the medical scheme or provide a better one for teachers. Group spokesperson Martha Omollo, a teacher in Nairobi, yesterday said TSC had forced teachers to register with AON Minet without allowing them to participate in the process of identifying and picking the scheme administrator and health provider.

“Forcing teachers into the AON Minet medical scheme was unconstitutional, and a violation of the TSC Act (2012) and the code of regulations for teachers,” said Ms Omollo. Other officials of the group are Mr Salvin Munene (Eastern), Mr Nelson Kirui (Rift Valley), Ms Eva Muchemi (Nairobi), Ms Betty Koech (Rift Valley), Ms Ann Wanyoike (Nairobi), Mr Mwangi Kinyua (Nakuru) and Mr Fanuel Ambole (Machakos).

Serious challenges

Ms Omollo said teachers must allowed to choose a scheme that meets their needs. Teachers have accused Kenya Union of Post Primary Education Teachers (Kuppet) and Kenya National Union of Teachers (Knut), of colluding with TSC to allow the AON Minet medical scheme to continue providing services to teachers.

“AON Minet is a cash cow for union officials and the TSC. No serious hospital has been approved except a few private hospitals that are not accessible to all teachers,” said a teacher.

To seek treatment in some big hospitals, approvals take up to a month, said the teachers. On Sunday, a secondary school teacher in Kisumu County lost her 16-month-old baby after AON Minet delayed to approve the baby’s referral to a better hospital.

Kuppet Nairobi branch secretary Moses Mbora admitted that teachers have been facing serious challenges when seeking treatment using the AON Minet medical card. Mr Mbora said most of the challenges teachers are to do with delays of approvals and some hospitals overcharging.

He said teachers suffering from chronic illnesses and expectant mothers who deliver babies before 37 weeks often pay extra.

He said the union has raised the issues with TSC. The Nation has also learnt that other union’s branch secretaries both in Kuppet and Knut have also been stepping in to help teachers. 

Teachers said some approved hospitals lack drugs, while, in some instances, the medical scheme refuses to clear bills for some hospitals. 

In most of the approved hospitals, there are no doctors and patients are attended to by nurses.

“Teachers don’t want AON Minet, it is just a scam and a true definition of frustration. They want a medical scheme negotiated by them because it’s their money,” said Ms Omollo. Speaking to the Nation yesterday, Knut Secretary General Collins Oyuu said the comprehensive medical cover was the best thing teachers got and said the union was addressing the challenges.

Medical scheme contracts

“AON Minet, just like any other organisation, may have challenges. As a union, we will continue to engage them and ensure teachers get better services,” said Mr Oyuu. Kuppet Secretary General Akelo Misori said it is not within the union’s powers to sign medical scheme contracts, which is TSC’s role.

“Whoever is calling for the revocation of the medical scheme is being mischievous and is malicious. What I know, is that even during this Covid-19 period, the teachers’ scheme was the first to cover Covid cases. It is, however, not a perfect scheme, and that provides opportunity for improvement,” said Mr Misori.

Mr Misori said when the medical scheme was introduced in 2015, Kuppet moved to court to stop it, but teachers said they wanted it, and the union abandoned the case.

According to TSC, teachers’ medical scheme covers over 1,036,000 people — 332,000 registered teachers and their dependants. The medical covers inpatient, outpatient, optical, dental, maternity, group life and last expense (funeral) expenses.

Teachers are also able to travel out of the country to seek medical treatment under the scheme, which has approved more than 500 hospitals and clinics across the country.

Efforts to get a comment from TSC boss Nancy Macharia, and AON Minet CEO Sammy Muthui, were futile as calls and text messages sent to their mobile phones went unanswered. The Nation also sent emails to TSC and AON Minet but there was no response.

When we sought an appointment with Mr Muthui, officials in his office took our contacts promising to get back but they are yet to do so three days later.

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