Hospitals start turning away teachers, police over insurance debts
Teachers and police officers are starting at a health crisis as hospitals start denying them services after their insurance provider failed to pay claims running into billions of shillings.
Police officers deployed to protect the Executive, the Legislature, Judiciary, Cabinet secretaries, principal secretaries, parastatal heads, security installations and MPs are among thousands of those affected.
The National Treasury has a Sh29 billion contract with Medical Administrative Kenya Limited (MAKL).
Reports indicate the Teachers Service Commission (TSC), the National Police Service (NPS) and the Kenya Prisons Services (KPS) have not released capitation funds to both private and public hospitals for medical services offered to their employers.
In the last seven months, some of the contracted hospitals have not been paid their dues. This has left more than 452,635 teachers and tutors without access to medical services in the country.
On Sunday, Rural and Urban Private Hospitals Association (Rupha) Chairman Brian Lishenga confirmed that hospitals had started turning away patients from the affected groups.
“What is happening is that Individual private hospitals are presenting official letters declaring they have suspended services,” Dr Lishenga told the Nation.
This, he said, is because “the private insurers who sort out police and teachers have not kept their end of the deal on payments to the private hospital.”
Hospitals that have discontinued services include AGC Tenwek, Siloam, Chelymo hospitals in the South Rift region, Kisi Teaching and Referral Hospital in Nyanza, and Raele hospital in Uasin Gishu and others spread across the country.
Disruption of the services affects not only those on referral cases but also normal admissions and outpatient services.
The management of AGC Tenwek Hospital discontinued the services on February 1.
“This decision has been made due to an outstanding payment owed by MAKL for services already rendered,” it stated.
“MAKL members will be required to pay in cash for all services. This measure is necessary to ensure the sustainability of our services”
The defunct NHIF owes Tenwek Hospital Sh560 million while the Social Health Authority (SHA) owes the hospital Sh120 million as of January 31, 2025.
“Both the defunct NHIF, SHA and MAKL have not paid over Sh1billion to AGC Tenwek hospital,” said Dr Robert Langat, the hospital’s board chairman.
“We have taken the matter before the Cabinet Secretary and Principal Secretary for Health, yet there is no solution to the problem. We have never been faced with this kind of crisis before,” Dr Langat said.
Kisii Teaching and Referral Hospital (KTRH) suspended the services from January 27, 2025.
Reale Hospital in Uasin Gishu County has also issued a notice to the teachers that they would not be offering the services.
Mr Collins Oyuu, the Kenya National Union of Teachers (Knut) secretary-general and the Kenya Union Post Primary Education Teachers (Kuppet) Chairman Omboko Milemba warned that the crisis would disrupt learning in schools if TSC does not address the plight of their members.
“Mr John Mbadi, the Cabinet Secretary for National Treasury should intervene,” Mr Milemba said.
“The disruption of medical services for teachers affects households across the 47 counties. Sick teachers cannot pay from their pockets and offer quality services to learners,” Mr Milemba said
Mr Oyuu said it was unfortunate that teachers were being turned away from hospitals.
“It is sad teachers suffering from terminal illness and those on maternity leave, cannot be treated due to failure by the employer to release capitation money to the insurance provider,” Mr Oyuu said.
“We cannot sit back and watch as the teachers suffer.”
TSC boss Nancy Macharia recently said the commission had not received funds from the National Treasury.
Teachers and their family members are entitled to outpatient, in-patient, maternity, dental, optical, psychiatric and counselling services, air and road evacuation, funeral benefits, international referrals and travel allocation benefits.
The medical scheme covers more than 800 facilities— including public, faith- based and private hospitals.
A source at the police headquarters said the officers were jittery after hospitals turned them away and their dependents.
“This is a serious matter that is being pursued by the National Treasury to have medical services resume in the affected hospitals countrywide,” a senior police officer stated.
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