The NHIF and Kemsa scandals could bring down more of President William Ruto’s appointees at the Ministry of Health.
MPs on Tuesday said acting NHIF CEO Samson Kuhora and acting Kemsa boss Dr Andrew Mulwa could be at the centre of the multi-billion shilling scandals recently uncovered at the two institutions.
They said Dr Kuhora was in charge of reimbursements at NHIF when private hospitals were paid billions of shillings for questionable surgeries that killed some elderly Kenyans.
Kuhora headed NHIF’s department of benefits designs and claims management before the fund’s board appointed him acting CEO on March 9, 2023.
NHIF paid most of its funds to private hospitals in the last financial year.
Of particular interest are six private facilities that recruited thousands of elderly Kenyans with arthritis and carried out unnecessary knee surgeries on them, each costing Sh300,000.
Some patients died.
Members of the National Assembly Health Committee invited the management of both Kemsa and NHIF for grilling on Tuesday.
However, Medical Services PS Harry Kimtai sent a regret letter saying NHIF bosses were holed up in an “urgent crisis meeting” and could not appear before the MPs.
The committee instead grilled Health CS Susan Nakhumicha and Dr Mulwa, the acting CEO of the Kenya Medical Supplies Authority, for three hours at a hotel in Nairobi.
The committee questioned why Dr Mulwa was appointed acting Kemsa CEO yet it is his office, then at MoH, that recommended Kemsa to make changes to the Sh3.7 billion mosquito net tender.
Kenya lost Sh63 million ($455,000) after the financier, the Global Fund, pulled out of the process and instead moved the procurement to its own platform.
“We will open a full inquiry because we have formed a proper basis and we broaden our scope. If we are able to tackle Kemsa and NHIF then UHC will be delivered, “ said the committee chairperson Dr Robert Pukose.
Nakhumicha defended Kuhora and Mulwa saying the two were appointed to head NHIF and Kemsa respectively, based on the best available information at that time.
“Picking the acting NHIF CEO was a difficult decision but he was the senior-most official at that time, otherwise we’d have brought a junior staff, so we got Kuhora who demonstrated understanding of the institution,” Nakhumicha said.
Dr Kuhora, a pharmacist, was first hired by NHIF in 2017 as the manager in charge of healthcare contracting.
He became head of claims management in 2019, where, he says on his Linkedin profile, he managed “a US $500 million a year medical claims docket at the national insurer.”
He was promoted to head claims and benefits department in 2019, until March this year.
Nakhumicha said picking him as acting CEO was probably a bad decision.
“By the time we were settling on Kuhora, we were reorganising the ministry and putting everything in place. It could have been a bad choice but we are in active recruitment for a substantive CEO,” she said.
Kisumu Central MP Joshua Oron also said this was not a wise decision.
“The current CEO has been head of claims and contracting, the problems are for the last year not when he's been in the current office. Last Friday one hospital was paid Sh52 million, did NHIF carry out an audit?” he asked.
Nakhumicha admitted that one private hospitals received the lion's share of the Sh11 billion the National Treasury sent to NHIF on June 10.
“I had already asked the board to do investigations. It’s not just the six facilities, we have a big problem. Over the payments made this month, the top facility to be paid is one we have suspended,” she said.
“You can't have a small private facility doing more surgery than KNH, Moi Referral or Nairobi Hospital, there's a problem. There will be casualties but bear with me.”
Nakhumicha temporarily closed the facilities on Monday and ordered them to transfer patients to other hospitals.
They include St Peters Orthopaedic Hospital near Kinoo in Kiambu county; Jekim Hospital Nkubu, Jekim Medical Centre, Joy Nursing and Maternity Hospital, Afya Bora Hospital, Afya Bora Hospital Annex and Amal Hospital.
Vice-chairperson of the committee Patrick Munene said the scandals will bring down more public officials.
He said the ministry had become a laughing stock for picking “architects” of scandals as heads of its semi-autonomous agencies.
“The whole county is laughing at us when we picked the head of claims as acting CEO. Even as you appoint people and fire others don’t let them make you look like a fool,” he told the CS.
In his presentation, acting Kemsa CEO Dr Mulwa said he allowed the head of malaria department, whom he did not name, to vary the Sh3.7 billion mosquito nets tender, to include aspects of the insecticide required.
He said the official wrote an advisory to former PS Josephine Mburu, who ordered a retendering.
He said the tender was initially launched on January 31, 2023, as an international open tender, with a bid deadline of February 23. However, it was extended to March 23 after communication from the PS.
In its investigation, the Global Fund accused the ministry and Kemsa officials of interference, and illegal changes of specifications to inflate the cost.
The fund, which was paying for the nets, instead moved the procurement to its Wambo.org process.
Dr Mulwa, who spoke with apprehension, attempted to extricate himself from the mess.
He was head of disease prevention and health promotion when the tendering took place.
“We were in a workshop when the head of malaria told me the tender needs a PBO (Piperonyl butoxide, an insecticide that repels mosquitoes). I told him if you think there’s a problem please do a memo. I realised the changes after Kemsa had changed the tender. I have all memos from my office and they have my signature, but this memo does not have my signature,” he said.
He also said generic specifications for mosquito nets were developed in 2016 when he worked as Health CEC in Makueni.
“I was not at the ministry. These specs were developed to guide all procurements. The inclusion of PBO was done in 2016,” he said.
Webuye East MP Martin Pepela accused the ministry of hiring tainted officials.
“The people being glorified and promoted are the architects and cartels in the scandals. We will go into a full inquiry,” he said.