Governors, MoH lock horns over Sh8 billion owed by NHIF to county hospitals

Governors have locked horns with the Ministry of Health over Sh8 billion owed to county hospitals by the National Health Insurance Fund.

The county bosses are demanding that NHIF clears the arrears before the transition to the Social Health Insurance Fund scheduled for July 1 – a week away.

On Friday, Health CS Susan Nakhumicha and the CoG leadership led by its chairperson Anne Waiguru were holed up in a meeting to resolve the outstanding concerns.

Addressing a press conference at the Council of Governors' office, Health Committee chairman Muthomi Njuki said failure to clear the arrears will plunge the facilities into a state of uncertainty.

“As we transition, we do not want to see a situation where the Sh8 billion becomes a pending bill for the public facilities,” Njuki said.

“We urge that the facilities whose debts have not been paid to be settled by NHIF. That is the only way we are going to transition to SHA (Social Health Authority) having no debt with county facilities."

Speaking on the meeting outcomes, the CoG chairperson said the outstanding debt was part of the agenda tabled during their discussions with the CS.

“We have agreed that the Ministry of Health shall ensure that Sh8 billion owed to counties by the defunct NHIF will be paid,” Waiguru said.

The Kirinyaga governor further revealed that the MoH and county governments shall conduct a public campaign on the roll-out of member registration to the SHA.

Further, the two parties shall have a continuous engagement to ensure effective implementation of Universal Health Coverage.

“We have been given the confidence by the ministry that (the transition) is progressing well. In the interim, they have agreed that they will use the system and the data that already exist under the defunct NHIF as they roll out SHIF,” she said.

Waiguru added, “They will be validating and hopefully in the next couple of months, they will fully have transitioned.”

The ministry will also channel funds set aside for payment of community health promoters to the counties.  

The MoH will also support county governments in the rollout of a comprehensive integrated information system for the facilitation of health service delivery.

“The Ministry of Health shall cover all costs about the roll-out and maintenance of the integrated health management system,” she said.

Meanwhile, governors have protested a plot by the National Treasury to slash county allocation for the 2024-25 Financial Year by Sh5 billion to manoeuvre cash flow challenges.

They termed the move as unconstitutional and against the spirit of devolution.

“This unilateral decision not only undermines the spirit of devolution but also jeopardises the essential services delivered to millions of Kenyans,” Waiguru said.

The law shields county governments in the event of a cash flow challenge by the Kenya Revenue Authority.

She cited section 5(1) of the Division of Revenue Act, 2024 which stipulates that whenever there is a shortfall in the revenue raised nationally, the shortfall shall be borne by the national government.

“We therefore wish to state unequivocally that the Council rejects this proposal in totality and demand that the National Treasury retains the County Equitable share as enumerated in the Division of Revenue Act, 2024.” 

The county chiefs spoke a day after the Treasury revealed intentions to cut the budget by about Sh200 billion.

Parliament allocated the devolved units Sh400 billion in the next fiscal year.

In addition, the governors demanded that the Treasury release Sh63.6 billion pending disbursement for the months of May and June.

Waiguru said county operations have been negatively affected.

"Many counties are unable to pay salaries. We are calling on the Treasury to release the money."