Duale cracks down on doctors over SHA claims

Health Cabinet Secretary Aden Duale has announced a tough crackdown on doctors filing claims with the Social Health Authority (SHA) while working in public hospitals during official hours.

Speaking on Tuesday while commissioning an Intensive Care Unit at Chuka Level Five Hospital, Mr Duale warned that private facilities will no longer be reimbursed for claims submitted by government-employed doctors during their official 8 a.m. to 5 p.m. work hours.

“Recently, I met private and faith-based hospital owners. A private hospital owner confidently said that her doctors work in the county referral hospital. According to the healthcare workers’ rules, each is required to deliver full service to the person they have a contract with. You are paid to work from 8 a.m. to 5 p.m.,” said Mr Duale.

The Health CS said the move comes in response to chronic absenteeism, with some doctors deliberately diverting patients from public hospitals to private facilities to earn extra income.

“It is unacceptable for a doctor to be on the government payroll and at the same time send patients away so they can make money elsewhere during working hours. Some doctors in public hospitals give far-off review dates but offer a closer appointment in a private facility. This is fraud, and it will not be tolerated,” he said.

Mr Duale cited Kenyatta National Hospital as one of the hardest-hit facilities. “Kenyatta National Hospital has 26 fully equipped theatres and highly qualified specialists, but patients are always in a queue. A patient is told to wait two months in a public hospital, only to be called later and offered treatment the next day in a private hospital. That is deliberate manipulation of the system,” he said.

He added that starting January, the Digital Health Authority will enforce the rule, ensuring that SHA reimburses claims only for doctors properly employed at the facility. “If you go to a private facility during official working hours, SHA won’t pay you,” Mr Duale warned.

The CS directed the Digital Health Authority to take strict action against health workers filing claims outside their registered public health facilities during official working hours.