The NHIF scandal is the latest case of misappropriation of public funds that has left a bitter taste in the mouths of Kenyans. It emerges that some clinics were paid millions of shillings in advance to provide out-patient services to civil servants, despite their glaring lack of capacity. The outpatient medical scheme for civil servants was rolled out in January this year, and NHIF was to pay suppliers at the beginning of each quarter.

The scandal came to light following the Central Organisation of Trade Unions’ (Cotu) threat of a national workers’ strike mid this month to oppose the planned increase in NHIF monthly rates. Cotu Secretary-General, Francis Atwoli, accused NHIF of paying insurance premiums to ‘ghost clinics’ under the civil servants’ medical scheme, a claim he used to argue against the new proposed NHIF rates increase.

“There was no consultation in the way this scheme was being implemented and in the way that the rates were increased but this time we are going to be involved and we are going to ask many questions including on rates, the capacity of NHIF and also on the facilities,” said Atwoli who insisted that COTU will remain vigilant on the issue.

NHIF: The rising of rates and why it is contentious

The new NHIF rates which were to take effect next month but have since been suspended, will see those earning more than Sh100, 000 pay Sh2, 000 per month, representing a 600 per cent increase. Those who earn less than Sh6, 000 will pay Sh150 while the self-employed will pay Sh500 and volunteers will part with Sh300. The current monthly remittance to NHIF for the highest salaried employee is Sh320, while those earning less than Sh6, 000 pay between Sh30 and Sh120.

It’s alleged that in the first quarter NHIF paid out more than Sh600 million and that virtually half of this amount went to two companies namely Clinix and Meridian (Medical Center). At the time this money was paid out, more than half of all the clinics under these institutions did not exist. It was also revealed that the biggest referral hospital Kenyatta National Hospital, with 26 departments handling thousands of patients daily only received Sh1 million, while Meridian Medical Center in Kisumu, which on a busy day handles on average 20 patients received Sh4, 874,500, but Mbagathi District Hospital was only allocated Sh61,000.

Pressure has been put on Medical Services Minister Anyang’ Nyong’o, who has been accused of presiding over the rot at NHIF to resign. Bonny Khalwale who chairs the Public Accounts Committee( a parliamentary watchdog that tracks government spending) demanded that Prime Minister Raila Odinga intervene and prevail upon Nyong’o to resign over the Sh4 billion scandal or the minister faces censure in Parliament. The Ikolomani MP had promised to move a motion in Parliament to pass a vote of no confidence in the Minister over the controversial medical scheme.

NHIF: Board-members given walking orders and a probe to be launched investigating spending

The Prime Minister Raila Odinga has since then sent the entire NHIF board packing and called in the government’s Efficiency Monitoring Unit to conduct a probe into the controversial payments and President Kibaki has demanded a speedy probe into the scam and promised tough action on the culprits.

A telephone conversation between Kerich and Thakker presented to the press on Tuesday morning by a lobby group, Bunge La Mwananchi, has however heightened the controversy surrounding the scam and has put COTU chairman Atwoli, on the spotlight as well. The lobby group is now calling for the resignation of Atwoli and representatives from the Federation of Kenya Employees from the caretaker committee, whom they say, will interfere with the investigations as they are also part of the interested parties.

“We are calling on the cabinet to allow us to present more proof on the NHIF scandal as I have done enough investigations, said the president of Bunge La Mwananchi Cidi Otieno.

NHIF: Questions arising over the existence of ‘ghost’ facilities to which payments were made

The Parliament’s Health Committee is planning a national tour of all accredited facilities to assess their capacity and have so far pointed out that some service providers have begun ambitious expansion plans using the pre-payments. The parliamentary team has also concluded that Meridian Medical Centre was awarded Sh30 million for ghost facilities under the ambitious Sh4.2 billion healthcare scheme for civil servants, while Clinix Healthcare received Sh202 million compared to Kenyatta National Hospital that received only Sh1 million.

Clearly, the NHIF’s choice of service providers is questionable and the outrageous allocation of funds to the private clinics raises eyebrows and particularly its decision to pay accredited hospitals and clinics in full even before they deliver their services. But alas! It’s the election year once again and such fraud cases involving multi billion shillings being misappropriated from public coffers are not new. Just the other day it was revealed that more than 200 million was, well, ‘misplaced’ in the budget estimates (another typing error, if you may)

The newly established Independent Electoral and Boundaries Commission (IEBC) has been given the task to ensure State resources are not misused in next year’s general elections and the law gives it the much needed ‘teeth’, it remains to be seen just how far can it flex its muscles.