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Duale confronted with sad cases of medics denied care over SHA payment delays
Health Cabinet Secretary Aden Duale addresses the media at the Ministry of Health headquarters in Nairobi, on April 10, 2025.
What you need to know:
- Mr Duale asked the National Treasury to deduct statutory contributions for SHA at source to ensure doctors and other healthcare workers access timely medical care.
- Mr Duale’s remarks came amid mounting frustration among doctors, many of whom say they are being denied treatment under SHA despite regular deductions.
Health Cabinet Secretary Aden Duale has revealed shocking details of how frontline medical workers are denied the very services they provide to Kenyans due to delays in the State and counties remitting their Social Health Authority (SHA) deductions in time.
Mr Duale asked the National Treasury to deduct statutory contributions for the Social Health Authority (SHA) at source to ensure doctors and other healthcare workers access timely medical care, a benefit that has remained elusive since the scheme’s rollout.
“It is immoral and unacceptable that those who deliver care cannot access the same care when they need it. It’s not SHA that locks you out, it’s the system,” Mr Duale said.
He was addressing delegates at the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Annual Scientific Conference at Pride Inn Paradise in Shanzu, Mombasa.
“I will take the proposal that SHA contributions be deducted at source, both at the national and county levels, to the National Treasury. We cannot build a successful UHC model without safeguarding the welfare of healthcare professionals,” he said.
Mr Duale’s remarks came amid mounting frustration among doctors, many of whom say they are being denied treatment under SHA despite regular deductions appearing on their payslips.
KMPDU officials narrated cases of doctors being turned away at top hospitals due to delayed remittances by counties.
Mombasa Governor Abdulswamad Nassir supported the proposal, stating that deducting statutory obligations at source was “common sense” and would end the cycle of unpaid arrears and denied services.
“When you have a situation where the person paying is different from the one you work with, that is a recipe for chaos. There is nothing wrong with Treasury deducting at source. Doctors should not be left to suffer due to bureaucratic lapses,” said Mr Nassir.
The push to reform SHA was among several urgent issues discussed at the health workers' forum, where participants decried systemic failures in the public health system, ranging from chronic underfunding to delayed salaries, training gaps, and staff shortages.
KMPDU Secretary-General Dr Davji Atellah said the union had resolved to postpone planned nationwide strikes for two weeks to give room for talks with national and county governments.
“We have declared 18 strikes across the country. But in the spirit of dialogue, we will delay this action. We want solutions, not patchwork responses,” Dr Atellah said, citing cases in Kakamega, Marsabit, Laikipia, Lamu, and Trans Nzoia counties where working conditions were dire.
He warned that the current structure of devolved healthcare was contributing to frequent labour unrest.
“We are not fighting devolution, but governors must stop interfering with doctors’ salaries. Let them manage human resources, but salaries must be protected,” he added.
Dr Atellah also called for improved postgraduate training opportunities, noting that many doctors fail to advance professionally due to lack of budgetary support from county governments.
“We used to be employed automatically after graduation. Today, we have unemployed doctors even as hospitals remain understaffed. It’s a contradiction that must be addressed,” he said.
The forum heard that public officers’ medical funds often appear on payslips but are never remitted, making healthcare workers de facto “debt collectors for government against government.”
“We had NHIF, which worked. SHA, as it is, has killed comprehensive cover. Who cares for the caregivers? We must get something that makes sense,” said Dr Atellah.
Public Health Principal Secretary Mary Muthoni admitted there were gaps in healthcare staffing and training, pledging reforms to streamline job standardisation and scope of practice.
“We must be clear on who is supposed to work where whether at primary, secondary, or tertiary levels and how they are trained. We are reviewing scope of practice, standardizing accreditation and training curricula to ensure competency and confidence among our workforce,” she said.
CS Duale warned against allowing healthcare to become commercialized through unchecked proliferation of private training institutions.
“You cannot commercialize the training of doctors. We must regulate these institutions to ensure they have the capacity to train professionals to standard,” he said.
CS Duale confirmed that the Ministry of Health had already paid Sh1.75 billion in basic salary arrears and would clear the balance within the current financial year.
He also revealed that tuition had been disbursed for the first cohort of 54 postgraduate students, with sponsorship for 39 others underway.
He pledged to convene a multi-stakeholder forum to audit training institutions and streamline internship deployment, stating that the current crisis had exposed “a broken pipeline.”
“We will not allow a noble, dignified profession to be turned into a money-making enterprise. Internship is a rigorous exercise. We have no problem paying — but we must have a plan,” said Mr Duale.
He also promised that 135 medical interns and 503 pharmacy interns would be absorbed soon, adding: “Healthcare delivery is about dignity. Doctors are trained to serve Kenyans, and they must be empowered to do so.”
On cases of SHA fraud, Mr Duale said the Digital Health Agency was developing a track-and-trace system to plug loopholes and protect public funds.
“We have reports of pre-authorisation codes being misused. Some facilities claim surgeries have been performed by doctors who were never there. That is criminal. We must exercise integrity — this sector cannot be run on shortcuts,” he said.
He promised: “Afya House will never again be called Mafia House. I am not a doctor, but I am here to drive policy, rebuild trust, and work for Kenya’s healthcare workers and patients.”
Mr Duale revealed that in the last one month 774,590 more Kenyans have been registered in SHA, taking the total tally to 22,165,249 up from 21,390,659 recorded last month.
Additional Reporting by Leon Lidigu