Cancer groups fight NHIF new regulations ending private hospitals cover


The National Hospital Insurance Fund (NHIF) in this picture taken on Tuesday, October 26, 2021. PHOTO | DENNIS ONSONGO | NMG

Cancer organisations have rejected the new proposed regulations by the National Health Insurance Fund that will compel cancer patients to seek medication only in public health facilities.

The Kenya Network of Cancer Organisations (KENCO) and Non-communicable Diseases Alliance Kenya (NCDAK) which brings together patient groups say faith-based health facilities should be allowed to offer treatment to cancer patients across the country under the national medical cover.

“Faith-based health facilities are not profit-driven, offer quality services and play a major role in supplementing health services available in the public sector," the group said.

"These are the only facilities that are available and accessible in certain regions of the country. A blanket limitation to public hospitals will compromise access to healthcare for patients who seek services from these facilities,” they said.

The organisations further observed that public hospitals in Kenya are not adequately equipped and lack the capacity to be the sole providers of healthcare to handle a rapidly increasing number of people with Non-Communicable Diseases, with the patients are often compelled to seek such services in faith-based or private hospitals.

“Some of the services and entire range of medicines and therapies required for chronic illnesses listed in the First Schedule are not readily available in public health facilities. These facilities have limited access points for services like chemotherapy and radiotherapy, including PET scan, and are supplemented by faith-based and private facilities that facilitate timely access to diagnosis and treatment which is critical for patients with NCDs. Thus, it would be limiting and unfair to require patients to seek these services only in public health facilities,” they said.

NHIF will stop paying for the treatment of chronic diseases such as cancer, diabetes, heart and kidney ailments in private hospitals if Parliament approves changes aimed at reducing payouts.

Fresh regulations published by the State-backed insurer require it to cover patients with chronic illnesses in government hospitals like the overburdened Kenyatta National Hospital (KNH) in Nairobi.

“A beneficiary with chronic illness shall access treatment for chronic illness from public health care providers only,” says the new regulations that were published Wednesday for public review pending approval by MPs.

This sets up low-income patients and affected households for tough times given the majority of them rely on the NHIF for diagnosis, drugs and hospital expenses.

The radical move will also hurt private hospitals like Nairobi Hospital, Nairobi West and Mater that receive billions of shillings to provide care to patients with chronic illnesses.

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