Abolish capitation to hospitals for junior civil servants, union urges NHIF

The Union of Kenya Civil Servants (UKCS) has urged the National Hospital Insurance Fund (NHIF) to abolish capitation to hospitals for junior civil servants.

Union’s Deputy National Treasurer Rehema Ibrahim says the capitation system was giving officers in job groups A to K a raw deal as many hospitals were denying them quality services while forcing them to either co-pay for services rendered or buy medicine in pharmacies.

Speaking at a Malindi hotel during a workshop to sensitize civil servants on the recently launched enhanced medical cover for civil servants, Ibrahim said many health facilities had abused the capitation system, leaving members to suffer as if they were not insured.

“We want this to come to an end. That is why we are advocating for civil servants A to K being given limited but quality health care. Let me be given my entitlement of 100,000, let me utilize it in the hospital that can account for that money for each and everyone in the family,” she said.

Ibrahim also noted with concern that many hospitals accredited by NHIF were using the capitation money sent to them every quarter to buy equipment while providing poor services to the supposed beneficiaries

The union treasurer at the same clarified that the health insurance scheme for civil servants was a comprehensive cover for all medical conditions which includes Covid-19, and chided health facilities that were denying services to officers suffering from the deadly virus.

“When Covid-19 struck, we talked to the government and Ksh 4 billion has been paid for the comprehensive medical cover and an additional Ksh 300 million has been paid to cater for Covid-related issues among the civil servants, hence officers should not be told to pay” she said.

A director with the Star Hospital, Dr Nurein Muhdin Mohamed, urged the national health insurer to include laparoscopic procedures for its members in its list of surgeries instead of only giving approvals for open surgery.

He lamented that NHIF only approves charges for open surgeries even when the patients wish to use modern technology that is less invasive and enables the patient to recover quickly.

“As you all know, technology is moving forward. In Europe, the only surgery that they don’t do laparoscopically is caesarean section. We have a contract with NHIF but even if you write a pre-authorization request for a laparoscopic procedure, they still approve the same figure as open surgery,” he lamented.

During the workshop, a number of civil servants complained that they were receiving poor services from their health facilities, with some saying they had been forced to look for medication elsewhere where they have to pay cash.