Governors are reading mischief in decisions to send money directly to hospitals without involving their governments.
They see it as part of a scheme by the national government to take back management of the health through the back door.
Consequently,
the Council of Governors has petitioned the Constitution Implementation
Commission to intervene, saying the move was against the Supreme Law
which assigns management of health institutions to counties.
“We
are shocked about the decision by the ministry on the release of the
money which is purported to be compensation for user fees in hospitals,”
chairman Isaac Ruto said at the close of the Governors' Summit in
Naivasha on Friday.
He added: ‘‘We have no idea about
that expenditure and even the Controller of Budget has no control over
distribution of the money which should have been channelled through the
County Revenue Fund for transmission to hospitals.
“This
is a scheme to micro-manage hospitals and fuel the propaganda that
counties have failed to manage the health sector. These are dirty tricks
by the national government to derail devolution because some of those
hospitals where the money has been sent to, are imaginary,” Mr Ruto
said.
The move is likely to open another battleground
between counties and the national government over devolution amidst
concerns by governors that the national government wants to claw back
functions assigned to them.
There is already a standoff
between the two governments over a Sh38 billion medical equipment
leasing agreement brokered by the national government.
The
project was launched three weeks ago by President Uhuru Kenyatta.
Governors have said they were not involved in its conception.
MOVE ALLOCATION
It
also came as it emerged that the government is set to move the Sh4.6
billion Free Maternity Health Allocation to the National Health
Insurance Fund, following claims of mismanagement of the funds by
various hospital authorities.
The decision to move the
funds follows intervention by President Kenyatta who is said to be
alarmed by reports of financial impropriety regarding the landmark
jubilee project.
Following the transfer of the health
function to the county governments the fund is jointly managed by the
ministry of health and the county governments.
NHIF is a parastatal under the National Executive.
While the county authorities spend the allocation through the hospitals, the money is processed through the parent ministry.
There
have been increased reports of falsified claims and forged documents
targeted at the Fund by unscrupulous health staff working with greedy
suppliers to access the free maternity billions at the expense of the
public.
Many hospitals benefiting from the fund are now under the management of county governments.
National Treasury Cabinet Secretary Henry Rotich confirmed to the Saturday Nation
that the fund was being moved to the NHIF and that it was being
designed to operate like an insurance scheme to guarantee its effective
utilisation.
“Yes, the fund is being moved to the NHIF.
And we are looking at it like an insurance package for effective
management and utilisation,” Mr Rotich said.
He said the NHIF would take charge of the Fund in the new financial year, starting in June.
Mr
Rotich said the moving of the free maternity cash to the NHIF was also
part of the government’s plan to restructure NHIF operations in
readiness for the provision of universal health care.
“Our
intention is to have a situation where hospitals are well equipped in
order to enable the universal healthcare plan to work,” the National
Treasury boss said.
UNIVERSAL HEALTH CARE
Health
Cabinet Secretary James Macharia said the funds would be transferred as
part of wider plans to ensure successful roll-out of universal health
care.
Mr Macharia declined to discuss questions touching on the alleged fraudulent claims by hospital staff.
Speaking
at the governors meeting in Naivasha, he said that a campaign by his
ministry to see as many Kenyans as possible enroll for health insurance
was bearing fruit.
“We are working of a plan to
transform NHIF to a national social insurance scheme that could even
handle the maternity fund,” Mr Macharia said.
NHIF
will from April 1 roll out new rates where members earning the lowest
income of between Sh6,000 and Sh7,999 would pay Sh300 while those
earning up to Sh100,000 would pay Sh1,700.
Trade Union
Centre of Kenya has opposed the new rates and threatened to move to
court but NHIF has insisted the rates will be rolled out as scheduled
and warned that employers who failed remit the deductions would face the
full force of the law.
NHIF Chief Executive Officer
Simon ole Kirgotty said the Fund was working on a master plan on how to
implement the free maternity services once the funds are re-channeled.
“We
are already formulating a master plan on how it will be implemented in a
manner that will make it much more beneficial to the public,” he said.
He said NHIF was ready to undertake the new challenge in order to make free maternal care a working reality.
UNDERMINE DEVOLUTION
Free maternity services was one of Jubilee’s flagship pledges in the 2013 election manifesto.
But
governors appeared unhappy with the new development saying they had not
been consulted and the move was meant to undermine devolution.
“That
idea sounds strange. The county governments are not involved. This is
actually part of the broader problem affecting the management of county
authorities,” Kisii Governor James Ongwae said.
In the
next financial year, Nairobi County has been allocated Sh375 million for
the free maternal health care programme followed by Kakamega Sh198
million, Bungoma Sh195 million, Kiambu Sh194 million and Nakuru Sh191
million.
The governors two-day summit co-hosted by
Nation Media Group ended on Friday with the leaders saying devolution
was on track despite resistance from some forces in the national
government.
Kisumu Governor Jack Ranguma accused the
Jubilee leadership and MPs of frustrating devolution and attributed it
to a lack of understanding of their roles.
“The role
of MPs and Senators is legislation, presentation and oversight and
should be judged by the number and quality of contributions in
Parliament,” he said.
Discussing the challenges they
faced, the county bosses cited frosty relationship with MPs over mainly
distribution of county jobs and tendering.
Kitui Governor Muli Malombe said he beat MPs at their own game by insisting on qualifications for county executive jobs.
His Tana River counterpart Hussein Dado said MPs’ constitutional demand for diversity had compromised merit in hiring.
“We are forced to pick candidates who are less qualified in order to balance clan and ethnic equations,” he said.
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