MPs Call for Termination of Minet Teachers’ Medical Scheme

The difficulties faced by teachers in accessing medical services are expected to continue due to the inadequacy and “exorbitant” insurance cover costs established by the Social Health Authority (SHA), as disclosed by the Teachers Service Commission (TSC) yesterday.

Concurrently, Parliament is now urging TSC to terminate its agreement with Minet Insurance brokers and a group of underwriters regarding the provision of medical cover services to teachers, defining this arrangement as an “amorphous structure. ”

A parliamentary committee was informed yesterday that TSC decided to renew the contract for the provision of a comprehensive medical cover for teachers with Minet Kenya Insurance brokers Ltd, which is presently facing operational difficulties that have obstructed teachers’ access to healthcare, attributable to SHA’s inadequate structures to support and cover the large number of teachers.

TSC Chief Executive Officer Nancy Macharia presented to the National Assembly Education Committee that the Commission had approached SHA to establish a medical scheme for teachers, but the authority acknowledged its lack of efficient structures to implement the initiative.

Macharia also disclosed that SHA was requesting Sh37 billion to enroll teachers in its medical scheme, a stark contrast to the current Sh20 billion allocated for the scheme.

“Last year, we did have a meeting with SHA but they indicated an absence of structures to manage the scheme. They were also demanding Sh37 billion to onboard teachers to SHA, yet even then they expressed that they were not prepared to accept teachers this year,” stated Macharia.

She clarified that TSC had entered into a three-year contract with Minet in 2015 and had issued tenders for the contract twice thus far, although at one point they aimed to terminate it following complaints from teachers regarding delayed approvals for insurance payments, onerous pre-authorization requirements at healthcare facilities, and instances of teachers being denied treatment at hospitals.

In light of this, she mentioned that the Commission had sought to enroll teachers in a public medical scheme.

“We have only tendered for this scheme under Minet Insurance two times. Previously, we had also attempted to utilize the now-defunct NHIF, but the amount they proposed was excessively high to finance. I subsequently wrote to the Treasury to request an increase in funding allocated to us so we could secure the cover, but no funds were available, leading us to ultimately engage with Minet Insurance and the consortium,” added Macharia.

The CEO’s comments were in response to concerns raised by the Education Committee, which had highlighted shortcomings in the medical scheme available for teachers and inquired about plans to integrate teachers into SHA.

“There are concerns regarding the inefficiencies of the medical scheme that teachers have reported. I am aware of a case involving a teacher who was held in solitary confinement at Upperhill Hospital for three months due to the facility not being pre-authorized to provide the medical services she had received,” remarked committee chair Julius Melly.
“We were required to intervene to secure her release,” he stated.

Kibra MP Peter Orero revealed that educators had lodged complaints indicating that whenever they visited the hospitals approved by the consortium, they were not provided with medication and were compelled to purchase the drugs elsewhere at their own expense.

Orero further noted that the majority of educators were being denied services at health facilities and informed that they had not been registered in the medical system.

Macharia elaborated that the absence of timely financial disbursement by the government had exacerbated the situation.

“We are experiencing initial difficulties with Minet, but if our educators are to receive premium services, they must be fully insured. However, we do not possess the resources to achieve that,” she remarked.

This, however, only prompted further scrutiny regarding the medical scheme from the committee members.

“We understand that Minet is a brokerage insurance firm that collaborates with eight other insurance firms under a consortium. In light of all these underwriters and the delays in approvals, who is responsible for overseeing the approvals? ” inquired committee vice chair Eve Obara.

Attempts by the Commission’s attorney to clarify that the contract with the consortium would conclude in November this year, with a decision regarding the onboarding of teachers to the “enhanced” SHA system to be made at that time, were met with criticism and demands to terminate the contract prior to that.

“What type of insurance coverage is this? It is inconsistent and lacks coherence. You are encountering an insurer, a lead consortium serving as an administrator and a capitator. It is an unusual form of insurance. You must extricate yourselves from this arrangement,” stated Melly.

“We cannot continue with the same approach and anticipate different outcomes. The consortium presents an amorphous structure that fails to deliver services,” asserted Luanda MP Dick Maungu.

Baringo North MP Joseph Makilap suggested the grouping of educators to facilitate access to premium healthcare.

“As TSC concludes this contract in the forthcoming six months, educators will endure hardships. I propose that we categorize them into groups and secure them adequate insurance cover, or we bundle them into SHA and hope for the best,” Makilap commented.

The Committee subsequently summoned the leadership of Minet Insurance Medical Association of Kenya, Blis Hospitals, and all members of the consortium to appear before it.