MPs call for termination of Minet teachers’ medical scheme

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 inability and ‘excessive’ insurance cover costs set by the Social Health Authority (SHA), the Teachers Service Commission (TSC) stated yesterday.

Simultaneously, Parliament is now urging TSC to end its agreement with Minet Insurance brokers and a group of underwriters for the delivery of medical cover services to teachers, referring to the arrangement as an “undefined structure. ”

A parliamentary group was informed yesterday that TSC chose to renew the contract for a comprehensive teachers’ medical cover with Minet Kenya Insurance brokers Ltd, which is currently facing operational issues that have restricted teachers’ access to healthcare, due to SHA’s absence of frameworks to manage and support the considerable number of teachers.

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

Macharia further disclosed that SHA was requesting Sh37 billion to enroll teachers in its medical scheme, which is significantly higher than the current Sh20 billion allocated for the scheme.

“Last year, we convened a meeting with SHA, but they indicated they lacked the structures to implement the scheme. They also requested Sh37 billion to onboard teachers to SHA, but even then they announced they were not prepared to enroll the teachers this year,” Macharia stated.

She clarified that TSC had signed a three-year contract with Minet in 2015 and had called for tenders for it twice since then, but at one point sought to terminate the contract due to complaints from teachers regarding late insurance payment approvals, burdensome pre-authorisation demands at healthcare facilities, and instances where teachers seeking treatment at hospitals were turned away.

In this regard, she mentioned that the Commission had aimed to integrate teachers into a public medical scheme.

“We have only called for tenders for this scheme under Minet Insurance twice. Previously, we also sought to utilize the defunct NHIF, but the price quoted was excessively high to finance. I later contacted the Treasury to request an increase in the funding we receive so we could engage the cover, but there were no available funds, and this is how we ended up with Minet Insurance, and the consortium,” Macharia added.

The CEO’s comments were a reply to concerns raised by the Education Committee, which had highlighted the flaws revealing the inefficiencies in the medical scheme accessible to teachers and inquired about plans to include teachers in SHA.

“There are concerns regarding the inefficiencies of the medical scheme voiced by teachers. I am aware of a situation involving a teacher who was kept in solitary confinement at Upperhill Hospital for three months based on the claim that the facility was not pre-authorised to provide the medical services she had received,” said committee chair Julius Melly.
“We had to step in to ensure her release,” he stated.

Kibra MP Peter Orero revealed that teachers had reported they were not provided with medication when visiting the consortium-approved hospitals and were instead required to purchase the drugs themselves.

Orero also noted that a significant number of teachers were being refused service at health facilities and informed that they were not registered in the medical system.

Macharia indicated that the delay in financial disbursement from the government had exacerbated the situation.

“We are experiencing initial difficulties with Minet, but if our teachers were to receive premium services, they should be fully insured. Unfortunately, we lack the resources to achieve that,” she mentioned.

This, however, led to further scrutiny of the medical scheme from the members.

“We recognize that Minet is a brokerage insurance firm that collaborates with eight other insurance companies under a consortium. Considering all these underwriters and the approval delays, who is accountable for the approvals? ” questioned committee vice chair Eve Obara.

Attempts by the Commission’s lawyer to clarify that the contract with the consortium would conclude in November this year and that a decision regarding whether teachers would be integrated into the “enhanced” SHA system would be made at that time, were nonetheless met with criticism and demands to terminate the contract before that date.

“What sort of insurance coverage is this? It is a mixed breed. It lacks coherence. You are getting an insurer, a leading consortium, as an administrator and a capitator. Quite a peculiar type of insurance. You must exit this arrangement,” Melly asserted.

“We cannot continue doing things the same way and expect different outcomes. The consortium is a nebulous entity that does not provide services,” stated Luanda MP Dick Maungu.

Baringo North MP Joseph Makilap suggested grouping teachers together so they could access better healthcare.

“As TSC ends this contract in the next six months, teachers will face difficulties. I propose that we segment them into groups to secure better insurance coverage or we bundle them into SHA and let us hope for the best,” Makilap commented.

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