Private hospitals in Kenya are reportedly turning away critically ill patients who depend on the National Health Insurance Fund (NHIF) for their treatment due to a lack of payment.

The hospitals claim that NHIF owes them a total of Sh12 million, which has been accumulating since last year, and until they receive a substantial amount of money from the government agency, patients with NHIF cards will not be served.

NHIF has allegedly failed to pay hospitals that have signed comprehensive cover agreements with the fund, leaving them with no option but to turn patients away.

Fearing reprisals, most hospital managers who spoke to the media requested anonymity because the system may end up not paying their claims.

Patients with non-comprehensive cover have been charged whatever the healthcare facility wants, but the reimbursement is standardized across all facilities.

According to insiders, NHIF is broke, and the National Treasury owes it over Sh27 billion and counties are yet to remit money to the NHIF, making it difficult for the fund to have money to pay hospitals.

The secretary-general of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Davji Atella said the government was out to frustrate and withdraw funding from the NHIF.

"The government cannot pretend to increase NHIF funds by increasing deductions from workers by up to 2.75 per cent of gross salaries when the same government has been on a spree of defunding NHIF," Atella said.

Atella alleged that both the national and county governments have been diverting more than Sh20 billion annually from NHIF to private insurance companies that are generating profits, instead of awarding the tenders to the national health insurer.

He pointed out that civil servants, including the police and the Parliamentary Service Commission (PSC), state officials, and county governments have opted for private insurance, which has led to the National Health Insurance Fund (NHIF) struggling to operate independently.

He also blamed the government for the situation, stating that it was responsible for the current state of affairs.

"Civil servants, including the police and the Parliamentary Service Commission, State officials and all county governments have private insurance, how do you expect NHIF to stand on its own? This whole mess is caused by the government," he said. 

Private hospitals have appealed to NHIF to release payments to enable them to serve their clients, saying the situation was unsustainable for most hospitals.

The Kenya Association of Private Hospitals secretary-general, Timothy Olweny, said the only way to save private hospitals was to release payments.

If the situation continues, hospitals may have no option but to stop attending to patients, according to a public referral hospital.

"Most hospitals are in debt and the only way they can continue to provide quality healthcare to their clients and NHIF members is if the money is released," Olweny said.

"If patients come, get services and leave without paying a single cent, then they have to wait for a long time for the money to be reimbursed. How are they going to operate? There needs to be a serious discussion now."