The Nairobi Women’s Hospital faces an existential crisis. Following public complaints of patient detentions and inflated billing, the tide of public opinion, business patronage and public regulation has finally turned. Why has this happened and what does it mean for the health sector?
In a brilliant stream of tweets and article, Morris Kiruga alias Owaahh laid bare a predatory business culture that had turned patients, people in need of care, into customers and inmates. Nairobi Women’s Hospital was established almost two decades ago. It’s 479 beds treats 300,000 out-patients and 120,000 in-patients in nine locations across Nairobi, Kajiado, Nakuru, Naivasha, Meru and Mombasa counties. Hundreds of thousands of gender-based violence survivors have been treated at their Gender Violence Recovery Unit funded by the Swedish and Danish Governments, private companies like Royal Media Services, Safaricom Foundation and Unilever among others.
Interspersed with stories of some of the remarkable work they have done are numerous cases of men and women being held against their will long after they were healthy enough to be discharged. The now public WhatsApp discussions reveal a clear strategy by Dr. Felix Wanjala and Chief Operations Officer Eunice Munyingi to increase the number of admissions regardless of the medical condition of their patients.
These revelations have forced the Association of Kenya Insurers and six of Kenya’s largest insurance firms - Jubilee, APA, GA, CIC, AAR and Old Mutual insurance – to suspend the hospital from their list of accredited service-providers. With the Kenya Revenue Authority, being the first to stop their staff from using the hospital, it will not be long before other corporates and state agencies follow suit. In response to the public outcry, the Kenya Medical Practitioners and Dentists Council CEO Daniel Yumbya has now called for an investigative audit. The hospital faces an existential crisis.
The extent of their crisis became very personal on Thursday night. We came across an accident between a restaurant rider and a private motorist near Yaya Centre. Badly hurt, we placed the twenty-one year old rider in our car while the motorist called the police. Being the nearest hospital, we turned towards the Adams Arcade branch of Nairobi Women’s Hospital only to reconsider and drive to Kenyatta National Hospital where we were treated with professionalism and care. It is tragic that this hospital is no longer a place that we can trust or consider safe.
The crisis also offers a wider insight into why the medical insurance industry is struggling. In 2018, the sector made losses of Kshs 1.1 billion. Medical Insurance is big business. Only motor vehicle insurance beats medical insurance in terms of gross premiums. If the bloggers, health rights activists and investigative journalists are courageous enough to dig more comprehensively, they will reveal how predatory healthcare has become.
There are at least six ways to defraud citizens, health insurance companies and the Government. They include billing for services not rendered, inflating costs, filing duplicate claims, unbundling and staggering billing to avoid scrutiny, offering unnecessary services and kickbacks for medical professionals to use more costly services. These practices have bankrupted numerous families, defrauded insurance agencies and torpedoed the Jubilee Administration’s commitment to free and universal health coverage.
Global communications firm Edelman released the 2020 Edelman Trust Barometer at Davos Summit last month. Despite a strong global economy, most respondents across the world feel they will not be better off in 2025. One in two people now believe that the current form of capitalism is doing more harm than good in the world. Further, inequality within societies is accelerating not slowing down.
There is no industry, perhaps except public safety that relies more on public trust than health care. As this column argued last month, medical negligence and malpractice literally kills. We must demand that our private health institutions now face their Damascus moment. Fortunately, there are many resources that are available.
Kenya is still one of the only African countries that has adopted a Human Rights and Business National Action-Plan. Based on ten principles, the action-plan calls for businesses not to be complicit in human rights abuses, extortion or corruption. The recent crisis confirms the late Bob Collymore’s arguments that voluntary compliance to the UN Global Compact is not enough. There must be enforcement and sanctions for companies that seek to make money out of other’s misery.
Perhaps our Ethics and Anti-Corruption Commission, Directorate of Criminal Investigation and incoming Health Cabinet Secretary Mutahi Kagwe should take a closer look at the sector and open their own files alongside that of the Medical Council.
First published Saturday Standard, February 8, 2020. Kindly reproduced here with permission from the Standard Group
One day after this article was published, CEO Dr. Felix Wanjala stepped aside to pave way for investigations.
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