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.
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.
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.