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NHIF in prescription row with clinical officers

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Geoffrey Mwangi
Geoffrey Mwangi, the NHIF chief executive. FILE PHOTO | NMG 

Kenya’s tumultuous health services sector was Tuesday facing yet another turbulent month after clinical officers issued a notice of a looming strike over the National Hospital Insurance Fund’s (NHIF) refusal to recognise their prescription of procedures such as CT scans and X-rays.

Kenya Union of Clinical Officers (KUCO) says in a letter to the national insurer that its members will not accept the demand that they register with the Kenya Medical Practitioners and Dentists Board for patients seeing them to get NHIF coverage.

The NHIF bars the officers from sending their patients for imaging and has set limits for pre-authorisation of certain procedures that include cataract surgery and Caesarian section.

The union has given NHIF 14 days to set aside the policies or face industrial action.

“Clinical Officers Council (COC) is our regulatory body. Our members register and get accreditation to open clinics and treat patients from the body.

“No law compels clinical officers to register with other bodies, making NHIF demand discriminatory,” said KUCO secretary-general George Gibore.

Mr Gibore said the demand does not only affect KUCO members in private practice but those in public hospitals.

“It is denying patients immediate access to life saving procedures and this is unacceptable,” he said.

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KUCO said it has not received any complaint of discrimination from private insurers.

The demand for additional registration has left the officers to offer select basic health services to NHIF covered patients forcing KUCO to ask for repeal of the offending policy that “limits and discriminates” its members.

The lobby, whose 6,000 out of the 20,000 members work for the government, said it first brought the matter to the attention of NHIF in November 2017 but the insurer has remained adamant even after the Ministry of Health and the Council of Governors intervened.

“The union has unanimously resolved to demand…. that the NHIF offers a written undertaking to accredit facilities registered by the Clinical Officers Council as directed by Ministry of Health within 14 days and…be allowed to practise and serve NHIF accredited patients as per their training, qualification and scope of service,” said Mr Gibore in the notice.

Director of Medical Services (DMS) Jackson Kioko in March wrote to NHIF chief executive officer Geoffrey Mwangi indicating that the law does not bar the insurer’s board from recognising health facilities that are registered and licensed by the COC.

“…. I therefore, authorise that the NHIF board should recognise the registration certificate and Licence issued by the Clinical Officers’ Council to any health facility for purposes of accreditation.

“In addition, all relevant forms should be amended to include clinical officers identification,” said Mr Kioko.

The council is mandated to license clinical officers and to regulate the teaching and practise of clinical health in Kenya.

Those seeking licensing must hold a diploma or bachelor’s degree in clinical medicine and community health, and undertaken the mandatory one-year internship.

Clinical officers are trained to perform general medical duties such as diagnosis and treatment of general diseases and injuries.

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