TSC: 360,000 instructors are unable to use SHA services

TSC: 360,000 instructors are unable to use SHA services

The Teachers Service Commission (TSC) medical scheme, which covers more than 360,000 teachers and their families, is still not addressing the healthcare problem because the Social Health Authority (SHA) rejected their integration due to insufficient capacity and expensive cost consequences.

TSC Chief Executive Officer Nancy Macharia told the Education Committee of the National Assembly that the government had set aside Sh20 billion for the teachers’ medical cover, but SHA estimated that it would need Sh37 billion to cover the beneficiaries.

According to Macharia, “This funding gap also affected the former National Health Insurance Fund (NHIF), which led us to renew our contract with Minet Insurance.”

From December 1, 2022, to November 2025, the Commission agreed to a three-year partnership with Minet.

“We intended to move our instructors to SHA last year when there were issues with Minet. We’ve always wanted our teachers to benefit from the national insurer, even during NHIF’s tenure, she continued.

“But we ran into a wall when SHA informed us that they lacked the infrastructure necessary to assume control of the program, which we are currently operating on Sh20 billion, and that they needed Sh37 billion to do so.”

Legislators have harshly criticized the Minet-run program, calling it a “mongrel system” that does not provide teachers and their families with timely and effective medical care.

Julius Taitum, the Igembe North MP, raised doubts about the integrity of the bidding procedure, claiming that the absence of other bidders could be a ploy to preserve a monopoly.

“You mentioned during the tendering process that no other insurance firms bid. Is this due to the current handlers’ mismanagement of the plan to discourage competition? Are they undermining the process in order to maintain their monopoly?

Mary Emase, a member of parliament for Teso South, made a fervent appeal, citing actual cases of teachers experiencing protracted delays or outright denial of treatment as a result of protracted approvals.

“I know of a teacher whose Minet approval was delayed until we had to use agents to intervene. Teachers in Bungoma are forced to wait for hours in hospital lobbies. In fact, some have been accused of exaggerating their sickness in order to receive treatment, Emase said.

The committee’s chairperson, Julius Melly, expressed his displeasure by describing the healthcare system as broken and fundamentally flawed. He gave an example of a teacher who was held in a hospital for three months because of late payments and whose bill was only paid by Minet after persistent pressure.

“We’ve had instances where instructors have been kept in hospitals for months because the institution isn’t listed as a service provider. That’s not acceptable,” Melly stated.

He encouraged the TSC to consider decentralized, competitive alternatives and give up the existing consortium-based model.

“You should divide teachers among several reputable insurers. You currently have a headless system that is chaotic and ineffective,” he stated.

The centralized approval model was blamed by Luanda MP Dick Maungu for ongoing delays. To simplify service delivery and lessen the load on central administrators, he suggested a cluster-based strategy.

“It’s no surprise that there are delays since Bliss Healthcare is in charge of approving all teachers. “Why don’t we divide them into smaller, more manageable groups?” Maungu proposed.

Unless major reforms are implemented before the contract’s expiration in November 2025, teachers will continue to struggle under the existing system, according to Baringo North MP John Makilap.

“This plan is unclear and lacks structure. Unless we restructure it by either dividing teachers into cohorts or moving them to SHA, it will continue to let them down, he stated.

Taitum said the consortium’s activities should be fully investigated since they were detrimental to the interests of educators.

Our teachers are being denied justice by this arrangement. We need a full day to question them and figure out a path ahead because it’s a cartel of insurers working together,” he said.

On the other hand, Cavin Anyour, the Director of Legal Services at TSC, maintained that the current approach is the best choice currently available in the private sector.

“Minet entered with a group of eight prominent medical insurers at the moment of tendering. They are the nation’s top suppliers, each with a unique function. Anyour stated that they took over all the competent businesses, leaving out the smaller competitors who didn’t have the resources.