Health Cabinet Secretary Aden Duale has firmly rejected demands for his resignation, insisting that the accusations regarding losses in the Social Health Authority (SHA) funds do not merit such a step.
During a Wednesday night interview, Duale emphasized that stepping down would only be appropriate if probes establish that he breached his oath of office.
He pointed out that Kenya’s Constitution outlines specific mechanisms for ensuring accountability among public officials, rendering voluntary resignation redundant.
“Why should I resign? You know there are reasons why one should resign, and in fact, I don’t need to resign. If I commit anything contrary to my oath of office, there are various ways of dealing with me.
Parliament can impeach me, the justice system can act if integrity issues arise, and as a political appointee, the president can replace me as Health CS,” Duale said.
The calls for his resignation came amid disclosures that Sh11 billion had been identified as missing within the SHA framework.
Duale clarified that the amount largely consisted of denied payments due to deceptive submissions from hospitals, which the AI-driven system identified through altered patient files and exaggerated charges.
While at the retreat with the National Assembly legislatives, Duale cited instances where private facilities claimed every birth was a Caesarean section, well above the World Health Organization’s advised range of 10 to 15 per cent.
“There are facilities in our country reporting 100 per cent of mothers who came to deliver have gone through C-section. In Tharaka Nithi, one private hospital claimed all 500 mothers delivered via C-section. If that happens, it’s against the law,” he said.
He further enlightened that those medical facilities submitting claim forms solely documented by a single person rather than the required three: patient, doctor and hospital administrator shall face rejection,
Adding, “Maternity claims without birth notifications are also rejected, and surgical claims without theatre notes are invalid. Even at primary health care facilities, we found patients visiting up to 10 times a day,” he said.
In the most impossible scenario, Duale said, one individual was presented with 381 dependents in Kwale County.Duale maintained that implementing digital systems is crucial for promoting openness and combating graft.
Duale confirmed the digitalization of 10,277 transacting facilities, spanning government, faith-based and private hospitals, into one digital superhighway, supported by the distribution of 30,087 digital devices countrywide.
He spoke of SHA’s AI-driven fraud detection system, which will automatically flag facilities claiming to perform C-sections procedures without a theatre yet they cannot perform.
So far, 22 doctors and 36 clinical officers linked to clinical fraud have been denied access to the SHA portals
“That is why under SHA, there’s no card; you use your thumb. The digital system ensures even the most remote dispensary can transact data in real time,” he said.
“The era of manual claims allowed theft to thrive. That is why the Sh11 billion lost between October, when SHA was launched, and April, when I took over, was rejected.
Facilities were stealing because they were used to stealing from NHIF,” he said.
Duale reiterated that any potential wrongdoing should be addressed through established avenues like Parliament, the judiciary, and the president.
