DRAMA!! Listen to what Sifuna told Gladys Wanga face to face after meeting in senate committee!

[0:00] Because if Shah fails, then it is a county government that has failed. [0:04] You are the face of service delivery. [0:10] Chairman, it's a discussion we have had with Shah, including with the minister, [0:14] that for public facilities, if there is a challenge, should the Shah be stopped [0:21] or should Shah continue to serve the public as we'd handle any issues on the background? [0:30] And the idea should be that Shah should continue as you handle the issues on the background. [0:37] But right now, we have had to support those facilities from our exchequer side [0:43] to be able to handle and the public is not able to access Shah. [0:50] But we are working around the clock to ensure that Shah is restored. [0:54] And I'm happy that some of the facilities that were off, like Rachwonyo South, Rachwonyo East, [0:59] they are now restored. [1:01] And we are sure that within the month or so, we should be able to restore the other facilities. [1:07] Okay. [1:09] Senator Sifuna? [1:11] Yeah, chair. [1:11] We move to the trade debtors. [1:13] My hearing, the county governor to be saying that the people of Omapay [1:17] who have been going to this hospital or facilities have not been charged money [1:21] that she has paid or the county government has paid for that. [1:24] Because I remember recently, we were told that there was an outage in that Shah system. [1:29] And at least in Nairobi, our experience was totally different. [1:32] People were being turned away from facilities. [1:35] Governor, are you saying you are the ones who have been paying for those people in those hospitals [1:39] where the shahs had issues? [1:43] No. [1:44] I think, Senator, my point was, because the facilities, especially at level 4, [1:50] rely a lot on the FIF. [1:52] Without an active shah program, they need to pay certain basic issues, including commodities [2:00] and so on, which we have supported them to support electricity and the other utilities. [2:08] But there are still out-of-pocket payments at your facilities because of this problem? [2:12] Yes. [2:13] Because of this problem, there is still out-of-pocket payment, particularly in the facilities [2:18] that are facing this particular problem. [2:21] Therefore, out of the 234 facilities, I think we have four of them now facing this shah problem. [2:28] I think, Chair, if I go to correct it, what you're raising is if a facility has been blocked by shah, [2:36] I'm a citizen of Omabe, I have the shah card, I will not get medical attention in that facility. [2:50] I think that's the question Chair is asking. [2:53] Then what happens to those innocent citizens of Omabe? [2:56] They have shah, the facility that is run by the county has been blocked from shah, [3:02] so how do they access health services, if that is the situation? [3:06] Maybe in addition, Senator Cherarke says services, they have to pay out-of-pocket [3:17] because the challenge is facing those facilities. [3:20] Are these the same facilities that the CS told us they were facing issues of fraud? [3:25] And then number two, do you as a county have indigent support to citizens [3:31] who don't have the ability to pay for the medical services? [3:35] Thank you, Chair. [3:36] And for the record, Senator Cherarke is the biggest defender of shah in this committee, [3:39] so we'll be... [3:41] Chair, I'm the biggest defender of government, I'm the biggest defender of broad-based, [3:46] and I'm the biggest defender of anything that government for the better of care. [3:51] Okay, that's extraneous. [3:52] And your governor also is the biggest defender of broad-based. [3:54] So let's come back to the audit. [3:59] Governor? [3:59] She did follow that you should be the biggest defender of mine. [4:02] I think on the issue of these specific facilities, the discussion we have had, [4:13] you can find that a facility has a case that can be said to be fraud, for example. [4:22] Maybe it is a case of not adjusting quick enough to the policies. [4:27] Maybe it is a question of people shared beds, so you claimed for 30 instead of 20 beds, [4:35] which you're registered to have. [4:38] So those kinds of issues are the ones that are resulting in the blocking of facilities. [4:45] Cher generally, if I would say Cher, reimburses facilities, [4:49] and is a big improvement from the previous system that we had. [4:54] That I can say. [4:55] Me, the concern is this innocent Kenyan who has Cher, [4:59] but comes to a public health facility. [5:02] But because of the mistake of that health facility, [5:05] he or she is not able to access service using the Cher card. [5:11] What do we do? [5:12] I'm in total agreement with you, Senator Okongo, [5:15] because, and this is the discussion we have had with the Cher, [5:21] and with the policy level, [5:22] that if a facility has an issue, [5:27] the issue should be dealt with while the public continues to access services. [5:34] This is what we have raised. [5:37] So that the punishment, [5:38] when you block a facility, [5:40] the punishment is not on the administrator. [5:43] It is on the patient. [5:46] So we have asked that the policy be changed [5:50] so that if there is an issue with the facility, [5:53] let the administrator, [5:55] administration of the facility, [5:57] who is the contract holder, [5:59] because, you know, facilities sign direct contracts with Cher, [6:04] to let them deal with that [6:05] as the facility continues to offer services to the public, [6:10] which is not the case at the moment. [6:12] Okay. [6:13] Senator Sifuna, finally. [6:15] Just a clarification. [6:16] Governor, [6:16] you know, [6:18] we in the Senate and you in the Council of Governors [6:20] are actually on the same side. [6:24] I actually view these conversations here [6:27] as you appearing at one of those facilities you're talking to, [6:30] because we're supposed to fight these causes together. [6:33] What we say out there, [6:35] whether you are the biggest supporter of whatever, [6:37] is something else. [6:38] But we shouldn't be hearing any complaints [6:41] when it comes to service delivery in hospitals [6:43] if Cher is working. [6:45] How much money does Cher owe [6:47] Homa Bay County [6:48] or 24 facilities in reimbursement? [6:52] I want to ask my health team [6:53] to just work that out and Cher. [6:57] And also just confirm to us [6:59] what is, [7:00] my Cher calls it an aging analysis, [7:02] because when people go around saying [7:05] this thing is working, [7:06] and yet maybe Homa Bay is prioritized [7:08] in terms of payments, [7:09] but in Nairobi, [7:11] Cher owes our hospitals a lot of money [7:13] and they're suffering. [7:15] Those are, you know, [7:16] maybe we should start being like Cherarge [7:18] and then our hospitals will be given money. [7:20] But we want to confirm. [7:23] But Cher is working. [7:25] He has called himself [7:25] the biggest defender of something. [7:27] Of course, yes, yes. [7:28] So the CEC there [7:29] should just confirm to me [7:31] if because Homa Bay [7:33] is one of those counties, [7:37] that cannot be an algorithm. [7:41] That's what I want to know. [7:42] That's what I want to know. [7:43] Governor, that's a political question [7:45] you can ignore. [7:47] No, no, no. [7:48] No, no, no, no, no, no, no, no. [7:49] On the Senator Cherargei... [7:51] Unless Senator Sifuna, [7:53] through with your indulgence chair, [7:55] gives us a system [7:56] that works 100% [7:58] anywhere in the world. [7:59] Chair. [8:00] Every system has a challenge. [8:01] Honorable senators, [8:02] we are the ones [8:03] who wrote the four laws [8:04] when we're in Turkana. [8:05] Of course. [8:06] So if it is not working well, [8:07] it is our responsibility. [8:08] You can't take that responsibility [8:11] to revisit them. [8:12] The argument is [8:13] if an entity has been blocked [8:15] because of fraud, [8:17] you know, [8:18] if it is blocked, [8:19] I agree with the argument [8:20] that the innocent Kenyans must serve. [8:22] But you also protect the resources [8:23] that belong to the people. [8:24] No, that's okay. [8:25] Let's allow Senator Sifuna to finish. [8:26] I don't think when we write laws, [8:28] we take on the responsibility [8:29] of implementation. [8:31] Because what we were promised [8:32] by the current administration [8:34] is universal free health care. [8:37] So even one person [8:38] going to a facility [8:39] and not being able [8:40] to receive medication [8:42] is a matter of concern [8:44] for us as a leadership. [8:45] Chair, [8:46] the question of fraud [8:47] is just one. [8:48] But for instance, [8:50] Chair, [8:50] if you take into account [8:51] the recent collapse [8:52] of that system of share, [8:54] that is not a question of fraud. [8:57] And bearing in mind, [8:58] Senator Cherarge, [8:59] how much money [9:00] the Kenyan taxpayer [9:01] paid for that system, [9:02] I am not saying, Chair, [9:04] that we expect 100%, [9:07] but we are saying [9:08] a system that expensive [9:09] cannot be out of service [9:11] for four days. [9:12] There's loss of lives [9:13] in the country [9:14] when things like those happen. [9:15] That is nothing to do with fraud. [9:17] So we are within our rights. [9:19] We are within our rights [9:20] to insist that [9:21] because of the amount of money [9:22] that we paid for that system, [9:24] my health care contributions [9:26] share when I was elected here. [9:29] I think they went down, [9:30] they went up almost 30 times. [9:32] I pay over 30,000 these days [9:33] and we used to pay NHIF [9:34] a fraction of that. [9:35] And the way that program [9:38] was sold to us [9:39] is because Sifuna, [9:40] you are well-to-do, [9:41] you are earning [9:42] a million shillings a month. [9:43] Let's contribute [9:44] so that the other people [9:45] who are unable to, [9:47] or don't have an income, [9:48] the people in the villages [9:49] in Karachiwonyo [9:50] can be able to do what? [9:51] Access health care. [9:52] That is the reason why [9:53] we supported the system. [9:55] Now, if it doesn't work, [9:57] if there is even just one person [9:59] in Karachiwonyo [10:00] who is not receiving health care [10:01] because the system is down, [10:02] a hundred and something billion [10:04] Kenyan shilling system, [10:05] so it's not to say [10:07] that these questions [10:08] are political, [10:10] but health care is political. [10:12] No, I think the questions [10:13] are proper. [10:14] We asked about [10:15] the size of the debt. [10:17] You have the figures? [10:19] Maybe you could share. [10:23] Chairman, [10:26] Shah owes us [10:27] approximately [10:28] 350 million [10:30] to the facilities [10:32] in Homabee. [10:36] Chairman, [10:36] on the other... [10:37] And how old is that debt? [10:40] Is it a month, [10:40] two months, [10:41] a year? [10:42] They're just working [10:43] on the aging. [10:44] I just wanted to bring [10:45] the amount. [10:48] Chairman... [10:49] But even before you go there, [10:51] Chair, [10:51] if the Auditor General [10:52] or the county entity itself [10:54] is saying that [10:55] in the entire financial year [10:56] that is under review, [10:57] they themselves told us [10:59] 900 and something [11:00] was collected [11:01] in all the facilities, [11:02] right? [11:02] If Shah alone [11:03] has 350 in debt [11:05] to the hospitals [11:06] in Homabee, [11:06] that's almost a third [11:07] of the collections [11:09] for the facilities, [11:10] you know? [11:11] So when we bring [11:13] out these things, [11:14] don't make it look [11:15] like it is political. [11:18] But if you have come [11:18] to the doctor [11:19] and you give me [11:20] the wrong... [11:21] What is it called? [11:22] No. [11:24] The wrong symptoms, [11:25] governor. [11:26] If you give me [11:27] the wrong symptoms, [11:27] I will not apply [11:28] the right injection [11:29] and you know how we do it. [11:30] We want you to be paid [11:31] the 350 million. [11:33] I think you are starting... [11:35] Your preamble [11:36] is what should [11:37] carry the... [11:38] rest of the conversation [11:39] that we are [11:40] on the same side. [11:41] When we ask these questions, [11:43] it's to get a solution. [11:45] And when we find [11:46] that 300 million [11:47] is owed to Homabee [11:48] out of a potential [11:50] collection of 1.6 billion [11:51] or 900 million, [11:52] it is significant. [11:55] And it is in these sessions [11:56] that we find [11:57] legislative interventions [11:59] or just interventions [12:01] we can call [12:01] the CS for health. [12:03] But it shows [12:05] that there's a problem. [12:07] If you don't have [12:07] 300 million [12:08] reimbursed on time. [12:09] Chairman, [12:10] maybe I can just [12:11] say this also [12:12] because [12:14] in our language [12:17] something is said [12:18] that the tail [12:19] of a sheep [12:19] is compared [12:20] with the other. [12:23] If we compare [12:24] the level [12:26] of reimbursements, [12:28] the amount [12:29] in terms of reimbursements [12:31] that Shia [12:32] is giving [12:32] to facilities [12:33] in comparison [12:34] to what NHIF [12:35] was giving, [12:36] Shia [12:37] is much more [12:37] enhanced. [12:38] if we compare [12:40] the timeliness [12:43] in payment, [12:47] Shia [12:47] is prompter [12:48] than what [12:49] NHIF was. [12:51] I'm just noting [12:51] that [12:52] in comparison. [12:55] Of course, [12:55] every... [12:56] I think the promptness [12:59] will determine [12:59] once we get [13:00] the aging analysis [13:01] of the debt. [13:02] Yes, [13:03] Chair. [13:03] Chair, [13:03] let me just [13:05] make a point. [13:06] A simple [13:07] but important point. [13:09] You know, [13:09] Governor, [13:10] you and I [13:10] and every [13:13] Kenyan worker [13:15] is not in arrears [13:18] in their contributions [13:20] to Shia. [13:23] None of us [13:24] is in arrears. [13:25] There can never [13:26] be an explanation [13:27] why Shia [13:28] really should [13:30] hold, [13:31] that's just [13:32] one county, [13:33] 350 million [13:35] Kenya shillings. [13:37] And you know [13:39] what, [13:39] Chairman [13:40] and Governor [13:41] and all of us, [13:43] we can choose [13:44] to compare [13:45] NHIF and Shia [13:46] or whatever [13:47] it is that we want [13:47] to do. [13:49] But you see, [13:50] Governor, [13:51] if Shia [13:52] was working [13:52] in Omabe [13:54] or in Kitui, [13:58] the first person [13:59] that would know [14:00] that Shia [14:00] is working [14:01] is a patient [14:03] visiting a facility. [14:05] We don't need [14:07] to tell them [14:07] that it's working. [14:08] I mean, [14:08] if it's working, [14:10] it's working. [14:10] If it's not working, [14:11] it's not working. [14:12] And we are talking [14:13] about a situation, [14:14] and I don't want [14:15] to go into [14:15] those comparisons, [14:17] where the Kenyan [14:19] taxpayer [14:20] has paid [14:22] in excess [14:23] of 100 billion [14:24] Kenya shillings [14:25] for a technology [14:27] that is supposed [14:28] to support Shia, [14:31] a system [14:32] that has been down [14:34] for now almost [14:35] a week [14:36] or more. [14:37] So let's not [14:39] even go there. [14:40] But if it's working, [14:42] then Kenyan people [14:44] will know [14:44] it's working. [14:45] We don't need [14:46] to tell them [14:48] that it's working. [14:51] And for the amount [14:51] of money that we have [14:52] spent for that system, [14:54] honestly, [14:56] the uptime [14:56] should be more [14:57] than 97%. [14:59] You ask me [15:00] for the cost. [15:01] I know [15:02] these members [15:04] here are seized [15:05] of this matter [15:06] on the floor. [15:07] CS-Dwale comes [15:07] regularly. [15:09] What we must demand [15:10] of Governor Wanga [15:11] is to account [15:12] for the 1.6 billion [15:14] reported as collected. [15:16] That's what we must [15:17] demand from Governor Wanga, [15:18] that that money [15:19] must go back [15:20] to facilities. [15:21] What we must demand [15:22] from CS-Dwale [15:23] is why 350 million [15:25] remains undisbursed [15:26] to the facilities. [15:27] So I think [15:28] let's separate it. [15:29] Let's not [15:30] attempt to [15:31] over-explain [15:32] the national [15:33] government's role [15:34] because this [15:36] is a county [15:37] government [15:37] that is