MICHAEL KAMAU: New NHIF chair takes over with pledge to rein in tender cartels

Chair of the National Health Insurance Fund, Michael Kamau. PHOTO | NMG

Engineer Michael Kamau left the public service in 2015 under a cloud of allegations that include abuse of office and failure to comply with applicable procedures, ultimately forcing him from his position as Transport Principal Secretary.

Last month, he made a return to public service as the chair of one the biggest State agencies, the National Health Insurance Fund (NHIF).

For the next three years, he will be at the helm of the entity tasked with ensuring a successful rollout of Universal Health Coverage.

He spoke to the Business Daily on the new challenge thrown his way, restructuring the NHIF and a host of other issues ahead of the UHC rollout.

How qualified are you for the task?

When I was in government I served as the board chair of the Engineers Board of Kenya where I led the changes that saw the enactment of the Engineers Act.

I have been chairman of many other boards, including Kenya Institute of Management where I chaired the council, so this is not my first time in this position, the only change is the time that I am sitting on NHIF because of its key role in a successful UHC.

How do you plan to deliver as the board chair of the NHIF?

You would be surprised to note that public health is a familiar ground for me. My interaction with health started a long time ago.

I was the one responsible for the upgrading of the Moi Referral Hospital when I was working in the Ministry of Health under PS, the late Donald Kimutai.

We have competent board members and management, so I am here to provide leadership.

Also, my time in public service speaks for itself, I have been a PS. For example, the PS for Health may not be a doctor, same case for the chair of the NHIF board.

What are your priorities?

We had a good meeting with my predecessor, Mr Lewis Nguyai and from our meetings, there are four key points — registration which is now compulsory, the IT systems need to be upgraded, the benefits to our members and filling vacant positions.

We are moving with speed to make sure the regulations are passed by parliament to operationalise UHC.

The IT system needs to be aligned with the new mandate of UHC, which calls for a complete overhaul.

The existing IT system cannot meet the needs of universal healthcare.

It has also not been upgraded for a long time. On the benefits, which are usually emotive issues for all Kenyans, the NHIF recently added benefits like PET scans and oncology.

But we need to review the benefits package again and we are also looking at telemedicine.

Will we see a push for an increase in premiums?

Because of inflation, there will come a time when we will have to increase from Sh500 to maybe Sh700 or Sh900.

But let us first get the experience of having everyone covered and see the revenue that will come in.

The fact that everyone above 18 years will be paying, then the burden will be less because we logically cannot have all members falling sick.

Something that, however, puzzles me is that all these young people take insurance for their cars, even the bodaboda people have insurance for their motorcycles, so why not insure your health?

How do you feel bad paying insurance for your family, how?

The Federation of Kenyan Employers (FKE) has fought sections of new regulations that will compel employers who do not provide private health cover that is superior to the NHIF to match the NHIF contributions.

How will you resolve this?

The FKE chief executive sits on the NHIF board. The regulations and proposals are all board decisions and these (proposed regulations last year) were a unanimous board decision. Do I need to say more? Let us leave it at that.

How far are regulations that are meant to implement compulsory membership of all Kenyans aged above 18?

I am told that the Attorney-General approved them and they are on their way to Parliament.

The electoral transition affected this process but now even the parliamentary Committee on Health has approved it.

There was a proposal for the NHIF to engage telcos and banks to allow members to get loans to pay premiums.

This was billed as the key to addressing the high default rate, are you keen to pursue this?

We are not a banking institution. First of all, our plate is full but let me say that we are very open to anything that is going to help us get members to pay up.

The previous board told MPs that it would restructure NHIF, especially the top management where there is talk of people holding positions they are hardly qualified for. Are you pushing for the restructuring?

The mandate of NHIF was expanded and therefore this institution has to be restructured to meet this new mandate. Restructuring had not started under the previous board, but even worse is the situation of the directors.

We have seven vacant positions. There is a huge gap and the CEO is having to work with people in acting capacities.

There are huge voids but they are not affected by the restructuring, all we have to do is look for competent people to fill them.

The restructuring is a separate issue from the vacant positions of the directors, we have many reports done and we are now implementing them.

How has this affected service delivery at NHIF?

The organisation is limping due to the many people in acting capacities. An organisation with a huge gap in the positions of directors makes it hard for the CEO.

The CEO is getting most of the things raw and the people in acting capacities are unsure of themselves.

Last year, the NHIF board and top management were caught in fights and most notably, the cancellation of the contracts for 17 healthcare service providers in the EduAfya scheme was a big issue.

Just like other public sectors, the talk of cartels infiltrating the NHIF has always been there. How are you going to tackle them?

All my life I have been in public service and I know zero-tolerance for corruption and fraud is what I believe in.

I am going to do everything possible to ensure that the funds of Kenyans are safe and that they get the benefits they pay for.

I am not new to the government. In 2006 when we came to the transport sector, we had cowboy contractors. Even in the time of Jesus, there were cartels so we must devise ways of dealing with cartels.

The devil is always here with us, so the only thing to do is invent new ways of dealing with them because you can never eliminate them from the face of the earth.

All you need to do is continue building firewalls. Otherwise, if the world was so good, we would not need police.

The NHIF board and its top management have been involved in public spats, the latest being with your predecessor. How would you end this?

The management and the board cannot be at cross purposes. This is because we are following the leadership of the president.

The head of State is the guiding light and as long as we are walking on his path in fulfilling his promises of universal healthcare, then we are okay.

Instead of walking at crossroads here at NHIF, people should walk away, that is the best thing to do.

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