No Cash, No Treatment: Private Hospitals Halt SHA Cover Over Payment Delays

Private hospitals across the country have suspended medical services under the Social Health Authority (SHA), forcing patients to dig into their pockets or risk going without treatment.

In a notice issued on Sunday, the Rural & Urban Private Hospitals Association of Kenya (RUPHA) directed its members to stop offering care on the SHA cover, citing prolonged government delays in settling claims.

“Effective today, all healthcare services (unless otherwise stated) at this facility for Social Health Authority (SHA) beneficiaries will be provided on a cash basis,” the statement read.

RUPHA, which represents hundreds of private hospitals nationwide, defended the drastic move, saying delayed payments had left facilities unable to restock drugs, pay staff, or settle suppliers.

“We regret the inconvenience this may cause, but this action is necessary to ensure that hospitals remain open and staff can continue to serve with the highest standards of care,” the association said.

For patients, the decision has been devastating. At a private hospital in Nairobi’s Eastlands, 52-year-old diabetic patient, Mary Atieno, sat on a bench clutching her SHA card. She had been told to pay Sh2,500 in cash for her routine check-up and medication.

“I don’t have that kind of money right now,” she said, her voice trembling. “This card was supposed to help us poor people. Where will I go now? Public hospitals are already full.”

Nearby, Ali Hussein, a boda boda rider from Kiambu, said he had to borrow Sh5,000 to admit his wife, who was in labor. “If I didn’t have friends to help, what would have happened? They can’t tell you to pay cash at the maternity when your wife is already pushing,” he said angrily.

Doctors warn of “collapse”

Doctors in private hospitals say they are equally frustrated, caught between unpaid bills and desperate patients.

Dr. Esther Mwangi, who runs a 40-bed hospital in Nakuru, told The Informant that she had gone six months without receiving any reimbursement from SHA.

“How do I pay my nurses, or order oxygen, if the government doesn’t release funds?” she asked. “We want to treat patients, but without money, hospitals will collapse. That is the painful truth.”

The SHA, introduced in October 2024 to replace the troubled National Health Insurance Fund (NHIF), was meant to guarantee universal health coverage. But critics say the authority has been riddled with inefficiencies, slow claims processing, and lack of transparency.

Unless the government intervenes swiftly, experts warn, millions of Kenyans may be locked out of private care, leaving already overstretched public hospitals to absorb the surge.

For now, patients walking into private hospitals with their SHA cards are being met with a stark message: “no cash, no treatment.”