Private Hospitals May Shut Down by December - RUPHA Chair Warns

The Rural and Urban Private Hospitals Association (RUPHA) Chairperson Brian Lishenga has warned that private hospitals risk closing down by December 2025 if the government fails to clear outstanding debts.

Speaking on Monday, September 8, Lishenga said the billions owed by the defunct National Hospital Insurance Fund (NHIF) and the Social Health Authority (SHA) have pushed private health facilities to the brink.

The RUPHA Chair also cautioned that the private hospitals may be forced to switch to a 100 percent cash payment model before patients can receive treatment.

“We are Ksh76 billion in debt as a sector, Ksh33 NHIF debt, and Ksh43 billion SHA liability. The health sector cannot continue bearing this burden.

“What we are saying is that if the NHIF debt is not paid immediately, it is very likely that by December, either you will not have private hospitals or the entire system will revert to 100 percent cash,” he said.

Lishenga also said the failure by the government to clear the outstanding debts could trigger the collapse of SHA.

“We are issuing this notice because we fear that SHA could collapse. If the matter is not resolved and hospitals begin demanding out-of-pocket payments, it will create a vicious cycle. Kenyans will start questioning why they are paying out of pocket while still contributing to SHA. Eventually, they will stop making contributions altogether, and the system will collapse,” The RUPHA Chair cautioned.

This comes days after RUPHA issued a 14-day go-slow notice to the Ministry of Health over the NHIF debt.

In a statement on September 5, the association said private hospitals are struggling as the government has failed to honour a presidential directive to settle debts of Ksh10 million and below.

RUPHA demanded the settlement of the NHIF debt and payment of 50 percent of outstanding SHA liabilities within 14 days.

“RUPHA hereby issues a 14-day go-slow notice effective today for the Social Health Authority (SHA) to address the following: Immediate settlement of NHIF liabilities in line with the Presidential Directive of 5th March 2025 and payment of at least 50% of the Kshs 43B outstanding SHA liabilities within 14 days,” read the statement in part.

On March 5, President William Ruto announced a plan to clear the outstanding debt left by the NHIF.

In a statement, Ruto said the government would immediately make full payments to hospitals with claims of Ksh10 million and below.

He added that hospitals with claims exceeding Ksh10 million will undergo a verification process to be completed within 90 days before a structured payment plan is implemented.

"The government has resolved to pay all hospitals with total claims of Ksh10 million and below in full, representing 91 per cent of all facilities that were contracted by NHIF.

"The remaining 9 per cent of hospitals, with total claims of above Ksh10 million, will be subjected to a verification exercise that should be completed within 90 days, after which a payment plan will be agreed on," Ruto stated.