Kenya’s limits government-backed medical travel

New rules will make it harder for government-backed Kenyans to travel abroad for treatment.

Between January and December 2019, more than 400 patients were cleared by the Ministry of Health and the Kenya Medical Practitioners and Dentists Council (KMPDC) to travel abroad for treatment. The numbers recorded in 2020 are slightly lower due to the Covid-19 lockdown.

The few patients who seek clearance from KMPDC are those who need the National Health Insurance Fund to help with their medical bills abroad. Thousands of others, especially those with private insurance go directly, without authorisation from the Council. The Ministry of Health believes 10,000 Kenyans seek medical treatment outside the country each year. They spend US$15 million on medical expenses abroad.

According to local data, the most common referrals are those to do with oncology, heart disease and organ transplants. Although some if not all of these services are available in health facilities in Kenya, a number of patients genuinely travel for services unavailable in the country.

While the treatment expenses overseas in some cases may appear cheaper than the costs in Kenyan hospitals, many patients are oblivious of a myriad of added costs resulting from travel. Besides the hospital fees, patients pay for accommodation, air ticket and food as separate bills. In most cases, family members accompany the patients adding to the costs. Such costs make treatment abroad extremely expensive and many patients, unable to meet these expenses, end up detained in foreign hospitals for unpaid medical bills.

KMPDC is committed to ensure that Kenyans get quality healthcare available in the country and in the event that they are referred abroad, their safety and healthcare concerns are well taken care of.  In 2017, it developed rules for the referral of patients abroad. Under these rules, a medical or dental practitioner may refer a patient for medical or dental management abroad where:

• there is evidence of inadequate expertise or medical facilities to handle the condition locally;
• when referral is the most cost-effective option available for the patient; and
• when the patient opts to pay for medical intervention abroad.

The rules determine the procedure for referrals and eliminate sporadic or unwarranted referrals that put excessive costs on Kenyans. Kenyans who want to seek treatment abroad must inform the Ministry of Health and KMPDC about their intent.

In recognition of loopholes in the current regulations, the National Assembly is  now seeking to amend the Health Act by introducing a new section in the law that will establish policy guidelines in the regulation of overseas medical referrals.

Sponsored by Kesses MP Swarup Mishra, the amendments make the referral of a patient abroad a multi-agency affair. KMPDC, the NHIF, the Association of Private Health Institutions, Kenyan Embassies and consulates all play a part in vetting the referrals.

In March 2021 Members of Parliament in Kenya passed the Health Amendment Bill 2019 that proposed patients can only be referred for treatment outside the country if there is sufficient evidence that local hospitals lack the capacity to handle their medical condition.

The Ministry of Health will be required to develop policy guidelines on the mechanisms for referrals of patients to health institutions abroad. The new rules are not just for hospitals and doctors as individual patients will have to get approval from the Ministry of Health before being allowed to go overseas for medical treatment.