RUPHA chair Brian Lishenga warns SHA scheme is unsustainable
By Aloys Michael, September 3, 2025The Chairperson of the Rural Private Hospitals Association (RUPHA), Brian Lishenga, has issued a stark warning on the sustainability of the government’s Social Health Authority (SHA) scheme, calling it financially unviable and plagued by questionable figures and poor policy direction.
Speaking during an interview on a local TV station on Wednesday, September 3, 2025, Lishenga dismantled recent claims by Health Cabinet Secretary Aden Duale regarding a Ksh10.6 billion fraud scandal involving private health facilities.
He accused the government of scapegoating small private providers while ignoring the broader systemic issues plaguing the SHA programme.
“SHA is unsustainable. SHA is generating every month claims worth Ksh9.7 billion from hospital visits. Yet, at best, it is collecting only Ksh6 billion. That is a monthly deficit of Ksh3.7 billion. They are fighting sustainability, and then they have decided everything is corruption,” he declared.
Lishenga warned that this monthly shortfall would snowball into a financial crisis, estimating the programme could end the year with a staggering Ksh48 billion deficit. He emphasised that while the government encourages Kenyans to seek healthcare services under the promise of free treatment, the scheme lacks the financial muscle to support such a surge in demand.
“The President is going around the country saying, ‘Go to the hospital. It is free. So people are flooding hospitals. These people end up in admissions and procedures. Now your dashboard looks crazy,” the RUPHA chair said.
According to Lishenga, the SHA has already accumulated Ksh43 billion in arrears in just 10 months of operation, further questioning its ability to remain functional.
It is worth noting that Lishenga has also accused Duale of undermining SHA leadership by micromanaging the institution and sidelining its executive.
Duale under SHA siege?
In a fiery critique of Duale’s handling of the claimed Ksh10.6 billion fraud, Lishenga dismissed the government’s claims as misleading and mathematically inconsistent.
“The CS wakes up one morning and says there are Ksh10.6 billion in fraudulent claims. Shocking, totally shocking for the entire country. But what does he do? He presents a list of 901,188 facilities; when you break it down, you get only 24 facilities that have actually completed investigations,” he scoffed.
He challenged the Ministry of Health to release evidence of these claims, especially the financial breakdown per facility.
“Even if you say 24 facilities are responsible for Ksh10.6 billion, you are saying each facility has stolen Ksh446 million. Can the Cabinet Secretary publish how much each facility has been paid? Does that add up to Ksh10.6 billion?” he posed.
Lishenga also highlighted where most of the SHA payouts are going and questioned why fraud investigations are not targeting the biggest recipients.
“Out of the Ksh53 billion that SHA has paid out so far, Ksh27 billion has gone to level five and level six referral hospitals. There are only 99 such hospitals in the entire country. Are you telling me we should be looking for fraud in small dispensaries all over Kenya?” he asked.
The RUPHA chair suggested that the SHA leadership, instead of confronting the economic realities of an underfunded system, is resorting to blanket accusations of corruption.
He drew a personal comparison between President William Ruto’s own journey and the current treatment of small healthcare providers. From humble beginnings as a chicken seller, the Head of State rose through resilience and determination, a path he argues is similar to the entrepreneurs who built many of Kenya’s private healthcare facilities.
“The story of President Ruto is a story of determination and resilience. I draw a parallel with many in the private health sector. They are not dynasties; they are hustlers who built these hospitals over many years,” Lishenga said.
He questioned whether the same country that once gave people like him a chance is now unfairly condemning private healthcare providers.
“Suppose, when the President was coming up as a chicken seller, he had given someone eggs on credit and never got paid? That’s the state private healthcare providers are in today, condemned without a hearing,” he challenged Ruto.