PAC Report Exposes Failing Healthcare System in Nairobi: Mbagathi and Mutuini Hospitals in Dire Straits
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A fact-finding mission by the Public Accounts Committee (PAC) of the Nairobi City County Assembly has revealed a dire situation at Mutuini and Mbagathi County Hospitals, marked by stalled projects, severe congestion, and a lack of adequate funding. The committee’s chair, Ngara Ward Representative Chege Mwaura, highlighted the critical challenges facing the hospital during a recent visit.
“We are here at Mbagathi County Hospital on a fact-finding mission,” Mwaura stated. “The Auditor General had raised a query with regards to congestion and a couple of stalled projects. We have ascertained that there is serious congestion that has actually tripled.”
The PAC’s investigation uncovered several factors contributing to the hospital’s overstretched capacity. Mwaura pointed to delays in remittances from the Social Health Authority (SHA) and pending bills from the defunct National Health Insurance Fund (NHIF), which have severely hampered the hospital’s operations. He also noted the absence of funding from the Nairobi County Revenue Fund.
“All they’ve been able to do is within their own source revenue,” Mwaura explained.
A key concern for the committee is the number of stalled county projects.
“The projects that are stalled are all county projects, none that are started by the hospital,” Mwaura emphasized.
The PAC plans to engage with City Hall officials to demand an explanation for the delays and to push for the release of funds to expedite the projects.
Mwaura suggested a shift in the county government’s approach to healthcare management.
“Instead of the county government rushing to do the environment with a management company, they should start with level 5s,” he said, highlighting the disparity between hospital-led projects and those initiated by the county.
He cited the stalled microwave incinerator project (70% complete) and a delayed transformer installation as examples of critical infrastructure projects hampered by lack of funding. The hospital’s current power supply is inadequate, forcing it to rely heavily on costly diesel generators. “We need to allow the level 5 hospitals belonging to the county to operate semi-autonomously, just like Mbagathi Hospital operates with the national government without interference,” Mwaura recommended. The transformer project, requiring only 21 million Kenyan Shillings, has been stalled for approximately a year.
Mwaura criticized Governor Johnson Sakaja’s proposed projects, stating, “We have missed priorities from Governor Johnson Sakaja’s proposed projects with regards to health, especially noticing that they’ve not been given any amount. Same again, we were in Mama Lucy Kibaki Hospital. They also don’t get any amount of support from City Hall.”
The financial strain on Mbagathi Hospital is further exacerbated by significant debts owed by SHA and the defunct NHIF.
“As we sit here as of today, SHA owes Mbagathi Hospital 107 million,” Mwaura revealed. “For NHIF, the defunct NHIF cumulative rate, they owe Mbagathi Hospital, Ksh. 305 million. This is a public facility and that is the only revenue stream that we have. If when SHA does not remit or reimburse, then that tells you about to undergo a lot of charities.” Mwaura stressed that this issue affects other public hospitals in Nairobi, including Mama Lucy, Pumwani, and Mutuini.
The power outages at Mbagathi Hospital are not only due to the unpaid Kenya Power bill but also stem from the hospital’s expanded services and the shared power supply with the surrounding area, including the Kibra informal settlement.
“We are expanding services, hospital services. In theatres, in radiology, laboratory and all over. And the ICU,” Mwaura explained.
The frequent power outages necessitate the use of diesel generators, adding to the hospital’s operational costs.
Mwaura also addressed the issue of patient waivers. “When the governor gives with us, most of the time he does so on humanitarian grounds,” he said, acknowledging that waivers are common practice for vulnerable families who cannot afford medical expenses.
He noted that other officials, including senators and members of the National and County Assemblies, also request waivers.
The PAC’s findings highlight a systemic problem within Nairobi’s county health facilities. The committee’s report is expected to provide a comprehensive assessment of the challenges and offer recommendations to improve healthcare delivery across the city. The report will address the stalled projects, the funding shortfalls, and the need for greater financial autonomy for level 5 hospitals.
The committee also visited Mutuini Health facility, where a new wing started by the Nairobi Metropolitan Service (NMS) has also stalled.
Following the renaming from Mutuini Hospital to Mama Rachel Ruto Hospital, the national government has assumed responsibility for its expansion, with workers actively progressing on site.
The national government will also furnish the facility with necessary equipment before its handover back to the county government.
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