Patients seeking specialised treatment at Kenyatta National Hospital (KNH) are grappling with significantly higher medical bills following a revision of charges for several diagnostic and specialised procedures, leaving some unable to afford essential healthcare.
The revised fees, which took effect in April, have more than doubled the cost of some procedures and nearly tripled others. Patients say they were not informed of the changes before arriving for scheduled appointments, while many have been forced to pay out of pocket because the procedures are either not fully covered or excluded from the Social Health Authority (SHA).
Among the services affected is colonoscopy, whose cost has increased from about Sh9,800, excluding biopsy charges, to Sh25,000.
Patients requiring a biopsy now pay an additional Sh2,500, bringing the total cost to Sh27,500. Endoscopy charges have also risen from Sh6,500 to Sh20,000, with biopsies attracting an extra Sh2,500. Ultrasound scans now cost Sh4,800, up from Sh1,800, while outpatient consultation fees have increased from Sh1,150 to Sh1,550.
Several patients said the higher charges have disrupted their treatment plans and placed vital medical procedures beyond their reach.
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One woman, who requested anonymity, said her family has relied on KNH for nearly a decade to manage her husband’s chronic digestive illness after treatment elsewhere proved unsuccessful.
“The increase is killing my hope that my husband will receive treatment and eventually recover,” she said after paying Sh27,500 for his colonoscopy and biopsy.
She recalled that the same procedure initially cost about Sh6,000 before increasing to approximately Sh9,800, making the latest revision the highest they have ever faced.
Another patient from Nyeri County said she only learnt of the new charges when she attended a scheduled review on April 24.
“That is the day we were informed that the new medical rate card had taken effect,” she said after paying Sh25,650 for the procedure.
A mother from Matuu in Machakos County said she struggled to raise enough money for her son’s follow-up colonoscopy after surgery, noting that the increased biopsy charges pushed the total bill to Sh27,500.
“I struggled to raise it,” she said.
For others, the higher costs have resulted in delayed treatment. Stanley, a resident of Kiambu County, said he postponed an endoscopy after discovering the revised charges.
“Because of the stomach pains I have been experiencing, I have been advised to undergo an endoscopy, but the price has gone up,” he said.
Patients also questioned why they were still required to make substantial cash payments despite government assurances that SHA would reduce out-of-pocket healthcare expenses.
A KNH doctor, who spoke on condition of anonymity because they are not authorised to speak to the media, said many specialised investigations are either not fully covered by SHA or are only reimbursed under limited benefit packages.
“Many patients assume SHA covers everything, but that is not the case. Colonoscopies, endoscopies and several specialised investigations are either not fully covered or are covered only under specific benefit packages. Patients are often shocked when they discover they have to pay cash,” the doctor said.
The medic attributed the increase in charges to rising operational costs, including imported medical consumables, laboratory reagents and the maintenance of specialised medical equipment. According to the doctor, hospitals face difficulties sustaining specialised services when reimbursements fail to match the actual cost of care.
The doctor urged SHA to broaden its benefits package to include essential diagnostic procedures.
“Our appeal is that SHA should review its benefits package to accommodate these essential procedures. Many gastrointestinal diseases are detected through colonoscopy and endoscopy. If patients cannot afford these procedures, diagnosis is delayed and treatment becomes even more expensive. Covering these investigations under SHA would save many lives in the long run,” the doctor said.
Efforts to obtain a response from KNH management were unsuccessful. Calls and text messages to the hospital’s Chief Executive Officer, Dr Richard Lesiyampe, and Deputy Chief Executive Officer, Dr John Ngigi, had not been answered by the time of publication.
