Cartel Jayesh Saini, owner of Nairobi West Hospital, is linked to a Senate probe over Sh176 billion missing from Kenya’s medical insurance schemes for teachers, police, and prison officers.
In December 2023, the Senate began investigating the loss of Sh176.1 billion allocated over nine years for medical schemes covering teachers, police, and prison officers.
At the center of this inquiry was Medical Administrators Kenya Limited (MAKL), a private company handling payments for medical services provided to these groups.
There were growing complaints from teachers and police officers about delayed payments, leaving them to cover medical expenses out of pocket, despite having insurance coverage.
MAKL, along with Bliss Medical, manages the capitation and administration for these insurance schemes. This issue led to concerns within the Senate, as highlighted by Nominated Senator Raphael Chimera, who called for an investigation into the delays in processing claims.
However, reports suggest that nine months later, the Senate’s oversight efforts may have been compromised, with allegations of bribery emerging.
Jayesh Saini, a known ally of President William Ruto, is believed to have played a key role in silencing the probe.
Saini has a controversial history, being previously involved in the Clinix scandal linked to the National Hospital Insurance Fund (NHIF).
Additionally, he was implicated in an illegal scheme to import the Sputnik-V COVID-19 vaccine into Kenya at inflated prices through his company Dinlas Pharma, raising questions about his deep political connections.
MAKL, through its administration of insurance schemes for teachers and police officers, allegedly prioritizes profit over service delivery. Hospitals contracted by MAKL reportedly face pressure to treat fewer patients to maximize earnings from the low capitation fees provided, leaving patients frustrated and often forced to pay for their own treatment.
Nairobi West Hospital, also owned by Saini, is accused of being part of this system, denying services or causing long delays to push patients toward out-of-pocket payments.
Furthermore, Saini’s involvement in other controversial deals, such as the planned takeover of Jomo Kenyatta International Airport (JKIA) by the Adani Group, has sparked public outrage.
This deal, along with Saini’s control over key healthcare institutions, has raised concerns about conflict of interest, as his companies both insure and provide medical services. Critics argue that public healthcare is being deliberately undermined, with Saini’s private enterprises benefiting at the expense of insured individuals.
Saini’s influence is believed to extend far beyond the healthcare sector, with his connections to high-ranking officials, including President Ruto, placing him at the heart of several political and economic controversies in Kenya. The Senate’s failure to act on the alleged corruption surrounding the medical insurance schemes has further fueled concerns about the extent of his power and influence.
