President William Ruto has denied claims that county governors were coerced into signing the Intergovernmental Participation Agreement, which provides a framework for devolved units to lease medical equipment.
Addressing the matter on Thursday, President Ruto dismissed the allegations, stating that the leasing of medical equipment under the Social Health Authority (SHA) is voluntary and conducted within procurement laws.
"You have to be a fool to be forced to sign the wrong thing, and you actually sign it and then go announce that you were forced. What kind of fool are you?" Ruto said.
He emphasized that counties are free to determine their equipment needs and explore alternative procurement methods.
"If you signed, it's for you to decide what equipment you need. If you have alternative means to get the equipment, you are free to get them from wherever," he added.
However, appearing before the County Public Accounts Committee, Council of Governors (COG) Vice Chair Mutahi Kahiga disclosed that counties felt pressured to sign the agreement to ensure service delivery, as most lacked the fiscal capacity to procure the equipment outright.
Kahiga also noted that declining to sign the agreement would hurt ordinary Kenyans, as essential medical machines in county hospitals, such as dialysis equipment provided under the Managed Equipment Services (MES) program, have become outdated and nonfunctional.
Voluntary scheme
President Ruto reiterated that health is a devolved function and emphasized that the SHA medical equipment leasing program operates on a voluntary, need-based model.
"The leasing of equipment that I'm seeing in the media [was] carried out through a procurement process between counties and the Ministry of Health. There's no obligation for any county to acquire equipment from any specific supplier," Ruto remarked.
He explained that county-owned hospitals could choose to lease equipment from seven approved suppliers based on their needs and financial capacity.
"There are seven or so suppliers, and there's no obligation on any county. Anyone who claims they [were] forced by the national government to sign a contract is either a conman or a liar. Nobody forced them," he asserted.
Senate Concerns
The Senate Committee on County Public Accounts, chaired by Homa Bay Senator Moses Kajwang, raised concerns about the SHA leasing program, questioning its value for money and its implications on devolution.
Busia Senator Okiya Omtatah challenged the legality of the deal, questioning its compliance with the Public Procurement and Disposal Act.
"What law are you using to sign the contract? Did you consult your attorney before signing?" Omtatah queried.
Kajwang criticized the arrangement, arguing that the Ministry of Health's involvement in procurement undermines devolution and raises doubts about the program's sustainability and effectiveness.
"Don't be defensive. We need to hold the ministry accountable. You cannot use people's health and lives for business," Kajwang said.
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Implementation Challenges
Kahiga admitted that the sustainability of the leasing agreement is uncertain, citing challenges in the transition and implementation of the Social Health Insurance Fund (SHIF).
"What I must admit here is that we have rushed this thing. We are too fast, and we might crash along the way. I don't want to say this is the best deal--I don't even know if it will work," Kahiga said.
So far, 34 county governments have signed the agreement, with limited details provided about the legal framework governing the procurement process.
Concerns persist over whether the program will deliver value for money or meet the healthcare needs of citizens effectively.
