The Senate County Public Investments and Special Funds Committee met with Baringo County Governor Benjamin Cheboi and his executive team, who were invited to account for what the Auditor General’s report described as a cascade of deficiencies across the county’s public hospitals for the 2024/2025 financial year.
The interrogation, led by Senator Godfrey Osotsi, focused on a systemic failure to bridge the gap between high-level designations and the reality of care.
While Baringo County Referral Hospital (BCRH) is classified as a Level 5 facility, sub-county hospitals, including Kabartonjo, Marigat, Eldama Ravine, and Chemolingot are designated as Level 4, the same status is not reflected on the ground.
The committee reviewed a catalogue of findings that cut to the heart of Kenya’s Universal Health Coverage (UHC) promise: hospitals classified as referral facilities that could not demonstrate the equipment or staffing ratios commensurate with that status.
Senator Godfrey Osotsi opened the interrogation with measured gravity:
“Governor, the Auditor General has visited these hospitals, physically verified what is there and what is not there, and put it in writing. We are not dealing with opinions here; we are dealing with facts on the ground. The people of Baringo were told these are Level 4 and Level 5 hospitals. Our question today is very simple: what exactly does that mean for a patient who walks through those doors?”
Governor Cheboi, responding to the committee, defended his administration’s record while acknowledging the resource gaps, stating:
“We are operating in a complex environment where the classification of a hospital often outpaces the arrival of specialized equipment. At Eldama Ravine, for instance, we have finally formed an asset management committee to ensure we recognize and depreciate our assets properly, a step that was previously ignored”.
Senator George Mbugua was unsparing in his critique of the equipment shortages, specifically targeting the Intensive Care Unit (ICU) at BCRH, which had only one functional ventilator.
“I am looking at this list, and I am asking myself: what exactly makes this a referral hospital? You have an ICU with one ventilator. You have a maternity ward that, by your own admission, is poorly equipped. Your eye care equipment breaks down, and you are waiting for parts from abroad. The upgrading of these hospitals has excited the organograms; it has not excited the patients. That is the problem.”
The Governor responded by explaining the commercial challenges of equipping remote facilities.
“Placement of expensive equipment like MRI scanners is often a matter of business feasibility. Suppliers expect a certain level of patient traffic to recover their investment. In remote Level 4 hospitals like Chemolingot or Kabartonjo, where traffic is low, we struggle to attract these vendors. It is therefore a joint responsibility of the county and national government to provide essential machines where the market logic fails”, explained the Governor.
The most damning evidence concerned the county’s human resource practices. Across Baringo’s hospitals, there are 730 casual employees. At the Level 5 Referral Hospital alone, 222 casual and contracted staff are on the payroll, including 41 nurses.
Auditors found that some of these technical staff have been working on three-month rolling contracts for up to ten years, a direct violation of the Employment Act and the County Public Service Human Resource Manual.
Senator Godfrey Osotsi observed:
“You cannot tell us that you do not have money to pay permanent nurses when you are already paying the same nurses on a three-month basis for ten years. The money is going out regardless. The only thing you are saving is their pension and their job security. That is not a saving the law allows you to make.”
Governor Cheboi responded:
“The wage bill is a heavy chain around our neck. While we admit that the engagement of technical staff on renewable three-month contracts is widespread, we have used Facility Improvement Funds to keep these hospitals running. We are now working on a plan to regularize these staff through the Public Service Board, but we must balance this against our fiscal envelope.”.
The session’s closing exchanges focused on a third anomaly: the issuance of over Kshs. 2.2 million in hospital bill waivers to patients not enrolled in the Social Health Authority (SHA). This practice violates the Social Health Insurance Regulations 2024, which requires a valid SHA number for all claims.
Governor Benjamin Cheboi noted:
“A significant portion of our population in Baringo lacks national identity documents, making SHA registration impossible. We are often forced to choose between strict legal compliance and the human necessity of releasing a body from the mortuary or treating an indigent patient.”
The committee adjourned with a plan for a physical site inspection of the Baringo County Referral Hospital and for a management action plan to absorb long-serving technical staff.
By Anthony Solly
