Report On Consideration Of The Health (amendment) Bill (na Bill No. 56 Of 2024)

REPUBLICOFKENYA

THENATIONALASSEMBLY

THIRTEENTHPARLIAMENT-FOURTHSESSION-2025

DIRECTORATEOFDEPARTMENTALCOMMITTEES

DEPARTMENTALCOMMITTEEONHEALTH

REPORT ON THE HEALTH (AMENDMENT)BILL,2024 (NATIONAL ASSEMBLYBILL NO.56OF2024)BYHON.JANENJERIMAINA,MP

November,2025

Published by: TheDirectorateofDepartmentalCommittees Clerk's Chambers Parliament Buildings NAIROBI

TABLEOFCONTENTS

| LISTOFANNEXURES | | |--------------------------------------------|-----| | CHAIRPERSON'SFOREWORD | U1 | | CHAPTER ONE | | | 1.0PREFACE | | | 1.1Establishmentand MandateoftheCommittee | | | 1.2Subjects under the Committee | | | 1.3 Oversight. | | | 1.4 CommitteeMembership. | | | CHAPTER TWO. | | | 2.1OVERVIEWOFTHEBILL | | | CHAPTERTHREE | | | 3.OCONSIDERATIONOFTHEBILLBYTHECOMMITTEE | | | 3.1LEGALPROVISIONONPUBLICPARTICIPATION | 6 | | 3.2PUBLICPARTICIPATIONINTHEREVIEWOFTHEBILL | 6 | | 3.3SUBMISSIONSONTHEBILL | 7 | | CHAPTERFOUR | 22 | | 4.0 COMMITTEEOBSERVATIONS. | 22 | | CHAPTERFIVE | .23 | | 5.0 COMMITTEERECOMMENDATIONS | 23 | | CHAPTERSIX | 24 | | 6.OSCHEDULEOFAMENDMENTS | 24 |

LISTOFANNEXURES

Annexure1

Minutes of Committee sittings

Annexure2

Report adoption schedule

Annexure3

Analysis of submissions by stakeholders on the Bill

Annexure4

Copy of the newspaper advertisement on public participation on the Bill

Annexure5

Letterinviting stakeholders to submit views on the Bill

Annexure6

Letter inviting stakeholders for a meeting with the Committee on the Bill

Annexure 7:

Stakeholdersubmissions

CHAIRPERSON'SFOREWORD

This report contains the proceedings of the Departmental Committee on Health on its considerationoftheHealth(Amendment)Bill,2024(National AssemblyBill No.56of 2024), whichwaspublished on 27thDecember,2024.TheBillwas read theFirstTimein theHouse onWednesday,4thJume2025,and thereaftercommittedtotheDepartmentalCommittee on Health for consideration and reporting to the House pursuant to the provisions of Standing Order127.

The Bill seeks to amend the Health Act, Cap. 241,to provide for access to emergency treatment and health care services prior to thepaymentofprospectivemedical costsbyusers. TheBillfurtherseeks tomakeit anoffenceforpublichealth facilitiesandhealth care providers in charge of health facilitiesto detain thebody of a deceased person as a means of enforcing settlement of outstanding medical bills. The proposed amendment is therefore intended to resolve the problem of patients or their relatives/kin having to pay medical fees and/or admissionfeesprior to their admission andtreatmentinpublichealthfacilities.

Following the placement of an advertisement in the print media on 13th June, 2025 seeking publicand stakeholderviewsontheBill pursuant toArticle11S(1)(b)ofthe Constitution and Standing Order 127(3), the Committee received submissions from four (4) stakeholders including; the Ministry of Health (MOH), Office of the Attorney General and Department of Justice (OAG), the Kenya Law Reform Commission (KLRC) and the National Gender and Equality Commission (NGEC),

The Committee also engaged various stakeholders, including the Ministry of Health (MOH) the Office ofthe Attorney General and Departmentof Justice(OAG and DOJ) and theKenya Law Reform Commission (KLRC), to make submissions on the Bill. The meeting was held on Tuesday,7thOctober2025.

The Committee is grateful to the Offices of the Speaker and the Clerk of the National Assembly for the logistical and technical support accorded to it during its sittings. The Committeefurther wishesto thank all stakeholderswho submitted memoranda on theBill.

Finally, I wish to express my appreciation to the Honourable Members of the Committee and the CommitteeSecretariatfor theirvaluable contributions towards the consideration of the Bill and the production of this Report

On behalf of the Departmental Committee on Health and pursuant to the provisions of Standing Order 199 (6), it is my pleasant privilege and honour to present to this House the Report of the Committee on its consideration of the Health(Amendment) Bill,2024 (National Assembly Bill No.56 of 2024) by Hon.Jane Njeri Maina,MP

It is my pleasure to report that the Committee has considered the Health (Amendment) Bill, 2024(National Assembly Bill No.56 of 2024) and has the honour to report back to the NationalAssemblywiththerecommendation thattheBillbeapprovedwithamendments asreportedbytheCommittee.

HON.DR.NYIKALJAMESWAMBURA,CBS,MP CHAIRPERSON,DEPARTMENTALCOMMITTEEONHEALTH

1.0PREFACE

1.1EstablishmentandMandateoftheCommittee

• 1.The Departmental Committee on Health is one of the Departmental Committees of the National Assembly established under Standing Order 216 whose mandates pursuant to the Standing Order 216(5) are as follows:
• a)To investigate,inquire into, and report on all matters relating to the mandate, management, activities, administration, operations and estimates of the assigned ministries and departments;
• b) To study the programme and policy objectives of ministries and departments and the effectiveness of the implementation;
• on a quarterly basis, monitor and report on the implementation ofthe national C budget in respect of its mandate;

d) To study and review all legislation referred to it;

• e) To study, assess and analyse the relative success of the ministries and departments as measured by the results obtained as compared with their stated objectives;

2. f) To investigate and inquire into all matters relating to the assigned ministries and departments as they may deem necessary, and as may be referred to them by the House; 3. g)To vet and report on all appointments where the Constitution or any law Order 204(CommitteeonAppointments);

• h) )To examine treaties, agreements and conventions;
• i) To make reports and recommendations to the House as often as possible, including recommendations of proposed legislation;

6. j)To consider reports of Commissions and Independent Offices submitted to the House pursuant to the provisions of Article 254 of the Constitution; and

CHAPTERONE

• k)To examine any questions raised by Members on a matter within its mandate.

1.2SubjectsundertheCommittee

2. InaccordancewiththeSecondScheduleof theStandingOrders,theCommitteeis mandated to consider matters related tohealth,medical care and health insurance, including universal health coverage.

1.3 Oversight

3. In executing its mandate, the Committee on Health oversees the:

• i. StateDepartmentforMedicalServices
• i. StateDepartmentforPublicHealth andProfessional Standards.

1.4 Committee Membership

4. The Departmental Committee on Health was constituted by the House on 27th October2022andcomprisesthefollowingMembers:

Chairperson

ODM Party

Hon.Dr.Nyikal James Wambura, CBS MP Seme Constituency

Vice-Chairperson

Hon.Ntwiga,Patrick Munene MP Chuka/Igambang'ombe Constituency

UDA Party

Hon. Owino Martin Peters, MP Ndhiwa Constituency ODM Party

Hon. Muge Cynthia Jepkosgei, MP Nandi (CWR) UDA Party

Hon. Wanyonyi Martin Pepela, MP

Webuye East Constituency Ford Kenya Party

Hon. Kipng'ok Reuben Kiborek , MP Mogotio Constituency

UDA Party

Hon.(Dr) Robert Pukose,CBS MP Endebess Constituency

UDA Party

Hon. Kibagendi Antoney, MP Kitutu Chache South Constituency ODM Party

Hon. Julius Ole Sunkuli Lekakeny, MP Kilgoris Constituency KANU

Hon. Maingi Mary, MP Mwea Constituency UDA Party

Hon.Mathenge Duncan Maina, MP Nyeri Town Constituency UDA Party

Hon. Lenguris Pauline, MP Samburu (CWR) UDA Party

Hon. Oron Joshua Odongo, MP Kisumu Central Constituency ODM Party

Hon. (Prof.) Jaldesa Guyo Waqo, MP Moyale Constituency

UPIA Party

Hon.Mukhwana Titus Khamala,MP Lurambi Constituency ODM Party

1.5 CommitteeSecretariat

5. The Committee is facilitated by thefollowing staff secretariat:

Mr.HassanAbdullahiArale

ClerkAssistantI/HeadofSecretariat

Mr.Timothy Kimathi Samson ClerkAssistantIII

Ms. Gladys Jepkoech Kiprotich Clerk Assistant III

Ms.Marlene Ayiro Principal Legal Counsel I

Ms.Sheila Chebotibin SeniorSerjeant-At-Arms

Ms. Faith Chepkemoi Legal Counsel 1I

Ms. Abigel Muinde

Research OfficerIII

Mr.Hiram Kimuhu

Ms. Rahab Chepkilim AudioRecording Officer II

Fiscal Analyst III

Mr Eric Lungai

Mr. Hillary Mageka MediaRelations OfficerIII

Hansard Reporter II

CHAPTERTWO

2.0 THE HEALTH (AMENDMENT) BILL, 2024 (NATIONAL ASSEMBLY BILL NO. 56 OF 2024)

6. The Health (Amendment) Bill, 2024 (hereinafter referred to as "the Bill"), sponsored by Hon. Jane Njeri Maina, MP, has been referred to the Departmental Committee on Health for consideration after First reading on Wednesday, 4th June 2025. 2. 7.The Bill seeks to amend the Health Act, Cap. 241, to provide for access to emergency treatment and health care services prior to the paymentof prospective medical costs by users.TheBill further seekstomakeit an offencefor public healthfacilities and health care providers in charge of health facilities to detain the body of a deceased person as a means of enforcing settlement ofoutstanding medical bills. The proposed amendment istherefore intended to resolve the problem of patients or their relatives/kinhaving topaymedicalfees and/or admissionfeespriortotheir admission and treatmentin publichealth facilities.

2.1OVERVIEWOFTHEBILL

8. Clause 1 provides the short title of theBill. 9. Clause2 amendssection2oftheHealthActbydeletingthedefinitionoftheterm "emergency treatment" which means"the necessary immediate health care that must beadministered toprevent death or worsening of a medical situation".This definitionisproposed tobesubstitutedwith thefollowingnewdefinition—

"emergency medical treatment" means the necessary initial or immediate medical care that is administered to a critically ill or injured person to avert or prevent death, disability, unnecessary morbidity or worsening of a medical situation".

10.Clause 3 amends section 7 of the Health Act by:

• immediately after the words"medical treatement"in subsection (1);
• (b) inserting the words "including the appropriate or recommended medical care provided at the scene of injury or illness, during transportation to a health facility, and through to a department responsible for emergency treatment and early in-patient care" immediately after the word "care" appearing in subsection (2)(a);
• (c) deleting the words"the individual" in subsection (2)(b) and substituting therefor the words"a critically ill or injure patient prior to transportation to a definitive healthcare facility";
• (d) deleting the words"the victim"and substituting therefor the words"a patient who is critically ill or injured" in subsection 2(c); and
• (e)inserting two new subsections immediately after subsection(3)that:
• (i)makes it an offence for a person in charge of apublic health facility if the person demands or permits the demand of payment of prospective medical fees or admission fees prior to providing emergency treatment; this offence shall attract a fine not exceeding three million shillings; and
• (i) makes it an offence for a person in charge of a public health facility if the person detains or permits the detention ofthe body of a deceased person for purposes ofenforcing the settlement of pending bills; this offence shall attract a fine not exceeding two million shillings.

11. Clause 4 amends section 12 of the Health Act by inserting a new subsection (2A) to the effect that "all health care providers in the public sector shall not demand for prepayment of prospective medical costs as a condition for the provision of emergency treatment to a user".

CHAPTERTHREE

3.0CONSIDERATIONOFTHEBILLBYTHECOMMITTEE

3.1LEGALPROVISIONONPUBLICPARTICIPATION

5. Article 118 (1) (b) of the Constitution of Kenya provides as follows-

"Parliament shall facilitate public participation and involvement in the legislative and other businessofParliamentanditsCommittees."

6. Standing Order 127(3) provides that

"TheDepartmentalCommitteetoehichaBilliscommittedshallfacilitatepublicparticipation on theBill through anappropriatemechanism, including——

• (a)inviting submission of memoranda;
• (C) consultingrelevant stakeholders in a sector; and
• (b)holding public hearings;
• (d) consulting experts on technical subjects.
• 7.Standing Order127(3A) further provides that—

"The Departmental Committee shall take into account the vieres and recommendations of the public under paragraph (3) in its report to the House.

3.2PUBLICPARTICIPATIONINTHEREVIEWOFTHEBILL

• 8.The Health (Amendment) Bill, 2024 (National Assembly Bill No. 56 of 2024), which was published on 27th December 2024. Pursuant to Standing Order 127(1), the Bill was referred totheDepartmental Committee onHealth,havingbeenread theFirstTimein the House onWednesday,4thJune 2025
• 9.Pursuant to the aforementioned provisions of the Constitution and the Standing Orders on public participation, the Committee, through local daily newspapers (Nation and Standard) of Friday,13th June 2025,published an advertisement inviting the public to submitmemorandaontheBill.

10. The Committee also sought comments on the Bill from relevant stakeholders, namely the Ministry ofHealth, the Office ofthe Attorney General and the DepartmentofJustice, and the Kenya Law Reform Commission, vide letter dated 25th July 2024.

• 11.Further,vide a letter dated 25th September 2025,the Committee invited the Ministry of Health, the Office ofthe Attorney General and Departmentof Justice (OAG & DOJ), and the Kenya Law Reform Commission (KLRC) to appear before the Committee to submit their memoranda on the Bill: The meeting to consider their submissions was held on Tuesday, 7th October 2025.

3.3SUBMISSIONSONTHEBILL

12. The Committee received submissions through oral presentations and written memoranda from the following institutions:

• a) The Ministry of Health (MOH);

3. b) The Kenya Law Reform Commission (KLRC);

• c) The Office of the Attorney General and Department of Justice (OAG and DOJ);
• d) The National Gender and Equality Commission (NGEC); and

6. e The Pharmaceutical Society of Kenya (PSK) Nairobi Branch. 7. 13.TheMinistry of Health(MOH) submitted as follows: 8. Delete Clause 2 as the definition of the term "emergency treatment" as provided in Section 2 of the Health Act, provides a holistic interpretation of the term "emergency treatment"and covers all aspects ofemergencysituations.

The removal of the word "must" from the original definition substantially broadens the scope of what may be classified as an emergency medical condition.

Furthermore, the inclusion of the term"injured person" without qualifying the degree or severity of injury is problematic. Emergency care frameworks are typically structured aroumd the urgency and seriousness of a condition.

The addition of terms such as "disability"and"unnecessary morbidity"may expose healthcare providers and facilities to increased legal liability, particularly in contexts where outcomes are difficult topredict or where resource constraints affect care.

Committee Resolution: Adopted. The proposed definition of the term "emergency medical treatment"is complicated and may lead to operational andlegal umcertainty. The current definition, as provided in Section 2 of the Health Act, Cap. 241 provides a holistic interpretation of the term "emergency treatment" and covers all aspects of emergency situations.

• b)Delete Clause 3(a) as primarily,the proposed amendment is a direct affront to the principle of Article 43(2) of the Constitution of Kenya, which recognizes every person's right to receive emergency treatment. The amendment will,in no doubt, result in loss of life, permanent disability and irreversible harm for persons seeking emergency treatment.

The amendment, further, fundamentally undermines the principle of non-discrimination in access tohealthcare and will result in the erosion of public trust in thehealth system. The amendment also grossly contravenes the principle of the Government's Bottom-Up Economic Transformation Agenda (BETA) that has prioritized the delivery of Universal Health Coverage, by introducing financial barriersin the access to essential healthcare services.

Further, the Social Health Insurance Act establishes the Emergency, Chronic and Critical Illness Fund to cater for any medical costs related to the provision of emergency medical treatment.

Committee Resolution: Adopted. The right to emergency medical treatment as drafted in section 7(1) of the Health Act, Cap. 241 is sufficiently guaranteed.

• C Clause 3(b) be deleted as the term 'pre-hospital care" as used in Section 7(2) (a) of the Organization (WHO) i.e., the provision of emergency medical services (EMS) for resuscitative, preventative, analytical, and stabilizing purposes, both at the scene of an

Further, Regulation 28(2)(j) ofthe Social Health Insurance Regulations, 2024, recognizes emergency services to include ambulance and evacuation services.

Committee Resolution: Adopted the term"pre-hospital care"includes medical care provided at the scene of injury to the point where comprehensive healthcare is provided at a health facility.

• d)Clause 3(c) be deleted as the proposed amendment is too prescriptive and will result in exclusion of legitimate persons in need of emergency treatment. Notwithstanding this, the definition of the term "medical emergency" as provided in Section 2 of the Health Act, already recognizes that a person in an emergency situation is one facing an acute situation of injury or illness that poses an immediate risk to life or health or has potential for deterioration in the health of the person or if not managed timely would lead to adverse consequences in the well-being.

Committee Resolution:Adopted with amendment. The issue of"prior to transportation toadefinitivehealthcare facility"deleted as stabilization of apatient isnot solely for

• Clause 3(d) be deleted as section 7(2)(c) ofthe Health Act already adequately provides for the stabilization of the victim, patient, or person within the context of medical emergency treatment. The current phrasing captures the core objective of emergency care— stabilization—and aligns with internationally accepted emergency care principles.

Theproposedinsertions ormodifications to this subsection donot addsubstantivevalue andmayinsteadintroduceredundancyor ambiguity.Giventhatthesectionspecifically pertains to emergency medical treatment,any furtherelaboration may be unnecessary and

Committee Resolution:Not adopted. The proposed amendment clarifies that the victim in the case of a health facility is a patient who is critically ill or injured.

• f) Clause3(e)bedeleted astheproposed amendmentcontradictstheproposed amendment to Section 7(1) of the Health Act. Nonetheless, the constitutional guarantee for every person to access emergency medical treatment bars any health facilities from requiring payment of prospective medical fees or admission fees prior to providing emergency treatment.

Further, the Social Health Insurance Act establishes the Emergency, Chronic and Critical Illness Fund to cater for any medical costs related tothe provision of emergency treatment.Fundamentally, mortuary services are categorized as billable services, and are therefore subjectto applicablefees and charges asper the institution's approvedrates. The charging of such services cannot, therefore, be criminalized as proposed.

Further, these services are already provided for under the tariffs for health care services under the socialhealth insurancescheme so as to alleviate anyfinancialburdens that may be experienced.Anyissuesrelating tothe samecan thereforebehandled administratively.

CommitteeResolution:Not adopted. The amendments are necessary to guarantee the right to emergency treatment in health facilities and to prevent the detention of bodies of dead persons for the enforcement of pending hospital bills.

• g Delete clause 4 as the proposed amendment contradicts the amendment proposed by Hon. Jane Njeri Maina, MP under the proposed changes to Section 7(1). Nonetheless, the constitutional guarantee for every person to access emergency medical treatment bars any health facilities from requiring payment of prospective medical fees or admission fees prior to providing emergency treatment.

Further,theSocial Health InsuranceAct establishes the Emergency,Chronic and Critical Illness Fund to cater for any medical costs related to the provision of emergency medical treatment.

Committee Resolution:NotAdopted.The amendmentis necessary toguarantee the right to emergency treatment inhealth facilities.

• 14.The Officeofthe Attorney Generaland Departmentof Justice(OAG),whilenoting that the policy informing the Bill lies with the Ministry, and that the Office had sought the Ministry's guidance on the Bill, submitted as follows:
• a)In clause 2,define the term"definitive healthcare facility"as the term is used in the proposed clause 3(c), which proposes to amend section 7(2) (b) of the Health Act, Cap. 241.

Committee Resolution: Not adopted. The issue of "definitive healthcare facility" is proposed for deletion.

• b Amendclause3(f)inrelationtothenewsubsection(4)to applytobothpublicandprivate health facilities; the proposal applies to public health facilities only. Section 12 of the Health Act, Cap. 241 imposes a duty upon all healthcare providers, whether in public or private, to emergency medical treatment. The proposal should therefore apply to both public and private health facilities. Section 28 of the Social Health Insurance Act, No. 16 of 2023 establishes the Emergency, Chronic and Critical Illness Fund to cover the cost of emergency treatment. All public and private health facilities should be able to provide emergencymedicaltreatandrecoverthecostfromthisFund.

Committee Resolution:Adopted. This will guarantee theright to emergency treatment in allhealthfacilities.

• C Clause 3(f)inrelation to theproposed new subsection (5) should beprovided as a separate provision and amended to apply to both public and private health facilities. The proposal is outsidethescopeofsection7oftheHealthAct,Cap.241,whichdealswiththeprovision ofemergency medical treatment.

Committee Resolution: Adopted. The proposed amendment is outside the scope of section 7 ofthe Health Act, Cap. 241, which deals with the provision of emergency medical treatment.

• d)Newproposal-amend themarginal note of section7 of theHealthActby deletingthe words "emergency treatment" and substituting therefor the words "emergency medical treatment". This is as a consequence ofthe proposal in clause 2 to amend section 2 ofthe Health Act, Cap. 241 to delete the definition of the term"emergency treatment" and substituting therefor the term"emergency medical treatment".

Committee Resolution: Not adopted. The proposed amendment of clause 2 is dropped andhencenoneedforthe amendment.

• e) New proposal-amend section 15(1) of the Health Act in paragraph(a) and (c) by deleting the words "emergency treatment" and substituting therefor the words "emergency medicaltreatment",this is as a consequenceoftheproposalin clause 2to amend section 2 of the Health Act, Cap. 241 to delete the definition of the term"emergency treatment" and substituting therefor the term"emergency medical treatment".

CommitteeResolution:Not adopted.The amendment of section 2 of theHealth Act, Cap.241isproposedfordeletionandhencethereisnoneedforthisconsequential amendment.

15. The Kenya Law Reform Commission (KLRC) submitted as follows:

• a) The Commission supports clause 2 to align the definition of "emergency medical treatment"withArticle 43(2) ofthe Constitution,ensuring it covers immediate,necessary, and life-saving interventions without prior conditions such as payment guarantees,. thereby safeguarding the right to health and life.

Committee Resolution: Not adopted. The proposed definition of the term "emergency medical treatment"is complicated and maylead to operationalandlegaluncertainty.The current definition,as provided in Section 2 ofthe Health Act, Cap.241provides a holistic interpretation of the term"emergency treatment"and covers all aspects of emergency situations.

• b)Proposestoincludenewdefinitionsasfollows:

"detention"means any act of restraining a person from leaving hospital premises, or withholding the body of a deceased person, for non-payment of hospital bills or medical expenses in whole or in part.To clarify and standardize the scope of"detention"in the context of medical facilities, ensuring alignment with constitutional protections against unlawful deprivation of liberty.

Committee Resolution:Not adopted. The term is used in its ordinary sense.

"guarantee"means an expressed assurance bya person to ahealth facility thatcertain facts or conditions are true or will happen, to pay the unpaid hospital bills or medical expenses ofa patient. To clearly define the legal obligation undertaken by a guarantor to prevent disputes and improve enforcement.

Committee Resolution: Not adopted. The term is used in its ordinary sense.

"health care guarantor" means a person, natural or juridical, who binds himself jointly and severally to pay the unpaid hospital bills or medical/hospitalization expenses of the patient. To ensure accountability by defining the party responsible for fulfilling the guarantee and to protect health facilities from non-payment risks.

Committee Resolution: Not adopted. The term is not used within the text of the proposedamendments

"hospital bill"means the amount owing for clinical and ancillary services rendered, charges for room, meals, medical supplies, drugs and medicines, and payments for use of equipment;and

"medical expenses"means any costs incurred in the prevention or treatment of injury or disease.

To clarify the scope of recoverable costs by health facilities, preventing ambiguity or disputes about what constituteshospital or medical expenses.

CommitteeResolution:Not adopted.The terms need not be definedas they used in their ordinary sense.

"Pre-hospital care"means any medical care received by a patient from an emergency medical service before arriving at a hospital, including any medical care provided at the scene of an injury or illness or during transportation to a health facility. The definition is introduced toprovide clarity on the scope of services considered as pre-hospital care.It ensures that both on-scene emergency interventions and medical assistance provided during transport to a health facility are expressly covered. This promotes consistency in interpretation and aligns the provision with recognized emergency medical service practices.

Committee Resolution: Not adopted. The termis used in the HealthAct, Cap.241 based on its ordinarymeaning.

"promissory note" means an unconditional promise made in writing by a patient or the patient's next of kin to the hospital or medical clinic, engaging to pay on demand, or at a fixed or determinable future time, a sum certain in money for any hospital bill or medical expenses in the course of medical treatment. To provide a clear legal framework for payment commitments to health facilities, facilitating debt recovery while protecting patient rights.

Committee Resolution: Not adopted.The term as used will adopt the meaning as set out in section 84 of the Bills of Exchange Act, Cap. 27.

• ) In relation to clause 3(a), delete the words "prior to the payment of prospective medical costs" and instead use the following phrase-(a) in sub-section (1),by inserting the words," prior to the payment of any hospital bill or medical expenses" immediately after the words "medical treatment".The amendmentis intended to enhance clarity and precision in the provision. The phrase "prospective medical costs" may be ambiguous and open to varying interpretations, particularly regarding whether it applies to anticipated, estimated, or actual medical expenses. By replacing it with the words "any hospital bill or medical expenses", the provision is aligned with common usage in medical and legal contexts,

ensuring certainty and ease of implementation.This also harmonizes the terminology with existing statutory and regulatory language governing medical treatment and related financial obligations.

Committee Resolution: Not adopted. The right to emergency medical treatment as drafted in section 7(1) of the Health Act, Cap. 241 is sufficiently guaranteed.

• d) In relation to clause 3(b), the original phrase in section 7(2)(a) be retained as follows-—

2. "(2) For the purposes of this section, emergency medical treatment shall include(a) Pre-hospital care. The retention of the phrase"pre-hospital care" acknowledges the 3. critical role of emergency medical services in saving lives before hospital admission.

Committee Resolution:Adopted.The term"pre-hospital care"includes medical care provided at the scene of injury to the point where comprehensive healthcare is provided at a healthfacility.

• e)In relation to clause 3(b), the words "through to a department responsible for emergency treatment"be deleted. The deletion is necessary to remove redundancy and avoid limiting the scope of emergency care to hospital-based departments only. It also prevents an unduly restrictive interpretation that might exclude other valid forms of emergency medical treatment. Pre-hospital care is an entire framework that goes beyond hospital settings. It encompasses ambulance services and management, regulation and deplo yment of emergency medical technicians, the role of emergency medical personnel, and overall emergency care management—including the critical role played by bystanders and members of the public in providing first response.

Committee Resolution:Adopted.The term"pre-hospital care"includes medical care provided at the scene of injury to the point where comprehensive'healthcare is provided at a healthfacility.

• In relation to clause 3(c), delete and insert the following words -in sub-section (2) (b) by deleting thewords"theindividualand substituting thereforwiththefollowingwords"a critically ill or injured patient including the appropriate medical care provided at the scene of injury or illness during transportation to a health facility, a department responsible for emergency and earlypatient care."Theamendment seeks tobroaden the scope of emergency medical treatment under sub-section (2) (b) by expressly recognizing the continuum of careprovided to an individual at different stages of an emergency.By inserting the words "including the appropriate medical care provided at the scene of injury orillnessduring transportation toahealthfacility,adepartment responsible for emergencyandearlypatientcare",theprovisionensuresclaritythatemergencytreatment is not confined tohospital-basedinterventions alonebutextendstopre-hospitaland early hospital-based care.

This clarification is necessary to align the law with practical realities of emergency medical services, which involve immediate response at the scene, care during transportation,and prompt attention at the receiving facility.It further promotes comprehensive protection of the constitutional right to emergency medical treatment under Article 43 of the Constitution of Kenya by guaranteeing access to timely, coordinated, and life-saving interventions at every stage of the emergency care chain.

CommitteeResolution:Not adopted.Stabilization ofapatientis notsolelyforpurposes of transportation to a definitivehealthfacility.

• ) Supports clause 3(d),the use of the word "victim" is ambiguous and is already defined in anotherstatute,theVictimProtectionAct.Theproposedamendmentwill bringstatutory harmonywithsection 9 of theActwhichprovides asfollows--

"9.No specified health service may be provided to a patient without the patient''s informed consentunless--

(d) The patient is being treated in an emergency situation.

The amendment replaces the term"victim"with the more accurate and medically contextually linked to criminal law and justice processes, and its continued use in a health statute createsambiguity andinconsistencywith existing lawssuchastheVictim Protection Act.

The proposed wording reflects the medical nature of emergency treatment, ensures statutoryharmonywithin theAct,and alignswith Section 9 oninformed consent in emergency situations. By adopting this language, the provision clearly centers on the patient's health condition rather than their legal or social status, thereby promoting clarity,precision,and uniformity in interpretation.

Committee Resolution: Adopted. The proposed amendments seeks to clarify that the victim in the case of a health facility refers to a patient who is critically ill or injured.

• h) In relation to clause 3(f) and the new subsection (4), proposes the following new subsection (4)—

"(4) A health facility that refuses to discharge a patient after medical discharge has been indicated, for reasons of non-payment in part or in full of hospital bills or medical expenses, commits an offence and is liable on conviction to a fine not exceeding three million shillings."

The current amendment limits protection to public hospitals,leaving patients in private facilitiesvulnerabletounlawful detention anddenial ofemergency care.Whilethisis a positive step, the provision fails to address hospital detention and discriminates against patients inprivatefacilities,whereviolations are equally prevalent.

This proposal must consider the following constitutional contexts, Article 43(1)(a) which guarantees that every person the right to the highest attainable standard of health, applicable inbothpublic and private facilities,andArticle 29which protects individuals from arbitrary detention, including wrongful confinement for unpaid medical bills.

Kenyan courts have repeatedly affirmed that hospital detention,whether in public or privatefacilities,is unconstitutional:

Gideon Kilundo & Daniel Mwenga v Nairobi Women's Hospital [2018]- Detaining patients for unpaid bills violates the right to freedom.

Christine Kidha v Nairobi Women's Hospital [2016] - Detention to compel payment of a contractual obligation undermines liberty.

TryphosaJebetKoskeyvElgonViewHospital[2o16]-Hospitals mustpursue debt recovery through lawful civil processes.

TryphosaJebetKoskeyvElgonViewHospital[2o16]eklrwhereitwasheld that the hospital could have released the petitioner and recovered the outstanding debt as provided bylaw.

The proposed amendment by KLRC:

• b aligns legislation with constitutional provisions and judicial precedents.
• C encourages lawful debt recovery mechanisms without compromising patient dignity.

CommitteeResolution:Adoptedwith amendments.Theprovision extended toprivate facilities are able to recover unpaid hospital bills through lawful debt recovery means without infringing on patients'rights.

• 1 )In relation to clause 3(f) and the new subsection (5), proposes the following new subsection (5)—

"A healthfacilitythatrefusestorelease thebodyorbodiesofdeceasedpatientsforreasons of non-payment in full or in part of hospital bills or medical expenses commits an offence andisliableonconvictiontoafinenotexceedingfivemillionshillings.

Section 7 ofthe Public HealthAct, Cap 241 currently lacks a clearprohibition against the detention of deceased bodies by hospitals. due'to unsettled medical bills. The proposed amendment seeks to address this gap by criminalizing such practices and ensuring that thedignityofthedeceased andtheirfamiliesisprotected.

JudicialPrecedent

In the case of Mary Nyang'anyi Nyaigero & Another v Karen Hospital Ltd & Another 2016]eKLR,theHighCourtorderedtheimmediatereleaseofadeadbodythathad been withheld by the hospital overpendingbills.The court held that detaining a body as security for payment is unlawful and violates the dignity of the deceased and the rights of survivingfamilymembers.

TheKLRCproposal therefore recommends strengthening the provision to cover all health facilities, not just public ones, and to impose a higher penalty. It will also ensure a uniform and comprehensivelegal frameworkprohibitingthe detention ofdeceased bodies, strengthen patient and family rights, and uphold constitutional and human dignity standards.Thisfurther-

• (a) upholds human dignity by preventing the commodification of deceased bodies.
• (b) extendsprotectiontobothpublic andprivatefacilitiestoeliminatediscrimination.
• aligns statutory law with constitutional rights under Articles 28 (human dignity) and 29(freedom and security oftheperson).
• (d)reinforces judicialpronouncements thathospitalsmustpursuelawfulcivil debt recoverymechanismsrather thandetainingbodies.

Committee Resolution:Adopted with amendments.The provision extended toprivate health facilities so as to guarantee access to emergency treatment and to ensure that health facilities are ableto recover unpaid hospital bills through lawful debtrecovery means without infringing on patients'rights.

• The new subsection 12A be amended to state as:"(2A)A healthcare provider shall not demand prepayment of prospective medical costs as a condition for the provision of emergency treatment to a user."Section 12 of the Principal Act currently regulates the provision of healthcare services but does not comprehensively prohibit demanding prepayment for emergency medical treatment. The proposed amendment seeks to address this gap by protecting patients in life-threatening situations from denial of urgent care due to financial constraints. The KLRC proposal recommends broadening this protection to include all healthcare providers, both public and private, to ensure non-discriminatory access to emergency care and ensuring that no life is put at risk due to inability to prepay. TheKLRC proposal will-
• (a)promote access to healthcare services without discrimination based on the type of facility.
• b )ensureequality andnon-discrimination ofpublicfacilities.Limitingprotection to public facilities undermines constitutional principles of equality under Article 27.
• (c)promote therealization oftherighttohealth.Requiringupfront payment during emergencies can lead to preventable deaths and violates the duty of care owed by healthcareproviders.

CommitteeResolution:Adoptedwith amendments.Theprovision extended toprivate healthfacilities so as to guarantee access to emergency treatment and to ensure that health facilities are able torecoverunpaidhospitalbills throughlawfuldebtrecoverymeans without infringing on patients' rights.

• Recommends deletion of Section 12(3) (a) of the Health Act as follows.""Section 12 of the Principal Act is amended by deleting subsection (3)". Deletion of section 12(3) (a) in its entiretywillsafeguardpatients'constitutionalrighttohealth andprevent arbitrary administrativeactions.Thedeletionwill:
• (a)ensureuniform access tohealthcareservicesnationwide.
• (b) protect healthcare providers from unjustified restrictions based on their health status.
• (c)promote fair, transparent, and rights-based health governance.

Section 12(3) of the Health Act, which currently grants the head of a health facility discretionary power to impose conditions on the services provided by healthcare professionals based on their own personal judgement as opposed to the law. The provision has been prone to arbitrary interpretation and application, resulting in the denial or limitation of patients' constitutional right tohealth. While the provision was intended to ensure patient safety and maintain professional standards,in practice,it has:

• (a) granted unchecked legislative power to facility heads, enabling themto unilaterally imposerestrictions without clearlegal or medical guidelines.
• (b) created inconsistent application across facilities, leading to unequal access to healthcare services.
• (c) been used, at times, to discriminate against healthcare providers, especially those livingwith chronic conditions or disabilities.

• (d) indirectly denied patients' right to access essential health services by reducing availableproviders orlimiting the scope of services offered.

If section 12(3) (a) remains, the following risks persist:

• (a) arbitrary restriction of healthcare services- Facility heads can limit or deny services without justification, disproportionately affecting marginalized populations.
• (b) workforce demotivation-Healthcare providers subjected to unwarranted conditionsface stigma,reduced morale,and potential attrition.
• (c) (c) Exacerbation of inequities in health access-Patients, particularly in rural and underserved areas, are most affected when qualified providers are restricted.

Shouldpatientsafety considerationsrequire assessmentofahealthcareprovider'shealth status, this should be addressed through separate regulations developed by the Ministry of Health in consultation with professional bodies, ensuring due process and adherence to humanrightsstandards.

Committee Resolution: Not adopted. The provision is necessary to give health facilities somelevelofdiscretion asneeddictates.

• 1)Amend section 12 of theprincipal Actbyinserting a newSection 12A as follows:

'HealthfacilityPaymentGuarantee

• 12A. (1) A health facility may demand a payment guarantee from a patient after medical discharge has been indicated, where there is non-payment in part or in full of hospital bills or medical expenses.
• (2) The payment guarantee under subsection (1) shall be in the form ofa promissory note issued to the health facility to facilitate lawful debt recovery.
• (3)A health facility shall ensure that the payment guarantee upholds the patient's rights and dignity.
• (4) The Cabinet Secretary may prescribe in regulations the manner in which payment guarantees to health facilities shall be enforced."

One of thekey challenges facing healthcare facilities is recovering unpaid hospital bills without infringing on patients' rights. While detaining patients for non-payment has been declared unconstitutional by Kenyan courts, there is currently no clear legal framework providing hospitals with lawful avenues for debt recovery. The proposed insertion of section 12A seeks to address this gap by allowing health facilities to request payment guarantees rather than resorting to illegal detention practices and infringing on patients' constitutional rights.

This amendmentintroduces a balanced approach.By allowing healthfacilitiestorequest a payment guarantee—in the form of apromissory note—after medical discharge is indicated,thelawprovides hospitalswitha legitimate mechanism tofacilitate debt recovery while ensuring that patients are not unlawfully detained. It safeguards the dignity of patients as protected under Article 28 of the Constitution by ensuring that financial inability doesnotresultin deprivation ofliberty or degrading treatment.

Moreover, the amendment strikes a fair balance between the financial sustainability of healthcare providers and the protection of patient rights. Hospitals require practical solutions to recover costs and remain operational, but these solutions must comply with the Constitution and existing jurisprudence. By formalizing the use of payment guarantees, the proposed Section 12A replaces coercive practices with a rights-based, lawful, and enforceable alternative that benefitsboth patients and health facilities.

In essence,this amendment promotes a patient-centered approach that respects fundamental freedoms while providing hospitals with a transparent and legally compliant frameworkformanaging unpaid bills.It represents an important step toward harmonizing healthcare financing, constitutional rights, and judicial directives.

Lastly, this provision empowers the Cabinet Secretary responsible for health to develop regulations detailing how payment guarantees will be enforced within the health sector.

Committee Resolution:Adopted with amendment.To introduce the aspect of payment guarantee and promissory notes. This will allow health facilities to request payment guarantees rather than resorting to illegal detention practices and infringing on patients' constitutionalrights.

m)The KLRC made the following general comments on the Bill:

• (i)KLRC supports the proposal as a timely and necessaryreform that aligns with the Constitution, particularly Articles 26 (Right to Life), 28 (Human Dignity), and 43(1) (a) (Right to the Highest Attainable Standard of Health).
• (i)Hospital detention practices (HDP), the unlawful detention of patients who are medically cleared for discharge or the withholding of deceased bodies due to unpaid bills—have been documented in both public and private facilities inKenya. The practice has attractedcondemnationfor violatingfundamental humanrights, including the rights to health, dignity, and freedom of movement. The World Health Organization recognises HDP.as a serious but underreported global health andhuman1 rights concern,especially prevalent in low- and middle-income countrieswherehealthcare costs arelargelyborne out-of-pocket.
• (ii) Parliament should consider developing a separate Bill, the Emergency Medical Care Services Act, to provide for standardized, unified, and quality-accessible emergency medical care, and for connected purposes. Such a framework law would services across the country.Currently,Kenya'slegislative framework does not This constitutes a significant gap in the health sector's legal and policy environment.
• (iv) In Kenya, media investigations continue to expose cases of patients denied discharge or bodieswithheld as collateral for unpaid fees.Governmentresponses have been mostlyinformal and reactive,often urging amicable resolutions between hospitals and familieswithout addressingthe systemic and socio-economicfactors that perpetuate the practice. The absence of a clear legislative framework has allowed HDP to persist,undermining public trust in the health system.
• (v)HDPraisesgravehumanrights concerns,contraveningtheprohibition oftorture and cruel,inhuman,ordegrading treatment as setout in the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, and the African Charter on Human and Peoples'Rights.It undermines patient autonomy, entrenches discrimination against economically disadvantaged

populations, and deepens social and economic inequalities, disproportionately affecting women, children, and the rural and urban poor.

• (vi)Kenya requires a clear legislative prohibition of HDP,combined with reforms to strengthen health financing and social protection to reduce out-of-pocket expenditure. The proposed amendments to the Health Act representa critical step toward upholding constitutional rights, protecting human dignity, and building a fairer health system

CommitteeResolution:TheCommitteenoted thegeneralcommentsduring the considerationoftheBill.

16. The National Gender and Equality Commission (NGEC) submitted as follows: 2. a)Amend Clause 3 (f) (4), by inserting the phrase "and Private" after the phrase "public". The provision will be discriminatory in its application as the Health Act interprets "Facility" to include private institutions.

TheMemorandum of Objects andReasonsstates thattheobjectiveistoresolve the problem of patients or their relatives/kin having to pay medical fees and/or admission feespriortotheir admission and treatment.

CommitteeResolution:Adopted.Theprovisionextended toprivatehealthfacilities so as to guarantee access to emergency treatment.

• inserting the phrase "a patient and or" before the phrase "the body" to read as follows: "A person in charge of a public and private health facility commits an offence,if the person detains or permits the detention. of a discharged patient or .the body of a deceased person... 》

The amendment will ensure that both private and public facilities do not detain patients who were admitted under emergency conditions, and not only bodies of the deceased. There are several cases where patients have been detained for non-settlement ofbills as the amount continues escalating to unmanageable levels. The Memorandum of Objects states thattheBill further seeksto amend theActtomakeit anoffencefor only public healthcare facilities and healthcare providers in charge ofhealthcare facilities to detain the bodyofa deceasedperson,onlyas a means ofenforcingsettlementofoutstanding medical bills and not for discharged patients.

CommitteeResolution:Adopted.Theprovision extended toprivatehealthfacilities so astoensurethathealthfacilitiesare abletorecoverunpaidhospitalbillsthroughlawful debt recovery means without infringing on patients' rights.

• In Clause 4 (2A), insert the phrase"and private"after the phrase"public". The amendment seeks to exempt private health facilities while the Act in section 12(2) provides that "all healthcare providers, whether in the public or private sector, shall have the duty to provide emergency medical treatment as provided under section 7."

Committee Resolution:Adopted with amendments.The provision extended to private healthfacilities so as toguarantee access to emergency treatment.

• d)Inclause 4,insert a new clause3Aasfollows:

"The settlement of medical bills incurred following an emergency treatment

3A. the settlement of outstanding medical bills incurred following an emergency treatment shall be under Regulations 27(4) and (5) and 29 ofthe Social Health Insurance Regulations,refer to the Provisions ofRegulation 27(2), (4) and (5) and Regulation 29 (1), (2) and (3) on payments out of the Emergency, Chronic and Critical Illness Fund."

CommitteeResolution:Not adopted.There is no need to cross reference Regulations 27(4) and (5) and 29 of the Social Health Insurance Regulations as the laws are read together.

• e)The NGEC made the following general comments on the Bill:
• (i) The Commission fully supports the proposal to streamline the process of emergency treatmentbyfacilitiesinKenya.However,thereare a few observations by the Commission regarding the targeting of public facilities only and the limitation on detention by thefacilities,hence itsproposalsfor amendment.
• (ii)Theproposed amendments ensure dignity and respect to all personswho, at one time or another, may require emergency quality care treatment and discharge thereafter.

Committee Resolution:TheCommittee noted the general comments during the considerationoftheBill.

17. The Pharmaceutical Society of Kenya(PSK)Nairobi Branch submitted as follows:

• a)In clause 2,in the definition of the term"health facility",proposes a new insertion after the place to include mobile and digital care inboth public care and private care and air rescue, marine rescue services by the public institution.More than 5o% of emergency events takeplace at the ambulatory level.

CommitteeResolution:Not Adopted.Section 7of the Health Act,Cap.241 provides that emergency medical treatment includes pre-hospital care which includes care in an ambulance.

• b) In clause 3, delete the words "any medical institution" and insert "health facilities" in section 7(3) of the Health Act. This is in line with the Health Act and Quality Care and Patient Safety Bill.

Committee Resolution: Not Adopted. Subsection (3) was not proposed for amendment.

• In clause 3,in the proposed new subsection (4) and (5),delete the words"public health facility" and insert "healthy facility". Health facilities shall include all facilities.

CommitteeResolution:Adoptedwith amendments.Theprovision extended toprivate health facilities so as to guarantee access to emergency treatment and to ensure that health facilities are able to recover unpaid hospital bills through lawful debt recovery means without infringing on patients' rights.

• d )In clause 3, proposed the insertion of new subsection (6) after subsection (5) as follows: "(6) A person in charge of a health facility commits an offence if the person enforces settlement of a pending bill if a patient or representative ofa patient launches a medical

19

complaint to therelevant authorityinregardstotreatmentof an individual,isliable on conviction to a fine not exceeding two million shillings."

This is in line with the Health Act and Quality Care and Patient Safety Bill.

Committee Resolution: Not Adopted. The Clause as, proposed for amendment to extend its application to private health facilities, is sufficient and applies to all persons irrespective of their age or disability status.

• e)In clause 3, propose the insertion of a new subsection (7) after subsection (6):

"Aperson incharge of ahealth facilitycommits an offence if theperson enforces settlementofa pending billif a patientis a personis registered with Disability according toDisabilityAct,Number82025andisliableonconvictionto afinenotexceedingtwo million shillings.

Apersonincharge ofahealthfacilitycommits anoffenceifthepersonenforces settlement ofa pending bill ifa patient is a child less than5years and is liable on conviction to a fine not exceeding two million shillings."

Committee Resolution:Not Adopted.Health facilities are required to provide the highest attainable standard of healthcare services. The Clause as,proposed for amendmenttoextendits application toprivate healthfacilities,is sufficientand applies to all persons irrespective of their age or disability status.

• 18.TheHon.Jane Njeri Maina,MP,the sponsor of theBill vide a letter dated 5th October 2025madethefollowingsubmissions totheCommittee:

Background andRationaleoftheBill

• a)TheBill is a product of wide consultations and a response to extensive pro-bonolegal representation for families whose loved ones have been detained in hospitals and mortuaries due to unpaid medical bills; a persistent humanitarian and ethical concern affecting countless Kenyan families.
• b)The Health (Amendment) Bill,2024 seeks to amend the Health Act,2017 to expressly prohibit the detention of bodies by health facilities due to unpaid medical bills. This practice,though common,offends the spirit of the Constitution and undermines the dignity of the human person. Under Article 28 of the Constitution, every person has an inherent right to dignity and to have that dignity respected and protected. Further, Article 43(1) (a) guarantees the right to the highest attainable standard of health, includingaccesstoemergencymedicaltreatment.
• C TheBill,therefore,seeks toreaffirm theserightsby ensuringthatnofamilyis denied the remains of theirloved one because of financial incapacity.Families deserve compassion, closure, and the opportunity to mourn and bury their loved ones in peace,without the added burden of humiliation and delay. Further, Kenyan's deserve access to emergency medical attention, irrespective of their financial capacity.

Judicial Complianceand GlobalBestPractice

• d)This Bill seeks to codify thelegal protection established by the courts.The High Court of Kenya,in severalinstances,has declared that it is unconstitutional to detainpatients and

or dead bodies in hospital facilities. It has clarified that hospitals may pursue payment through standard civil legal channels.Most recently,in a ruling delivered on 23rd September,2025,byJusticeNixonSifuna declared detainmentofa deadbodyforfailure to pay medical bills as unlawful, unconstitutional and contrary to public policy.

• e) Further, this legislative proposal is anchored in comparativeexperience,the Philippines (Anti-Hospital Deposit Law), Uganda's Patients' Rights and Responsibilities Charter, and Canada's Canada Health Act et. al. This global, rights-based approach, balances hospital operations with theprimacy ofhuman dignity and emergency care.

ObjectivesoftheBill

• The primary objectives of the Health (Amendment) Bill, 2024 are:
• (i)To criminalize the detention of human bodies by health facilities over unpaid bills
• (ii)To safeguard human dignity and compassion in the delivery of health services
• (ii) To strengthen the legal framework that protects the rights of patients and their families
• (iv)To ensure harmony between medical practice, constitutional values and ethical obligations
• (v) To safeguard the constitutional right to emergency care.
• g) While the Bill addresses a moral and constitutional imperative, it also recognizes the need for a balanced andsustainableframework thatprotectsbothpatients and healthfacilities. Accordingly, the Hon. Member proposed that the Committee and the House consider the following measures during implementation:
• (i)Strengthened Oversight and Accountability: To ensure·compliance, the Bill should empower the Ministry of Health, working with county governments, to develop a policyframework tomonitor implementation andprovide clear procedures for reporting, redress, and enforcement.
• (i)PublicAwareness and Education:The success of the law will depend on citizen awareness. The Bill, therefore, calls for adequate public awareness and professional sensitization campaigns to ensure that all parties understand their roles, rights, and obligations.
• (ii) Protection for HealthcareProviders: To prevent undue hardship on health facilities, thelaw should promote a policyframework that provides amicable debt management, payment plans, and insurance coverage mechanisms to ensure financial sustainability withinthesector
• (iv)A Bipartisan Moral Imperative:The Health(Amendment) Bill,2024 is not merely a legislative proposal ——- it is a moral and social duty to restore compassion, fairness, and justice to our health system. By ending the inhumane practice of detaining bodies, Parliament will be affirming Kenya's constitutional commitment to human dignity, equity, and social justice.
• h) TheHon.Member therefore urged theCommittee togivefavorableconsideration to the Bill and to facilitate its timely passage for the benefit of all Kenyans.

Committee Resolution: The Committee took note of the Member's views during the considerationoftheBill.

CHAPTERFOUR

4.0COMMITTEEOBSERVATIONS

19.TheCommitteeobservesthat:

• a)The intention of the Bill is to improve access to emergency treatment and health care services prior to the payment of prospective medical costs by patients. In this regard, the Billis aligned to Article 43(1)(a) of the Constitution on theright to the highest attainable standard of health, which includes the right to health care services. The Bill is also aligned to Article 43(2) of the Constitution which provides that a person shall notbe deniedemergencymedicaltreatment.
• b Article 28 provides that every person has inherent dignity and the right to have that dignity respected and protected. This right extends posthumously.
• The Billwas informed by thefact thathealthfacilities and healthcare providers generally have been detaining the bodies of persons who died while receiving medical treatment as a means ofenforcing settlement ofoutstanding hospital bills and medical expenses. The Bill therefore seeks to remedy this situation by prohibiting the detention patients including deceased patients and requiring that health facilities are infringing on patients' rights.
• d)The High Court in Mutua v Mater Misericordiae Hospital [2025] KEHC 13266(KLR) held that there is no law in Kenya that makes provision for a hospital's right of lien over patients or over their remains should they die while hospitalized or while undergoing treatment. There is also no property in a dead body and hence no right of lien on a dead body. Debts related to treatment and mortuary charges are recoverable as civil debts and should be pursued as such, through demand and litigation if need be.
• e)Health facilities and healthcare providers should employ other legal mechanisms of recovering outstanding medical bills including executing promissory notes as recognized under the Bills of Exchange Act, Cap. 27 instead of detaining the bodies of deceasedpersons.

[22

CHAPTERFIVE

5.0COMMITTEERECOMMENDATIONS

20. The Committee recommends that the House considers and passes the Health (Amendment) Bill, 2024 (National Assembly Bill No. 56 of 2024) with amendments. The amendments are set out in Chapter Six of this report.

THENATIONALASSEMBLY

13THPARLIAMENT-FOURTHSESSION(2025) DIRECTORATEOFDEPARTMENTALCOMMITTEES DEPARTMENTALCOMMITTEEONHEALTH

REPORTONTHECONSIERATIONOFTHEHEALTH(AMENDMENT)BILL (NATIONALASSEMBLYBILLNO.56OF2024)BYHON.JANENJERIMAINA, MP

We,the undersigned Members of the Departmental Committee on Health dohereby append our signatures to adopt thisReport

Date:

202S

VENUE.

focnds

Shoraton

Hetel

| NO | NAME | SIGNATURE | |------|-----------------------------------------------------------|-------------| | 1. | The Hon. Dr. Nyikal James Wambura, M.P, CBS - Chairperson | | | 2. | TheHon.NtwigaPatrick Munene,M.P-Vice- Chairperson. | | | 3. | The Hon.Dr.Pukose Robert,CBS,M.P | | | 4. | The Hon.TitusKhamala,M.P | | | 5. | The Hon.Sunkuli Julius Lekakeny Ole,EGH,EBS,M.P. | | | 6. | TheHon.Prof.JaldesaGuyoWaqo,M.P. | | | 7. | The Hon.Owino Martin Peters,M.P. | | | 8. | The Hon.Wanyonyi Martin Pepela,M.P | | | 9. | The Hon.Lenguris Pauline,M.P | | | 10. | The Hon.Mary Maingi, MP | | | 11. | The Hon. Muge Cynthia Jepkosgei, M.P | | | 12. | The Hon. Oron Joshua Odongo, M.P. | | | 13. | The Hon.Kibagendi Antony, M.P. | | | 14. | The Hon.Mathenge Duncan Maina,M.P | | | 15. | The Hon. Kipngor Reuben Kiborek, M.P | 000 |