Kenya’s healthcare system could be heading for a significant legal and policy shift following the passage of the Health (Amendment) Bill, 2024, sponsored by Kirinyaga Woman Representative Jane Njeri Maina.
The legislation seeks to end the practice of public hospitals detaining medically discharged patients and withholding bodies of deceased persons as security for outstanding medical bills, a controversial approach that has subjected financially struggling families to prolonged distress.
But beyond the emotional appeal of allowing families to collect their loved ones for burial and patients to leave hospitals after receiving medical clearance, the proposed law has opened a wider debate about the financing of healthcare, the responsibilities of medical institutions and who should ultimately bear the cost of treatment when patients cannot afford their bills.
The National Assembly passed the Bill on Wednesday, November 11, 2026, marking a major step towards strengthening protections for patients and bereaved families.
The proposed legislation also seeks to ensure that emergency medical treatment is not delayed or denied because patients cannot produce money, insurance confirmation or proof of their ability to pay.
However, contrary to what some Kenyans may assume, the Bill does not abolish medical bills or make all healthcare services free.
Instead, it seeks to change how hospitals provide emergency treatment and recover outstanding payments, requiring medical institutions to pursue debts through lawful mechanisms rather than using patients or human remains as leverage.
The legislation will now proceed to the Senate for consideration before it can be presented to President William Ruto for assent.
The human tragedy behind the proposed law
For Maina, the campaign against hospital detention is rooted in encounters with families whose grief has been compounded by financial difficulties.
One of the cases that informed her legislative intervention involved Kelvin, a former medical student who reportedly turned to the boda boda business after struggling to secure employment.
Kelvin died following a road accident, but his family was unable to retrieve his body for burial because of an outstanding medical bill of Sh1.42 million.
His remains were reportedly held at a funeral home for nearly a year as the family struggled to raise the money.
Maina, an advocate of the High Court, said she provided the family with pro bono legal assistance and witnessed the emotional suffering of a mother who could not give her son a dignified burial.
The experience helped shape her determination to address what she considers a serious injustice within the country’s healthcare system.
For families in similar circumstances, the loss of a relative is often followed by another painful battle involving hospital administrators, accumulated bills, mortuary charges and the uncertainty of when they will finally be allowed to bury their loved ones.
The proposed amendments seek to ensure that financial disputes between healthcare providers and patients do not translate into prolonged restrictions on personal freedom or access to human remains.
What exactly does Njeri Maina’s Bill propose?
The Health (Amendment) Bill, 2024, seeks to amend provisions of the Health Act, 2017, particularly those dealing with emergency medical treatment and the responsibilities of healthcare providers.
One of its central proposals is to strengthen the definition of emergency medical treatment to cover care provided before a patient reaches hospital, stabilisation of the patient’s condition and arrangements for referral where a facility lacks the capacity to provide the necessary treatment.
This means healthcare providers would be expected to prioritise the patient’s medical condition rather than first establishing whether the individual or their relatives can afford treatment.
The Bill also seeks to criminalise the detention of deceased persons by public healthcare facilities as a means of forcing families to settle outstanding medical bills.
Under the proposed provisions, a person in charge of a public health facility who detains a deceased person’s body for debt recovery purposes could face a fine of up to Sh2 million upon conviction.
Healthcare facilities that fail to provide emergency medical treatment despite having the capacity to do so could face penalties of up to Sh3 million.
The proposed penalties are intended to strengthen accountability and discourage institutions from placing financial considerations ahead of emergency medical obligations.
The legislation also provides for legally binding instalment payment arrangements, allowing hospitals to recover outstanding expenses without keeping patients or bodies in their custody as security.
An important distinction is that the Bill’s scope, following parliamentary committee consultations, is focused on public health facilities. It should therefore not be interpreted as automatically imposing the same statutory provisions on every private hospital.
Who should pay the hospital bills?
Perhaps the most significant policy question arising from the proposed legislation is the responsibility for settling medical expenses once hospitals are prohibited from detaining patients and deceased persons.
The Bill does not transfer all outstanding medical debts to the government, nor does it automatically relieve patients and their relatives of financial responsibility.
Patients and families remain responsible for legitimate medical expenses, while hospitals retain the right to pursue payment through lawful means.
The proposed instalment arrangements provide one possible solution, particularly for households whose financial circumstances make immediate settlement impossible.
Under such arrangements, healthcare facilities could negotiate repayment schedules with patients or their families instead of allowing unpaid bills to accumulate through prolonged detention.
The debate therefore shifts from whether patients should pay for services received to whether hospitals should be allowed to use coercive measures to recover their money.
For lawmakers supporting the Bill, the answer is clear: healthcare providers must protect human dignity while pursuing outstanding debts through legally acceptable procedures.
However, the financial sustainability of hospitals remains a legitimate concern, particularly for facilities that must meet salaries, purchase medicines, maintain equipment and finance daily operations.
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