The proposed hefty contribution increase announced by the Government Employees Medical Scheme (GEMS) has been roundly rejected by unions in the Public Service Co-ordinating Bargaining Council (PSCBC), which say the 9.8% hike from January, followed by a revised 9.5% increase from 1 April, is economically unjustifiable.
They have demanded a withdrawal, and vowed to organise a march to the GEMS headquarters – and a demonstration – on 21 February, reports TimesLIVE.
The proposals, they added, were “socially regressive and inconsistent with the founding mandate of GEMS”.
The unions include the Public Servants Association, the Health and Other Service Personnel Trade Union of South Africa and the South African Policing Union, who said the cumulative effect threatened access to affordable healthcare and had direct implications for worker well-being as well as the sustainability of public service delivery.
“This decision comes at a time when public servants continue to face sustained financial pressure due to rising living costs, increased household debt and stagnant real wage growth,” they added.
They argue that GEMS was established through PSCBC Resolution 1 of 2006 as a social solidarity medical scheme and was never intended to operate as a commercial enterprise.
Instead, its mandate was to expand access to healthcare, particularly for lower- and middle-income public servants, to provide affordable, sustainable and cost-effective medical cover and to promote equity, risk pooling and social solidarity within the public service.
It had already implemented a 13.4% contribution increase in 2025.
The 9.8% increase from January 2026, followed by the 9.5% adjustment effective 1 April results in a cumulative increase of 23.2% over two years.
The unions said public servants received a 5.5% salary increase for 2025/26 and would receive a 4% salary increase for 2026/2027, effective April 2026. Inflation remained at about 3.5% in late 2025.
“The mismatch between wage adjustments and medical aid contribution increases is clear.”
The unions also expressed concern about governance and operational deficiencies at GEMS, including: weak accountability and insufficient consequence management, continued outsourcing of administrative functions nearly two decades after the establishment of the scheme, and high administrative costs reflected in annual reporting.
They have demanded the immediate withdrawal of the 9.8% increase from January and the 9.5% adjustment from 1 April, as well as a forensic audit into governance, finances, procurement practices and administrative expenditure.
“Organised labour in the PSCBC will embark on a co-ordinated programme of action, including a march and demonstration to the GEMS head office on 21 February and engagements with the Ministers responsible for public service and administration, health and finance.”
TimesLIVE article – Public servants face healthcare cost clash over medical aid
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