15 February 2026
Today, trade unions in the Public Service Coordinating Bargaining Council address the media at the PSCBC to formally reject the decision by the Government Employees Medical Scheme to implement a 9.8 percent membership contribution increase from January 2026, followed by a revised 9.5 percent adjustment effective 1 April 2026.
These trade unions represent hundreds of thousands of public servants across critical and essential public services. We stand united in rejecting a contribution increase that is economically unjustifiable, socially regressive, and inconsistent with the founding mandate of GEMS.
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. The cumulative effect threatens access to affordable healthcare and has direct implications for worker wellbeing and the sustainability of public service delivery.
A Fundamental Betrayal of the GEMS Mandate
GEMS was established through PSCBC Resolution 1 of 2006 as a social solidarity medical scheme. It was never intended to operate as a commercial enterprise. Its mandate was clear:
• To expand access to healthcare, particularly for lower- and middle-income public servants
• To provide affordable, sustainable, and cost-effective medical cover
• To promote equity, risk pooling, and social solidarity within the public service
The repeated imposition of above-inflation contribution increases reflects a sustained departure from this mandate. Instead of strengthening affordability and solidarity, the scheme has shifted financial pressures onto members.
Unaffordable and Disproportionate Increases
The 2026 increases must be understood in their cumulative context:
• GEMS implemented a 13.4 percent contribution increase in 2025
• The 9.8 percent increase from January 2026, followed by the 9.5 percent adjustment effective 1 April 2026, results in a cumulative increase of 23.2 percent over two years
• Public servants received a 5.5 percent salary increase for 2025/26
• Public servants will receive a 4 percent salary increase for 2026/2027, effective April 2026
• Inflation remained approximately 3.5 percent in late 2025
The mismatch between wage adjustments and medical aid contribution increases is clear. Real income is being eroded. Workers are being forced to choose between healthcare and other basic necessities.
Government Subsidy Remains Inadequate
The employer subsidy structure does not adequately protect workers:
• A 4.5 percent subsidy from 1 January to 31 March 2026
• An additional 0.5 percent subsidy from 1 April 2026
This arrangement does not offset the contribution increases and leaves public servants materially worse off.
Disregard for Regulatory Guidance
The Council for Medical Schemes proposed an average membership contribution increase of 3.3 percent for 2026 as reasonable. GEMS proceeded with a 9.8 percent increase from January 2026, followed by the 9.5 percent adjustment from 1 April 2026. This significantly exceeds the regulator’s benchmark.
Organised labour in the PSCBC calls on the regulatory authority to exercise its oversight responsibility to ensure that member interests are protected.
Governance and Operational Concerns
Organised labour in the PSCBC remains deeply concerned about ongoing governance and operational deficiencies, including:
• Weak accountability and insufficient consequence management
• Continued outsourcing of administrative functions nearly two decades after the establishment of the scheme
• High administrative costs reflected in annual reporting
• Executive and board remuneration practices misaligned with public service norms
• Limited transparency regarding operational budgets and line items Instead of addressing these structural cost drivers, members are being required to absorb escalating increases.
Failure to Protect Lower-Income Members
There has been no meaningful restructuring of benefit options to strengthen affordability for lower-income public servants. Risk pooling and cross-subsidisation mechanisms have not been sufficiently enhanced. The consequence is that some members downgrade benefits or exit the scheme entirely.
Unilateral Changes to the Tanzanite One Benefit Option
We have a grave concern to have learned that GEMS has taken a decision to unilaterally change the benefits related to the Tanzanite option which requires members to have a down payment when they should be hospitalized. These has a negative impact on the healthcare of members who are on that benefit option, and are already overburdened by the high cost of living.
Engagement at the PSCBC
Organised labour in the PSCBC places on record its dissatisfaction with the manner in which engagements have been conducted. Consultations have not adequately reflected meaningful consideration of labour’s submissions and proposals.
Demands of Organised Labour in the PSCBC
1. Immediate withdrawal of the 9.8 percent increase from January 2026 and the 9.5 percent adjustment effective 1 April 2026
2. A forensic audit into governance, finances, procurement practices, and administrative expenditure
3. Full transparency on operational budgets and specific line items
4. A comprehensive review of outsourcing arrangements and administrative costdrivers
5. Implementation of labour-proposed anti-fraud and cost-containment measures
6. Review of the funding model, including the statutory 25 percent reserve ratio requirement
7. Structured and meaningful engagement with organised labour at the PSCBC
8. Appropriate governance interventions at executive level
Programme of Action
Organised labour in the PSCBC will embark on a coordinated programme of action, including:
• A march and demonstration to the GEMS Head Office at Vutomi House, Menlyn Maine on Saturday, 21 February 2026.
• Engagements with the Ministers responsible for Public Service and Administration, Health, and Finance
Due to the continued deviation from its founding mandate, organised labour in the PSCBC is compelled to review PSCBC Resolution 1 of 2006, including exploring alternatives that would allow public servants greater choice in medical scheme participation with the existing government subsidy.
Conclusion
Public servants cannot be expected to carry the burden of governance shortcomings, operational inefficiencies, and structural cost escalations. GEMS was created as a social solidarity instrument. It must remain one. Organised labour in the PSCBC will defend the right of public servants to affordable and quality healthcare through all available collective, legal, and institutional mechanisms.
END.