The National Teachers’ Union (NATU) rejects, in the strongest possible terms, the proposed 9.8 per cent annual increase in Government Employees Medical Scheme (GEMS) member contributions for the 2026 benefit year. GEMS initially tabled a 9.8 per cent increase, which was later marginally revised to 9.5 per cent. Notwithstanding this revision, all trade unions represented at the Public Service Co-ordinating Bargaining Council (PSCBC) unanimously expressed their dissatisfaction and categorically rejected the proposed increase.

NATU, together with other labour parties to the PSCBC, engaged the GEMS Board of Trustees in a series of meetings to discuss the proposed contribution increase scheduled for implementation in January 2026. During these engagements, labour made it unequivocally clear that the proposed increase is unaffordable and unjustifiable, particularly in light of the escalating cost of living, rising household debt, and increasing basic living expenses faced by public service employees.

Workers cannot reasonably be expected to pay increased contributions for medical scheme benefits that show no corresponding improvement. Instead of addressing inefficiencies and cost drivers within the Scheme, the Board has failed to take adequate accountability. GEMS presented a proposal to increase member contributions for the 2026 benefit cycle, which was firmly rejected by labour. The proposed increase is significantly above the Consumer Price Index (CPI) and far exceeds the anticipated public service salary adjustment of between 4 and 5 per cent.

GEMS tabled its proposed contribution increases after having already submitted the proposal to the Council for Medical Schemes (CMS). This demonstrates that there was no meaningful or adequate consultation with organised labour prior to the submission. As such, GEMS failed to comply with the statutory consultation and governance obligations set out in section 57 of the Medical Schemes Act. The continued conduct of the Board of Trustees reflects a pattern of failure to act in the best interests of members, warranting appropriate remedial action.

The PSCBC facilitated several engagements between GEMS and the parties to the Council in an effort to encourage reconsideration of the decision. Unfortunately, these engagements did not yield any positive outcome.

During follow-up meetings, GEMS acknowledged labour’s concerns and undertook to conduct internal deliberations. However, the subsequent reports presented—purportedly based on actuarial advice—were, in NATU’s view, calculated using an incorrect Medical Price Index (MPI) of 9.33 per cent, rather than the projected MPI. The medical subsidy adjustment for 2026 is based on Statistics South Africa’s Consumer Price Indices, using the average health-related MPI for the period September 2024 to August 2025. The Department of Public Service and Administration (DPSA) issued a formal communication on 19 December 2025 confirming this position.

GEMS further conceded in its own briefing that there will be no improvement in member benefits for 2026, despite members being expected to pay substantially higher contributions. The Board attributes the increase to claim history, administrative pressures, and efforts to maintain the statutory reserve ratio of 25 per cent. This is not the first instance in which the Board has unilaterally imposed contribution increases without adequate consultation. Such actions undermine workers and disregard the role of the PSCBC as the recognised bargaining structure for public service employees.

NATU maintains that GEMS has deviated from its founding mandate, which includes:

• Providing accessible and affordable medical cover to all public service employees, particularly lower-income earners;
• Ensuring cost-effective and sustainable medical cover over the long term; and
• Promoting the efficient and transparent administration of the medical subsidy.

During engagements, the Board of Trustees failed to disclose critical information relating to administrative and operational costs, executive remuneration, and the cost of outsourcing scheme administration to external service providers. This lack of transparency is deeply concerning. The GEMS matter has also been escalated to the level of the federation FEDUSA, including discussions within joint labour caucuses involving other federations.

Joint labour, representing two federations, met with the Minister of Public Service and Administration, Honourable Inkosi Mzamo Buthelezi, to formally raise these concerns. The Minister committed to meeting with the full complement of the GEMS Board of Trustees during the first week of February 2026. All public sector unions, supported by their respective federations, have resolved to embark on a programme of action to express their dissatisfaction with GEMS.

NATU DEMANDS THE FOLLOWING:

• The immediate withdrawal of the proposed 9.8 per cent contribution increase with effect from 1 January 2026;
• A full, independent forensic review of all cost drivers within GEMS;
• The protection of workers’ right to choose their own medical scheme without discrimination in the payment of medical subsidies; and
• The alignment of executive and Board remuneration and conduct with established public service norms and standards.

NATU will exhaust all available avenues to protect its members from a scheme that continues to undermine workers’ rights to decent wages and equitable benefits, including access to affordable medical aid and related allowances.