COSATU Public Service Unions on GEMS Increases-
The public service unions affiliated to COSATU — DENOSA, NEHAWU, SADTU, POPCRU, SAMATU, PAWUSA and SAEPU are united and outraged by the decision of the Government Employees Medical Scheme (GEMS) to impose a 9.8%-member contribution increase for 2026.
This high member contribution follows a 13.4% increase imposed by GEMS in 2025 which was equally rejected. Our members from January 2026 will pay 9.8% which GEMS says it will be revised down to 9.5 from 1 April 2026. Accumulatively, the increase amounts to a 23.2% over two years.
At the same time:
• Public servants received only 5.5% salary increase in 2025/26 and in 2026/27 increase might even be below 5%
• Government subsidy increases are only 4.5% (Jan–March 2026) and 0.5% from April 2026
It is puzzling that GEMS went ahead to increase the member contribution despite the advice by the Council for Medical Schemes (CMS) on a proposed average member contribution increase of 3.3 percent for 2026 as reasonable. The Medical aid costs are rising far above wages and inflation, and this represent a real wage erosion and a direct attack on workers’ take-home pay.
GEMS Has Abandoned Its Mandate
GEMS was created through PSCBC Resolution 1 of 2006 to provide affordable medical cover for public servants, especially lower- and middle-income workers. It was meant to promote social solidarity — not operate like a commercial business. In addition, the Medical Schemes Act mandates the Board of Trustees and Principal Officers to act in the best interests of beneficiaries with care, diligence, and in good faith. The conduct of the GEMS board of trustees and the decisions they take is inconsistent with this mandate.
According to the Council of Medical Schemes of 2023, the Board of Trustees of GEMS were the highest earning in the industry of medical schemes. In the same period, they got paid millions of rands after holding 52 meeting, including strategic planning and workshops. This is shocking when compared to earnings of other Boards of Trustees of in 2023 which held only 7 meetings.
Serious Governance Concerns
GEMS was a created by parties in the PSCBC but because of how the Board of Trustees are elected it is now dominated by private individuals and less Worker representation. This creates serious governance and administrative challenges as both the Trustees and the Executives act as if they run their own private business not in the beneficiaries’ interests. This is demonstrated by the intransigence displayed to labour in all our engagements with the Executives and Trustees.
We are deeply concerned about:
• Weak accountability and poor consequence management
• Costly outsourcing of administration and managed care
• High executive and board remuneration
• Leadership instability
• Ignoring labour’s anti-fraud and cost-saving proposals
• Failure to redesign benefits to protect lower-income members
• Tanzanite members being excluded from private healthcare despite paying contributions
Instead of fixing internal problems, GEMS passes the bill to workers. Workers are paying for governance failures they did not create.
Attack on Collective Bargaining
The unilateral implementation of the increase undermines the Public Service Coordinating Bargaining Council (PSCBC) and weakens collective bargaining.
Engagements with the Board have produced no results. This reflects arrogance and contempt for organised labour.
Our fight is not only about medical aid increases — it is about defending collective bargaining and protecting workers’ rights.
Programme of Action
Since all the engagements with GEMS failed to yield and positive results, we have decided to act by mobilising members across the public service and the working communities affected by this ridiculous increases imposed by GEMS. In this regard we are going to roll out the program of action as follows:
Lunch Hour Demonstrations: 24 February 2026
- Lunch hour demonstrations in the nearest identified GEMS offices in all provinces. The demonstrations will also take place in workplaces where there are no GEMS offices closer to also bring our concern to the attention of the employers
📢Day of Action: 26 February 2026
- National Day of Action at GEMS Head Offices, Pretoria.
Our Central Demands
• Immediate withdrawal of the 9.8%
• A full forensic audit into governance, finances and procurement
• Review of outsourcing contracts and high-cost drivers
• Alignment of executive pay with public service norms
• Implementation of labour’s anti-fraud proposals
• Review of the GEMS funding and operating model
• Genuine engagement with Labour at the PSCBC
• Review the appointment process of Board of Trustees
• Removal of the Principal Officer and implicated executives
If GEMS continues to deviate from its founding purpose, we will review PSCBC Resolution 1 of 2006 and explore alternatives that allow public servants freedom of medical scheme choice with government subsidy.
Public servants are suffocating under the cost-of-living crisis.
We will not allow GEMS to throttle workers’ hard-earned wages.
GEMS exists because of workers — and it must serve workers.
We are united. We are mobilised. And we will fight until justice is done.
END