Minister for the Public Service and Administration said the Government Employee Medical Scheme (GEMS) should be trend setters in rooting out corruption in medical aid schemes.
He was speaking at the Gems 11th Symposium Gala Dinner held in Durban yesterday.
The Minister said the symposium takes place at a very important period as it coincides with the Competition Commission’s findings and recommendations into medical aids.
“It is very important for all medical aid schemes to pause and take note of what is contained in the findings and gauge themselves in terms of how much they are affected by the report.
One of the Commission’s findings is that private health care sector needs to be regulated in terms of quality and price. The inquiry also found that the sector was neither efficient nor competitive.
“Then comes the most notorious habit, which is no longer a rumour, but a finding from a judicial commission, that of over-treating patients.
“This basically means we send patients to hospitals more frequently and longer than necessary without any real medical benefit. It lends credence to an old debate that some medical schemes make money out of people’s health conditions,” Minister Mchunu said.
Some of the recommendations of the Commission includes ensuring greater access to quality healthcare services by improving affordability of private healthcare goods and services, reducing price uncertainty for healthcare services, promoting innovative models of healthcare funding and delivery, and promoting competition among service providers.
“The findings place an even bigger responsibility to us as GEMS since we cover more than 688 000 principal members and over 1.8 million beneficiaries.
“We are also a Government-run medical scheme and therefore should lead the way in ensuring that we give our client the best service and be the trendsetter in the fight against corruption and injustice in the health sector, in line with what President Ramaphosa said during the launch of the Health Sector Anti-Corruption Forum that we have to make sure that the pool of funds of the NHI is not wiped out through fraud and corruption,” Minister said.
He said Gems expected to lead the way in terms of ensuring that affordable good quality health care is necessary and possible, more so considering the fact that medical health care continues to be on the rise.
In regard to the 4th Industrial Revolution (4IR), the Minister said Gems should use the Symposium to deliberate on the advantage of the technological advancements in creating new jobs, but also saving them by retraining their personnel to be well-versed with technology such as the use of drones and robots in their work environment.
The Minister said while innovation is applied, care should be taken not to isolate the poorest of the poor from access to healthcare and to ensure that the Bill of rights as enshrined in the constitution is protected.
Minister Mchunu emphasized on the observation of the priorities of the 6th Administration, which are Economic transformation; Education, skills and health, Consolidating the social wage through reliable and quality basic services, Spatial integration, human settlements and local government, Social cohesion and safe communities, A capable, ethical and developmental state and A better Africa and the World.
“As the Department, we have also set ourselves five priorities, which are full implementation of Batho Pele principles, full implementation of Public Administration Management Act, Stabilising the Public Service, Fighting Corruption and policy implementation,” he said.
