Cape Town, 25 September 2002
Today the Department of Public Service and Administration outlined the new provisions for medical assistance to public servants. The policy framework is designed to ensure that the medical assistance benefit is accessible and affordable. The framework policy paves the way towards a cost efficient and sustainable arrangement, which will be for the benefit of all Public Servants.
The framework policy proposes a compulsory closed medical scheme for all Public Servants. Within the closed medical scheme, there will be provision for a range of benefit options with a basic benefit package. The basic benefit package should provide for comprehensive hospital cover, chronic medication, and a disease management programme that is inclusive of a HIV/Aids programme including an out-of-hospital cover.
The subsidy will be based on the basic package, structured according to income. The employee contribution will be on a sliding scale to ensure increased support for workers at the lower level. Employees, who prefer and can afford more extensive cover, would be able to buy-up into the medium and high benefit options.
While the optimal usage of the public hospital system is envisaged, a hospital accreditation system is planned to ensure quality health care for scheme members. Both public and private hospitals that meet accreditation criteria will be used. The framework further proposes that the Administration of the scheme be outsourced to professional administrators.
A Board of Trustees would be responsible for scheme's governance. The State as employer and employees would have equal representation on the Board.
Presently employees receive financial assistance from the State towards the payment of medical scheme membership fees. Membership is voluntary and Public Servants may join any registered medical scheme to qualify for the employer contribution. Almost 50 % of these employees do not enjoy the benefit of medical assistance. To date, approximately 450 000 out of 890 000 employees in the Public Service, excluding those in the South African Police Services and Correctional Services belong to medical schemes Medical assistance restructuring was prompted by numerous problems associated with the current system. The problems relate to inequality in access to health care cover, inconsistency in the quality of health care cover enjoyed by employees, the employer's/member's vulnerability to problems in the medical schemes industry and resultant uncontrolled cost increases.
Government has submitted this framework policy to the Public Sector Unions for consideration. The process is in line with the restructuring of macro benefits in the public service which was part of the Public Service Co-ordinating Bargaining Council resolution of 2000. The framework will still be subjected to further refinement and development in the Public Service Co-ordinating Bargaining Council.
Issued by Ministry for Public Service and Administration.