Govt faces union backlash over new Psemas rules

Trade unions representing government employees have accused the state of sidelining both workers and their representatives in its decision to compel members of government's medical aid fund to use designated public health facilities, arguing that the move fundamentally alters employees’ conditions of service.

The decision has sparked tensions within the public service, with a growing storm brewing ahead of the 1 April deadline, when Public Service Medical Aid Scheme (Psemas) members will be barred from seeking treatment at private facilities.

At the centre of the dispute are the unions’ accusations that government leaders bypassed their own workforce in reaching the decision.

The policy shift forms part of Swapo’s five-year N$85.7 billion development plan aimed at upgrading public hospitals and clinics to match private-sector standards.

A readiness assessment has already identified certain public health facilities as suitable for inclusion. The development was disclosed during a recent meeting between Psemas and stakeholders in the private healthcare sector.

Under the proposed reforms, public hospitals will submit claims in a manner similar to private facilities.

However, Psemas has acknowledged a significant operational hurdle – the absence of a billing system capable of processing such claims.

'We were not consulted'

The policy has been met with shock by unions tasked with protecting civil servants’ interests.

Namibia National Teachers’ Union (Nantu) secretary-general Loide Shaanika said the union learned of the development through media reports.

“We are also just reading this development in the media,” she said.

Shaanika explained that Nantu engages primarily with the Public Service Commission rather than the health ministry and confirmed that no formal consultation took place.

“They said 1 April is the deadline. Maybe they are still to consult us? Thus far we have not been consulted and I cannot comment further on the matter,” she said.

The lack of consultations has fuelled suspicions among union leaders that government is prioritising fiscal recovery over the quality of healthcare provided to public servants.

Former veteran unionist and Swanu member of parliament Evilastus Kaaronda questioned the ambiguity surrounding the concept of “designated” facilities and the rationale behind the policy.

“Designated means what exactly?” he asked.

“If this is pegged to the specialised nature of the facilities and their capacity to render top-notch services, then perhaps it is worth trying. But if it will compromise employees’ health, then it must be addressed.”

Kaaronda argued that government appears to be “putting the cart before the horse”, suggesting that public health facilities should first be comprehensively upgraded before restricting access to private providers.

“The best approach would have been to beef up public health facilities before attempting to crowd out private providers,” he said.

Pressure on an already strained system

The Namibia Nurses Union (Nanu) has also voiced concern, warning that the move risks overburdening an already stretched public health system.

Nanu secretary-general Junias Shilunga described the decision as “premature”, noting that state hospitals already serve at least 80% of the population.

He warned that compelling public servants to rely exclusively on state facilities would create unsustainable pressure, particularly in a system already grappling with staff shortages, infrastructure gaps and surgical backlogs.

“We already have a shortage of nurses, doctors and infrastructure,” Shilunga said.

He suggested the move may be aimed at redirecting funds historically flowing to private healthcare providers back into the state system.

Shilunga cautioned that introducing such a significant policy shift without structured negotiations could erode trust between government and its workforce.

As the 1 April deadline approaches, the absence of a formal social dialogue framework threatens to escalate tensions into a broader industrial dispute.