Harare — Civil servants will soon resume paying some of their medical aid contributions, returning to the traditional split seen up to the start of this year and the common position in the private sector.

But civil servants and healthcare service providers have said the switch could have "disastrous consequences" if it does not come with a salary increment.

Finance Minister Tendai Biti announced last week in his 2010 National Budget proposals that Government would from around March next year reduce its contribution to medical aid cover.

This year Government has paid full contributions, starting when civil servants were only getting US$100 allowances rather than salaries.

The minister said Government could not afford to continue paying the full cover for every member and the up to three beneficiaries allowed under the scheme.

All State employees are catered for through the Premier Service Medical Aid Society.

While Minister Biti did not say what percentage Government would pay, reliable sources said current deliberations indicated it would probably be the traditional 50 percent.

The sources said the alternative was for Government to reduce the number of beneficiaries a member could include on medical aid.

While critics conceded that Government could not afford to maintain the 100 percent full cover, they said it was imperative that the new measures be coupled with the payment of meaningful salaries.

They said only through the payment of better salaries could State employees afford health care for themselves and their families and dependants.

Public Service Association executive secretary Mr Emmanuel Tichareva said: "We heard the minister saying they will only make full contributions for the next three months and we hope thereafter they would have come up with a meaningful package for civil servants for us to pay the shortfalls often associated with medical aid."

He said the proposed rationalisation of the number of beneficiaries could be negotiated so that the number of people with access to healthcare would not be drastically cut.

Contacted for comment, PSMAS chairman Mr Cuthbert Dube said he would only be in a position to respond fully today.

However, a senior administrator at PSMAS said in the absence of salary increments, the proposed measures would result in less people accessing healthcare.

"If salaries are not increased steadily and meaningfully over the next three months, it means come March civil servants will only probably be able to afford medical aid for themselves.

"Their families will be stranded because they most likely will not be able to afford private schemes with any service provider.

"This could be a disastrous situation for both public healthcare and the service provider.

"If we get to a situation such as last year's where member contributions are a pittance, then PSMAS faces viability concerns," said the official.

The executive director of the Community Working Group on Health, Mr Itai Rusike, said the new measures were an infringement of workers' rights to healthcare.

The Community Working Group is an umbrella body bringing together several non-governmental organisations with an interest in public health issues.

Said Mr Rusike: "When Government introduced the 100 percent contribution scheme in July, it was already lagging behind the private sector.

"Companies were already cushioning their workers with full contributions and cover.

"So reversing this will be a negative development for all civil servants as their low salaries are not enough to meet medical costs, thereby infringing on their right to health for all."

Mr Rusike said civil servants would be forced to depend entirely on public health institutions because they could not afford private clinics and hospitals.

In his Budget statement, Minister Biti said a number of civil servants who were previously not on medical aid had joined PSMAS after Government announced the 100 percent contribution and full cover for a member and three beneficiaries in July.

He said while the arrangement was a noble idea, it was not sustainable given the financial constraints facing Government.

"Mr Speaker Sir, currently Government is meeting 100 percent medical aid contributions for all civil servants.

"This has resulted in a huge bill in employer contribution given the number of civil servants who were not on medical aid who have joined the scheme with a view to benefit from the scheme," Minister Biti said.

To lessen the burden, the Finance Minister proposed rationalising the number of beneficiaries.

"The Public Service Medical Aid Society will collect fully from any additional beneficiaries outside the stipulated number," he said.

He allocated US$21 million as the employer's contribution to PSMAS for 2010.