Healthcare shake-up threatens 10 000 jobs

At least 10,000 jobs could be lost if government proceeds with plans to bar medical aid societies from owning clinics and hospitals, stakeholders in Zimbabwe's healthcare sector have warned.

The concerns arise from proposed amendments by the Ministry of Health and Child Care to the Medical Aid Societies Regulations, governed under Statutory Instrument 330 of 2000.

Medical aid societies and industry players say the changes - particularly revisions to Section 14 - would force them to divest from healthcare service providers, potentially resulting in losses exceeding US$200 million and widespread job cuts.

Among those raising concerns are major societies including First Mutual Health, CIMAS, PSMAS, VIVAT and ParksMed, which collectively serve millions of Zimbabweans.

In a joint submission to government, the societies cautioned against adopting the amendments in their current form.

"This submission sets out why the proposed replacement of section 14… introducing a blanket prohibition on medical aid societies from owning or holding interests in service provider assets… should not be supported in its current form," they said.

The proposed regulations are aimed at addressing conflicts of interest within the healthcare financing system, where some medical aid societies act as both funders and service providers.

However, stakeholders argue the reforms could have unintended consequences, including higher healthcare costs, reduced access to services and increased financial strain on patients.

They noted that society-run hospitals and clinics currently help shield members from unpredictable out-of-pocket expenses by offering controlled pricing structures.

"In many cases, private providers charge above what societies can sustainably pay… This often leaves members with unpredictable shortfalls," the submission noted.

The Association of Health Funders of Zimbabwe warned that the proposed 24-month deadline for divestment is unrealistic.

Chief executive Shylet Sanyanga said the requirement could force societies to dispose of assets at significantly reduced values.

"That will result in huge losses. It is also possible that some might still be repaying bank loans for the investments," she said.

On the other hand, Itai Rusike, executive director of the Community Working Group on Health, said reforms are necessary to address structural weaknesses in the sector.

"The separation of functions of the medical aid societies is very weak… making it difficult for them to focus on their core business," he said.

Meanwhile, Discent Bajila, chairperson of the Parliamentary Portfolio Committee on Health and Child Care, urged stakeholders to engage Parliament if they seek changes to the proposed regulations.

Government, however, has maintained a firm stance. Deputy Health Minister Sleiman Kwidini said the reforms are necessary to protect patients and eliminate conflicts of interest.

"The regulations would be there to protect members who were put in a corner and did not have a choice," he said.

Kwidini added that medical aid societies should focus on their core mandate of providing insurance cover rather than operating healthcare facilities.

The debate comes as Zimbabwe pushes toward universal health coverage under its National Development Strategy 2, with stakeholders warning that poorly calibrated reforms could undermine access, affordability and system stability.