The meeting was held on 13 February 2017 at the ZEWU Offices in Harare and was attended as follows;
- Chitambo (President)
- Masiya (NWAC Chairperson)
- Ranji (NYWAC Chairperson)
- Mhaka (NEC Member- Harare)
- Rati (NEC Member –Harare)
- Mhou (NEC Member – Harare)
- M.Chikuni (General Secretary)
- Chenyika (Education & Training Officer)
Dr. M. Mujuru (Principal Coordinator)
- Makore (Acting Head Marketing & Services)
- Hakuna (Marketing Officer)
After introductions, the President welcomed every one and outlined, in brief, the ZEWU structures and operations and indicated that the meeting was to deal with issues that had been raised by the members of ZEWU, who are members of PSMAS.
The following were the issues discussed;
- Poor service delivery
- Drugs shortages
- Rejection of service to PSMAS card holders by service providers
- Delays in reimbursement of cash paid to service providers.
- Inexperienced doctors at PSMAS Units
- Demand for cash upfront on employees injured whilst on duty
PSMAS representatives outlined an overview of the Society which they described as being an insurance against ill health that was formed in 1930. They explained that, ordinarily, the idea was for members to pool their contributions to pay for any member who would have fallen sick and contributions should be more than what would be required.
It was also explained that the Society is obliged, by regulatory authorities, to have a 5% cover for any eventuality. The following were explained as some of the challenges that PSMAS is currently facing;
- Most organizations failing to remit contributions on time with others failing altogether.
- PSMAS struggling to pay up Health Service Providers due to erratic remittances
- Most Health Service Providers shunning PSMAS card holding members due to delays in payments.
- Loss of qualified and experienced doctors moving into the diaspora
- It was also reported in the meeting that ZESA Holdings group of companies owed about $14 million in unremitted subscriptions, ZINWA had stopped remitting altogether and service to its employees had been discontinued. Powertel was the only company up to date in its payments and its employees were therefore getting full service at the PSMAS Baines Avenue Unit.
- The delegation also explained that PSMAS had set up the Premier Service Medical Investments (PSMI) as an investment vehicle which also operated as a provider of drugs to PSMAS.
On specific issues, the delegation responded as follows;
Rejection of PSMAS Cards
It was reported that the low card acceptance was mainly due to the fact that due to delayed payments most doctors ended up declining to attend to PSMAS card holders. It was then agreed that members should identify doctors in their respective centers with whom PSMAS could enter into an arrangement whereby they would provide a dedicated service and would be prioritized in payments.
The delegation explained that as an institution providing medical health care, they were obliged ,by law to employ qualified personnel, especially doctors who would have served their houseman ship and were holders of the Open Practicing Certificate (OPC) and to that extent, all doctors manning PSMAS units were qualified and certified to work on their own. It was further explained that it was not possible to dedicate a doctor to a particular unit as they tend to have a high staff turnover causing regular changes in personnel manning the respective PSMAS units.
Shortfalls and Delay in Reimbursements
It was explained that, whilst tariffs were regulated and set at AFOZ rates of $35.00 for General Practitioners and $120.00 for Specialists, these were not being abided by and as a result, shortfalls will always arise and the delay in reimbursements was due to cash flow challenges caused by the inconsistent remittances.
Congestion at PSMI Units
There was concern on the long queues and congestion at PSMI Units. The delegation explained that it was working on expanding the service network but success depended on the availability of resources which again goes back to the issue of remittances. To date some efforts had been made by opening up the West End Clinic and also the recently acquired facility at Dorothy Duncan. PSMAS had also set up an Optometry to deal with provision of optical equipment and services.
Demand for Cash On Employees injured at Work
It was explained that ordinarily the employer should be responsible for all injuries at the workplace as covered through the WCIF under NSSA. To that extent, PSMAS, as any other Medical Service Provider, would not, at law, be obliged to cover any workplace related injuries. However, PSMAS had provided the service, purely on humanitarian grounds and then made claims for reimbursement to NSSA.
During the interaction, the following information was shared;
- PSMAS had a facility of delivering drugs for people on chronic medication to either their homes or workplaces so as to avoid them having to queue at its units.
- PSMAS had been engaging the management at ZESA Holdings with a view to having them settle the debt, but would now also periodically update the union on the position.
- The information gap between PSMAS and ZEWU needed to be bridged through more regular meetings.
- PSMAS would be amenable to being incorporated onto the programme whenever ZEWU addresses its constituencies
- PSMAS does not impose any age limit on beneficiaries and this includes where proof is availed that a child is still at school or in college.
- PSMAS promised to investigate issues of malpractices by staff at Baines unit in the selective dispensary of drugs.
- Workers needed to be represented on the Board of Directors and therefore more information would be availed by the PSMAS delegation on the current Board set up.
- PSMAS had introduced an electronic health record for individuals which would be accessible to the member and any other doctor who may take- over their treatment.
- PSMI had opened a branch in Zambia and intended to open up more within the region for the convenience of members who would enjoy travel cover without having to pay cash.
- Treatment outside the country would be strictly for treatment which PSMAS would not able to provide and would be governed by the RBZ as it involved foreign currency.
The delegation also informed ZEWU that, other than just providing for ill health misfortunes, PSMAS was introducing a Wellness Programme designed to create an awareness to all its members on how best to take care of themselves. The programme would be targeted at such diseases as high blood pressure, stress, diabetes and cancer and members would be taken through a “Know Your Health” exercise to detect any of these diseases.
The Way forward
It was agreed that, going forward, ZEWU and PSMAS would communicate on a regular basis with a view to addressing all of the issues raised at the meeting.
EDUCATION & TRAINING (MINUTING)