Sizwe Hosmed medical scheme makes significant progress under curatorship

Sizwe Hosmed Medical Scheme says it has made substantial progress towards long-term stability and financial sustainability of the scheme and its members, with the focus now on building membership over the next few months.

This was according to the scheme's Curator Lebogane Mpakati, who said Wednesday that since her appointment, she has been managing the scheme to stabilise operations and to access to healthcare facilities for members.

Service providers have been engaged to resolve issues, following industry concerns and healthcare access restrictions for members in the past few months, due to the scheme's financial position.

"Within a few months after my appointment, the scheme's members are now able to access more healthcare services across most service providers. Most hospital groups have since reopened access to members, supported by more predictable claim payment cycles and strengthened engagements," said Mpakati.

The Gauteng High Court on October 9, 2025, reaffirmed an earlier provisional court order to place Sizwe Hosmed under curatorship. The Council for Medical Schemes (CMS) had originally filed their application for the curatorship on August 28, 2025.

Some of the hospital groups that have reopened their doors to the scheme's members include Netcare, Life Healthcare outlets, Beacon Bay, and Lenmed facilities (La Verna, Kathu, Lenasia, and Randfontein), Busamed, Clinix facilities, and various NHN facilities including ARWYP, Emalahleni Private Hospital, Carewell Robertson, JMH Hospitals, and Nongoma Private Hospital.

Despite this improvement in the scheme's relationship with service providers, membership movements remain a critical focus, said Mpakati.

"This has been especially important following the 19.15% contribution increase and service disruptions earlier this year," she said in a statement.

Mpakati said even with the upcoming exit of members affiliated to the South African Local Government Association, the scheme will remain viable with non-SALGA members.

"This is still within operational viability, but necessitates a stronger focus on rebuilding membership – a major focus in the next couple of months," she said.

Retention and recovery strategies had been prioritised to rebuild membership, supported by actuarial comparisons that show strong benefit and price competitiveness when compared to schemes of the same size, Mpakati said.

Apart from prioritising membership retention, the scheme is focused on pivoting on competitive benefit offerings and on improved price positioning. The scheme had also managed to stabilise claims processing times with service providers.

"We continue to focus on resolving aged enquiries to improve member experience and moderated payment runs. This will allow the scheme to improve predictability and reduce unnecessary alarm," she said.

"We are encouraged by the meaningful progress made...we acknowledge the difficulties of the past few years, and we remain committed to correcting them with transparency and accountability," says Mpakati.

Corrective actions were underway, supported by recommendations from a KPMG forensic investigation, which had found that the scheme's decline in the Statutory Solvency Ratio had resulted largely from a surge in claims in the first half of 2023.

Mpakati said the scheme recognises that long-term sustainability requires attracting younger healthy members to boost sustainability.

As part of current structural improvements, marketing responsibilities would be an urgent focus area. Key strategic priorities were hinged on solvency improvement, rebuilding strategic stakeholder relationships, service excellence, governance enhancement, digital transformation, and exploration of amalgamation opportunities with other comparative schemes, with strong solvency ratios.

"We are committed to placing Sizwe Hosmed on a sustainable path underpinned by strong governance, transparency, and integrity. Our members have stood by us in both good and difficult times, and we are confident that better days lie ahead," said Mpakati.

The CMS 2022 Industry Report ranked Sizwe Hosmed as the sixth-largest open medical scheme and the tenth largest in South Africa, with the scheme then serving 63,577 members.

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