74
Bringing health within your reach Xiviko xa lembe ra 2009

Xiviko xa lembe ra 2009 - pggmeds.co.za

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Bringing health within your reach

Xiviko xa lembe ra 2009

Leswi swi nga endzeni

Leswi swi nga endzeni

1 Xitiviso eka Swirho 4

2 Makanelwa ya Nhlengeletano ya Lembe ya Swirho 5

3 Nkatsakanyo wa mutshamaxitulu 8

4 Xiviko xa Mufambisinkulu 14

5 Xiviko xa Huvo ya swa Nawu 25

6 Xitatimente xa vutihlamuleri bya Huvo ya swa Nawu 53

7 Xitatimente xa mafambiselo lama ma yelanaka hi Huvo ya swa Nawu 54

8 Xiviko xa Komiti yo Odita 55

9 Xiviko xa Tioditara to Tiyimela 58

10 Switatimente swa Timali swa Lembe swo Tsemakanya 59

4

Xitiviso eka Swirho

Xitiviso lexi xa nyikiwa leswaku Nhlengeletano ya Lembe ya Mani na Mani ya Vumune (“nhlengeletano”) ya Swirho swa Xikimi xa Swa Vutshunguri xa Vatirhela-mfumo (GEMS) yi ta khomiwa eMmabatho Convention Centre, 740 Dokodela James Moroka Drive, Mmbatho, hi Ravunharhu wa, 30 Khotavuxika 2010 hi 10:00 nimixo.

Ku tsarisa swi sungula hi 08:00 nimixo.

Agenda leyi yi nga ta tirhisiwa eka nhlengeletano yi hi ndlela leyi yi landzelaka: 1. Mbulavulo: Nkatsakanyo wa mutshamaxitulu wa bindzu ra Xikimu ku fika hi 31 N’wendzamhala 2009.2. Mbulavulo: Nkatsakanyo wa matirhelo hi Mufambisinkulu wa Bindzu ra Xikimi ku fika hi 31 N’wendzamhala 2009.3. Ku tiyisisa na ku amukela makanelwa ya Nhlengeletano ya Lembe ya Vunharhu ya Swirho ya Xikimi leyi yi khomiweke hi 30

Khotavuxika 2009 eCrocodile Inn Conference Centre, eNelspruit, eMpumalanga.4. Ku amukela na ku amukela switatimente swa swa timali swa lembe eri ri helaka hi 31 N’wendzamhala 2009, ku katsa Swiviko

swa Huvo ya swa Nawu na Xiviko xo huma eka tioditara ta le handle ta GEMS.5. Ku thoriwa ka Sizwe Ntsaluba VSP tanihi oditara wa le handle wa Xikimi hi ku landza Nawu wa 27.1 wa Milawu ya GEMS.6. Ku tiyisisa ku cinca ka Huvo ya swa Nawu:

a. Ku tivisa swirho eka AGM eka va timali vanharhu lava va thoriweke ku tirha nkarhi wo ringana malembe manharhu ku sukela hi 21 Mawuwani 2010; na

b. Ku tivisa swirho eka AGM eka va swa timali lava va thoriweke hi muthori ku tirha nkarhi wa ku ringana malembe manharhu ku sukela hi 21 Mawuwani 2010.

7. Ku xavisa ku fana na bindzu rin’wana tanihi leswi swi nga vaka swi xavisiwa eka nhlengeletano ya mani na mani ya lembe (ku ya hi Milawu ya GEMS na ku nyika Nawu wa swa Vutshunguri wa Nomboro ya 131 ya lembe ra 1998, tanihilaha wu antswisiweke ha kona).

Ku yingisa Swirho leswi swi tsakelaka ku andlala timhaka leti ti faneleke ku kaneriwa na/kumbe ku lulamisa agenda ya nhlengeletano ya endliwa eka ku nyika milawu ya 28.1.5.1 ku fika eka 28.1.5.6 ya Milawu ya GEMS leyi yi endliwaka nakambe laha hansi:

28.1.5.1 XiboholexixibumabumeriwekexifanelekufikaekaMufambisinkulukungasihela10ramasikukungasifikasikuranhlengeletanoyamaninamaniyalembe.

28.1.5.2 Xiboholexixibumabumeriwekexifanelekutaxikan’wenanhlamuseloyamemorandamuleyiyihlamuselakakahlekurihikokwalahokayinixifanelekutekeriwaenhlokweninamatimuyokarhilamamanyikakakutlakusaekaxiboholexixibumabumeriweke.

28.1.5.3 Maritolamamabumabumeriwekeyaxiboholamamangatapasisiwayafanelekuyisiwa.28.1.5.4 AkunaxiboholexixibumabumeriwekelexixilwanakanakumbekukwetlembetananaNawu,Swinawanakumbe

milawuleyiyingatavayivekiwileekaajendakutekeriwaenhlokweniekanhlengeltanoyalembe.28.1.5.5 Xibohoxalokokumbexakukatsamhakakumbexiboholexixibumabumeriwekeekaajendayanhlengeletanoya

lembeyitavayaMufambisinkulu,loyiangatakombelakutsundzuxiwakusukaekaHuvo.28.1.5.6 LokoMufambisinkuluatsandzekakumbeaalakuvekamhakakumbexiboholexixibumabumeriwekeekaajendaya

kuhelakalembeyamaninamanikutaniXirhoxingahalavaleswakuMufambisinkuluanyikaswivangeloswaxibohoxayenahikutsala,naswonalokoswifanerile,Xirhoxingahakombelaleswakumhakayibohiwaekanhlengeletanoyohlawulekaleyiyingavitaniwakahikulandzanawuwa28.2.

Swirho leswi swi lavaka ku bumabumela ku engeteriwa ka swiyenge swa ajenda swi fanele ku swi rhumela eka Xikimi hi poso eka Private Bag X782, CAPE TOWN, 8000 kumbe ku fekisa eka 0861 00 4367. Swiboho leswi swi fanele ku fika eka Xikimi hi 20 Khotavuxika 2010. Nakambe swirho swi khutaziwa ku yisa swiyenge swo engetela swa ajenda hi ku hetiseka hi ku landza milawu ya GEMS. Swirho leswi swi nga landzeleriki Milawu ya GEMS a swi nga hoxiwi eka ajenda ya AGM.

Swi humesiwile hi Huvo ya swa Nawu.

Dokodela EA WatsonMufambisinkulu

1

Bringing health within your reach

5

Makanelwa ya Nhlengeletano ya Vunharhu ya Lembe

Makanelwa ya Nhlengeletano ya Vunharhu ya Lembe ya Swirho swa Xikimi xa Vatirhelamfumo xa swa Vutshunguri leyi a yi khomiwile hi 30 Khotavuxika 2009 eCrocodile Country Inn, Nelspruit, eMpumalanga.

1) KupfulanakuAmukela

a) Xandla xa Mutshamaxitulu wa Huvo ya swa Nawu, Manana Vuyelwa Vumendlini-Schalk, u pfurile nhlengeletano hi awara ya 10:00 nimixo.

b) Nhlengeletano yi twananile leswaku Manana Vumendlini-Schalk u ta fambisa nhlengeletano hi ku landza Nawu wa GEMS wa 28.1.8 tanihileswi Mutshamaxitulu Phurof Richard Levin, a nga eka nhlengeletano ya ku vhotela bajete ya Holobye wa Mitirho ya Mfumo na Mafambiselo hi xiyimo xa yena tanihi Dayirekitara-Jenerala wa Xiyenge ya Mitirho ya Mfumo na Mafambiselo.

c) Mutshamaxitulu wa nhlengeletano u tiyisisile leswaku khoramu leyi yi lavekaka ya 30 wa swirho leyi yi vekiweke eka Nawu wa GEMS wa 28.1.3 yi fikeleriwile.

d) Na ku va nhlengeletano yi kotile ku ringanela ku ya emahlweni na ku lunghisa timhaka eka ajenda, Mutshamaxitulu wa nhlengeletano u tiyisisa leswaku xitiviso xa ku hlengeletana eka nhlengeletano ya Vunharhu ya Lembe ya swirho swa Xikimi ndhawu yin’we na ajenda yo sungula, xiviko xa Huvo ya swa Nawu, switatimente swo oditiwa lexi xi kombisiweke xa lembe na xiviko xa oditara xi nyikiwa swirho ku nga si fika Mudyaxihi 2009 hi ku landza Nawu wa Xikimi.

e) Mutshamaxitulu wa nhlengeletano u amukela swirho leswi swi nga kona nakambe na vanhu lava va landzelaka eka nhlengeletano: (i) Vahlayisi va Xikimi lava va tirhaka eka Huvo eka nkarhi lowu wu pimiweke; (ii) Mutshamaxitulu wo tiyimela wa Komiti yo Odita ya GEMS, Dokodela DP Van Der Nest;(iii) Mufambisinkulu, Dokodela Eugene Watson; na(iv) Oditara wa le handle, Tatana Johann Strauss wa feme yo oditara ya SizweNtsaluba VSP.

f) Nhlengeletano yi langutisa mahungu ya vhidiyo ku suka eka Mutshamaxitulu wa Huvo ya Tithirasiti, Phurofesa Richard Levin eka swiphemu swa Xikimi swa 2008.

g) Mutshamaxitulu wa nhlengeletano u nyika Mufambisinkulu wa Xikimi, Dokodela Eugene Watson, nkarhi wo vika eka nhlengeletano eka maendlelo ya matirhiselo ya Xikimi nkarhi wa nkarhi lowu wa ku kambisisa. Dokodela Watson u ya emahlweni a nyika nhlengeletano na swivumbeko swa nkoka swa matirhelo ya Xikimi ehenhla ka pulani ya xitirateji ya 2008 na swikombiso swa nkoka swa bindzu na ku cinca eka leswi swi humelelaka hi nkarhi wa ku kambisisa.

2) KuamukelaajendayaAGM

a) Mutshamaxitulu u andlala ajenda leswaku yi amukeriwa na ku tsundzuxa swirho leswi hi ku landza Nawu wa GEMS wa 28.1.5, xirho xin’wana na xin’wana lexi xi tsakelaka ku veka timhaka leti ti nga ta kaneriwa na ku lulamisiwa eka tinhlengeletano ta lembe ta mani na mani eka ajenda, va nga ha endla tano ntsena loko xiboho lexi xi bumabumeriweke va fanele ku tihlanganisa na Mufambisinkulu hi 10 ra masiku ku nga si fika nhlengeletano ya lembe ya mani na mani. Xiboho lexi xi bumabumeriweke xi fanele ku va xi tekeriwa enhlokweni nakambe na ku nyika masungulo lama ma kulaka eka xiboho lexi xi bumabumeriweke. Nakambe i xilaveko leswaku mavekelo ya xibumabumelo ya xiboho leswaku xi vekiwa.

b) Mutshamaxitulu wa nhlengeletano leswaku swirho a va yisangi swibumabumelo hi ku landza Nawu wa GEMS wa 28.1.5 na ku amukela ajenda leyi yi nyikiweke eka desika ra ku tsarisa. Nhlengeletano yi bumabumerile leswaku swirho swin’wana swi tirhisa tifomo ta vona to yimela swin’wana ku nyika swibumabumelo eka Xikimi na leswaku timhaka leti ti ta kaneriwa hi nkarhi wa ku vutisa na ku nyika tinhlamulo. Tatana Adriaan Van Wyk u bumabumerile leswaku ajenda yi bumabumeriwa hi Tatana John Themba.

2

6

3. Ku amukela swiboho

a) Mutshamaxitulu wa nhlengeletano u tiyisisa leswaku swiboho swinharhu leswi swi bumabumeriweke leswi swi lulamisiweke nhlengeletano yi nga swi sungula ku nga:(i) Ku kuma na ku amukela Makanelwa ya Nhlengeletano ya Mani na Mani ya Lembe leyi yi khomiweke hi 30 Khotavuxika 2008;(ii) Ku hlamuseriwa ka switatimente swa timali swa lembe leri ri helaka hi 31 N’wendzamhala 2008, na(iii) Ku thoriwa ka tioditara ta le handle ta Xikimi ta lembeximali leri ri helaka hi 31 N’wendzamhala 2009.

b) Nhlengeletano yi bumabumerile leswaku hi ku landza Nawu wa Xikimi, swiboho leswi swi tekiweke eka nhlengeletano yin’wana na yin’wana ya lembe ku ta va ndlela ya vhoti ya nhlengo ya vanhu vo tala ya swirho hinkwaswo leswi swi nga kona na ku yimeriwa hi muyimeri.

c) Mutshamaxitulu u tivisa nhlengeletano leswaku Xikimi xi kumile 207 wa tifomo ta vayimeri va nkoka to thola ku suka eka swirho hi siku ro hetelela ra 19 Khotavuxika 2009. Ntsengo wa tifomo ta vuyimeri ta 48 ti fanele ku handzuleriwa tanihileswi ti nga lulamangiki kumbe ti nga riki na tinomboro ta vuxirho kumbe vanhu lava va nga riki swirho swa Xikimi tanihi vayimeri.

d) Nhlengeletano yi twananile leswaku swirho swa Xikimi leswi swi hlawuriweke hi swirho swin’wana ku vhota hi ku va yimela hinkwaswo i swirho swa vahlayisi va xipano xa Komiti ya Vafambisi bya Xikimi. Vanhu lava va hlawuriweke, leswi swi kombisiweke hi 23 Khotavuxika 2009 eka nhlengeletano ya Huvo ya Tithirasiti hilaha va tsakelaka ha kona ku vhota hi ku landza xiboho xin’wana na xin’wana lexi xi hlamuseriweke eka nhlengeletano.

e) Endzhaku ka ku andlariwa na ku kanerisana eka xiboho xin’wana na xin’wana xa leswi swi landzelaka, Mutshamaxitulu u byela swirho hilaha va hlawuleke vayimeri na ku andlala swiboho leswaku swi amukeriwa.

f) Ku amukela Makanelwa ya Nhlengeletano ya Vumbirhi ya Lembe ya Mani na Mani ya swirho leyi yi khomiweke hi 30 Khotavuxika 2008 (i) Mutshamaxitulu u byela swirho leswaku Makanelwa ya Nhlengeletano ya Vumbirhi ya Lembe ya Mani na Mani leyi yi

khomiweke hi 30 Khotavuxika 2008 eBoardwalk Conference Centre, ePort Elizabeth swi katsiwile eka Xiviko xa Lembe xa 2008 lexi xi rhumeriweke swirho na ku andlala Makanelwa leswaku ya amukeriwa.

(ii) Swirho swi twananile leswaku:(a) Huvo ya Tithirasiti yi languta mpfhampfharhuto wa makanelwa hi 24 Mudyaxihi 2009 na ku hlamusela vonelo leswaku hi

wona ya ntiyiso ya mafambiselo ya Nhlengeletano ya Vumbirhi ya Lembe ya Mani na Mani ya swirho leyi yi khomiweke hi 30 Khotavuxika 2008;

(b) Hi ku ya hi tifomo ta vuyimeri leti ti kumiweke hi ku ya hi ku pfuna ku amukela Makanelwa ya Nhlengeletano ya Vumbirhi ya Lembe ya Mani na Mani ya swirho leyi yi khomiweke hi 30 Khotavuxika 2008 tanihi xikombiso lexi xi nga hetiseka xa nhlengeletano, loko xirho xi 1 xi tsakela ku ka xi nga vhoti.

(iii) Mutshamaxitulu u bumabumela makanelwa leswaku ya amukeriwa.(iv) Makanelwa ya Nhlengeletano ya Vumbirhi ya Lembe ya Mani na Mani ya amukeriwile endzhaku ka loko Tatana Manganyi

Abraham a bumabumerile leswaku nhlengeletano yi amukela makanelwa naswona swibumabumelo swi seketeriwa hi Tatana Nxumalo Themba.

g) Ku amukela Switatimente swa Timali swa Lembe swa lembe leri ri helaka hi 31 N’wendzamhala 2008(i) Mutshamaxitulu wa nhlengeletano u bumabumela switatimente swa swa timali swa Xikimi swa lembe leri ri helaka hi 31

N’wendzamhala 2008 ku amukeriwa na ku hlamusela nhlengeletano leswaku swirho swi nyikiwile switatimente swo koma swa swa timali leswi swi nga oditiwa ku nga si fika nhlengeletano.

(ii) Oditara wa le handle wa Xikimi, Tatana Johann Strauss wa feme ya SizweNtsaluba VSP, yi sunguriwile eka swirho leswi a swi ri kona na ku ya emahlweni ku nyika nhlengeletano leswi swi nga hleriwa hi oditara ya yena yo tiyimela ya le handle hi vuxokoxoko lebyi byi nyikiweke eka swirho eka Xiviko xa Lembe xa Huvo ya Tithirasiti ya 2008. Oditara wa le handle u tiyisisa leswaku xiviko lexi xi nga basangiki xi nga oditiwa xa lembeximali leri ri helaka hi 31 N’wendzamhala 2008 na leswaku Xikimi xi lawuriwa kahle.

(iii) Mutshamaxitulu wa nhlengeletano u tsundzuxa swirho leswi swi nga kona leswaku hi ku ya hi tifomo ta vayimeri leti ti amukeriweke, 205 wa swirho leswi swi vhoteke hi ku amukela Switatimente swa swa Timali swa Lembe kasi ku hava swirho leswi swi nga amukelangiki switatimente swa swa timali. 2 wa swirho swi tsakele ku nga ka swi nga vhoti.

Bringing health within your reach

7

2

(iv) Mutshamaxitulu u bumabumerile leswaku nhlengeletano yi amukela Switatimente swa swa Timali swa Xikimi swa lembe leri ri helaka hi 3 N’wendzamhala 2008. Xiboho xi tekiwile endzhaku ka loko Tatana Elliot Nyathikazi a bumabumerile leswaku Switatimente swa swa Timali swa Lembe eka lembe leri ri helaka hi 31 N’wendzamhala 2008 xiamukeriwa na leswaku swibumabumelo swi seketeriwile hi Manana Sibongile Nkosi.

h) Ku thoriwa ka SizweNtsaluba VSP tanihi tioditara ta le handle ta Xikimi.(i) Nhlengeletano yi bumabumerile leswaku SizweNtsaluba VSP yi thoriwile ku suka 1 Sunguti 2006 hi Huvo ya Tithirasiti va

Xikimi va xinkarhana endzhaku ka maendlelo ya ximfumo ya ku thendara lama ma landzeleriweke hi 2005. Feme yi tlhele yi thoriwa ravumbirhi hi swirho swa Xikimi ku odita switatimente swa swa timali swa Xikimi eka nkarhi lowu wu helaka hi 31 N’wendzamhala 2007, nakambe tanihi switatimente swa swa timali eka nkarhi lowu wu helaka hi 31 N’wendzamhala 2008 endzhaku ka loko feme yi kombisile leswaku va na vuswikoti na ntokoto wa ku odita switatimente swa swa timali swa Xikimi hi ku landza swilaveko swa mfumo.

(ii) Nhlengeletano yi twile leswaku endlelo ra ku thendera leri ri pfulekeke ri landzeleriwile ku kuma feme ya ku odita ku thoriwa tanihi tioditara ta le handle ta Xikimi eka lembeximali leri ri helaka hi 31 N’wendzamhala 2009.

(iii) Mutshamaxitulu wa nhlengeletano u tivisile Mutshamaxitulu wa wo tilawula wa Komiti yo Odita ya Xikimi, Dokodela DP Van Der Nest, eka swirho swa Xikimi.

(iv) Dokodela Van Der Nest u nyikile nhlengeletano nkatsakanyo wa maendlelo ya ku xava lama ma landzeleriwaka na ku hlamusela swirho leswi swi nga kona leswa SizweNtsaluba VSP yi kumekile ku va yi thoriwa hi maendlelo lama ma nga pfuleka na ku voniwa hi mani na mani.

(v) Dokodela Van Der Nest u bumabumerile leswaku swirho swi pasisa ku thoriwa ka SizweNtsaluba VSP tanihi oditara ya le handle ya Xikimi eka lembeximali leri ri helaka hi 31 N’wendzamhala 2009.

(vi) Mutshamaxitulu wa nhlengeletano u hlamusela swirho leswi swi nga kona leswaku hi ku ya hi tifomo ta lava va nga yimeriwa leti ti kumekeke, 201 wa swirho swi vhotile ku amukela xiboho xa ku thoriwa ka oditara ya le handle ya Xikimi eka lembeximali leri ri helaka hi 31 N’wendzamhala 2009, 2 wa swirho swi alanile ni ku amukela xiboho kasi 4 wa swirho a swi vhotangiki.

(vii) Mutshamaxitulu wa nhlengeletano u bumabumerile leswaku swirho swi pasisa SizweNtsaluba VSP ku odita switatimente swa swa timali swa Xikimi swa lembeximali leri ri helaka hi 31 N’wendzamhala 2009, hi ku ya hi ku pasisiwa ka ku thoriwa ka feme ya ku odita hi Murhijisitara wa Swikimi swa Vutshunguri. Xiboho xi amukeriwile endzhaku ka loko Patrick Malatjie a thoriwile tanihi oditara ya le handle ya Xikimi eka lembeximali leri ri helaka hi 31 N’wendzamhala 2009 naswona xibumabumelo xi pasisiwile hi Tatana Katleho Tsotetsi.

4) Xiyenge xa ku vutisa na ku nyikiwa tinhlamulo

a) Swirho swi nyikiwa nkarhi wa ku vutisa swirho swo angarhela mayelana na timhaka leti ku vulavuriweke ha kona eka Xiviko xa Lembe na AGM.

b) Mutshamaxitulu wa nhlengeletano, Mufambisinkulu na vahlayisi lava va nga kona va ta endla hinkwaswo swivutiso va nga si sungula nhlengeletano.

5) Nkomiso wa swiboho

a) Makanelwa ya ta kombisa leswaku(i) Makanelwa ya Nhlengeletano ya Vumbirhi ya Lembe ya Mani na Mani leyi yi khomiweke hi 30 Khotavuxika 2008 i xikombiso

xa kahle xa maendlelo ya nhlengeletano.(ii) Switatimente swa Lembe swa swa Timali swa Swikimi swa vatirhelamfumo swa Vutshunguri eka lembeximali leri ri helaka hi

31 N’wendzamhala 2008 swi amukeriwile hi swirho swa Xikimi eka Nhlengeletano ya Vunharhu ya Lembe ya Mani na Mani leyi yi khomiweke hi 30 Khotavuxika 2009, na

(iii) SizweNtsaluba VSP yi thoriwile hi swirho swa Xikimi xa swa Vutshunguri xa Vatirhelamfumo eka Nhlengeletano ya Vunharhu ya Lembe ya Mani na Mani ya swirho leyi yi khomiweke hi 30 Khotavuxika 2009, tanihi tioditara ta le handle ta Xikimi ku odita switatimente swa swa timali swa Xikimi eka lembeximali leri ri helaka hi 31 N’wendzamhala 2009 na ku endla ntirho lowu wu yelanaka, ntsena loko Murhijisitara wa Swikimi swa swa Vutshunguri swi kuma ku pasisiwa ku kota ku thola.

8 Bringing health within your reach

Tanihi xikimi lexi xi nga na swiphemu xa swa vutshunguri etikweni, nakambe na ku va xikimi lexikulu xa swa vutshunguri hinkwako, Xikimi xa swa Vutshunguri xa Vatirhelamfumo (GEMS) xi sungurile hi 2009 tanihi ku hundzuluxa ka nkoka ka bindzu ra malembe manharhu hi vukhale.

Xikimi xi yile emahlweni xi kula hi 2009 naswona handle ka ku kula loku, ku cinca ka sayizi ya bindzu na mintlhontlho leyi yi humelelaka, ku vile na ku humelela eka swo tala swa nkoka leswi swi kumekeke hi 2009. Huvo ya Tithirasiti va GEMS ya tinyungubyisa hi ku humelela lowu ku endliweke hi Xikimi na hi ndlela leyi mintlhontlho leyi yi humeleleke hi 2009 swi kotekile ku ri yi lawuleka na hilaha ku tsakela ka vavuyeriwa va GEMS ku sirheleriwile mikarhi hinkwayo.

Hi ku yimela Huvo ya Tithirasiti, i ntsako eka mina ku mi hlamusela hi nkatsakanyo wa ntirho lowu wu endliweke hi Huvo hi 2009 na ku mi nyika Xiviko xa Huvo eka swirho swa GEMS eka nkarhi lowu wu helaka hi 31 N’wendzamhala 2009.

Mixini, xivono na nkoka

Huvo yi kambisisile mixini wa Xikimi, xivono na switatimente swa nkoka eka nkarhi wa vona wa xitirateji xa ku pulana lowu wu khomiweke hi 11 na 12 N’wendzamhala 2008. Huvo yi tiyisisile leswaku switatimente swa ku letela leswi swi vuriweke na ku nyika swiletelo hi 2008 swi tama swa ha ri kahle na ku va kona hi 2009, ku hlayiseka ku engetela ku ya emahlweni tanihi nkoka wa ku seketela hi Xikimi. Hi nkarhi lowu wu nga pimiwa wa ku kambisisa, nghingiriko wa Huvo wu ringeta hi matimba ku ku kombisa switatimente swo letela leswi swi landzelaka:

XitatimentexaMixiniKu nyika hinkwavo vatirhelamfumo mfikelelo wo ringanela ku fikelela na mimbuyelo ya vuhlayiseki eka rihanyo hi ku angarhela.

XitatimentexaXivonoXikimi xa swa vutshunguri xa xiyimo xa le henhla, xo tirhiseka na ku hetiseka eka vatirhelamfumo.

XitatimentexaNkoka• Vuswikoti • Ku olova• Mbulavurisano wa kahle• Ku hlamusela swirho• Xikombelo xo fana• Ku koteka • Ku va na vutshila• Ku va na tinhlamulo• Nkoka wa mali• Ku komba vuhlayiseki

Pulani ya Xitirateji

Sisiteme ya mafambiselo yo hlanganisa ya ku hetiseka ya Xikimi yi endla leswi swi faneleke swa nhluvukiso swa pulani ya xitarateji xa nkarhinyana lexi xi letelaka na ku fambisa bindzu ra Xikimi. Ku humelela ka GEMS tanihi hi nchumu lowu wu yimelaka vuswikoti

Nkatsakanyo wa Mutshamaxitulu

Phurofesa Richard LevinMutshamaxituluwaHuvo

9

3

bya fambiselo na swiyenge swa malawulelo ya swona, nakambe na tanihi pulani ya xitarateji leyi xi yi endlaka – kun’we leswi swi hambanyisaka leswimbirhi leswi GEMS yi tumbuluxeke rhekhodo ya kahle leyi yi tirhisekaka hi ku hetiseka eka tipulani ta xitirateji xa lembe ra kona na ku hetisa swikongomelo leswi swi nga kona kwalako.

Huvo yi endlile ku pulana xitirateji xa yona xa 2009 hi ku tekela enhlokweni leswaku Xikimi xi ndlandlamukile xi va xa nhlangano lowu wu nga kula lowu wu nga na matirhelo ya ndhawu lama ma twalaka na tisisiteme ta malawulelo ya swa timali lama ma nga hetiseka. Ku pulana swi endliwile hi miehleketo yo yisa emahlweni xiyimo xa GEMS tanihi hi xa le henhla, xo hetiseka na xikimi xa swa vutshunguri leswi swi kotekaka.

Nhlokomhaka ya Pulani ya Xitirateji hi Huvo ya 2009 a yi “Ku fikelela nhlayiseko wa swa rihanyo wa xiyimo xa le henhla lowu wu kotekaka na mafambiselo lama ma nga hetiseka” na pulani leyi yi faneleke ku hlayisa na ku tlakusa swiyenge swa matirhelo ya bindzu, loko hi tlhelo ku nyikiwa Xikimi nkarhi wo sungula ku lavisisa mphakelo lowu vonakaka kumbe ku hakela tihakelo leti ti yelanaka eka mitirho ya nhlayiso wa rihanyo leyi yi lavekaka na ku kumiwa hi swirho. Pulani leyi ku kongomisaka eka yona eka ntirho lowu wu lavekaka ku veka masungulo lama ma nga tiya leswaku swiyimo swa GEMS eka xiyimo lexi xi kotekaka ku sungula ku tihlanganisa na tihakelo ta kona na nkoka xikimi eka ku langutela loku ku nga kona eka vavuyeriwa va xikimi na vatirhisani va nkoka ha vambirhi ku fana na muthori. Ku fika eka makumu lawa, xikongomelo xa xitirateji xa “Masungulo ya malawulelo ya nkoka ya nhlayiso wa rihanyo lama ma nga ta antswisa phurofayili ya khombo ya swa tlilinikali ya Xikimi” yi katsiwile eka pulani. Swin’wana swikongomelo swa xitirateji leswi swi nga kona eka pulani a ku ri: • Ku maketa hi ku hetiseka na ku veka xiyimo xa GEMS tanihi Xikimi xa swa Vutshunguri xa Xiyimo xa le Henhla eka swirho

hinkwaswo na swirho leswi swi nga swa nkoka, na ku hunguta swinene nhlayo ya vatirhi lava va nga khavhariwangiki eka vukorhokeri bya mfumo

• Ku kuma sisiteme ya mafambiselo ya kahle, leyi yi nga exikarhi ka vutihlamuleri, ku landzelela na ku vuxaka lebyi byi nga hetiseka bya vatirhisani

• Ku kuma na ku tirhisa swinene mitirho ya Xikimi na ku lawula matirhiselo, hi swiyimo swa mitirho ya le henhla swinene na ku korhokela swirho hi ku hetiseka

• Ku vekela leswi saleke, ku kuma vukorhokeri lebyi byi nga hetiseka na ku tlakusa switandati swa vutihlamuleri byo twala bya xiyimo xa le henhla

• Ku kuma na ku tlakusa vukorhokeri bya nhlanganiso eka xikimi • Ku lawula khombo hi ndlela leyi yi twisisekaka na hi ku hetiseka, hi xikongomelo xo kuma ku lemukisiwa ka Xikimi eka ku

lahlekeriwa

Huvo yi kumile swiviko swa matirhelo ya kotara na ya swa xinkarhana ku suka eka Vufambisi bya Xikimi eka ku hetisa tirhelo ra swikombiso leswi a swi ri kona eka pulani ya xitirateji ya 2009 naswona ya enerisa leswaku swikongomelo swa xitirateji swi fikeleriwile hi 31 N’wendzamhala 2009.

Mafambiselo hi 2009

Huvo yi kambisisile xivumbeko xa Tikomiti leti ti tumbuluxiweke hi Huvo hi 2009 hi xikongomelo xo lava ku tirhisa swikili na vuswikoti bya Tithirasiti na tikomiti ta swirho leswi swi tilawulaka. Nakambe mavonelo ya Huvo ya languta ku hetiseka ka mikarhi leyi yi kongomisiweke eka Tikomiti na ku cinca katsongo a ku laveka.

Tithirasiti eka Tikomiti hi 2009 tanihilaha swi vikiweke ha kona eka xiyenge xa 7 na 8 eka Xiviko xa Huvo. Huvo yi tiyisisile eka Mahlelelo ya lembe ya Huvo yo Hetiseka ya yona leswaku Tikomiti ti tirha kahle na leswaku mavikelo eka Huvo ya va eka xiyimo xa nkoka xa le henhla.

Swirho leswi swi Tiyimelaka swa Komiti leswi swi tirhaka eka Oditi ya Xikimi, Ex Gratia na Tikomiti ta Alana ti thoriwile hi Huvo ya mitirho ya hofisi ya malembe manharhu na nkarhi wa nhlayo ya swirho swa komiti leyi heleriweke hi nkarhi hi nkarhi lowu wu nga ku kambisisiweni. Huvo yi tlhela yi thola Swirho swa Tikomiti hi Vuntshwa ku yisa emahlweni nkarhi wa malembe manharhu lama ma helaka hi 2012.

Tithirasiti na Swirho swa Komiti nakambe va endla vuleteli bya le henhla eka mafambiselo yo hlanganisa, ku katsa swilaveko leswi swi “lavaka ku tirhisiwa hi xihatla” King III u vika hi Mafambiselo yo hlanganisela, malawulelo ya swikimi swa swa timali, mayelana na huvo

10 Bringing health within your reach

yo endla milawu, nhluvukiso wa swa vumaki ku katsa leswi swi lavaka ku endliwa hi Xiyenge xa Nsirhelelo wa swa Rihanyo swa Rixaka na mafambiselo ya swa rixaka. Tindhawu ta kaye to dyondzisela kona ti endliwile hi 2009. Ku letela Tithirasiti hi 2010 swi ta endliwa hi ku ya hi pholisi ya ku letela ya Tithirasiti leyi yi pasisiweke hi Huvo ku tirhisiwa hi 01 Sunguti 2010.

Ku pima mafambiselo lamanene swi endliwa hi Xikimi loko xi engeteriwa hi nkarhi wa ku kambisisa hi ku nghenisa endlelo ro kambisisa swihoxo swa Tithirasiti, swirho swa komiti leswi swi tiyimelaka na vatirhi. Endlelo ro kambisisa swihoxo ri vumba xiphemu xa rimba ra mafambiselo lamanene ya Xikimi lama ma fikelelaka mafambiselo ya Xikimi na swiyenge swa mafambiselo, Maendlelo ya Xiyenge xa ku Thola Vatirhi, Xiyenge xo Xava Nhundzu na Pholisi na Pulani yo Lwisana na Vuxisi.

Maasaselo Lama ma nga Hetiseka ya Lembe ya Xikimi ya endliwile hi Ndzhati na Nhlangula 2009. Huvo yi tirhile maasaselo yo tikambela lama ma fambisiwaka hi feme yo odita yo tilawula na matirhelo ya Huvo na Tikomiti ta Huvo ti kumile leswaku swi kahle.

Hi mayelana na milawu leyi yi nga rhijisitariwa ya ka GEMS, nkarhi wa ku khoma ehofisini 50% ya Tithirasiti va tirhile eka Huvo ya sweswi ya Tithirasiti leyi yi nga fika emakumu hi Mawuwani 2010. Huvo leyintshwa yi ta komberiwa ku sungula ntirho hi 21 Mawuwani 2010. Ku fika emakumu, swirhonkulu swa Xikimi swi ta hlawula Tithirasiti vanharhu lavantshwa loko hi tlhelo Holobye wa Mitirho ya Vaaki na Mafambiselo u ta thola Tithirasiti lavantshwa ku endla 50% ya Huvo. Ku hlawuriwa ka Tithirasiti swi ta endliwa hi mayelana na milawu leti yi rhijisitariweke ya ka GEMS leyi yi hlamuselaka leswi swi landzelaka:

“19.1 Ku hlawula Xirho lexi xi hlawuriweke xa Tithirasiti swi fanele ku endliwa hi papila ro vhota naswona hi mayelana na maendlelo lama ma vekiweke eka milawu leyi.

19.2 Munhu loyi a tiyimelaka kumbe huvo leyi yi thoriweke hi Huvo yi fanele ku vona hinkwaswo swa ku hlawula Xirho xa Tithirasiti naswona u fanele, endzhaku ka nhlawulo, a yisa xiviko eka Huvo laha eka xona munhu loyi a nga tiyimela kumbe huvo yi fanele ku hlamusela Huvo ya:19.2.1 Hambi va enerisiwile leswaku nhlawulo wu fambile kahle naswona hi mayelana na fambiselo leri ri pasisiweke hi

Huvo hi mayelana na milawu leyi;19.2.2 Mavito ya Swirho leswi swi hlawuriweke tanihi Tithirasiti na mavito ya vanhu lava va tlhela va hlawuriwa eka Huvo,

naswona19.2.3 Ku fanele ku tiyisisiwa leswaku vanhu lava va hlawuriweke tanihi Swirho swa Tithirasiti, na kona i Swirho lava va nga

eka xiyimo xa kahle ku ringanela ku hlawuriwa.19.3 Loko Huvo, endzhaku ka loko va vonile xiviko xa munhu loyi a nga lo tiyimela kumbe huvo, yi enerisiwile leswaku nhlawulo

wu vile kona hi ku mayelana na endlelo leri ri bohiwile hi huvo na leswaku nhlawulo wu vile lowu wu nga famba kahle, Mufambisinkulu u fanele, hi ku tsala, a tivisa swirho leswi swi hlawuriweke eka nhlawulo wa vona na siku, nkarhi na ndhawu ya nhlengeletano ya leyi yi nga ta landzela ya Huvo na ku va rhamba ku nghenela nhlengeletano.”

Huvo yi khutaza swirhonkulu swa Xikimi ku hoxa xandla eka maendlelo ya nhlawulo wa 2010 na ku tekela enhlokweni leswaku Huvo ya Tithirasiti va na vutihlamuleri bya nkoka bya ku languta mafambiselo ya Xikimi na timhaka ta swa timali na ku endla tano leswi swi tsakelaka hi swirho. Hikokwalaho i swa nkoka leswaku swirho swi tikarhata swi hlawula Tithirasiti lava va xiyimo xa le henhla naswona lava va nga na vuswikoti lebyi byi nga fanela na ku va na ntokoto wa ku tirha mitirho ya muhlayisarifuwo.

Mintlhontlho ya Xitirateji hi 2009

Ku humelela ka Xikimi swi kaneriwa hi xitalo eka Xiviko xa Matirhelo xa Mufambisinkulu na ntirho lowuntshwa lowu a wu nga voniwangi loko ku endliwa pulani ya xitirateji ya eka 2009 swi endliwile loko swi tlakusiwa hi nkarhi wa khoso ya 2009. Huvo ya Tithirasiti na vafambisi va ololoxile mintlhontlho leyi ku fika emakumu na ku vona leswaku Xikimi xi tshama nkarhi na nkarhi xi kongomisa eka ku humelerisa mixini na xivono xa Xikimi handle ka ku amukela switatimente leswi swi nga amukeriwangiki swa nkoka swa Xikimi. Yin’wana ya mintlhontlho leyi na ntirho lowuntshwa lowu wu katsa ku hundzisela ka bindzu ra MEDCOR’ eka GEMS, ku tirhisiwa ka ku engetela ka muholo ku sukela eka nkarhi lowu wu hundzeke wa vatirhelamfumo wu kavanyetile eka mahumeselo ya swirho na xikweleti na ku langutisisiwa hi vuntshwa milawu ya vuxirho lebyi byi faneleke eka GEMS hi Khansele ya Swikimi swa swa Vutshunguri.

MEDCOR

Ku hlangana exikarhi ka Xikimi na vatirhisani va nkoka swi fikisile eka xiboho xa Huvo ku twana ku hundzisela bindzu ra MEDCOR eka GEMS hi mayelana na xiyenge xa 63 xa Nawu wa Swikimi swa swa Vutshunguri wa 1998.

11

Swiboho xa mutirhisani xi sivela eka ku tirhisana leswi swi vangiwaka hi ku hlwerisiwa eku sunguleni ka ntirho lowu wu lavekaka ku hetisa ku xaviselana hi mayelana na mikarhi leyi yi vekiweke hi Khansele ya Swikimi swa swa Vutshunguri.

Ku xaviselana loku ku endliweke ku humelerile swinene na ku landzelela na swilaveko swa nawu leswi swi yelanaka leswi swi katsaka ku kandziyisa ka ku kombisa nxaviselano tanihilaha swi pasisiweke hi Khansele ya Swikimi swa swa Vutshunguri na ku pasisiwa hi ku xaviselana hi Khomixini ya Mphikizano.

Bindzu ra MEDCOR ri hundziseriwile eka GEMS ku sukela hi 1 Sunguti 2010 hi ku ya hi Memorandamu ya Ntwanano leyi yi endliweke exikarhi ka swikimi swimbirhi.

Tikontiraka ta ku thoriwa ka vatirhi vanharhu va MEDCOR ti hundziseriwile eka GEMS loko vatirhi vambirhi va le henhla va MEDCOR va kumile tiphakeji ta vona ti humile.

MEDCOR yi khanseriwile ku va yi rhijisitara tanihi xikimi xa swa vutshunguri hi Khansele ya Swikimi swa swa Vutshunguri ku sukela hi 21 Sunguti 2010 naswona ku MEDCOR yi kumeka ya ha tirhisiwa swi herisiwile hi 30 Dzivamisoko 2010.

Hi mayelana na ku kuma ku pfuniwa eka pholisi ya sabusidi ya swa vutshunguri yi vile kona eka vatirhelamfumo, ku katsa Ndzawulo ya Mitirho ya swa Makhotso, swirho swa MEDCOR swi kotile ku joyina GEMS hi ku tinyiketela hi swoxe. Hi ku yimela Huvo ya Tithirasiti, ndzi rhandza ku amukela swirho swa khale swa MEDCOR leswi swi tsariseke eka GEMS.

Ku hakeriwa ka muholo wa Vatirhelamfumo ku suka masiku ya le ndzhaku

Tafula ra mahakelelo leri ri nga rhijisitariwa ra Xikimi ri ya hi muholo naswona swirho swi hakela hi n’hweti tihakelo hi mayelana na miholo ya vona ya n’hweti. Ku engeteriwa ka muholo elembeni swi nga ha vangela xirho ku hakela mali ya le henhla eka benefiti yin’we leyi yi hlawuriweke hikuva va kumeka va fanela ku wela eka ntlawa wa muholo wa le henhla.

Swirho swa GEMS swi hlanganile na ku va ntlawa wa swona wa muholo wu antswisiwa (ku vonaka tilevele ta 16 ti kumeka ti hungutiwa ti va 12), mixavo na yona yi vile yi tlakuka nakambe na tanihi Ku Ava ku ya hi Ntirho wo Karhi (OSD) hi 2009. Ku cinca loku ku endliwile handle ka ku hakela ku sukela eka masiku ya le ndzhaku, leswi swi vulaka leswaku swirho leswi swi faneleke ku hakela tihakelo ta le henhla nakambe na ku hakela xikweleti lexi xi nga vangiwa.

Hambileswi Xikimi xi hunguteke mitlawa ya miholo hi ndlela ya kahle swinene ku suka hi 1 Sunguti 2009 ku yisa ehansi ku engetela miholo ya 2009 eka vatirhelamfumo, miholo ya swirho swa GEMS yi cincile hi ndlela leyikulu swinene ku tlula hilaha a swi languteriwile ha kona hikokwalaho ka mbuyelo wa OSD na ku antswisiwa ka miholo ya mitlawa. Huvo yi kambisisile ku nga enerisiwi ka swirho na vatirhisani leswi swi yeke ehenhla hikokwalaho ka mbuyelo naswona nakambe swi languta maendlelo eka ku lulamisa Xikimi ku hunguta xiphiqo lexi a xi nga languteriwangi xa muholo ku ya hi tiphirimiyamu eka swirho swa GEMS na le ka maendlelo eka malawulelo ya xikweleti eka Xikimi.

Ntirho wu ta va kona hi 2010 wa ku antswisa mitlawa ya miholo hi ndlela leyi yi nga ta sivela phenseteji ya nkoka ya swirho leswi swi khumbekaka na ku tiyisisa hambi ku ri ku hangalaka ka tilevele ta miholo na swirho eka ntlawa wa muholo wun’wana na wun’wana. Nawu wa ku cinca ku sivela ku hlengeletiwa ka leswi swi nga salela endzhaku ku suka eka ku cinca ka miholo nakambe naswona swi ta tumbuluxiwa.

Milawu leyi yi nga fanela Swirho swa GEMS

GEMS yi rhijisitariwile tanihi xikimi xa vuxirho lexi xi pfumelelaka swa vutshunguri na mfanelo ya vuxirho lexi xi lawuriwaka hi milawu leyi yi nga rhijisitariwa ya Xikimi. Ehansi ka milawu ya sweswi, vatirhi va tindzawulo ta mfumo wa le xikarhi na ta xifundzankulu na swiyenge swa mfumo leswi swi langutaka hi vuenti eka xiyenge xa 7(2) xa Nawu wa Vatirhelamfumo xa, 1994, tanihilaha yi antswisiweke, na vatirhi lava va tivekaka lava va tiviwaka hi Huvo ya Tithirasiti tanihi vatirhi lava va hoxaka xandla, va na mfanelo eka vuxirho.

Khansele ya Swikimi swa swa Vutshunguri yi lava leswaku Milawu yi antswisiwa ku yisa swikombelo swo pfumeleriwa hi Huvo ya Tithirasiti eka ku tiva xiyenge xa vaakatiko lexi xi tivekaka ehandle ka leswi swi nga eka xikopu xa Nawu wa Vatirhelamfumo. Ku antswisiwa ka nawu swi yisiwile hi Xikimi kambe xibumabumelo xa Khansele xi ringetile ku kurisa xikopu xa GEMS hi mfanelo.

3

12

Ku tikeriwa eka matirhelo na xiyimo xa swa timali ka Xikimi na ku kongomisa ko karhi ku kuma ku veka xiphemu lexi xi laviwaka hi Nawu swa fakeleleka swinene. Hi ku tsakela ku sirhelela ku navela ka tibenefixari ta GEMS, Xikimi xi ta yisa emahlweni ntwanano na Khansele ya Swikimi swa swa Vutshunguri hi 2010 ku vona leswaku xirho xa Xikimi xi kumeka xi ri eka milawu leyi yi nga vekiwa hi ku landza mpfumelelo na Vatirhelamfumo lowu wu nyikiweke GEMS emasungulweni ya yona.

Leswi swirho swi hlanganaka na swona

Huvo yi tirha ku vona leswaku ku tsakela ka swirho ka sirheleriwa hi mayelana na xiyenge xa 57(6)(a) xa Nawu wa Swikimi swa swa Vutshunguri, na leswaku va tiphina hi ku hetiseka na ku fikelela hi ku hetiseka eka tibenefiti ta vona leti ti faneleke tanihi swirho swa GEMS. Hi ku landzelela vutihlamuleri bya Huvo na mixini ya Xikimi ku phamela hinkwavo vatirhelamfumo hi ku fikelela ku ringana loku ku fikelelekaka na tibenefiti ta nhlayiso wa rihanyo hi ku angarhela, ku tekiwile magoza yo hlaya swinene ku antswisa ku fikelela na ku tlakusa leswi swirho swi hlanganaka na swona.

Nhluvuko wuntshwa lowu wu landzelaka i wa masungulo:• Huvo yi pasisa xiyenge xa vuhundzuluxeri eka hinkwawo matheriyali wa Xikimi na ku tihlanganisa na swirho hi 11 wa tindzimi ta

ximfumo. Phurojeke yi sungurile hi 2009 naswona yi ta famba malembe manharhu ku fika 2012. • Xikimi xi sungurile ku tirhisa timvhilopho to hlamulela eka tona swa bindzu hi mayelana na ku va xirho xi lava ku tihlanganisa loko

xi lava ku kuma tinhlamulo ku suka eka swirho. • Phurogireme ya GEMS ya Vuntswedyana yi sunguriwile ku vona leswaku vamanana lava va langutelaka va kuma ku hlayiseka ka

xiyimo xa le henhla hi nkarhi wa vona wa vuyimani na ku pfuna ku hunguta khombo ra ku tikeriwa loku ku nga ha vaka kona. • Benefiti ya SMS yi languta vukorhokeri lebyi byi kumaka hi swirho ku tiyisisa tibenefiti leti ti nga kona eka vona na vanhu va vona

lava va nga va tsarisa swi sunguriwile eka tibenefiti hinkwato leti ti nga kona.• Hinkwato tisenthara leti u nga yaka hi milenge ti nga kona tikurisiwile naswona van’wana va yile eka tindhawu letintshwa na leti ti

nga antswisiwa. Senthara ya vumbirhi leyi u nga yaka hi milenge yi pfuriwile eka xifundzankulu xin’wana na xin’wana ku endlela leswaku swi olovisela swirho ku kuma vukorhokeri bya ku “vulavurisana na vatirhi hi xiviri”.

• Switatimente swa tihakelo swa kotara swi sunguriwile ku pfuna swirho ku vona leswaku tiphiriniyamu ti tshama ti hetisekile.• Tiawara ta ku tirha to engetela eka senthara ya ku fowunela na ku va swirho swi ya hi milenge swi sunguriwile, ku katsa na

vukorhokeri bya masiku ya Mugqivela.• Switirhisiwa swo hambana-hambana swa “ku tihlanganisa” swi kona eka swirho ku fana na webusayiti ya ximfumo ya ka GEMS

ku hlamusela ku cinca ka leswi swi nga hlawuriwaka hi hela ka lembe.

Ku khensa

Tithirasiti

Huvo ya Tithirasiti yi tirha ku fana na hi ndlela ya xiyimo xa le henhla hi nkarhi wa ku kambisisa. Ntsengo wa 33 wa tinhlengeletano ta Huvo na ta Tikomiti ti fanele ku vekiwa hi nkarhi wa ku kambisisa hikokwalaho ka ku va khoramu yi nga fikeleriwi. Tinhlengeletano ta Huvo na Komiti ti endliwile hi ndlela yo vuyerisa na hi ndlela leyi yi kotekaka ku pfuna Huvo ku tirhana na timhaka ta matheriyali hinkwawo exikarhi ka xikopu xa mfanelo ya yona. Ku tiyimisela ko hava mpimo ka Tithirasiti eka tibenefixari va Xikimi va tshama va ri eka xivumbeko xa Huvo leyi naswona ndzi rhandza ku khensa Tithirasiti eka ntirho wa vona eka ku va Xikimi xi tlhela xi humelela eka lembe rin’wana.

Ndzi rhandza ku khensa eka Manana Vuyelwa Vumendlini-Schalk, Xandla xa Mutshamaxitulu xa Huvo, eka ntirho wa yena eka ku va a tirhile hi ku hetiseka eka Huvo.

Dokodela D P Van Der Nest, loyi a nga Mutshamaxitulu wa ku tilawula wa Komiti yo Odita ya GEMS, u nghenerile tinhlengeletano ta Huvo tanihi xirho xo engetela hikokwalaho ka ntirho wa yena kutani ndzi rhandza ku n’wi khensa eka ntirho wa yena mayelana na ku vona leswaku ndhawu ya Xikimi yi tshama yi lawuleka hi ku enerisa na hi ku hetiseka.

Bringing health within your reach

3

Ku engetela, ndzi rhandza ku khensa Tatana Velile Mbethe, Dokodela Tertius Geldenhuys na Dokodela Eugene Watson eka ku fambiseni ka Mafambiselo na swa Khombo, Matirhelo na Tikomiti ta ku engetela ta Gratia eka Huvo hi nkarhi wun’we hi nkarhi wa lembe ra ku kambisisa.

SwirhoswaKomitiyoTiyimela

Swirho swa Komiti yo Tiyimela leswi swi thoriweke hi Huvo ku tirha eka Komiti yo Odita ya Xikimi, Komiti yo Engetela ya Gratia na Komiti ya ku lulamisa Swiphiqo nakambe leyi yi hoxaka xandla hi matheriyali ku fikelela ku humelela ka Xikimi hi 2009 kutani hi ku yimela Huvo, ndzi rhandza ku khensa swirho eka ku hoxa ka swona xandla na vutivi lebyi va byi vekeke eka ku tirhisa matimba ya Huvo na Mafambiselo ya Xikimi.

Mufambisinkulu

Hi ku yimela Huvo, ndzi rhandza ku hundzisa marito ya ku khensa hi ntsako lowukulu swinene eka Dokodela Eugene Watson, Mufambisinkulu wa GEMS. Nakambe Mufambisinkulu u endlile hilaha Huvo a yi languteleke ha kona naswona yi n’wi vekile hi ku tshembha eka yena naswona u tirhile handle ko cinca ku tsakela ka Huvo ku tiyimisela ka yena na ku navela ka GEMS. Mufambisinkulu u tirhisile Pulani ya Xitirateji leyi yi pasiseke hi 2009 hi ndlela ya kahle naswona u tiyisisile leswaku bindzu ra Xikimi ri tirha hi vuswikoti na hi ku hetiseka.

Huvo ya tsaka hi mbuyelo lowu wu kumekeke hi Mafambiselo ya Vurhangeri bya Xikimi na xiyenge xa vatirhi ehansi ka vurhangeri bya Mufambisinkulu.

Huvo yi ta nyiketa “xinhongana” eka Huvo ya Tithirasiti leyintshwa hi 21 Mawuwani 2010 naswona yi twa yi ri na ku tshemba leswaku masungulo lamanene ya sunguriwile leswaku Xikimi yi ya emahlweni xi tirha hi vuswikoti.

13

14 Bringing health within your reach

Hi 2009 Xikimi xi vonile nkoka wa ku ya emahlweni no lava vuhlawuleki byo tlula malawulelo ya mafambiselo na timhaka ta nkoka ta bindzu ku ya eka xiyenge xa vukorhokeri bya swa rihanyo - lexi nga eka xiyimo xin’we xa 90% ya timali ta Xikimi leti phakeriweke na hilaha Nawu wa Swikimi swa Swa Rihanyo wu hlamuselaka bindzu ra swa rihanyo. Kungu ra sitirathejiki ra 2009 leri amukeriweke hi Huvo ya Tithirasiti ri languterile Xikimi ku ya emahlweni na ku humelela loku nga kona na ku fikelela ku humelela eka xiyenge xa swa rihanyo hi ku tirhisa makunguhatelo ya vutlhari na mahlelelo lamanene na malawulelo ya makhombo ya swa rihanyo.

Nkongomelo wa 2009 wu ri, “Ku kuma swa rihanyo swa xiyimo xa le henhla leswi olovaka ku swi kuma no lawuriwa kahle”, lowu tirhiseriwaka ku lawula timhaka ta mafambiselo ya bindzu, hi hala tlhelo Xikimi xi na nkarhi wo lavisisa tindlela ta mphakelo wa le henhla kumbe ku hakeriwa ka tihakelo leti yelanaka na vukorhokeri bya swa rihanyo lebyi laviwaka no kumiwa hi swirho. GEMS yi sungurile hi ntirho wo cinca mphakelo wa vukorhokeri wa swa rihanyo eka swirho swa yona. Ntirho lowu endliweke hi 2009 wu vekile masungulo lamanene ya ku ya emahlweni na ntirho lowu.

Ku tirhisiwa ka kungu ra xitirathejiki ra 2009

Kungu ra xitirathejiki ra lembe na lembe ri kombisa vutihlamuleri bya Huvo hi ku kombisa migingiriko ya Mufambisinkulu na vulawuri, ri kombisa matirhelo lama nga kamberiwaka no vona leswaku bindzu ra Xikimi ri tirha kahle

no humelela. Naswona kungu ra sitirathejiki ri pfuna Huvo ku pfuxeta swiphemu hinkwaswo swa bindzu no vona leswaku hambileswi bindzu ri tirhaka kahle, ri fanele ri tshama ri ri kona.

Tani hi Mufambisinkulu, hi mina muofisiri wa tinkota wa Xikimi lexi naswona i vutihlamuleri bya mina byo vona leswaku makungu ya mafambiselo ya Xikimi ya kongomile eka ku humelerisa hi ndlela leyinene makungu ya matirhelo ya Xikimi lama pasisiweke hi Huvo, na ku vona leswaku tixedyulu ta ku vika ta nkarhi na nkarhi leti pimanyisiwaka na mifungho ya matirhelo swa humelela.

Eka lembe leri kambisisiwaka, Huvo yi nyikiwile swiviko swa matirhelo swa kotara na kotara swa ntirho lowu endliweke loko swi pimanyisiwa na mifungho ya matirhelo lama nga eka Kungu ra Matirhelo. Xiviko xo hetelela xi rhumeriwile eka Huvo ya Tithirasiti hi 10 N’wendzamhala 2009, leswi tiyisisaka leswaku 96% ya mifungho ya matirhelo yi fikeleriwile.

Kungu ra Xitirathejiki ri tirhile tani hi xikoweto xa mafambiselo eka lembe-ximali ra 2009. Hi ndlela yaleyo ndzi rhandza ku nyika xiviko lexi hi ku landza Kungu ra Xitirathejiki. Mahungu yo engetela ya mifungho ya bindzu ya nkoka, maendlelo na tinhlayo swi kombisiwile eka Xiviko xa Huvo ya Tithirasiti lexi kumekaka eka mapheji ya 23 ku fika eka 50 ya xiviko lexi.

KumaketeGEMSkahlenakuyivekaekaxiyimoxakahletanihiXikimixaSwaRihanyoxoHumelelaxaswirhohinkwaswonaswirhoswintshwanakuhungutanhlayoyavanhulavangatsarisiwangikiekaVukorhokeribyaTiko

Hi 31 N’wendzamhala 2009 swirho a swi fika eka 409,804, laha a ku ri na nkulo wa swirhonkulu swa 100,000 hi 2009. Leswi swi kombisa nkulu wa 36% loko ku pimanyisiwa na swirhonkulu swa 300,536 hi 31 N’wendzamhala 2008. Ku hundza 150,000 wa vatirhi lava holaka muholo wa xikalo xa 1 – 5 a va titsarisile eka GEMS hi 31 N’wendzamhala 2009.

Xiviko xa Mufambisinkulu

Dr Eugene Watson

Mufambisinkulu

15

4

Ku humelela ka ku tirhisiwa ka Phurojekite ya Sisonke swi endlile leswaku ku maketiwa ti-sms ta mune kotar yin’wana na yin’wana eka vatirhi lava nga ri ki na nsirhilelo lava nga eka tilevhele ta 1 – 5 na mapfhumba manharhu ya rhadiyo lama endliweke exikarhi ka lembe.

Vayingiseri lava mapfumba lama a ma kongomisiwile eka vona va hlamurile kahle naswona Xikimi xi ta ya emahlweni na mapfhumba lama hi 2010.

Ku endliwile mikandziyiso na mikombiso yo hundza 1,320 exikarhi ka lembe naswona ku vile na vuxaka bya ntlheriselano exikarhi ka Xikimi na Tindzawulo ta Mfumo laha ku veke na nseketelo wa masiku yo hundza 250 ya swa rihanyo.

Xitiratheji xa Xikimi xa ku tihanganisa na vaphakeri xi antswisiwile hi tirhisiwa ka Papila ra Mahungu ra Vaphakeri va Swa Rihanyo leri hangalasiweke eka vaphakeri va swa rihanyo vo hundza 28,000 kotara yin’wana na yin’wana. Ku phakiwile mapapila ya mahungu ya 594 ya Ntirho wa Tipurakitixinara kotara yin’wana na yin’wana. Tiatikile to hambana ti kandziyisiwile eka mikandziyiso ya tiyuniyoni, mikandziyiso ya swa rihanyo mapapila ya mahungu ya tindzawulo na mapapila ya mahungu ya GEPF ya kotara na kotara.

Kungu ra vuhundzuluxi ra malembe manharhu ri sungurile hi 2009 naswona methiriyele hinkwawo wa Xikimi wa vutihlanganisi na ku maketa, lowu katsaka Swinawana swa Xikimi, swi ta hundzuluxeriwa eka tindzimi ta ximfumo hinkwato. Hi 2009, mapapila ya mahungu ya swirho ya hundzuluxiwile naswona ya kumeka eka webusayiti ya GEMS.

Nongonoko wa GEMS wa Vutswedyana wu simekiwile hi 1 Mudyaxihi 2009 leswaku swirho swa Xikimi swi kuma nseketelo, dyondzo na switsundzuxo eka swiphemu hinkwaswo swo biha emirini, ku tshama na nkarhi endzhaku ka ku tswala. Mimbuyelo na vukorhokeri lebyi kumiwaka endzhaku ka ku titsarisa eka nongonoko lowu swi katsa Buku ya swo biha emirini ya GEMS; vutswari endzhaku ka ku veleka na le ku sunguleni’ bege hi nkarhi wa ku biha emirini; tidyondzo ta xirho mayelana na mimbuyelo ya xikimi; kungu ra mahlayiselo na switsundzuxo swo ya emahlweni swa riqingho na nseketelo.

Ku tsarisiwile vaphakeri va vukorhokeri bya swa rihanyo vo tlula 10,000 eka nongonoko wa Friends of GEMS naswona Xikimi xi kamberile mpimo wa ku humelela ka nongonoko lowu, h.l. laha swirho swi nga swi kota ku kuma vuxokoxoko bya vutihlanganisi bya vaphakeri va swa rihanyo lava tihakelo ta vona ti lawuriwaka hi mpimo wa Xikimi.

Vutihlanganisi na swirho exikarhi ka 1 Sunguti 2009 ku fika 31 N’wendzamhala 2009 byi tikombisile hi ku hangalasiwa ka mapapila ya mahungu yo hambana, na mapipila ya mahungu ya nkarhinyana lama a ma tivisa swirho hi vukorhokeri byintshwa. Naswona ku kandziyisiwile tikhopi ta 340, 000 Xiviko xa Lembe na Lembe xa 2008 leti rhumeriweke eka swirho hi 29 Mudyaxihi 2009 naswona Xikimi xa tinyungubyisa hi ndlela leyi swirho swi vikeriwaka ha yona.

Mbalango wa vumbirhi wa Xikimi wa mavonelo ya swirho wu endliwile hi kotara ya vumune ya 2010 laha mbuyelo wo hetelela na nhlelo swi nga nyikiwa Huvo ya Tithirasiti hi 10 N’wendzamhala 2009. Mbuyelo wa mbalango wu kombisile leswaku 77.6% ya swirho swi enetiwa hi vukorhokeri bya Xikimi na leswaku Xikimi xi kota ku fikelela swilaveko swa swirho.

Hixikongomeloxolandzelelamafumelolamanene,lamanganavutihlamuleri,kulandzelelavuxakabyakahlenavanhulavakhumbekaka

Vukorhokeri bya vamatsalana bya vuswikoti byi nyikiwile Huvo ya Tithirasiti na Tikomiti eka nkarhi lowu kambisisiwaka na hi ku landza Tipholisi ta Mafumele leti pasisiweke ta Xikimi. Swipimelo leswi nga eka pholisi swi endleriwa ku vona leswaku swivumbeko leswi tumbuluxiweke swa mafumelo swi tirha kahle.

Ms Liziwe KonyanaHuvonkulu:VutihlanganisinaTimhaka

taSwirho

16 Bringing health within your reach

Hambileswi tithirasiti na swirho swa tikomiti swi nga ya eka ndzetelo wo karhi eka malembe lama nga hundza, ku tumbuluxiwile pholisi yintshwa ya maletelo ya tithirasiti hi 2009 ku vona leswaku ku dyondza ka tithirasiti na ndzetelo swi endliwa hi ku landza nongonoko wa ximfumo. Ha swi tiva leswaku ku ta va na ku cinca ka Huvo ya Tithirasiti eka nkarhi lowu helaka hi N’wendzamhala 2010 naswona ku fanele ku va na ntshiklelo eka ndzetelo wa tithirasiti letintshwa.

Sisiteme ya mafumele ya Xikimi swi yisiwile emahlwni hi ku simekiwa ka vhetingi ya tithirasiti na vatirhi. Maendlelo ya ku vheta ya tiyisisa leswaku tithirasiti, swirho swa komiti swo tiyimela ha swoxe na vatirhi va faneriwile hi ku nghena eka ntirho lowu. Ku thoriwile muphakeri wo vheta ku va a endla nkambisiso lowu nga fanela naswona mbuyelo wa kona wu hundziseriwile eka oditara wa lendzeni wa Xikimi ku endla mpfuxeto.

Ku endliwile mpfuxeto wo angarha wa Swinawana swa GEMS hi xikongomelo xo vona loko swinawana leswi swi fanerile. Hikwalaho ka mpfuxeto lowu, swinawana leswi hlamuselaka vanhu lava nga tsarisiwaka tani hi vahlayisiwa va swirho va hlamuseriwile hi vuntshwa leswaku swi tirhisiwa hi ndlela yo fana. Ku tumbuluxiwile na swinawana swintshwa swa malawulelo ya Xikimi. Rhejisitara wa Swikimi swa Swa Rihanyo u tsarisile swinawana leswi nga cinciwa hi 30 Khotavuxika 2009.

Oditara wa le ndzeni wa Xikimi u endlile mpfuxeto wa ku fikeleriwa ka milawu ku kambela Swinawana swa GEMS swi fanerile na ku kambela swiyenge swa Nawu wa Swikimi swa Swa Rihanyo. Xikalo lexi vekiweke hi oditara a xi ri lexinene naswona vulawuri byi kamberile mimbuyelo leyi nga eka xiviko.

Xitiratheji xa Malawulelo ya Vanhu lava khumbekaka va Xikimi xi pfuxetiwile eka Kotara ya 1 ya 2009 naswona migingiriko ya vanhu lava khumbekaka na mavikelo swi endliwile hi ku landza xitiratheji lexi pfuxetiweke eka lembe hinkwaro leri kambisisiwaka. Vuxaka byo thleriselana exikarhi ka vanhu lava khumbekaka vo kota Huvo ya Swikimi swa Swa Rihanyo, Nkwama wa Rixaka, Huvo ya Mimbulavurisano ya Swa Miholo ya Vutirheli bya Tiko, Vapurakitixinara va Timhaka ta Vatirhi na Vapurakitixinara va Swa Rihanyo, byi hlayisiwile kahle. Vanhu van’wana va nkoka lava ku tirhaniwaka na vona va kumile swiviko swa kotara na kotara eka Xikimi naswona tinhlengeletano ta kotara na kotara leti a ti kunguhatiwile ti humelerile. Migingiriko ya kotara na kotara a yi katsa tihlengeletano na mihlangano leyi lawulaka tisisiteme ta maholele ya vatirhi na vadyuhari va vukorhokeri bya tiko, h.l. PHESALI na GEPF.

Holobye wa Vulawuri bya Vukorhokeri bya Tiko a a tshama a ri karhi a hlamuseriwa hi xiyimo xa Xikimi kasi na yena a tshama a tihlanganisa na Xikimi mikarhi hinkwayo.

Nongonoko wa GEMS wa lembe na lembe wa Switirhisiwa swo Letela wu vile kona ku suka 1 Dzivamusoko 2009 ku fika 30 Khotavuxika 2009 naswona swiyenge swa ndzetelo a swi katsa tindzwawulo hinkwato ta rixaka, tindzawulo ta swifundzankulu na vatirhi va GEMS van’wana. Ku sunguriwile Papila ra mahungu ra ilekithironiki ra kotara na kotara ra Mupurakitixinara wa HR eka lembe leri kambisisiwaka naswona ri tirhisiwile ngopfu ku langutisa swivangelo swa swivilelo swa malawulelo ya tihakelo. Swin’wana swa swiphiqo leswi, swo kota ku panga vukorhokeri bya ku tshika loku tlheriseriweke endzhaku eka PHESALI, swa ha ri kona naswona ka ha ta tirhiwa ntirho wo tala hi 2010 hi ku tirhisana na HR na vapurakitixinara va swa muholo eka vukorhokeri bya tiko.

Simphoziyami ya vumbirhi ya GEMS ya lembe na lembe yi khomeriwe eKwaZulu-Natal ku suka 26 – 27 Nhlangula 2009. Xikongomelo xa simphoziyami a xi ri eka tihakelo ta Xikimi, ku ya eka Malawulelo ya HR na Vukorhokeri bya Tiko.

Swivilelo swa swirho swi kambisisiwile no fikeleriwa eka lembe leri kambisisiwaka. Swirho swi komberiwile ku rhumela swivilelo swa swona eka Xikimi hi ku tirhisa adirese ya [email protected]. Swivilelo leswi a swi kongomisiwile eka

Ms Jeannie CombrinkHuvonkulu:Mafumelonavuxakana

vanhulavakhumbekaka

17

4

Mafambiselo ya Xikimi naswona swi rhumeriwile eka adirese ya imeyili ya swivilelo. Swivilelo leswi kumiweke hi adirese leyi ya imeyili swi hleriwile hi xikongomelo xo kuma swivangelo no kuma tindlela to ololoxa swiphiqo. Ku vile na swiviko leswi endleriweke Huvo ya Tithirasiti na vanhu lava khumbekaka mayelana na ntokoto wa swivilelo swa Xikimi leswi veke kona. Swirho swi nga ha rhumela swivilelo swa swona eka Huvo eka lembe leri kambisisiwaka.

Swivilelo leswi kombisiweke tani hi mpimo wa vuxirho hi yin’wana ya mifungho ya nkoka ya bindzu leyi kamberiwaka hi Huvo ya Tithirasiti naswona nhlelo wa maendlelo lama wu kumeka eka xiyenge xa 4.9 xa Xiviko xa Huvo xa swirho swa Xikimi.

Swirho leswi nga enetiwangiki hi xiboho xa swivilelo swa swona hi Xikimi, swi nga ha hundzisela swivilelo leswi eka Komiti ya Swivilelo ya GEMS leswaku swi hleriwa. Mayingiselelo ya Swivilelo swa GEMS ya pfuxetiwile eka Kotara ya 1 ya 2009 naswona Komiti yi ta ya emahlweni yi tiyimiserile ku ololoxa swiphiqo hi ndlela ya kahle no amukeleka.

Nhlengeletano ya Mani na Mani ya ya Swirho ya vunharhu yi vile eNelspruit, Mpumalanga hi 30 Khotavuxika 2009. 91 wa swirho swi yile eka AGM naswona swi pasisile swiboho hinkwaswo leswi andlariweke.

Ku hlayisa na ku yisa emahlweni vukorhokeri bya Xikimi na malawulelo ya oparexinali, hi swiyimo swa vukorhokeri bya le henhla na vukorhokeri bya kahle bya swirho swi humelerile

Xitiratheji xa malawulelo ya tihakelo lexi veke kona hikwalaho ka mpfuxeto wa le kaya xi tumbuluxiwile ku langutana na timhaka ta nsalo wa swikweleti na khirediti, ku rhumeriwa ka PHESALI, swirho swa vadyuhari, ku yimisiwa ka swirho na swikombelo leswi nga languteriwa. Mpfuxeto lowu wu endlile leswaku swivilelo swa swirho swi hunguteka hi 50%.

Matirhelo ya vaphakeri va vukorhokeri ya lawuriwile kahle no pfuxetiwa nakambe leswaku ku langutiwa swiphiqo leswi nga voniwa. Ku vile na ku kamberiwa ka matirhelo loko ma pimanisiwa na swipimelo swa kontraka na mavikelo eka makungu na switiratheji.

Ku tumbuluxiwile matirhiselo ya mitila ya swikoxo leswaku swikoxo swi rhumeriwa kahle, swi kamberiwa no lawuriwa eka xiyenge xa swa rihanyo xa rixaka. Hi ku angarhela, mpimo wa ku humelela ka nkambelo wa swikoxo swa Xikimi hi 2009 wu hundza 99%.

Tsalwa ra ku hlela na ku hakela swikoxo mayelana na Mimbuyelo ya Le Hansi leyi Pimiweke (PMBs) ri tumbuluxiwile. Leswi swi endlile leswaku ku va na ku humelela eka matirhiselo ya PMB ya othomethiki lama tirhaka hi ku landza Xitandzhaku xa G xa Swinawana swa Xikimi na swipimelo swa Nawu wa Swikimi swa Swa Rihanyo. Tsalwa ra PMB leri lulamisiweke hi Xikimi ri endleriwa ku fikelela swilaveko hinkwaswo swa Sekhula ya CMS ya 37 ya 2009.

Ku pfuxetiwile tikontraka hinkwato na vaphakeri va Xikimi. Tikontraka leti nga kona ti hlayisiwile naswona ku tirhisiwile kahle tikontraka ta sweswi naswona ku na tikontraka ta vukorhokeri byintswa swa mphakelo wa Swa Riahanyo Lerinene, Nongonoko wa Vutswedyana na vukorhokeri bya swa Vutihlanganisi.

Oditi ya Ntwanano wa Levhele ya Vukorhokeri ya 2009 yi endliwile hi oditara wa le ndzeni wa Xikimi na vulawuri bya tikontraka ta Xikimi, na mbangu wa vukorhokeri, naswona swi amukeriwile swi ri swa kahle.

In 2009 GEMS yi yile emahlweni ku vona leswaku maendlelo ya malawulelo ya datha ya hlayisiwa na leswaku datha hinkwayo yi hlayisiwile kahle no sirheleriwa. Mimbuyelo hinkwayo ya REF a yi tiyile naswona yi rhumeriwile hi nkarhi eka Huvo ya Swikimi swa Swa Rihanyo.

Ms Bella MfenyanaHuvonkulu:TikontrakanaMatirhelo

18 Bringing health within your reach

Maendlelo yo hundzisela bindzu ra MEDCOR ku ya eka GEMS ri sunguriwile. Ku tumbuluxiwile tsalwa ra Take-on na kungu ra phurojekite ya Wind down naswona swi vumbile masungulo matirhiselo ya kungu ra MEDCOR.

Take-on ya vatirhi va Swikimi swa Swa Rihanyo, National Institute for Higher Education- Mpumalanga (NIHE) na Council on Higher Education (CHE) yi endliwile naswona vatirhi va mihlangano leyi va tsarisiwile eka Xikimi. Pholisi ya malawulelo ya Vungungundzwana eka Xikimi yi tirhisiwile naswona vukorhokeri byi kamberiwile hi Foramu ya Vungungundzana ya Xikimi, hi nseketelo wa vulavisisi lebyi endliwaka hi Special Investigating Unit (SIU).

Ku rhumeriwile tihakelo ta GEMS ta 2010 na dizayini ya mimbuyelo eka Huvo ya Swikimi swa Swa Rihanyo hi 25 Ndzhati 2009 naswona swi tirhisiwile kahle eka vaphakeri va vukorhokeri lava nga eka kontraka hi 31 N’wendzamhala 2009.

Maliyoengetela, tirhizevhe toengetela letihlengeletiwekenaku tirhisaswitandadiswatinkotaswoamukeleka

Xikimi xi hlengeletile tibiliyoni ta R8,9 na ku hakela tibiliyoni ta R7,9 ta swikoxo, Laha Xikimi xi saleleke hi timiliyoni ta R774 eka lembe leri. Tihakelo to ka ti nga ri ta swa rihanyo ti lawuriwile kahle naswona a ti ri 7.19% ya tihakelo ta mali ya giroso. Mbuyelo wa mimbekiso wa 5% wu kumekile hi ku ya emahlweni no tirhisa switiratheji swa mimbekiso swa Xikimi laha endzhaku Xikimi xi ve ke na mali yo engetela ya timiliyoni ta R263 eka lembe-ximali leri.

Matirhiselo ya mali na nsalo wa le bangini wa Xikimi swi kamberiwa vhiki na vhiki ku vona leswaku ku fikeleriwa swilaveko swa matirhiselo ya mali. Xikimi xi vile na nsalo eka bangi wo hundza R1 bililiyoni eka lembe-ximali leri naswona ku engeteriwile ntsengo wa nete wa R572 timiliyoni.

Swikweleti swa Xikimi swi lawuriwa hi ku tirhisa tindlela ta malawulelo ya swikweleti. Xikimi xi swi kotile ku antswisa mipimo ya swikweleti lembe hinkwaro, kambe GEMS yi kongomanile na mipimo ya le henhla ya swikweleti (swikweleti swa tihakelo swi tlakukile hi 90% hi Nhlangulo) leswi vangeke hi ntlakuko wa miholo lowu hakeriweke ku tlhelela endzhaku na Occupational Specific Dispensations (OSD’s) leswi tirhisiweke hi Vukorhokeri bya Tiko hi Mawuwani 2009. Ku tlakuka ka mipimo ya swikweleti leswi vangiweke hi ku tirhisiwa ka mitlakuso ka miholo loku tlheriseriweke endzhaku na OSD, swi lawuriwile hi ku tihlanganisa na vapurakitixinara va HR na valawuri vo hambana va swa miholo. Pholisi ya ku lawula Xikimi yi pfuxetiwile na yona exikarhi ka lembe leswaku ku antswisiwa timhaka ta malawulelo ya swikweleti swa Xikimi.

Ku kumekile ndzindzakhombo wa nsirhelelo no antswisiwa eku sunguleni ka 2009 naswona ku kumekile ndzindzakhombo wa tiasete eka lembe rona leri kambisisiwaka.

Malawulelo ya tinkota nhweti yin’wana na yin’wana hi 2009, ku katsa swiviko swa huvonkulu, swi tisiwile no andlaleriwa Huvo ya Tithirasiti na Tikomiti ta yona.

Mimbuyelo hinkwayo ya xinawu ya mimbuyelo ya REF yi rhumeriwile hi ntalo na hi nkarhi eka Huvo ya Swikimi swa Swaihanyo eka lembe-ximali hinkwaro. Ku rhumeriwa ka mimbuyelo ya xinawu a swi pimeriwe eka ku rhumeriwa ka tinkota ta malawulelo ya nhweti na nhweti hi ku landza Xitiviso xa 35 xa Huvo ya Swikimi swa Swaihanyo xa 2009.

Matirhiselo ya vulawuri bya swa timali eka Xikimi ma seketeriwile hi mitirho ya akichari leyi katseke ku rhumeriwa ka swiviko swa nhweti na nhweti na swa kotara na kotara swa demogirafi ya swirho, mahlelelo ya swikoxo na mikumbetelo ya swa timali eka nkarhi wo koma na wa le xikarhi. Ku engetela, nhlayo ya le henhla ya mitlawa ya vathori va hleriwile hi 2009 ku ringeta ku kuma nkoka wa mitlawa leyi eka xiyimo xa swa timali swa Xikimi ku nga se va na mpfumelelo wa take-on’s.

Ms Karyna PierceHuvonkulu:Timali

19

4

Ndlela leyi tirhisiwaka ku hlayela swikoxo leswi humeleleke kambe swi nga amukeriwangiki (IBNR) swa 2009 yi cinciwilenyana hi tindlela leti tirhisiweke hi ti-achuwari hi ku landza vukorhokeri bya masiku ya tihakelo eka swiyenge swo hambana swa swikoxo, ku hungutiwa ka mahetelelo ya mphakelo hi ku landza ntokoto wa ntiyiso wa swikoxo leswi hakeriweke na ku pimanyisa phesente ya swikoxo leswi amukeriweke swa ilekithironiki na swa phepha. Xikimi xi amukerile matihiselo ya maendlelo yo ringanyetiwa (SOP) ku hlayelamiphakelo ya IBNR ku suka Nyenyenyani 2009.

Nkoka wa Nkwama wa Mpimanyeto wa Makhombo eka xiyimo xa swa timali swa Xikimi wu hleriwile kotara yin’wana na yin’wana hi 2009 leswaku Xikimi xi kota ku tirhisa tindlela to karhi to kongoma to sirhelela. Ku tirhisiwa ka Nkwama wa Mpimanyeto wa Makhombo swi ta va na nkoka wo karhi eka Xikimi hikuva Xikimi xi ta va xona munghenisi wa mali ya nete ya nkwama.

Mpfuxeto wa dizayini ya mimbuyelo wa lembe na lembe wu endliwile hi Xikimi eka kotara ya vunharhu ya 2009 wa 2010 wu kombisile ntlakuko wa mipimo ya mimbuyelo hinkwayo na ku tumbuluxiwa ka mimbuyelo yo engetela ya mihlawulo hinkwayo hi ntlakuso wa 10.8% wa nhlayo-xikarhi ya ntlakuso wa tihakelo. Kungu ra bindzu ra 2010 na mahakelelo ri rhumeriwile eka Huvo ya Swikimi swa Swa Rihanyo hi 25 Ndzhati 2009.

Eka kotara yo hetelela ya 2009 ku endliwile ntirho wo karhi ku vona leswaku ku hundziseriwa ka bindzu ra MEDCOR ku ya eka GEMS hi 1 Sunguti 2010 swa humelela. Vatsundzuxi va ku hundzisela loku (Alexander Forbes) va thoriwile ku tumbuluxa dyondzo ya makotelo, dokhumente yo humelerisa, kungu ra matirhelo na ku lawula mitirho leyi nga ta nghenelela eka ku hundzisa. Dyondzo ya makotelo yi kombisile leswaku swa koteka ku endla ku hundzisa loku no boxa tindhawu leti a ti kanakanisa. Dokhumente yo humelerisa yi rhumeriwile eka Huvo ya Swikimi swa Swa Rihanyo hi ku landza Xiyenge xa 63 xa Nawu wa Swikimi swa Swa Rihanyo. Ntirho wa Mutsundzuxi wa ku hundzisela na kungu hinkwaro ra ku hundzisela swi kamberiwile hi Komiti yo Fambisa leyi mutshamaxitulu wa yona a ri Damaria Pholosi.

Xikimi xi pfuxetile xitiratheji xa mbekiso exikarhi ka lembe na ku ya emahlweni no tirhisa xitiratheji lexi lembe hinkwaro. Xikimi xi vekisile mali eka tidipoziti ta nkarhi wo karhi na tiakhawunti ta call eka mihlangano ya ntlhanu ya swa timali.

Mimbuyelo ya mbekiso hi ntalo yi kumiwile eka mitsengo leyi vekisiweke eka mihlangano leyi. Tihakelo ta mimbekiso tani hi phesente ya tihakelo a ti ri eka 0,90% hi 31 N’wendzamhala 2009.

Matirhelo ya mimbuyelo ya mimbekiso ya nhweti na nhweti hi ku lawuriwa ka tinkota ta nhweti na nhweti naswona swi vikiwile ximfumo eka xiviko xa matirhelo ya mimbekiso xa kotara na kotara. Hikwalaho-ke, Xikimi xi lulamisa xiviko xa kotara na kotara xa mimbuyelo ya switiratheji leswi tirhisiwaka ku vekisa. Swiviko leswi swi tiyisisile leswaku mimbuyelo leyi kumiweke yi fambelana na timakete. Hambileswi a ku ri na rhisexini hi 2009, Xikimi xi swi kotile ku vekisa mali hi vutlhari na ku kuma mimbuyelo ya le henhla.

Ku tirhiwile ntirho wo tala hi 2009 ku kuma tisisiteme na malawulelo ya timali no kuma tindhawu leti faneleke ku antswisiwa. Kungu ro angarhela ro odita, ku katsa na ntirho wo odita wa le ndzeni na le handle, swi kamberiwile hi Komiti yo Odita exikarhi ka lembe.

Ku va hi kumile xiviko xa oditi xo ka xi nga khwalifayiwangi eka lembe ra vumune ra ntirho swi kombisa ndlela leyi vufambisi na Huvo va tirheke hakona ku hlayisa tiasete ta Xikimi na swilaveko swa swirho.

KusimekamlawuleloyaswarihanyoyokhomekalamangataantswisaphurofayiliyamakhomboyatlilinikhaliyaXikimi

Kungu ra Xitirathejiki ra 2009 ri kombisile ku suka eka sisiteme ya swa ndzindzakhombo ku ya laha swirho ha xin’wexin’we swi kumaka vukorhokeri bya

Dr Stan MoloabiHuvonkulu:MalawuleloyaSwaRihanyo

20 Bringing health within your reach

swa rihanyo leswi nga fanela, laha ku nga na mikambelo yo karhi. Ntirho wo simeka ku suka eka sisiteme ya swa ndzindzakhombo wu endliwile ehansi ka xikongomelo xa sitirathejiki xo tumbuluxa vulawuri bya swa rihanyo swo khomeka leswi nga ta antswisa phurofayili ya makhombo ya tlilinikhali ya Xikimi.

Huvo yi pasisile kungu ra swa tithendara hi 2009 leri kombiseke nxanxameto wa malawulelo ya vukorhokeri bya swa rihanyo swa Xikimi ku ya hi xiyenge - kasi khale, vukorhokeri bya malawulelo ya swa rihanyo a swi endliwa ku ya hi nhlawulo wa mbuyelo. Tithendara ti humesiwile hi 13 Mudyaxihi 2009 ta vukorhokeri lebyi landzelaka:• Malawulelo ya vukorhokeri bya swa rihanyo, ku katsa malawulelo ya netiweke ya vuphakeri bya swa rihanyo eka mihlawulo ya mimbuyelo

hinkwayo leyi tsarisiweke;• Malawulelo ya vukorhokeri bya swa rihanyo ya xitirathejiki ya mihlawulo ya mimbuyelo ya GEMS hinkwayo;• Mphakelo wa mirhi ya mavabyi ya nkarhi hinkwawo eka vahlayisiwa hinkwavo va GEMS lava tsarisiweke va mihlawulo ya mimbuyelo hi

ku tirhisa endlelo rin’we ro yi rhumela (khemisi yo rhumela) ; na• Vukorhokeri byo Lawula Mavabyi ya HIV bya vahlayisiwa eka mihlawulo ya mimbuyelo ya GEMS hinkwayo leyi tsarisiweke.

Vaphakeri lava nga tirhisiwaka va hlawuriwile hi Huvo ya Tithirasiti hi 31 Mawuwani 2009 naswona tikontraka ti hetile ku tsariwa hi Nhlangula 2009.

Hikwalaho ka ku cinca ka vukorhokeri bya vuhlayisi lebyi lawuriwaka, a ka ha yiwangi emahlweni na malulamisele yo khapitetiwa hi 2010 na malawulelo ya makhombo ya nhlayiso wa swa rihanyo ra mihlawulo ya mimbuyelo hinkwayo ya Xikimi, ku katsa Beryl na Sapphire, swi hundziseriwile eka muphakeri wa nhlayiso lowu lawuriwaka wa Xikimi. Ku endliwilentirho wa ku tumbuluxa na ku simeka Netiweke ya GEMS yintshwa ya vahlayisiwa va Beryl na Sapphire naswona ku na tihakelo tintshwa ta 2010. Tikontaka ta Netiweke ya GEMS ta mimbuyelo hinkwayo ya Xikimi ti katsa ka vaphakeri lava nga eka Netiweke ya Friends of GEMS. Swirho leswi khumbekaka swi kumile dyondzo yo letela swirho yo anama hi 31 N’wendzamhala 2009 ku swi toloveta ku cinca loku ka vukorhokeri.

Mimbuyelo ya 2010 ya Xikimi na mipimanyeto ya swa rihanyo ya mihlanganiso ya malawulelo ya swa rihanyo leyi nga na kontrika na Xikimi yi tumbuluxiwile hi kulandza nhlelo wo enta wa akichwari na wa swa timali.

Swikongomelo swa matirhelo ya swa rihanyo swa mimbuyelo ya Beryl na Sapphire swi katsiwile eka tikontraka ta malawulelo ya swa rihanyo swa Xikimi swa 2010.

Ntirho wo languta tindlela tin’wana ta mahakelelo wu sungurile hi ku tirhisiwa ka phurojekite yo kambela exikarhi ka Xikimi na Netiweke ya Vuswikoti ya KZN. Xikongomelo xa phurojekite yo kambela leyi i ku kambela no pimaku hungutiwa tihakelo ta swa rihanyo leswi nga vangiwaka hi ku tirhisana ka Xikimi na vaphakeri va vukorhokeri va netiweke. Ku hlanganisiwile na mitlawa ya swibedhlele ku ringeta ku kuma tindlela tin’wana to hakelela vukorhokeri.

Tsalwa ra phurojekite ya ku tumbuluxiwa ka phurofayili ya makhombo ya muhlayisiwa un’wana na un’wana wa GEMS, leyi yi nga ta tirhisiwa ku tiva muxaka vukorhokeri bya mimbuyelo ya swa rihanyo leyi nga fanela vahlayisiwa va GEMS eka theme ya le xikarhi, ri tumbuluxiwile no tirhisiwa.

Ku avelaniwile timhaka ta nkoka ta GEMS na Ndzawulo ya Vukorhokeri bya Tiko na Vufambisi hi xikongomelo xo tumbuluxa minongonoko leyi khumbaka timhaka ta swa rihanyo.

Kuhlayisanakuyisaemahlwenivukorhokeribyamafumelo

Xivumbeko xa oparexinali xa Xikimi xi humelerisiwa eka hofisinkulu leyintsongo kambe ya vuswikoti leyi lawulaka no valanga bindzu ra Xikimi no seketela Huvo ya Tithirasiti na Tikomiti ta Huvo. Ku thoriwile vatirhi vantshwa va nkombo eku heleni ka lembe leri kambisisiwaka, h.l. nkarhi lowu heleke hi 31 N’wendzamhala 2008 no sungula ku tirha hi Sunguti na Nyenyenyani 2009. Vatirhi lavantshwa va kumile ndzetelo wo tolovela ku tirha ema mbangu wo hatlisa wa Xikimi. Ku tlhele ku thoriwa vatirhi van’wana vambirhi eka nkarhi lowu kambisisiwaka naswona vatirhi hinkwavo va Xikimi i 27.

Kungu ra ku siva vatirhi van’wana ri tumbuluxiwile eka lembe leri kambisisiwaka naswona ku tumbuluxiwile pholisi yo kongoma ya ku siva Mufambisinkulu leri nga pasisiwa hi Huvo. Tipholisi hinkwato ta GEMS ta ku siva vatirhi van’wana se ti tumbuluxuwile naswona ti le ku tirheni.

21

4

Ndzetelo wa vatirhi wu endliwile eka lembe leri kambisisiwaka hi ku landza makungu yo antswisa vuswikoti bya vatirhi.

Hikwalaho ka sayizi ya hofisinkulu ya Xikimi, vukorhokeri bya malawulelo ya timhaka ta vatirhi (HR) byi nyikiwa hi muphakeri wa le handle. Ku thoriwile muphakeri wa vukorhokeri wuntshwa ku va a tisa vukorhokeri lebyi bya nkoka eka Xikimi.

Maendlelo ya swa tithendara na swa timali a ya kamberiwa nkarhi na nkarhi ku vona loko swi fambelana na tipholisi na malawulelo ya le kaya. Matsalwa ya ku seketela ma hlayisiwile hi ku landza swipimelo naswona ya pfuxetiwa lembe na lembe hi oditi ya le ndzeni.

Rhejisitara ya tiasete ta nkarhi hinkwawo yi antswisiwile no kamberiwa nhweti yin’wana na yin’wana naswona milawu ya le kaya ya malawulelo ya Xikimi na yona a yi kamberiwa ku vona leswaku tiasete ta Xikimi ti tirhisiwa kahle. Ku tlhele ku kamberiwa nhundzu leyi nga kona eka lembe leri kambisisiwaka. Swilaveko swa switirhisiwa swa Xikimi swi tlakukile hikwalaho ka ku thoriwa ka vatirhi vantshwa. Tihofisi leti a ti ri kona ekusuhi na tihofisi leti tsarisiweke ta Xikimi ti kumile eka Kotara ya 4 ya 2009 naswona ti lombiwile hi Xikimi endzhaku ka ku kuma mpfumelelo wa Huvo ya Tithirasiti. Tihofisi letintshwa ti lulamisiwile leswaku vatirhi va ta nghena eka tona hi Nyenyenyana 2010.

Van’wana vaphakeri lava ku tihlanganisiweke na vona ku seketela mbangu wa vukorhokeri bya malawulelo ya Xikimi va katsa muphakeri wuntshwa wa IT na muphakeri wa HR.

Xikimi xi tirhile tindlela to hambana ta vutihlanganisi na vanhu eka lembe leri kambisisiwaka. Yin’wana ya tiphurojekite a yi katsa ku kumiwa ka swikolo swinharhu eka ndhawu yo karhi ya vanhu vo hlupheka eKwaZulu Natal. Swikolo leswi swi pfuniwile hi ku antswisiwa ka miako ya swona na switirhisiwa, swo kota ku cinciwa ka mafasitere lama fayekeke na ku lulamisiwa ka tithoyilete.

KulawulamakhombohixihatlanaswonakahlehixikongomeloxosivelaXikimikuwelaekamakhombo

Malawulelo ya khombo ma kumeka eka swiyenge hinkwaswo swa bindzu ra Xikimi naswona makungu hinkwawo ya matirhelo ya katsa malawulelo ya makhombo tani hi xiyenge xa nkoka xa ntirho lowu. Hi ku landza Pholisi ya Malawulelo ya Makhombo Leyi Pasisiweke ya Xikimi, sekele ya malawulelo ya makhombo ya Xikimi yi sungurile hi Nyenyenyana 2009 hi ku hleriwa ka xitirathejiki ka mana muphakeri wa khombo hi vulawuri bya Xikimi ku kuma makhombo ya xitirathejiki lama langutaneke na Xikimi. Hi ku landza ntirho lowu, rhejisitara ya makhombo ya xitirathejiki ya Xikimi yi antswisiwile naswona ntirho hinkwawo wa oditi ya le ndzeni wu pimanyisiwile na makhombo lama kumiweke. Kungu ra nhlanganelo leri kombisaka leswaku makhombo hinkwawo lama nga voniwa ya sirheleriwile hi mitlawa leyi nga na vutihlamuleri, ri rhumeriwile Huvo ya Tithirasiti laha ku nga na swiboho swo karhi swo lulamisa makhombo lama.

Ku engetela eka makhombo ya xitirathegiki, makhombo ya oparexinali ya kombisiwile naswona magoza yo sivela makhombo lama ma tumbuluxiwile leswaku ma tirhisiwa eka nkarhi lowu kambisisiwaka. Mahlelelo hinkwawo ya makhombo na switiratheji swo lawula swi pasisiwile hi Huvo no kamberiwa hi Komiti yo Odita. Mufambisinkulu u nyikile Huvo swiviko swa kotara na kotara swa matirhelo mayelana na ku tirhisiwa ka magoza yo lawula makhombo naswona swi tiyisisiwile hi N’wendzamhala 2009.

Pholisi ya Malawulelo ya Makhombo ya Xikimi yi pfuxetiwile nakambe yi katsa nkongomiso eka Xiviko xa King III xa Mafumelo ya Bindzu.

Kungu ra Tithendara ta GEMS hi 2009 ri pasisiwile hi Huvo ya Tithirasiti hi 26 Nyenyenkulu 2009 naswona tithendara ta vukorhokeri bya 2009 byi endliwile hilaha swi nga fanela.

Pholisi ya Malawulelo ya Tithendara yi endliwile hi ku tirhisiwa ka maendlelo ya matirhiselo ya milawu hi 2008 naswona yi tirhisiwa na le ka lembe leri kambisisiwaka.

22 Bringing health within your reach

Mitlhontlho na timhaka ta ku landzelela nawu

Huvo ya ku aphila ya Huvu ya Swikimi swa Swa Rihanyo yi vonile GEMS nandzu hi Ndzhati 2008 mayelana na ku tisiwa ka xikoxo xa paediatrician xa Modifier Code 0019 naswona Huvo yi pasisile leswaku GEMS yi hakela swikoxo leswi ku suka Hukuri 2008 tani hileswi Khodi a yi katsiwile eka mpfampfarhuto wa Nongonoko wa Tihakelo wa Rheferense ya Swa Rihanyo ya Rixaka ya 2009 (NHRPL). Hambiswiritano, NHRPL yo hetelela ya 2009 a yi katsangi tihakelo ta swokoxo swa paediatrician swa Modifier Code 0019 naswona GEMS yi hakerile swikoxo leswi lembe hinkwaro ra 2009. Mhaka leyi yi tivisiwile Huvo naswona Huvo yi pasisile leswaku GEMS yi ta ya emahlweni yi hakela Modifier Code 0019 loko yi koxiwa hi ti-paediatrician.

Eka nkarhi lowu nga hundza Huvo ya Tithirasiti yi pasisile leswaku GEMS yi pfuna Ndzawulo ya Timhaka ta Tinxakaxaka na Ntirhisano eka ku tumbuluxa nhlawulo wa mbuyelo wa matiko ya tinxakanxaka wa vatirhi lava nga ndzandzeni wa matiko. Nkunguhato wa masungulo, ntirho wa akuchwarulali na vutihlanganisi na Huvo ya Swikimi swa Swa Rihanyo wu endliwile, kambe ntirho lowu wu yimisiwilenyana hikuva a ku kumeka datha ku suka eka Ndzawulo kambe swikimi swa swa rihanyo swa ha tiyimiserile ku ya emahlweni na magoza yo tsarisa vatirhi lava eka GEMS. Datha leyi yi vuye yi kumeka naswona ntirho lowu wu sungurile eke heleni ka 2009.

Mpimo wa ku humelela ka swirho swa vukorhokeri bya Friends of GEMS wu le hansi ka 50%. Vulawuri byi tekile magoza yo hambana yo antswisa mpimo wo humelela, ku katsa na mphakelo wa burawuchara ya ‘how to’ eka swirho. Hi ku tumbuluxiwa na ku ya emahlweni ka hungu leri, swi languteriwile leswaku mpimo lowu wa ku humelela wu ta antswisiwa hi ku ya ka nkarhi.

Mpimo wa tirhizevhe ta Xikimi a wu enetangi swipimelo swa Xinawana xa 29(3) xa Nawu wa Swikimi swa Rihanyo. Xikimi xi vile na ku engeteriwa ka swirho eka nkarhi lowu kambisisiwaka naswona leswi swi cincile mipimo ya tirhizevhe ta Xikimi na mipimo ya ku wa ka bindzu. Mpimo wa ku wa ka bindzu ku khumbiwile hi ku tlakuka loku a ku nga languteriwangi ka tihakelo ta Nongonoko wa Tihakelo wa Rheferense ya Swa Rihanyo ya Rixaka (h.l. mpimo lowu tirhisiwaka hi Xikimi ku hakela swikoxo) na miengetelo ya Nxavo wo Huma Wun’we (SEP) hi nkarhi lowu wa mpfuxeto lowu lowu hunguteke tirhizevhe hi 0.89%. Naswona, ntokoto wa le henhla wa swikoxo lowu a wu nga languteriwangi hi 2009 wu vangiwile hikwalaho ka mavabyi yo hambanahamba (h.l. mukhuhlwana, mukhuhlwana wa tinguluve na RSV) na ntlakuso wa nhlayo ya nhlayo ya tindlela to hamban leti tirhisiwaka exibedhlele. Mpimo wa ku wa ka bindzu ka 11.08% hi 31 N’wendzamhala 2009 wu le hansi ka mpimo wa 11.93% lowu pasisiweke hi Rhejisitara hi 2007 endzhaku ka ku pasisiswa ka kungu ra bindzu leri rhumeriweke hi Xikimi eka Huvo ya Swikimi swa Swa Rihanyo. Xikimi xi rhumerile xiviko eka Huvo ya Swikimi swa Swa Rihanyo hi ku landza Xiyenge xa 29 (4) xa Nawu wa Swikimi swa Swa Rihanyo. Xankoka hileswaku mitsengo leyi hlengeletiweke yi tlakukile hi ku ringana 36% ku suka eka timiliyoni ta R 723 ku fika eka timiliyoni ta R 986 kambe leswi a swi nga ringanangi ku fikelela ntlakuso wa 59% wa tihakelo ta lembe na lembe.

Nhlawulo wa Onyx hi wona wu ri woxe wu nga kombisa ku lahlekriwa eka lembe leri kambisisiwaka naswona wu tsandzekile ku fikelela swipimelo swa xiyenge xa 33 xa Nawu wa Swikimi swa Swa Rihanyo. Ku lahlekeriwa ka nhlawulo lowu ku fambelana na swikoxo swa le henhla, mavabyi ya nkarhi hinkwawo yo hlaya na mpimo wa le henhla wa ku amukeriwa exibedhle ka vahlayisiwa va mbuyelo lowu, na leswaku ku tlula 20% ya vahlayisiwa eka mbuyelo lowu i vadyuhari (ku tlula kanharhu mpimo wa va vadyuhari va xikimi lexi). Nkoka na mitolovelo ya swikoxo a yi ri ehenhla ku tlula leswi a swi languteriwile, eka swirho swintshwa na swa khale swa Onyx. Hambiswiritano, mimbuyelo na tihakelo swi cinciwile hi 2008 ku ya eka 2009 ku antswisa ntokoto wa swikoxo na ku angarhelisa xivandla xa vuxiho bya nhlawulo. Rhejisitara u pasisile kungu ra bindzu ku endla leswaku nhlawulo lowu wu tiyimela eka theme ya le xikarhi na mavikelo lama kunguhatiweke ma humelela. Xankoka hileswaku nhlawulo wa Onyx wu tsarisiwile tani hi nhlawulo wa mbuyelo wa 2010 endzhaku ka ku rhumeriwa ka kungu ra bindzu ra 2010.

Mikarhi yin’wana exikarhi ka lembe ra 2009 vathori a va tsandzeka ku hakela tihakelo eka siku ra vunharhu ra nhweti. Leswi a swi vanga hikwalaho ka tihakelo ta ndzawulo yo karhi hinkwato ti hundza matirhelo ya le ndzeni ya ndzawulo yaleyo mayelana na tihakelo ta EFT. Xikimi xi tihlanagnisile mikarhi yo tala na vafambisinkulu va tindzawulo leti ta vathori ku vona leswaku tihakelo ti hlengeletiwa hi ku landza xiyenge xa section 26(7) xa Nawu wa Swikimi swa Swa Rihanyo. Hi ndlela yaleyo, tidipoziti hinkwato leti a ti salerile endzhaku ti hakeriwile eka masiku ya 5 ya ntirho ya ku sungula ka nhweti leyi a ti languteriwile ha yona. Oditara-Jenerali u tivisiwile laha nawu a wu nga landzeleriwi na nongonoko wa vathori lava a va landzeleli.

23

Nkatsakanyo na mahetelelo

2009 a ri ri lembe ra migingiriko leri hi ku tumbuluxiwa ka vukorhokeri byintshwa byo hambana bya swirho, na ku tumbuluxiwa ka tithekiniki na switirho swa malawulelo ya swa rihanyo. Hambileswi swi tiviwaka leswaku Huvo yi ta cinca hi 2010 na leswaku Xikimi xi tekile magoza yo tiantswisa eka malembe ya mune yo tirha, ntshikelelo wa xitirathejiki eka nkarhi lowu helaka hi N’wendzamhala 2010 wu le ka “Ku tshikelela ku hlawuleka hi ku pfuxeta matirhelo ya bindzu ra GEMS, ku katsiwa matirhelo lamanene na ku tirha eka mbangu wa kahle lowu tisaka ku humelela eka nkarhi lowu taka”.

2010 yi ta tirhisiwa ku humelerisa ku tirhisa na ku humelerisa switiratheji swintshwa. Mavonelo ya swirho mayelana na matirhelo lama ya ta kambisisiwa ku vona leswaku GEMS yi tiva swilaveko swa swirho swa yona.

Rito ro Khensa

Mutshamaxitulu,HuvoyaTithirasitinaTikomitiHi ku yimela vulawuri bya Xikimi, Ndzi rhandza ku khensa Huvo ya Tithirasiti eka vuhlari bya xitirathejiki bya vona na swiletelo leswi va swi nyikeke hi 2009 na nseketelo wo ya emahlweni lowu va wu nyikaka Mutshamaxitulu, Prof Richard Levin. Ndlela leyi Huvo yi tekaka swiboho ha yona yi pfunile Vulawuri bya Management ku tirhisa minongonoko yintshwa na ku tirha mitirho leyi nga fanela ya vufambisi.

Swirho swa Komiti yo tiyimela naswona swi hoxile xnala xa switsundzuxo swa nkoka exikarhi ka lembe naswona ndzi rhandza ku khensa vanhu lava va vuswikoti eka ku tinyela ka vona eka Vahlayisiwa va GEMS.

VatirhivaGEMSNdzi rhnaza ku khensa xipano xa Swirho swa Huvo ya GEMS lexi yeke emahlweni na migingiriko ya xona hi 2009. Xirho xa Huvo xintshwa, Dr Stan Moloabi, u tirhile swinene ku titoloveta matirhelo ya bindzu leri na maendlelo ya swilo eka GEMS. Hi khensa na ku va swirho swa huvo swi tiyimiserile ku tirha mitirho ya swona hi vuswikoti. Hi pfumeleni ku khensa ntirho wa xirho xa huvo: xa Timali, Karyna Pierce, ku va a kumile xiviko xa oditi xo ka xi nga khwalifayiwangi, xirho xa huvo: Mafumelo na vuxaka na vanhu lava khumbekaka, Jeannie Combrink, hikwalaho ka nhlengeletano ya mani na mani ya lembe leyi humeleleke, xirho xa huvo: Vutihlanganisi na Timhaka ta Swirho, Liziwe Konyana, hi ndlela leyi a maketeke GEMS ha yona na xirho xa huvo: Tikontraka na Matirhelo, Bella Mfenyana, hikwalaho ka mbangu lowunene wa tikontraka.

Ndzi rhandza ku khensa no hoyozela swirho hinkwaswo swa vatirhi va hina hi ku kula ka vona ko ya emahlweni. Ndzi rhandza no yisa rito ro khensa eka swirho swa Komiti yo Lawula, h.l Damaria Pholosi (Mutshamaxitulu), Charles Irumba na Nokukhanya Zwane, lava swi koteke ku lawula timhaka ta MEDCOR ehenhla ka mitirho ya vona ya siku na siku.

Ndzi rhandza ku khensa David Makgalo ku va simekile Nongonoko wo Letela wa HR ya GEMS EKA Vukorhokeri bya Tiko hinkwabyo eka kotara ya vumbirhi ya 2009.

VaphakerivaVukorhokeriNdzi rhandza ku teka nkarhi lowu ndzi khensa vatirhi va Vaphakeri va Vukorhokeri lava nga na kontraka na Xikimi ku nyika Vukorhokeri. vatirhi lava va hlanganile na mitlhontlho yo tala eka lembe leri kambisisiwaka kambe va kombisile mikarhi hinkwayo ku tiyimisela ka vona eka Vahlayisiwa va Xikimi.

HolobyewaVukorhokeribyaTikonaVufambisiNdzi rhandza ku khensa Holobye ku va a nyikile Xikimi nkarhi wo humelela na ku seketela migingiriko ya Xikimi na maendlelo ya xona.

HuvoyaSwikimiswaSwaRihanyoRhejistara wo khomela wa Swikimi swa Swa Rihanyo, Tatana Craig Burton-Durham, na xipano xa yena lava tihlanganisaka na GEMS nkarhi na nkarhi ku hi nyika Xikimi ndzetelo lowu nga fanela na vuswikoti leby nga fanela loko swi laveka, swa khensiwa swinene.

4

24 Bringing health within your reach

Rhejistara wa khale wa Swikimi swa Swa Rihanyo, Tatana Patrick Masobe, ku katsa na Rhejistara wa khale loyi a khomerile wa Swikimi swa Swa Rihanyo, Tatana Patrick Matshidze, na vona va khensiwa eka ndzetelo na nseketelo wa vona wa GEMS eka lembe leri kambisisiwaka.

EkandyanguwaminaXo hetelela, ndzi rhnaza ku yisa rito ro khensa eka nghamu ya mina leyo xonga na vana ku va va ndzi pfumelerile ku tirha mitirho ya mina tani hi Mufambisinkulu wa Xikimi xa swa rihanyo lexinene xa Mfumo.

Xipano xa GEMS

25

Xiviko xa Huvo ya Tithirasiti

Laha hansi ku landzela xiviko xa lembe na lembe xa Huvo ya Tithirasiti lexi heleke hi 31 N’wendzamhala 2009.

Nomboro yo Titsarisa: 1598

1. NHLAMUSELO YA XIKIMI XA SWA RIHANYO

1.1. Swipimelo swo titsarisa

Xikimi xa Swa Rihanyo xa Vatirhelamfumo a hi Xikimi xa Swa Rihanyo xa swipimelo lexi tsarisiweke hi ku landza Nawu wa Swikimi swa Swa Rihanyo 131 wa 1998 (Nawu), hilaha wu hundzuluxiweke hakona.

1.2. Mihlawulo ya mimbuyelo leyi nga eka Xikimi xa Swa Rihanyo xa Vatirhelamfumo

ku na mihlawulo ya mimbuyelo ya nthlanu, leyi kumekaka eka Milawu ya Xikimi, leyi nyikiweke swirho hi 2009, naswona hi leyi landzelaka:• Sapphire• Beryl • Ruby • Emerald• Onyx

1.3. Kungu ra ku hlayisa mali

Tihakelo ta kungu ro hlayisa mali ti yimerile tihakelo ta kungu ro hlayisa mali leti nga xiyenge xo dipozita xa tikontraka ta ndzindzakhombo leti nga exikarhi ka swirho na Xikimi, ku susiwa swikoxo leswi hakeriweke ku suka eka tihakelo ta mali leyi hlayisiweke hi Xikimi hi ku yimela swirho swa xona. Xiyenge xo dipozita xi tlhantlhiwile, hikuva Xikimi xi kota ku pima xiyenge xo dipozita ethlelo naswona tipholisi ta xona ta tinkota a xi lavi leswaku ku langutiwa swiboho na timfanelo hinkwato leti va ka kona hikwalaho ka xiyenge xo dipozita. Xiyenge lexi xa ndzindzakhombo wa tihakelo ta ntsengo wa nhweti na nhweti wa swirho xi tekeriwa enhlokweni hi ku lnaza IFRS 4.

Layibilithi ya kungu ra mali leyi hlayisiweke, h.l. xiyenge xo dipozita, xi tekeriwa enhlokweni hi ku landza IAS 39 naswona xi pimiwa hi ku lnaza tihakelo -xidzi hikuva ku na xilaveko xa xivangelo eka xona. Tihakelo ta kungu ro hlayisa mali ti kuma mali hi ku landza mali leyi humesiwaka, h.l. ku hava leswi hlamuseriwaka Mudyaxihielana na swikoxo leswi saleke eku heleni ka lembe.

1.4. Malawulelo ya vuhlayisi na malulamiselo yo hundzisela khombo

Xikimi xi nghenile eka mitwanano ya mahlayiselo yo lawuriwa leswaku ku lawuriwa tihakelo ta vukorhokeri byo rhumela mirhi eka swirho. Vukorhokeri lebyi sirheleriweke ehansi ka mitwanano leyi byi katsa mpfumelelo wa masungulo wa le xibedhlele, malawulelo ya HIV, malawulelo ya mimbuyelo ya le tikhemisi na vukorhokeri bya xilamulelamhangu bya xihatla. Vukorhokeri lebyi byi kumeka eka Primecure Health (Pty) Ltd, MedScheme Holdings (Pty) Ltd, Qualsa Healthcare (Pty) Ltd na Netcare 911 (Pty) Ltd.

Mitwanano leyi yi fambelana na swinawana swa Xikimi na hi ku lnaza swipimelo leswi vekiweke hi tithirasiti. Ntwanano lowu pfuxetiweke wu ta tirha ku suka 1 Sunguti 2009 ku fika 31 N’wendzamhala 2009. Xikimi xi na lunghelo ro tsema mitwanano leyi hi ku nyika xitiviso xa masiku ya 90. xikimi xi kambisisile nakambe ntwanano wa ku hundzisela khombo eka swirho swa mimbuyelo ya Sapphire na Beryl eka lembe leri kambisisiwaka naswona ku cinciwile swivumbeko leswi hi 2010.

Hi ku landza mpfumelelo wa masungulo wa le xibedhlele na vukorhokeri bya xilamulelamhangu bya xihatla, timali ti hlayeriwa ku ya hi nhlayo ya swirho leswi nga tsarisiwa eka nhweti yo karhi (ku nga katsiwa swirho leswi nga yimisiwanyana). Ku hava ntswalo wa nsalo naswona mali yi fanele yi hakeriwa eka masiku ya 7.

2. MAFUMELO NA MAFAMBISELO Mafumelo na mafambiselo ya Xikimi swi lawuriwa hi Huvo ya Tithirasiti, leyi nga na vanhu va khumembirhi lava tekiwaka va lulamerile ku tirha ntirho lowu. ku hlawuriwile tithirasiti ta tsevu hi swirho endzhaku ka nhlawulo wa Tithirasiti lowu a wu fambisiwa hi Electoral Institute of South Africa (EISA) hi 2007 kasi Holobye wa Vulawuri bya Vukorhokeri bya Tiko yena u hlawurile Tithirasiti ta tsevu hi ku landza Swinawana swa Xikimi leswi tsariweke.

5

26 Bringing health within your reach

2.1. Tithirasiti ta Huvo eka lembe leri kambiwaka

Ms T Baloyi Tatana M Brand Ms J C Brink Dr A Ferreira Dr T Geldenhuys Ms M K Kgang Prof R Levin (Mutshamaxitulu) Tatana V Mbethe Ms S Moodley Tatana A Schoeman Tatana A van Wyk Ms V Vumendlini-Schalk 2.2. Adirese ya hofisi ya Mufambisinkulu na adirese ya poso

Dr E WatsonHillcrest Office Parkc/o Lynnwood and Dyer RdHillcrestPretoria0028

Private Bag X1 Hatfield0028

2.3. Adirese ya hofisi leyi tsarisiweke na adirese ya poso

Hillcrest Office Parkc/o Lynnwood and Dyer RdHillcrestPretoria0028

Private Bag X1 Hatfield0028

2.4. Adiminisitireyita wa Xikimi xa Swa Rihanyo exikarhi ka lembe, adirese ya hofisi na adirese ya poso

Metropolitan Health Corporate (Pty) LtdTown Square Building61 St George’s MallCape Town8001

P.O. Box 4313Cape Town8001

2.5. Adirese ya hofisi na adirese ya poso ya Actuaries Deloitte Actuarial and Insurance Solutions yi nyikile vukorhokeri bya akchwariyali hi 2009. Kontraka na Deloitte Actuarial

and Insurance Solutions yi tsemiwile hi 2009.

Khamphani ya Health Monitor yi thoriwile hi acturies ta Xikimi eku sunguleni ka 2010 naswona yi nyikile Xikimi nhlayo ya IBNR yo hetelela hi 31 N’wendzamhala 2009

Vuxokoxoko bya vona hi lebyi lnazelaka:

Deloitte Actuarial and Insurance SolutionsBuilding 8The WoodlandsDeloitte PlaceWoodmead

The Health Monitor CompanyGround floor, Block JCentral Park400 16th RoadRandjesparkMidrand

27

2.6. Adirese ya hofisi na adirese ya poso ya Tioditara

SizweNtsaluba VSP2nd floor, Block ACentury Falls32 Century BoulevardCentury City7441

P.O. Box 15565Vlaeberg8018

3. XITIRATHEJI XO VEKISA

Xikimi xi vekisile eka tidipoziti to vekisa nkarhi wo karhi (fixed) lowu nga hundziki mavhiki ya tsevu na le eka tiakhawunti ta call hi 2009. Xitiratheji xa mbekiso lexi xi kambisisiwaka hi Huvo ya Tithirasiti lembe na lembe, ku voniwa loko xi fambelana na Nawu, makhombo ya mimbuyelo ya switirhisiwa swo hambana swa mimbekiso na mali yo engetela leyi nag kona. Eka 2009 Xikimi xi yile emahlweni na xitiratheji xa mbekiso xa xona xa timali to engetela hi ku tirhisa switirhisiwa swa khombo ra le hansi swa ntswalo wa nkarhi wo koma.

Migingiriko ya mimbekiso ya Xikimi yi endla leswaku xi va eka makhombo yo karhi ya swa timali, ku katsa leswi khumbaka mipimo ya ntswalo. Nongono wa Xikimi wa malawulelo yo angarha wu kongomisiwe eka ku tsekatseka ka timakete ta swa timali na ku hunguta makhombo lama nga eka matirhelo ya swa timali ta mimbekiso na leswaku Xikimi xi fikelela swilaveko swa swirho swa xona.

Malawulelo ya makhombo na mimbekiso swi endliwa hi Huvo ya Xikimi, hi ku leteriwa hi tipholisi leti pasisiweke hi Huvo ya Tithirasiti. Vulawuri bya Huvo byi kombisa milawu leyi nga tsariwa ya malawulelo ya makhombo, na milawu leyi nga tsariwa leyi angarhelaka timhaka to karhi to kota khombo ra mpimo wa ntswalo, khombo ra khirediti, matirhiselo ya switirhisiwa swo hambana swa swa timali na ku vekisa mali ya tiasete leti xavisiweke.

4. NKAMBISISO WA MIGINGIRIKO YA NKARHI LOWU WA TINKOTA Eka xiyenge lexi ku kombisiwa tinhlayo ta nkoka ta bindzu na tipharamitara ta matirhelo ta Xiviko xa Huvo ku kombisa ndlela leyi bindzu ra Xikimi ri nga kurisa xiswona, vukorhokeri lebyi nyikiweke na leswaku bindzu ri tirhile hi ndlela yihi eka nkarhi lowu.

5

28 Bringing health within your reach

4.1 Tipharamita ta Matirhelo

Matafula lama nga laha hansi ma kombisa nhlelo lowu timali ta Xikimi ti aviwaka hakona eka vukorhokeri bya swa rihanyo na byo ka byi nga ri bya swa rihanyo. Ku engetela, mpimanyiso wa tipharamita leti wu kombisa vundzeni bya leswaku Xikimi xi kurile ku fika kwihi na ku tirhisa ku kula ka xona ku ku tlakusa tiikhonomi ta xikalo leswaku swirho swi vuyeriwa.

2009Nhlawulo Ntsengo wa

XikimiSapphire Beryl Ruby Emerald Onyx

Tihakelo ta Neti hi xirho hi Nhweti (mpimo-xikarhi)

R1,045

R1,252

R1,548

R1,952

R2,691

R1,752

Ttihakelo ta Neti hi muhlayisiwa hi Nhweti R307 R478 R547 R762 R1,116 R732

Swikoxo swa Giroso tani hi phesente ya tihakelo ta giroso 50% 79% 43% 91% 121% 89%

Tihakelo ta vulawuri bya swa rihanyo hi xirho hi Nhweti

R23

R36

R38

R38

R38 R38

Tihakelo ta vulawuri bya swa rihanyo hi muhlayisiwa hi Nhweti R7 R14 R14 R13 R16 R14

Tihakelo to ka ti nga ri ta swa rihanyo tani hi phesente tihakelo ta giroso 10% 10% 7% 6% 5% 7%

Tihakelo ta Vufambisi hi xirho hi Nhweti R51 R53 R62 R62 R68 R62

Tihakelo ta Vufambisi hi muhlayisiwa hi Nhweti R21 R32 R37 R34 R47 R35

Mitsengo ley hakeriweke adimisiteritara R12,944,406 R7,710,021 R26,320,526 R234,614,031 R25,665,024 R307,254,008

Nhlayo ya swirho swintshwa 7,296 3,475 8,957 104,281 5,481 129,490

Nhlayo ya swirho leswi tshikaka Xikimi 970 11,232 1,722 2,018 1,140 17,082

Nhlayo-xikarhi ya swirho exikarhi ka lembe 17,701 10,499 30,535 270,859 28,002 357,596

Nhlayo ya swirho hi 31 N’wendzamhala 2009 21,126 11,993 34,290 312,827 29,568 409,804

Mpimo wa vahlayisiwa na swirho hi 31 N’wendzamhala 2009 2.4 1.6 1.7 1.8 1.4 1.8

Mpimo wa Vudyuhari 0.85% 6.73% 2.73% 2.87% 20.40% 4.13%

Nhlayo-xikarhi ya mali leyi hlengeletiweke hi xirho R2,407 R2,407 R2,407 R2,407 R2,407 R2,407

Mbuyelo wa mimbekiso tani hi phesente ya mimbekiso 8.56% 8.56% 8.56% 8.56% 8.56% 8.56%

*Swirho swi vula swirhonkulu swa Xikimi

29

2008Nhlawulo Ntsengo wa

XikimiSapphire Beryl Ruby Emerald Onyx

Tihakelo ta nete hi xirho hi Nhweti (nhlayo-xikarhi) R949 R1,152 R1,360 R1,876 R2,380 R1,799

Tihakelo ta nete hi muhlayisiwa hi Nhweti R396 R702 R826 R1,067 R1,682 R1,031

Swikoxo swa giroso tani hi phesente ya tihakelo ta giroso 53% 81% 43% 86% 115% 85%

Tihakelo ta vulawuri bya swa rihanyo hi xirho hi Nhweti R15 R15 R30 R32 R35 R31

Tihakelo ta vulawuri bya swa rihanyo hi muhlayisiwa hi Nhweti R5 R6 R11 R12 R15 11

Tihakelo to ka ti nga ri ta swa rihanyo tani hi phesente ya tihakelo-xidzi 10% 8% 8% 7% 6% 7%

Tihakelo ta vulawuri hi xirho hi Nhweti R62 R62 R74 R74 R74 R72

Tihakelo ta vulawuri hi muhlayisiwa hi Nhweti R26 R38 R45 R42 R52 R35

Mitsengo leyi haleriweke adiminisitireyitara

R3,863,051 R4,552,840 R11,668,037 R61,603,796 R11,464,763 R93,152,487

Nhlayo ya swirho swintshwa 7,215 4,681 10,922 90,182 7,911 120,911

Nhlayo ya swirho leswi tshikaka Xikimi 1,253 2,053 3,424 15,911 3,500 26,141

Nhlayo-xikarhi ya nhlayo ya swirho exikarhi ka lembe 10,968 8,449 22,832 168,515 23,260 234,023

Nhlayo ya swirho hi 31 N’wendzamhala 2008 15,366 10,727 28,731 218,594 27,118 300,536

Nhlayo-xikarhi ya vahlayisiwa va swirho hi 31 N’wendzamhala 2008 2.40 1.64 1.65 1.76 1.41 1.74

Mpimo wa vadyuhari 0.60% 4.00% 1.60% 2.00% 14.30% 4.25%

Mpimo-xikarhi wa mitsengo leyi hlengeletiweke xirho R1,339 R1,339 R1,339 R1,339 R1,339 R1,339

Mbuyelo wa mimbekiso tani hi phesente ya mimbekiso 8.02% 8.02% 8.02% 8.02% 8.02% 8.02%

*Swirho swi vula swirhonkulu swa Xikimi

5

30 Bringing health within your reach

4.2 Ntokoto wa Matirhelo

Ku kula ka Xikimi hi 2009 ku vangile engetelo wa migingiriko ya matirhelo. Laha hansi ku longoloxiwile tindlela ta vutihlanganisi hi 2009.

NhwetiTiqingho ta swirho leti

amukeriweke

Phesente ya tiqingho ta swirho leti

amukeriweke

Tiimeyili leti kumiweke

Tiqingho leti humaka

SMS leti kumiweke

Nhlayo ya ti-SMS ta ku tswariwa leti rhumeriweke

Sunguti-09 208,219 2.61% 11,201 2,791 2,700 25,031Nyenyenyani-09 190,084 2.51% 10,554 2,755 2,598 23,614Nyenyankulu-09 199,894 2.46% 11,892 19,446 23,012 24,138Dzivamusoko-09 168,274 2.29% 9,711 4,318 2,908 27,434

Mudyaxihi-09 183,180 2.14% 10,771 7,657 6,205 27,985Khotavuxika-09 195,350 2.22% 10,247 4,779 4,355 30,011Mawuwani-09 235,388 2.42% 12,998 2,359 2,772 27,884Mhawuri-09 245,057 2.64% 12,540 5,811 7,847 39,908Ndzhati-09 253,876 2.67% 12,702 3,574 4,078 36,025

Nhlangula-09 256,693 2.43% 13,581 4,446 5,019 32,445Hukuri-09 281,319 2.80% 16,741 4,975 5,408 30,894

N’wendzamhala-09 266,617 2.71% 15,103 4,489 5,205 34,957

GEMS yi vonile ku engeteleleka ka Tisenthara to endzeriwa hi ku nghena u huma ta swifundza swa 18 hi 2009. Tinharhu leti a ti tirha ngopfu hi 2009 i: Durban (45,712), Polokwane (28,728), na Pretoria (37,421).

Nghetelelo wa migingiriko hi nhweti ya Ndzhati wu vangiwile ku pfala ka swikolo na swikombelo swa switifikheti swa xibalo leswi a swi ri kusuhi na siku ro hetelela ra SARS ro rhumela matsalwa ya SARS hi voko. Ku ya ehansi ka migingiriko eka nhweti ya N’wendzamhala swi vangiwile hi ku ya ehansi ka swivutiso mayelana na timhaka ta vuxirho, leswi vangiweke hi ku cinca loku veke kona eka nhlawulo leswi a swi tele ngopfu eka nhweti leyi nga hundza.

Nghingiriko wa swikombelo wu yile emahlweni hi nhlayo-xikarhi ya 12,688 hi Nhweti hi 2009. N’wendzamhala yi kombisile nhlayo ya le henhla ya swikombelo hi 2009 laha ku kambisisiweke 20,527 wa swikombelo eka Nhweti leyi. Leswi swi vangiwile hi ku tirhisiwa ka Medcor.

45,000

40,000

35,000

30,000

25,000

20,000

15,000

10,000

5,000

0

Sun

09

Nye

n 09

Nye

ny 0

9

Dzi

09

Mud

y 09

Kho

t 09

Maw

09

Mha

09

Ndz

h 09

Hla

n 09

Huk

09

N’w

e 09

Tisenthara to endzeriwa hi ku nghena u huma

Nhl

ayo

ya T

isen

thar

a to

end

zeriw

a hi

ku

nghe

na u

hum

a

Tisenthara to endzeriwa hi ku nghena u huma hi Nhweti

31

Gauteng na KwaZulu-Natal i tindhawu leti nga na vuswikoti byo kula, tanihileswi ti nga na vatirhelamfumo vo tala. Hambileswi swifundzankulu leswimbirhi swi nga na mpimo wa le hansi wo fikeleriwa ku nga 25.40% na 32.89%, swi na 41% ya ntsengo wa swirho swa GEMS.

Ku kula ka vuxirho hi 2009 swi endlile leswaku Xikimi xi kuma swirho swintshwa swa 109,000 eka lembe leri. ku engeteleleka loku ka vuxirho swi vangile leswaku ku va na nhlayo ya le henhla ya swikoxo leswi amukeriweke, leswi hleriweke no hakeriwa. Ntsengo hinkwawo wa swikoxo leswi hakeriweke wu hundza mamiliyoni ya 47 hi 2009 (loko ku pimanyisiwa na swikoxo swa mamiliyoni ya 32 hi 2008).

Ku engeteleka ka tihakelo ta mimbuyelo ku suka Dzivamusoko ku fika Ndzhati lembe rin’wana na rin’wana i mhaka ya ku cinca ka tinguva (hl. tinhweti ta vuxika). Xikimi xi na sekele ya mahakelelo ya swikoxo ya mavhiki ya 4 kambe migingiriko ya le henhla ya tinhweti ta Mawuwani na Mhawuri yi vangiwa hi ku leha ka sekele ya swikoxo leyi nga na masiku ya vukorhokeri yo tala, hl. sekele ya swikoxo swa mavhiki ya 5. Mpimo wa swikoxo swa N’wendzamhala 2009 a wu ri 72.06% loko wu pimanyisiwa na 41% ya N’wendzamhala 2008. leswi swi vanga hi ku va N’wendzamhala yi ri na masiku yo tala ya Vukorhokeri (34 wa masiku) ku tlula Hukuri (28 wa masiku). Naswona, Vaphakeri va Vukorhokeri va hatlile va rhumela swikoxo swa vona hi N’wendzamhala, hikuva ku hundza 60% ya swikoxo leswi hakeriweke swi hakeriwile hi nhweti leyi.

24,000

20,000

16,000

12,000

8,000

4,000

0

Sun

09

Nye

n 09

Nye

ny

09

Dzi

09

Mud

y

09

Kho

t 09

Maw

09

Mha

09

Ndz

h 09

Hla

n 09

Huk

09

N’w

e 09

Swikombelo leswi amukeriweke

Swikombelo hi Nhweti

5,000,000

4,500,000

4,000,000

3,500,000

3,000,000

2,500,000

2,000,000

1,500,000

1,000,000

500,000

0

Sun

08

Nye

n 08

Nye

ny 0

8

Dzi

08

Mud

y 08

Kho

t 08

Maw

08

Mha

08

Ndz

h 08

Hla

n 08

Huk

08

N’w

e 08

Sun

09

Nye

n 09

Nye

ny 0

9

Dzi

09

Mud

y 09

Kho

t 09

Maw

09

Mha

09

Ndz

h 09

Hla

n 09

Huk

09

N’w

e 09

Mpimo wa Swikoxo

Nhl

ayo

ya s

wik

ombe

loN

hlay

o ya

sw

ikox

o

Swikoxo hi nhweti

5

32 Bringing health within your reach

Tani hilaha swi kombisiweke hakona eka tafula leri nga laha hansi, Xikimi a xi langutile mhaka ya ku engetela netiweke ya Vaphakeri va Vukorhokeri Lava Hlawuriweke (DSP) leswaku swirho swi kuma nhlayiseko hi ku veka swirho eka mepe wa tindhawu lowu pimanyisiwaka na netiweke ya DSP.

Ku kuma netiweke ya DSP hi swirho ya mimbuyelo ya Sapphire na Beryl a swi pimeriwangi ntsena nhlayo ya nkulo wa vuxirho bya netiweke, kambe swi ya na hi ndhawu ya vuphakeri bya netiweke hi ku landza laha swirho swi tshamaka kona na laha swi tirhaka kona. Ku tlula 90% ya swirho swa mimbuyelo ya Sapphire na Beryl swi tshama kumbe ku tirha eka 10 km kusuhi na muphakeri wa netiweke. Mepe wa ndhawu wa laha netiweke yi kumekaka kona ku ya hi vuxirho wu kombisiwile laha hansi.

3,000

2,500

2,000

1,500

1,000

500

0

Sun

09

Nye

n 09

Nye

ny 0

9

Dzi

09

Mud

y 09

Kho

t 09

Maw

09

Mha

09

Ndz

h 09

Hla

n 09

Huk

09

N’w

e 09

Nkulo wa Netiweke ya Beryl na Sapphire DSP 2009

Sun 09

Nyen 09

Nyeny 09

Dzi 09

Mudy 09

Khot 09

Maw 09

Mha 09

Ndzh 09

Hlan 09

Huk 09

N’we 09

Madokodela ya mahlo

1,082 1,106 1,130 1,130 1,144 1,152 1,160 1,138 1,160 1,220 1,220 1,234

Madokodela ya meno

1,073 1,083 1,103 1,117 1,121 1,125 1,132 1,137 1,132 1,134 1,134 1,137

Madokodela 2,682 2,695 2,746 2,760 2,785 2,786 2,797 2,807 2,806 2,805 2,825 2,832

Swibedhlele 250 251 268 270 270 270 270 270 270 270 271 276

Tifamasisiti 981 981 965 965 965 965 965 965 965 965 953 953

Num

ber o

f pro

vider

s

33

4.3 Ntokoto wa vuxirho

Girafu leyi nga laha hansi i nkatsakanyo wa ku kula ka vuxirho na sayizi ya ndyangu swa GEMS ku suka Sunguti 2009 ku fika N’wendzamhala 2009.

Vuxirho bya Xikimi byi kurile hi nhlayo-xikarhi ya 36% eka lembe-ximali leri ku suka eka 300,536 (824,738 wa vahlayisiwa) wa swirhonkulu eku heleni ka 2008 ku fika eka 409,304 (1,147,897 wa vahlayisiwa) eku heleni ka 2009. Mimbuyelo hinkwayo yi kombisa mpimo wa ku kula hi 2009. Tani hi 2008, mbuyelo wa Emerald wu kurile swinene hi nhlayo ya (277,121 ya vahlayisiwa kumbe 46% loko ku pimiwa na 2008) naswona mbuyelo wa Beryl wu kurile swintsongo (3,314 ya vahlayisiwa). Girafu leyi nga laha hansi yi kombisa leswaku mbuyelo wun’wana na wun’wana wu kurise ku yini ku fikela N’wendzamhala 2009.

Mbuyelo wa Emerald hi wona mbuyelo lowukulu (76.6% wa swirhonkulu) kasi mbuyelo wa Beryl hi wona mbuyelo lowuntsongo wa Xikimi (2.8% wa swirhonkulu). Mbuyelo wa Sapphire wa ku kula hi tiphesente hi xirho hi xirho na nhweti na nhweti loko wu pimanisiwa na leyin’wana. Mbuyelo lowu wu kombisile ku kula hi ndlela yaleyo eka tinhweti ta ntlhanu hi ku landzelelana ku fika N’wendzamhala, leswi tiyisisaka ku humelela ka Xikimi eka magoza ya ku maketa eka tinhweti leti khumbekaka.

Ku kula ka Vahlayisiwa hi Nhlawulo wa mbuyelo hi 2009 ku longoloxiwile laha hansi. Mihlawulo ya Beryl na Onyx yi kombisa yi kombisa mpimo wa ku kula ka nhweti na nhweti ehansi ka 1%.

Vahlayisiwa wa GEMS va aviwile ku ya hi Nhlawulo hi 31 N’wendzamhala 2009

Onyx6% Sapphire

6% Beryl3%

Ruby8%

Emerald77%

GEMS

1,400,000

1,200,000

1,000,000

800,000

600,000

400,000

200,000

0

3.00

2.80

2.60

2.40

2.20

2.00

1.80

1.60

1.40

1.20

1.00

2008

-12

2009

-01

2009

-02

2009

-03

2009

-04

2009

-05

2009

-06

2009

-07

2009

-08

2009

-09

2009

-10

2009

-11

2009

-12

Nhl

ayo

ya v

anhu

Sayizi ya nd

yangu

Siku

Vahlayisiwa Swirhonkulu Nhlayo-xikarhi ya sayizi ya ndyangu

5

34 Bringing health within your reach

Matafula lama landzelaka ya katsakanya tinhlayo ta le xikarhi ta mihlawulo ya mimbuyelo yo hambana ya GEMS hit 31 N’wendzamhala 2009. Xiyenge xa matirhelo eka tafula leri nga laha hansi xi kombisa tinhlayo leti nga kona ta matirhelo ya Xikimi xa swa rihanyo xa swipimelo. Leti ti kumeka eka Xiviko xa Lembe na Lembe xa Huvo ya Swikimi swa Swa Rihanyo xa 2008/2009. Huvo ya Swikimi swa Swa Rihanyo yi hlamusela vadyuhari tanihi vanhu lava nga hundza malemeb ya 65.

N’wendzamhala 2009

Tinhlayo ta Swirhonkulu Sapphire Beryl Ruby Emerald Onyx GEMS

Swikimi swa le tlhelo swa bindzu – 31 N’wen 2008

Vuxirhonkulu 21,126 11,995 34,294 312,855 29,569 409,839 1,251,622Vahlayisiwa 72,015 31,691 92,773 880,571 71,861 1,148,911 2,985,920Nhlayo-xikarhi ya sayizi ya ndyangu 3.41 2.64 2.71 2.81 2.43 2.80 2.39Mpimo wa muhlayisiwa wa Munhunkulu 0.70 0.53 0.46 0.51 0.62 0.53 Mpimo wa muhlayisiwa wa N’wana 1.71 1.12 1.24 1.30 0.81 1.28 Nhlayo-xikarhi ya malembe ya swirhonkulu 45.2 41.7 40.3 40.3 49.4 41.2Nhlayo-xikarhi ya malembe ya Vahlayisiwa 27.5 28.4 26.3 26.4 36.0 27.1 29.80 Nhlayo ya Vahlayisiwa va le henhla ka malembe ya 65

948 906 1,382 17,867 7,196 28,299

Phesente ya Vahlayisiwa va le henhla ka malembe ya 65

1.3% 2.9% 1.5% 2.0% 10.0% 2.5%

Phesente ya swirhonkulu swa xinuna 61.9% 53.5% 42.4% 32.9% 36.8% 36.1% Phesente ya Vahlayisiwa va xinuna 47.7% 47.4% 45.0% 42.7% 43.6% 43.4% Phesente ya swirho leswi holaka ehansi ka R6,000 hi Nhweti

89.4% 66.1% 36.2% 25.9% 26.1% 31.3%

*Swirho swi vula swirhonkulu swa Xikimi

Hi ku landza tinhlayo ta vuxirho hi 31 N’wendzamhala 2009 GEMS yi na 38.5% ya ntsengo wa Vahlayisiwa va Bindzu ra swipimelo ra Xikimi (hl. 1,148,911 eka ntsengo wa 2,985,920 ya vahlayisiwa va bindzu). Phesente leyi a yi na ntiyiso hikuva tinhlayo leti ti kumiwa hi mikarhi yo hambana. Hi 31 N’wendzamhala 2009, GEMS yi na nhlayo-xikarhi ya le henhla ya sayizi ya ndyangu loko yi pimanyisiwa na ya Bindzu, hl. 2.80 ya vahlayisiwa hi ndyangu loko ku pimanyisiwa na 2.39 ya Vahlayisiwa va Bindzu hi ndyangu. Nhlayo-xikarhi ya malembe ya Vahlayisiwa va GEMS eku heleni ka 2009 i 2.7 wa malembe lama nga ehansi ka nhlayo-xikarhi ya Bindzu (hl. 27.1 wa malembe loko ku pimanyisiwa na malembe ya 29.80) hi 31 N’wendzamhala 2008.

3.5%

3.0%

2.5%

2.0%

1.5%

1.0%

0.5%

0.0%

Sap

phire

Ber

yl

Rub

y

Em

eral

d

Ony

x

GE

MS

Ku cinca ka Vahlayisiwa hi nkarhi

Nhl

ayo

ya V

ahla

yisiw

aP

hesente ya ku cinca ka Vahlayisiwa

Siku

N’we-08 N’we-09 Nhlayo-xikarhi ya nhweti na nhweti ya mpimo wa ku kula

1,400,000

1,200,000

1,000,000

800,000

600,000

400,000

200,000

0

35

Nhlawulo wa Onyx wu ya emahlweni wu ri na swirho swa vanhu lavakulu kasi vahlayisiwa va wona va le ka nhlayo-xikarhi ya malemeb ya 36.0 kasi nhlawulo wa Ruby wu na swirho swa malemeb lamantsongo na vahlayisiwa va nhlayo-xikarhi ya malembe ya 26.3. Nhlayo-xikarhi ya malembe ya vahlayisiwa va GEMS i 27.1. Mpimo wa vahlayisiwa lava nga ehenhla ka malembe ya 65 wu tlakukile ku suka eka 2.34% hi N’wendzamhala 2008 ku ya eka 2.46% hi N’wendzamhala 2009.

Hi 2009 mpimo wa vahlayisiwa wa vana loko wu pimanyisiwa na wa swirhonkulu swa GEMS wu tlakukilenyana ku suka eka 1.20 ku ya eka 1.28, kasi mpimo wa muhlayisiwa wa Munhu nkulu wu yile ehansi ku suka eka 0.54 ku ya eka 0.53. Xikimi xi rhekodile nhlayo-xikarhi ya le henhla hi ndyangu hikwalaho ka swivangelo leswi boxiweke laha henhla.

Nhlayo-xikarhi ya sayizi ya ndyangu wa GEMS hi 2008 a ku ri 2.75. Mihlawulo ya Sapphire na Emerald yi na nhlayo-xikarhi ya le henhla ya tisayizi ta ndyangu (3.41 na 2.81). Girafu leyi nga laha hansi yi kombisa mpimo hi muhlayisiwa (swi kombisa tisayizi ta ndyangu).

Mihlawulo ya GEMS hinkwayo yi kombisa leswaku nhlayo ya le henhla i ya Vahlayisiwa va vaxisati ku tlula Vahlayisiwa va xinuna. Mihlawulo ya Sapphire na Beryl, hi yona leyi a yi ri na nhlayo ya le henhla ya swirhonkulu swa xinuna ku tlula swirhonkulu swa xisati. 56.6% ya Vahlayisiwa va Xikimi hi 2009 i vaxisati (56.4% in 2008). swi languteriwile ku va nhlayo ya Vahlayisiwa vaxisati yi va ehenhla hikuva eka swiyenge swa rihanyo na dyondzo ku thoriwile vaxisati vo tala.

2.0

1.75

1.50

1.25

1.00

0.75

0.50

0.25

0.00

Sap

phire

Ber

yl

Rub

y

Em

eral

d

Ony

x

GE

MS

Ku cinca ka mpimo wa vahlayisiwa hi Nhlawulo

Dep

enda

nt ra

tio

NhlawuloMunhunkulu – N’wendzamhala 08 N’wana – N’wendzamhala 08 Munhunkulu – N’wendzamhala 09 N’wana – N’wendzamhala 09

80%

70%

60%

50%

40%

30%

20%

10%

0

Sap

phire

Ber

yl

Rub

y

Em

eral

d

Ony

x

GE

MS

Mpimo wa vaxisati hi Nhlawulo

Phe

sent

e ya

sw

irhon

kulu

sw

a xi

sati

Phesente ya Vahlayisiw

a va xisati

NhlawuloN’wendzamhala 08 Swirhonkulu N’wendzamhala 09 Swirhonkulu N’wendzamhala 08 Vahlayisiwa N’wendzamhala 09 Vahlayisiwa

58%

57%

56%

55%

54%

53%

52%

51%

50%

49%

5

36 Bringing health within your reach

Eka mihlawulo ya Sapphire na Beryl, Beryl yi na mpimo wa le hansi wa vanhu lava holaka mali yintsongo (ehansi ka R3,000) kasi mihlawulo ya Onyx na Emerald yi na mpimo wa le henhla wa swirhonkulu leswi holaka mali yo tlula R6,000 hi Nhweti. Hi ku angarhela 31.3% ya swirho swa GEMS swi kuma mali ya le hansi ka R6,000 hi Nhweti (ku katsa na vadyuhari).

Nhlawulo wa Onyx wu ya emahlweni wu ri na mpimo wa le henhla wa Vadyuhari ku tlula mihlawulo letin’wana hi 15.0% loko ku pimanyisiwa na Sapphire (1.2%), Beryl (4.0%), Ruby (1.9%) na Emerald (2.2%). Nhlayo-xidzi ya Vahlayisiwa lava nga ehenhla ka 65 wa malembe yi engetelelekile hi nkarhi lowu (ku suka eka 20,090 hi N’wendzamhala 2008 ku fika eka 28,299 hi N’wendzamhala 2009). Swirho swa vadyuhari swa Xikimi swi kombisiwa hi ku tirhisa mfungho wa vadyuhari na ku tiyisisiwa ka vuxirho bya vona.

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0

Sap

phire

Ber

yl

Rub

y

Em

eral

d

Ony

x

GE

MS

Mpimo wa vahlayisiwa lava holaka mali ya le hansi ka R6,000 hi Nhweti

Phe

sent

e

Nhlawulo

N’we-08 N’we-09

16%

14%

12%

10%

8%

6%

4%

2%

0%

Sap

phire

Ber

yl

Rub

y

Em

eral

d

Ony

x

GE

MS

Mpimo wa vadyuhari hi Nhlawulo hi muhlayisiwa

Phe

sent

e

Nhlawulo

N’we-08 N’we-09

37

Tafula leri landzelaka ri kombisa ku kula ka vadyuhari (leswi swi tikombaka hi mfungho) na ku kula ka Vahlayisiwa ku suka N’wendzamhala 2008 ku fika N’wendzamhala 2009:

Nhlawulo Ku kula ka Vaddyuhari Ku kula ka Vahlayisiwa growthSapphire -42.93% 38.32%

Beryl 21.36% 12.49%Ruby 13.85% 22.25%

Emerald 23.80% 46.27%Onyx 3.52% 9.98%GEMS 14.14% 39.52%

Loko hi languta tafula leri nga laha henhla, swa tikomba leswaku mihlawulo ya Ruby, Emerald na Onyx yi vile na ku kula ka le hansi ka nhlayo ya vadyuhari loko ku pimanyisiwa na ya Vahlayisiwa ku suka N’wendzamhala 2008 ku fika N’wendzamhala 2009. Leswi swi hlamusela ku ya ehansi ka mpimo wa vadyuhari ku suka N’wendzamhala 2008 ku fika N’wendzamhala 2009 h.l. hi ku landza tiphesente mihlawulo ya Ruby, Emerald na Onyx yi vile na vanhu vo tala lava nga ri ki vadyuhari lava yi joyineke ku suka N’wendzamhala 2008 leswi hungutaka mpimo wa vadyuhari eka mihlawulo leyi.

Beryl a wu ri wona Nhlawulo wu ri woxe lowu veke na ku kula ka nhlayo ya vadyuhari loko ku pimanyisiwa na ku kula ka nhlayo ya vahlayisiwa h.l. ku vile na ku kula ka nhlayo ya vadyuhari ku suka N’wendzamhala 2008 ku fika N’wendzamhala 2009 loko ku pimanyisiwa na nhlayo ya Vahlayisiwa eka Beryl hi nkarhi wolowo. Leswi swi nyika nhlamuselo ya mpimo wa le henla wa mpimo wa vadyuhari hi N’wendzamhala 2009 loko yi pimanyisiwa na N’wendzamhala 2008. Sapphire yi vile na ku ya ehansi eka mpimo wa vadyuhari eka Nhlawulo. Leswi mikarhi yin’wana swi vangiwa hikuva swirho swa vadyuhari swi xava mihlawulo yo angarha ya GEMS. Hi Sunguti 2009, loko ku pimanyisiwa na mihlawulo yin’wana ya GEMS, nhlawulo wa Sapphire wu vile na phesente ya le henhla ya vadyuhari lava wu tirhisaka leswi nga hlmuselaka mpimo wa le hansi wa vadyuhari hi 2009.

Hi ku landza maavelo ya swifundzankulu, 20.6% kumbe 236,219 wa Vahlayisiwa va GEMS’ va kumeka eGauteng (173,482 hi 2008), 20.1% kumbe 231,454 va le KwaZulu-Natal (173,482 hi 2008), kasi Northern Cape a yi ri na swirho switsongo ku nga 3.0%. Tinhlayo leti ti fanele ti langutisiwa hi ku landza nhlayo ya Vatirhelamfumo eka xifundzankulu xin’wana an xin’wana hikuva swifundzankulu swin’wana, swo kota, Northern Cape, a xi na Vatirhelamfumo vo tala kumbe vanhu vo tala.

25%

20%

15%

10%

5%

0%

Kap

a-Vu

xa

Free

Sta

te

Gau

teng

Kw

azul

u-N

atal

Lim

popo

Mpu

mal

anga

Nor

th W

est

N’w

alun

gu

Kap

a-Vu

pela

dyam

bu

Maavelo ya Vahlayisiwa hi xifundzankulu na xifundzankulu

Phe

sent

e

Xifundzankulu

N’we-08 N’we-09

5

38 Bringing health within your reach

Lembe ra 2009 ri kombisile ku engeteleka ka vatirhi lava nga sirheleriwa hi Xikimi tiko hinkwaro. Western Cape, Free State na Northern Cape ti vile na tinhlayo ta le henlha ta vusirheleri. Eka Girafu leyi nga laha hansi, Eastern Cape yi vile na phesente ya le henhla ya ku engeteleka ka swirho (53.64%), yi landzeleriwa hi Mpumalanga (39.76%) kutani ku landzela Free State (38.08%).

4.4 Ntokoto wa swikoxo

Ku hakela swikoxo i ntirho wun’wana wukulu lowu tirhiwaka hi GEMS.

Xikimi xi tirhile kahlenyana hi 2009, laha ku hlengeletiweke mali leyi a yi ri ehenhla ka ya swikoxo na tihakelo tin’wana eka mihlawulo hinkwayo ehandle ka nhlawulo wa Onyx. Tafula leri lnazelaka ri katsakanya matirhelo ya mihlawulo yo hambana ya GEMS hi 2009.

60%

50%

40%

30%

20%

10%

0%

Kap

a-Vu

xa

Free

Sta

te

Gau

teng

Kw

azul

u-N

atal

Lim

popo

Mpu

mal

anga

Nor

th W

est

N’w

alun

gu

Kap

a-Vu

pela

dyam

bu

Nsirhelelo wa vatirhi lava nga faneriwa

Xifundzankulu

N’we-08 N’we-09

Phe

sent

e

4,000

3,500

3,000

2,500

2,000

1,500

1,000

500

0

Sap

phire

Ber

yl

Rub

y

Em

eral

d

Ony

x

GE

MS

Tihakelo, swikoxo na matirhiselo ya mali hi 2009

Nhlawulo

Mali leyi hakeriwaka Swikoxo na mali leyi tirhisiweke Mpimo wa ku lahlekeriwa

Nhl

ayo-

xika

rhi y

a nt

seng

o w

a xi

rhon

kulu

Loss ratio

140%

120%

100%

80%

60%

40%

20%

0%

39

Mipimo ya ku lahlekeriwa eku heleni ka 2009 i 58.99% eka Sapphire, 88.06% eka Beryl, 66.64% eka Ruby, 97.15% eka Emerald na 126.46% eka Onyx. Mpimo wa ku lahlekeriwa hi ku angarha ka GEMS i 97.9%. Mipimo ya ku lahlekeriwa eka Mihlawulo hinkwayo ya GEMS yi engetelelekile swinene ku suka eka 2008. Hambiswiritano, leswi swi vangile leswaku ndyangu wun’wana na wun’wana wu hakela ku ringana R53 eka Nkwama wa mali leyi hlengeletiweke ya Xikimi hi 2009 loko ku pimanyisiwa na R150 hi 2008.

Xiyenge 33(2)(c) xa Nawu xi languterile mihlawulo ya Xikimi ku tiyimela ha yoxe. Ehnale ka nhlawulo wa Onyx, mihlawulo leyin’wana ya GEMS yi tiyimela hayoxe. GEMS yi kumile mpfumelelo eka Huvo ya Swikimi swaa Swa Rihanyo ku ya emahlweni na nhlawulo wa Onyx hi ku lnaza kungu ra bindzu leri humesiweke hi 2007. Ntokoto wa Onyx wu vangiwile hikwalaho ka mipimo ya le henhla ya vadyuhari na ya swikoxo eka nhlawulo lowu. Ku vile na ku cinca loku endliweke eka nhlawulo wa Onyx exikarhi ka lembe leswi vangeke leswaku mali yi kota ku tirhisiwa eka nhlawulo lowu swirho swi nga xanisiwangi. Swiviko swa kotara na kotara swi ta nyikiwa eka Huvo ya Swikimi swa Swa Rihanyo leswaku nhlawulo lowu wu kota ku tihakelela hawoxe exikarhi ka mpfhuka.

4.5 Swikoxo swa Mihlawulo ya Onyx, Emerald na Ruby

Tafula leri landzelaka ri kombisa ntolovelo wa swikoxo eka swiyenge swo hambana swa tihakelo. Swikoxo swo tala i swa mitsengo leyi nga ehansi ka R2, 500 naswona leswi i swikoxo swa vaphakeri (xik. dokodela) na mirhi.

Ntsengo wa Firikhwensi ya SwikoxoNtsengo lowu koxiweke RUBY EMERALD ONYX

R0 - R2,500 97.09% 97.33% 96.77%R2,501 - R5,000 1.43% 1.16% 1.47%R5,000 - R7,500 0.48% 0.51% 0.62%R7,501 - R10,000 0.29% 0.30% 0.35%

R10,001 - R12,500 0.18% 0.18% 0.22%R12,501 - R15,000 0.11% 0.11% 0.11%R15,001 - R17,500 0.12% 0.10% 0.09%R17,501 - R20,000 0.10% 0.09% 0.08%

R20,001+ 0.21% 0.20% 0.29%Nkatsakanyo 100.00% 100.00% 100.00%

Tafula leri landzelaka ri kombisa swikoxo leswi tirhisiweke eka mihlawulo ya Ruby, Emerald na Onyx Nhlawulo leyi aviweke hi ku landza swiyenge swa mimbuyelo swo hambana.

5

40 Bringing health within your reach

Nhlayo-xikarhi ya tihakelo ta swikoxo hi Nhweti hi ndyangu hi xiyenge xa mimbuyelo: 2009

Xiyenge xa Mimbuyelo EmeraldR

OnyxR

RubyR

REOR

REO (pimanyetiweke)

R

Ku engeteleka/Ku kayivela ka mpimanyeto

% ya ku hambana ka Mpimanyeto

In-h

osp

ital

be

nefi

ts

Ku amukeriwa exibedhlele 626.09 1,000.69 391.49 636.21 693.79 -57.59 -8.30%Madokodela 23.03 23.16 17.09 22.49 23.90 -1.42 -5.93%Van'waswikoti 159.99 259.09 102.22 163.07 173.67 -10.60 -6.11%Swa xikandza swa Maxillo 0.36 1.35 0.35 0.44 0.64 -0.20 -30.52%Swa meno swa masungulo na swo hlawuleka 1.94 3.52 0.79 1.97 2.15 -0.18 -8.46%Mimbuyelo ya swa Vutswedyana 78.82 38.74 68.41 74.45 87.92 -13.46 -15.31%Rihanyo ra miehleketo 13.21 35.73 6.94 14.54 13.75 0.79 5.76%Radiyoloji ya masungulo le mahlweni 19.34 33.15 11.94 19.83 20.11 -0.28 -1.41%Radiyoloji ya le mahlweni 36.82 92.22 19.91 39.96 42.12 -2.16 -5.13%Patholoji 56.52 77.63 36.91 56.50 55.36 1.13 2.05%Fiziyotherapi 18.58 24.59 12.21 18.50 17.73 0.77 4.34%Onkholoji 29.61 96.12 19.32 34.31 34.92 -0.61 -1.75%Prosthesisi ya le Ndzeni na le Handle 26.32 109.33 15.31 32.36 27.02 5.34 19.75%Vuongori bya phurayivhete 9.92 9.87 8.38 9.78 11.32 -1.54 -13.61%HIV/AIDS 0.28 0.27 0.18 0.27 0.40 -0.13 -32.65%Ku cinca swirho na Dayilesisi ya Tinsu 20.78 39.26 12.96 21.63 18.80 2.82 15.00%Ku hunguta mavele 1.26 1.74 0.01 1.18 0.10 1.09 1138.66%Ntsengo wa ku amukeriwa exibedhlele 1,122.87 1,846.49 724.43 1,147.48 1,223.71 -76.23 -6.23%

Ou

t-o

f-h

osp

ital

ben

efits

Van'waswikoti 50.93 92.06 27.83 52.29 48.15 4.14 8.60%Madokodela 189.91 195.62 140.54 185.83 156.73 29.09 18.56%Fiziyotherapi 2.05 4.97 1.71 2.27 1.67 0.60 36.05%Okhuphexinali na Therapi/Audioloji ya Mbulavulo 10.55 19.84 4.07 10.74 7.92 2.82 35.62%Vukorhokeri bya Allied Health 1.94 6.64 1.55 2.30 1.82 0.48 26.21%Radiyoji ya masungulo 30.69 57.60 16.24 31.64 29.59 2.05 6.94%Patholoji 44.21 85.49 27.45 46.16 42.21 3.95 9.36%Radiyoloji ya le mahlweni 0.00 0.00 0.01 0.00 0.01 -0.01 -85.86%Swikene swa Ultrasound hi Ku biha emirini 3.37 1.56 2.07 3.10 3.14 -0.04 -1.32%Swa meno swa masungulo 45.33 100.22 32.40 48.80 43.45 5.35 12.32%Swa meno swo hlawuleka 18.71 52.70 3.32 20.18 9.07 11.11 122.49%Mirhi ya Acute 141.44 242.88 80.66 144.43 123.74 20.69 16.72%Mbuyelo wa mirhi yo tikumela 78.31 65.62 43.54 74.01 53.15 20.86 39.24%Mirhi ya mavabyi ya nkarhi hinkwawo 60.56 305.26 19.87 77.59 79.92 -2.33 -2.92%Swa mahlo - ku kamberiwa 42.44 56.01 30.68 42.51 35.09 7.42 21.13%Swa mahlo - tifureyimi na tilense 27.19 33.09 24.30 27.42 24.02 3.40 14.16%Switirhisiwa 9.70 34.13 4.42 11.29 8.65 2.64 30.56%HIV/AIDS 42.45 28.08 28.66 39.95 22.95 17.00 74.08%Swikunguhata-mbeleko 0.00 4.80 0.00 0.41 0.34 0.07 21.22%Mimbuyelo ya swa Vutswedyana-Ku tswalela ekaya 0.03 0.02 0.01 0.02 0.02 0.01 41.22%Nhlayiso wa nsirhelelo 0.00 0.00 11.37 1.05 0.00 1.05 0.00%PMBS 9.71 34.84 4.02 11.32 9.97 1.34 13.47%Ntsengo wa le handle ka xibedhlele 809.52 1,421.43 504.74 833.30 701.61 131.70 18.77%Ntsengo wa Swikoxo 1,932.39 3,267.92 1,229.17 1,980.78 1,925.31 55.47 2.88%

41

Hi ku angarhela, ntsengo wa swikoxo swa ku tshama exibedhele a swi ri ehansi eka leswi a swi pimanyeteriwile hi kwalomu ka 6.23%. Swiyenge swa swikoxo swa ku tshama exibedhlele leswi a swi ri na phesente ya le henhla swi hambanile na mpimanyeto h.l. ehansi ka swikoxo leswi a swi languteriwile a ku ri HIV/AIDS, swa xikandza swa Maxillo na mimbuyelo ya swa vutswedyana. Kambe hi nhlamuselo yo olova, ku hambana ku suka eka mpimanyeto ka swa xikandza swa Maxillo na HIV/AIDS a ku ri kuntsongo (h.l. ku hambana ku suka eka mpimanyeto ka le ehansi ka R0.20 hi xirho hi Nhweti).

Swiyenge swa swikoxo swa le ndzeni ka leswi veke na phesente ya le henhla ya ku hambana ku suka eka mpimanyeto h.l. ehenhla ka swikoxo leswi a swi languteriwile a swi ri swa ku hunguta mavele, prosthesisi ya le ndzeni na le hnale, ku cinciwa ka swirho swo karhi swa miri na na dayilesisi ya tinsu. Hi nhlamuselo yo olova ku hambana ka swikoxo swa le ndzeni ka xibedhlele ku suka eka mpimanyeto a ku ri ka ku amukeriwa exibedhlele xa mani na mani h.l. R57.59 hi xirho hi Nhweti loku nga ehansi kaloku a ku languteriwile naswona ku vangeke leswaku ku va ehansi ka swikoxo swa le ndzeni ka xibedhlele leswi a swi languteriwile hi 2009.

Hi ku angarhela, swikoxo swa le handle ka xibedhlele a swi ri ehenhlanyana ku tlula leswi a swi languteriwile h.l. 18.77% ku hundza leswi a swi languteriwile. Swikoxo hinkwaswo swa le hnale ka xibedhlele ehnale ka swikene swa ultrsound swa ku biha emirini a swi ri ehenhla ka leswi a swi pimanyetiwile. Swiyenge swa swikoxo leswi kumeke phesente ya le henhla yo hambana na mpimanyeto a swi ri swa swilo swa meno, HIV/AIDS na ku tswalela ekaya. Hambiritano, ehnale ka HIV/AIDS hi nhlamuselo yo olova ku hambana ku suka eka mpimanyeto ka swiyenge leswi swa swikoxo a ku nga ri na nkoka.

Hi nhlamuselo yo olova, ku hambana lokukulu ku suka eka mpimanyeto ka swikoxo swa le hnale ka xibedhlele a ku ri ka van’wavutivi va le handle ka xibedhlele, akhuti na mirhi yo tikumela ha wexe, HIV/AIDS na swilo swa meno swo hlawuleka. Swikoxo leswi hi swona swi vangeke ku hambana ku suka eka mpimanyeto loku veke kona ka swikoxo swa le hnale ka xibedhlele hi 2009.

44.6 Swikoxo swa Mihlawulo ya Beryl na Sapphire

Mihlawulo ya Beryl na Sapphire i mihlawulo ya netiweke laha GEMS yi hundziseleke khombo ra xikoxo eka Muphakeri wa Vukorhokeri loyi a hlawuriweke (Ntshungulo wa masungulo) laha mpimo wa vuhlayisi wu nga wa netiweke ya Vaphakeri ntsena.

Exikarhi ka lembe Xikimi xi nghenile eka pfhumba ro va swirho swi tirhisa tindlela to tisirhelela eka mihlawulo ya Beryl na Sapphire. Pfhumba leri ra dyondzo ri vangile leswaku ku va na matwisiselo yo antswa ya mimbuyelo na matirhiselo ya mihlawulo.

Matirhiselo ya DSP ya tlakukile hi 90% in Sunguti 2009 ku fika eka 95% hi N’wendzamhala 2009.

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

Sun

09

Nye

n 09

Nye

ny 0

9

Dzi

09

Mud

y 09

Kho

t 09

Maw

09

Mha

09

Ndz

h 09

Hla

n 09

Huk

09

N’w

e 09

Beryl GP Matirhiselo hi 2009

OON Swa xihatla swa Beryl swa GEMS OON Beryl GEMS Netiweke ya Beryl ya GEMS

*OON = Ehandle ka netiweke

Phe

sent

e

5

42 Bringing health within your reach

Leswi swi tirha na le ka Nhlawulo wa Sapphire tani hileswi matirhiselo a ya ri ehenhla ka 97% hi 2009.

4.7 Malawulelo ya makhombo ya swa rihanyo

Phurofayili ya makhombo ya demogirafiki eka Emerald na Ruby a yi ri eka xiyimo xin’we kambe yi yile ehansi eka Onyx naswona leswi swi tikomba eka matirhiselo ya xibedhlele na tihakelo. Ku ya hi mpimo wa Xikimi, matirhiselo ya xibedhlele hi ku angarha a ya tlakukangi ngopfu, kambe ku tlakuka ka tihakelo ta xibedhlele ku fambelana na ku cinca ka case mix, leswi yelanaka na tinhlayo to karhi na miamukelo yo karhi.

Hi ndlela yaleyo, ku vile na ku amukeriwa ko tala ka nyumoniya, rihanyo ra miehleketo, ku siviwa ka matsolo na arthrosikhopi, kambe miamukelo yo tala ya tihakelo ta le henhla yo kota ya mbilu na orthopaediki yi yile ehansi. Miamukelo ya ku biha emirini na ya mavabyi ya xisati, hambileswi ya nga ya tihakelo ta le henhla ta xibedhlele, yi yile ehansi hi mpimo naswona leswi swi tikomba eka xiyenge xa vuhandzuri na xa maendlelo ya laparosikopiki. Hambileswi mavabyi ya nkarhi hinkwawo ya engetelekaka, tihakelo to tala ta mirhi ti le ka makumelo ya yona na mirhi leyi kumekaka ekhawuntareni. Ntshikelelo eka 2010 ka matirhiselo ya mirhi leyi kumekaka ekhawuntareni, mavabyi ya nkarhi hinkwawo, swirho leswi nga eka makhombo ya le henhla na nkucetelo wa tihakelo ta le xibedhlele eka mavabyi ya mahanyelo, na le ka rihanyo ra miehleketo na HIV/AIDS.

Ku engeteriwa ka tihakelo ta munhu un’wana na un’wana loyi a amukeriwa hi 16.6% ti fambelana na mipimo ya mitlakuso ya ntolovelo na ku cinca ka nkarhi wa ku tshama hilaha swi kombisiweke hakona eka Girafu leyi nga laha hansi.

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

Sun

09

Nye

n 09

Nye

ny 0

9

Dzi

09

Mud

y 09

Kho

t 09

Maw

09

Mha

09

Ndz

h 09

Hla

n 09

Huk

09

N’w

e 09

Matirhiselo ya Sapphire GP

Netiweke ya Sapphire OON Sapphire OON Swa xihatla swa GEMS

*OON = Ehandle ka netiweke

Phe

sent

e

16,000

14,000

12,000

10,000

8,000

6,000

4,000

2,000

0

Q1

Q2

Q3

Q4

Kotara

Mpimanyeto wa Nhlelo: Tiahakelo ta ku amukeriwa

2007 2008 2009

Tiha

kelo

ta k

u am

uker

iwa

43

Hambileswi nkarhi wa ku tshama exibedhlele wu nga engeteleleka hikwalaho ka ku cinca ka case mix na ku tika ka mavabyi eka swiyenge swo karhi swa ku amukeriwa, a ku vangi na ku tlakuka hi ku angarhela ka mpimo wo amukeriwa hilaha swi kombisiwaka hakona eka Girafu leyi nga laha hansi.

96% ya tihakelo ta ku amukeriwa ehansi ka R50, 000 naswoan ku vile na ku tlakukakanyana ka ku amukeriwa ehenhla ka R5,000.

Ntsengo wa Tihakelo ta le XibedhleleNhlayo ya vanhu lava amukeriweke

- YTDPhesente ya vanhu lava

amukeriweke - YTD2008 2009 2008 2009

R0-R5,000 58,392 69,392 37.9% 31.1%

R5,001-R10,000 47,207 70,440 30.6% 31.6%

R10,001-R15,000 20,276 33,025 13.2% 14.8%

R15,001-R20,000 13,579 23,921 8.8% 10.7%

R20,001-R50,000 10,161 18,306 6.6% 8.2%

R50,001-R100,000 3,070 5,213 2.0% 2.3%

R100,001-R200,000 1,004 1,769 0.7% 0.8%

R200,001-R300,000 229 372 0.1% 0.2%

R300,001-R500,000 131 233 0.1% 0.1%

R500,001+ 45 109 0.0% 0.0%

Ntsengo 154,094 222,780 100.0% 100.0%

Tinhlayo ta 2009 leti nga eka pheji leri ti khumba nhlangano wa tinhlayo leti koxiweke na leti languteriweke.

Swiyenge swa le henhla swa 10 swa ku amukeriwa swa mihlawulo ya Ruby, Emerald na Onyx swi longoloxiwile laha hansi. Tihakelo ta le henhla ta ku amukeriwa a ti katsa tihakelo ta tioparexini ta longo na ta ku susiwa ka mahlanganisi, nyumoniya, rihanyo ra miehleketo, coronary stents na angiograms, xiyenge xa caesarean na vuhlayisi bya neonatal. Eka leswi, ku amukeriwa hi swa rihanyo ra miehleketo hi swona swi nga tala ngopfu. Ku amukeriwa kun’wana ka le henla, kambe ku nga durhiki ngopfu, ku katsa maendlelo ya cataract excision, endoscopic na sejari ya meno. Ku na nhlayo ya le henhla ya ku amukeriwa mayelana na ku hlanganisiwa ka longo na arthroscopy na ku susiwa ka tsolo, ku katsa na cataract excision na rihanyo ra swa miehleketo leswi vangeke ku cinca eka case mix na ku engeteleka ka tihakelo ta le xibedhlele hi ku angarha.

350

300

250

200

150

100

50

0

Q1

Q2

Q3

Q4

Kotara

2007 2008 2009

Mpimanyeto wa Nhlelo: Mpimo wa ku amukeriwa

Mpi

mo

wa

ku a

muk

eriw

a

5

44 Bringing health within your reach

Swiyenge swa le henhla swa 10 swa ku Amukeriwa exibedhlele hi firikhwensi

Xiyenge xo amukeriwa

Ku amukeriwa / vanhu va 1000

Nhlayo-xikarhi ya LOS

Nhlayo-xikarhi ya tihakelo hi ku

amukeriwa ka munhu

Tihakelo ta le xibedhlele ha munhu

hi Nhweti

2008 2009% Kucinca

2008 2009% Kucinca

2008R

2009R

% Kucinca

2008R

2009R

% Kucinca

1 Nyumoniya 15.70 17.36 11% 4.95 4.85 -2% 11,903 12,881 8% 15.57 18.63 20%2 Ku tswala hi oparexini 14.63 13.87 -5% 2.95 2.95 0% 15,799 17,699 12% 19.27 20.46 6%3 Gastroenteritis 10.72 10.02 -7% 3.31 3.36 2% 6,788 7,972 17% 6.06 6.66 10%

4Ku amukeriwa hikwalaho ka mavabyi ya miehleketo 8.36 9.03 8% 7.69 7.95 3% 7,884 9,348 19% 5.50 7.04 28%

5 Ku tswala ka ntolovelo 8.22 7.50 -9% 1.75 1.78 1% 9,164 10,336 13% 6.28 6.46 3%6 Uphi GI Endoscopy 6.46 6.22 -4% 0.13 0.13 3% 1,833 2,155 18% 0.99 1.12 13%

7 Ku amukeriwa hikwalaho ka meno 6.57 6.11 -7% 0.36 0.25 -30% 5,341 5,909 11% 2.92 3.01 3%

8 Maendlelo ya Tithonsili/Adenoid 5.97 5.97 0% 0.37 0.40 9% 5,109 5,874 15% 2.54 2.92 15%

9 Ku biha emirini ko tika 5.68 5.69 0% 2.00 2.09 5% 3,851 4,653 21% 1.82 2.20 21%10 Swa le ngomeni 5.20 5.40 4% 0.13 0.14 15% 4,295 4,968 16% 1.86 2.23 20%

Swiyenge swa le henhla swa 10 swa ku Amukeriwa exibedhlele 87.52 87.16 0% 2.88 3.00 4% 8,612 9,738 13% 62.81 70.73 13%Swiyenge hinkwaswo swa le henhla swa 10 tani hi % 26.0% 25.1%

Ku vile na mitsariso yintshwa ya 46,018 hi 2009 eka nongonoko wa mavabyi ya nkarhi hinkwawo, laha ku nga 11.4% ya vahlayisiwa. Tihakelo ta munhu un’wana na un’wana loyi a tirhisaka mirhi ya mavabyi ya nkarhi hinkwawo ti tlakukile hi 13.5%, ngopfungopfu hikwalaho ka engetelo wa vatirhi va mirhi ya mavabyi ya nkarhi hinkwawo. Matirhiselo na tihakelo ta mirhi swi lawuriwa kahle.

Ku tirhisiwa ngopfu ka mimbuyelo ya ntolovelo na ya mavabyi ya nkarhi hinkwawo swi kumeka ngopfu eka Onyx, kambe Onyx na Emerald havumbirhi ti na nhlayo ya le henhla ya mbuyelo wa Thirapi ya Ndzetelo ya Famasi.

Tihakelo leti pfumeleriweke ta mavabyi ya nkarhi hinkwawo i R514, 268,253 naswona phurofayili ya tihakelo ta mavabyi ya nkarhi hinkwawo ngopfungopfu i ya hayiphathenxini, mavabyi lama vangaka hi mahanyelo, dipirexini na asthma.

Mavabyi ya le henhla ya 10 hi firikhwensi

Nkambelo Nhlayo ya Vahlayisiwa lava tsarisiweke % Vahlayisiwa

1 Mpopo wa le henhla wa ngati (Highbloodpressure) 65,746 6.4%2 Mavabyi ya chukele yo ka ya nga tirhisi insulin 24,440 2.4%3 Swiphiqo swa ku songasongana ka ngati 21,616 2.1%4 Kholesteroli ya le henhla 19,266 1.9%5 Asima 16,180 1.6%6 Hay fivha 13,557 1.3%7 Dipirexini 12,325 1.2%8 Menophosi 11,865 1.2%9 Thyrodi ya Underactive 7,935 0.8%10 Mavabyi ya Reflux 5,264 0.5%

Muphakeri wa Vukorhokeri bya mirhi ya Mavabyi ya Nkarhi Hinkwawo loyi a Hlawuriweke wa mihlawulo ya Ruby, Emerald na Onyx u thoriwile ku suka hi Sunguti 2007. Xipano xo lawula xi yile emahlweni no tshikelela vuhlanganisi exikarhi ka mihlangano yo hambana ya swa vuhlayisi na DSP hi 2009. Tinhlayo ta migingiriko mayelana na mavabyi ya nkarhi hinkawo ya DSP ti kombisiwile laha hansi.

45

Nhlayo ya tiayitheme na tipirisikiripixini leti humesiweke ta mavabyi ya nkarhi hinkwawo DSP ta Mihlawulo ya Ruby, Emerald na Onyx ta 2009 Kotara ya 1 Kotara ya 2 Kotara ya 3 Kotara ya 4

Ntsengo wa tipirisikiripixini 243,332 272,391 300,496 328,778Ntsengo lowu koxiweke R71,438,227 R83,841,842 R91,990,917.18 R101,238,173.19Ntsengo wa nhlayo ya tiayitheme 525,101 592,443 649,519 715,277Nhlayo-xikarhi ya nkoka hi ayitheme R135.87 R141.41 R141.63 R141.51Nhlayo-xikarhi ya nkoka hi phirisikiripixini R293.28 R307.82 R306.12 R307.84Nhlayo-xikarhi ya ya tiayitheme hi phirisikiripixini 2.16 2.17 2.16 2.17

Hikwalaho ka ku thoriwa ka Muphakeri wa Vukorhokeri bya mirhi ya Mavabyi ya Nkarhi Hinkwawo loyi a Hlawuriweke wa mihlawulo ya Ruby, Emerald na Onyx, GEMS yi kotile ku hlayisa mali ya ku humesa mirhi, ku landzelela milawu na ku pfumaleka ka swihoxo eka vuhlanganisi bya ohiational eka Vukorhokeri lebyi.

Ehenhla ka switiratheji swa makhombo ya swa rihanyo swo hambanahambana, GEMS yi tshikelele na timhaka ta malawulelo ya onkholoji (khensa) hi 2009. Ku kumeka ka matirhiselo ya chemotherapy swi le hansi hi ku landza matirhelo ya Bindzu naswona tihakelo ta swikoxo i R5.49 ha munhu ha munhu hi Nhweti in 2009. Tinhlayo ta mavabyi ya swiyimo swa ntlhanu swa onkholoji ti kombisiwile laha hansi.

NkambeloNhlayo ya Mavabyi

2009Nhlayo ya Mavabyi

2008Malignant Neoplasm ya Vele 814 411Malignant Neoplasm ya Prostate 371 150Non-Hodgkins Lymphoma 121 46Malignant Neoplasm ya Bronchus kumbe Hahu 113 -Malignant Neoplasm ya Xivelekelo 105 -Kaposi’s sarcoma - 33Myeloma-nyingi - 32

4.8 Nkwama wa Maringaniselo ya Makhombo

Nhlelo lowu endliweke hi tiakichwuri ta Xikimi eka xiyenge lexi wu kombisa engetelo wa mavikelo hi ku angarha laha ku veke na ku hunguteka ka ntsengo wa mali leyi languteriweke ku hakeriwa REF. Leswi swi vangiwa hikuva swirho swo tala swi fikelela swihlawulekisi swa ku nghenela (ku kuma mirhi hikwalaho ka mavabyi eka tinhweti timbirhi leti nga hundza) na ku ya emahlweni ka ku antswisiwa ka phesente ya swirho leswi tsarisiweke hikwalaho ka mavabyi lama.

Xihlawulekisi xa ku nghena na ku kambisisa lexi tirhisiwaka eka REF xa ha ri na nkucetelo eka GEMS. Ku ya emahlweni swi vula leswaku swirho swintshwa a swi hlayeriwi hikwalaho ka mavabyi yo karhi. Ku fikelela xihlawulekisi xa ku nghena xa REF, ku laveka vumbhoni byo komba leswaku muhlayisiwa u amukerile ntshungulo wo karhi eka tinhweti timbirhi ta khalendara eka tinh’weti tinharhu ta khalendara emahlweni ka nhweti leyi (nhweti leyi muhlayisiwa a kumeka xiyimo xa yena xa REF).

Girafu na tafula leri landzelaka ri pimanyisa phurofayili ya GEMS na ya bindzu ra sweswi ra REF na mahangalaselo ya mavabyi.

12.0%

10.0%

8.0%

6.0%

4.0%

2.0%

0.0%

Und

er 1

01-0

4

05-0

9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

5-54

55-5

9

60-6

4

65-7

0

75-7

9

80-8

4

85+

Mphakelo wa malembe

Swiyimo swa malembeN’we REF

Phe

sent

a ya

vux

irho

5

46 Bringing health within your reach

Mphakelo wa malembe hi REF eka girafu leyi nga laha henhla i nhlayo-xikarhi ya phurofayili ya malembe ya bindzu. Xikimi xi na phesente ya le henhla ya vahlayisisiwa va vana ku tlula mphakelo wa malembe ya REF naswona ku na vahlayisiwa vatsongo lava nga ehenhla ka malembe ya 50. Timhaka letimbirhi ta nkoka ti na nkucetelo eka tihakelo ta Xikimi eka REF.

Ntokoto wa ntiyiso wa mavabyi ya nkarhi hinkwawo ya Xikimi wu kombisa hilaha Xikimi xi nga ta hakela hakona eka REF. Tafula leri landzelaka ri kombisa xiphemu xa swirho swa GEMS leswi nga na mavabyi ya nkarhi hinkwawo loko ku pimanyisiwa xiphemu xa bindzu.

Bindzu GEMS N’wendzamhala 2009

Ku hava vuvabyi 88.5% 88.6%

Vuvabyi byin'we bya nkarhi hinkwawo 8.1% 7.6%

Mavabyi mambirhi ya nkarhi hinkwawo 2.6% 2.6%

Mavabyi manharu ya nkarhi hinkwawo 0.6% 0.9%

Mavabyi ya mune ya nkarhi hinkwawo 0.1% 0.4%

Swa tikomba leswaku ku na ku kala ka ndzinganiso wa nhlayo ya vahlayisiwa lava nga na mavabyi ya CDL. Kambe leswi swi fanele ku langutiwa hi ku kamba ku kula ka vuxirho loku voniweke hi Xikimi eka nkarhi lowu nga hundza.

Ku kala ka ndzinganiso wa nhlayo ya vahlayisiwa lava nga na mavabyi ya CDL swi languteriwile ntsena loko Xikimi xa ha ya emahlweni xi ri na nhlayo ya le henhla ya vuxirho. Kambe nkucetelo lowu ta hunguteka nh’weti yin’wana na yin’wana loko vahlayisiwa vantshwa va vumba xiphemu xitsongo xa nhlayo ya swirho swa Xikimi.

Nkucetelo wa REF eka GEMS wu kambisisiwile hi vukheta hi Huvo ya Tithirasiti eka 2009 naswona ku tihlanganisiwile na vanhu vo karhi lava khumbekaka. Nkucetelo wa swa timali wu kamberiwa kotara yin’wana na yin’wana naswona ku ta tekiwa magoza yo kambela matirhiselo ya switiratheji ya bindzu leswi nga na nkucetelo wa REF eka GEMS.

4.9 Malawulelo ya swivilelo

Xikimi xi langutana na swivilelo swa swirho hinkwaswo. Huvo ya Tithirasiti yi kambela timhaka ta vukorhokeri na swivilelo leswi humaka eka swirho naswona Mufambisinkulu u hlela swivilelo hinkwaswo ku kuma swivangelo swa swona na tindlela to ololoxa swiphiqo leswi hi ku tirhisa matirhelo ya bindzu leri.

Ku na adirese ya imeyili leyi nga tirhisiwaka ku rhumela swivilelo swa swirho eka Xikimi. Swivilelo swa ku tsariwa naswona swi nga rhumeriwa hi ku tirhisa adirese ya imeyili leyi. Swivilelo hinkwaswo swi kamberiwa hi Xikimi ku vona leswaku swi amukeriwa kahle no kuma switshunxo swa swona.

Mpimo wa Xikimi wa swivilelo ku ya hi nhlayo ya swirho leswi tsarisiweke wu vile ehansi ka 0.10% eka lembe leri kambisisiwaka hilaha swi kombiwaka hakona laha hansi.

450,000

400,000

350,000

300,000

250,000

200,000

150,000

100,000

50,000

Sun

06

Nye

n 06

Nye

ny 0

6D

zi 0

6M

udy

06K

hot 0

6M

aw 0

6M

ha 0

6N

dzh

06

Hla

n 06

Huk

06

N’w

e 06

Sun

07

Nye

n 07

Nye

ny 0

7D

zi 0

7M

udy

07K

hot 0

7M

aw 0

7M

ha 0

7N

dzh

07

Hla

n 07

Huk

07

N’w

e 07

Sun

08

Nye

n 08

Nye

ny 0

8D

zi 0

8M

udy

08K

hot 0

8M

aw 0

8M

ha 0

8N

dzh

08

Hla

n 08

Huk

08

N’w

e 08

Sun

09

Nye

n 09

Nye

ny 0

9D

zi 0

9M

udy

09K

hot 0

9M

aw 0

9M

ha 0

9N

dzh

09

Hla

n 09

Huk

09

N’w

e 09

Mintsariso Swivilelo swa Swirho

0.30%

0.25%

0.20%

0.15%

0.10%

0.05%

0.00%

-0.05%

Swirho leswi Tsarisiweke na Swivilelo

Vuxi

rho

Phe

sent

e

47

Lexi tsakisaka hileswaku mpimo wa swivilelo wu yile ehansi eku heleni ka 2009 hambileswi nhlayo ya swirho a yi engeteleleka.

Ku engeteleka ka swivilelo swa swirho hi Nyenyenyani na Nyenyankulu swi vangiwile hi swilo swo tala, xin’wana ku ri leswaku swivutiso swin’wana na swin’wana a swi rhumeriwa hi ndlela yo hoxeka eka maendlelo ya swivilelo. Malulamiselo ya swivilelo ya antswisiwile ku suka 16 Nyenyankulu 2009. Xin’wana xivangelo xa nhlayo ya le henhla ya swivilelo i malawulelo ya tihakelo mayelana na sapusidi ya muthori na ku yimisiwa ka mimbuyelo ya swirho. Ku tirhisiwile kungu ro lulamisa leri katsake magoza ya mbulavurisano na swirho naswona leswi swi vangile matirhelo yo antswa ku suka hi Dzivamusoko.

Lexi vangeke leswaku nhlayo ya swivilelo yi engeteleleka hi Ndzhati 2009 i mhaka ya ku engeteleleka ka swikombelo swintshwa na ku va ku nga kumiwangiki makhadi ya vuxirho. Masiku ya ku rhumeriwa ka makhadi mantshwa eka swirho ma fambelana na ku khira ka ntirho hi vatirhi va South African Post Office (SAPO). Nhlayo ya le henhla ya swivilelo swa mimbuyelo yi vangiwile hi ku hela ka mpimo wa mimbuyelo eku heleni ka lembe.

Nhlayo-xidzi ya swivilelo hi ku landza swiyenge swa vukorhokeri eka kotara yin’wana na yin’wana ya 2009 yi kombisiwile eka tafula leri nga laha hansi.

4.10 Mbuyelo wa matirhelo

Mbuyelo wa Xikimi wu kombisiwile eka switatimende swa swa timali naswona Titherasiti titshemba leswaku a ka ha laveki nhlamuselo yin’wana.

4.11 Mpimo wa ku wa ka bindzu

2009

R2008

RNtsengo wa mali ya swirho hi xitatimende xa xiyimo xa swa timali 986,269,453 722,979,746

Tihakelo ya giroso 8,898,964,033 5,599,264,873

Mpimo wa ku wa ka bindzu 11.08% 12.91%

Mpimo wa ku wa ka bindzu eku heleni ka N’wendzamhala i 11.08% naswona wu le hansi lowu lavekaka wa ku wa ka bindzu wa 11.93% hi 31 N’wendzamhala 2009 lowu nyikiweke GEMS hi Huvo ya Swikimi swa Swa Rihanyo. Swin’wana swa swivangelo swa ku va tirhizevhe ti ri ehansi ka leti languteriweke ta 0.85% hi leswi landzelaka:

200

180

160

140

120

100

80

6

40

20

0

Q1

Q2

Q3

Q4

Maendlelo ya Vukorhokeri bya Swivilelo

Nhl

ayo

ya s

wiv

ilelo

Tihakelo

Vuxirho

Mimbuyelo

Swikoxo

MHRS

Medipost

Prime Cure

Webusayiti

Friends of Gems

Vukorhokeri bya Swirho

Pinnacle

Thuso

Qualsa

Geneal

Ex gratia

Medcor

5

48 Bringing health within your reach

• Ntlakuso wa tihakelo ta SEP na NHRPL lowu simekiweke exikarhi ka lembe a wu ri ehenla ka lowu a wu languteriwile hi eka mpimanyeto wa 2009 leswi hunguteke mpimo wa tirhizevhe hi 0,89%;

• Ku hambana ka le henhla loku a ku nga languteriwangi ka mix ya swirho ku ya hi mbuyelo wun’wana na wun’wana, demogirafiki na vahlayisiwa;

• Tihakelo ta swilo swo ka swi nga ri swa rihanyo a ti ri ehenhla ku tlula leti a ti languteiwile; • Tihakelo ta swikoxo ti vile ehenhla hi 7% ku tlula leti a ti languteriwile; naswona• Swa tikomba leswaku malembe ya swirho ya le henhla.

Xikimi xi ya emahlweni xi karhi xi kula naswona ku tekiwile magoza ku vona leswaku tirhizevhe leti lavekaka ta kumeka eka malembe lama taka na leswaku ku fikeleriwa 25% hi 2011. Swa tsakisa ku va ku ri na ku kula ka mitsengo leyi hlengeletiweke ya mamiliyoni ya R986 ku suka eka mamiliyoni ya R723.

4.12 Tiakhawunti ta rhizevhe

Mafambafambelo ta tirhizevhe ya kombisiwile eka Xitatimende xo Cinca eka Nkwama na Tirhizevhe. ku hava mafambafambelo yo ka ya nga ri ya ntolovelo lama Tithirasiti ti ehleketaka leswaku ya nga tivisiwa swirho swa Xikimi.

4.13 Mitlawa ya vathori leyi hlwelaka ku hakela

Hi ku landza Xinawana xa 13.2 xa Swinawana swa Xikimi xa GEMS na Xiyenge xa 26(7) xa Nawu wa Swikimi swa Swa Rihanyo, tihakelo ta swirho ti fanele ku kumiwa nhweti yin’wana na yin’wana ti salele endzhaku naswona ti fanele ku hakeriwa ku nga se hundza siku ra vunharhu ra nhweti yin’wana na yin’wana. Hi nkarhi lowu kambisisiwaka, vathori van’wan va hakerile tihakelo ta vona ta swirho swa vona endzhaku ka siku ta vunharhu ra nhweti. Vulawuri bya Xikimi byi tihlanganisile na mitlwa ya vathori leyi khumbekaka ku kuma swivangelo swa ku hlwela ku hakela mali na ku kombisa khombo leri leswi swi ri vangaka eka swirho swa Xikimi. Oditara - Jenerali u tivisiwile hi mitlawa ya vathori lava hlweleka ku rhumela tihakelo ta vona.

4.14 Swikoxo leswi nga se hakeriwaka

Masungulo ya makhalikhuletelo na mafambafambelo ya miphakelo ya swikoxo swi kombisiwile eka Noti ya 8 ya switatimende swa swa timali swa lembe na lembe. Mafambafambelo lama a ya nga ri ya ntolovelo naswona Tithirasiti ti tshemba leswaku leswi swi fanele ku tivisiwa swirho swa Xikimi.

5. VUKORHOKERI BYA AKICHWARI

Deloitte Actuarial and Insurance Solutions yi thoriwile tani hi tiakuchwari ta Xikimi ku suka 1 Khotavuxika 2007. Ku thoriwa ka Deloitte a ku landzela maendlelo yo thendara lama antswisiweke hi ku landza Tipholisi taku Thendara ta ta Swa Timali ta Xikimi. Kontraka ya Deloitte Actuarial and Insurance Solutions yi herisiwile hi Nhlangulo 2009.

Khamphani ya Health Monitor yi thoriwile ku endla mitirho ya Xikimi ya akichwari hi 2010 naswona yi nyikile Xikimi mphakelo wa IBNR hi 31 N’wendzamhala 2009.

6. MIMBEKISO YA VATHORI LAVA NGHENELEKE VA SWIRHO SWA XIKIMI XA SWA RIHANYO

Xikimi a xi na mimbekiso ya vathori lava nga eka Xikimi.

7. KOMITI YO ODITA

Komiti yo Odita yi haverisiwile matimba hi Huvo ya Tithirasiti hi ndlela yo tsala (Chata ya Komiti yo Odita) mayelana na vuxirho bya yona, matimba na mitirho. Komiti yi na swirho swa tsevu laha swimbirhi swi nga swirho swa Huvo ya Tithirasiti. Swirho swo tala swa yona, ku katsa na Mutshamaxitulu, a hi Vaofisiri va Xikimi kumbe va vaphakeri va vukorhokeri. Un’wana wa swirho leswi tiyimeleke a a ri thirasiti.

Komiti yi hlanganile mikarhi ya tsevu hi 2009 hi tindlela leti landzelaka:• 22 Sunguti 2009• 10 Nyenyankulu 2009• 9 Dzivamusoko 2009

49

• 23 Mawuwani 2009• 5 Hukuri 2009

Mufambisinkulu, Huvo: Timali ta Xikimi, Mininjhere wa swa Timali wa Vulawuri, Tioditara ta le ndzeni ta Xikimi na Tioditara ta le handle, va nghenela tinhlengeletano leti loko va rhambiwile naswona va tihlanganisa na Mutshamaxitulu na Komiti yo Odita.

Swirho swa komiti hi leswi landzelaka:• Dr T Geldenhuys (Thirasiti)• Ms S Hari (Xirho xa Komiti xo Tiyimela)• Tatana C Senoamadi (Xirho xa Komiti xo Tiyimela)• Ms G Spelman (Xirho xa Komiti xo Tiyimela)• Dr DP van der Nest (Mutshamaxitulu)• Ms V Vumendlini-Schalk (Thirasiti)

Hi ku landza swipimelo swa Nawu, vutihlamuleri-xidzi bya Komiti yo Odita i ku pfuna Huvo ya Tithirasiti ku tirha mitirho ya yona hi ku landza tipholisi ta matirhelo ta Xikimi, tisisiteme ta malawulelo ta le ndzeni, na mavikelo ya swa timali na malawulelo ya makhombo. Komiti yo Odita yi tirhile mitirho ya yona hi ku leteriwa hi Chata yo Odita hi 2009. Tioditara ta le handle na Tioditara ta le ndzeni ti nyika xiviko xa ximfumo eka Komiti mayelana na mimbuyelo ya migingiriko yo odita.

8. TIKOMITI TIN’WANA TA HUVO YA TITHIRASITI

Tikomiti leti longoloxiweke laha hansi ti haverisiwile matimba hi Huvo ya Tithirasiti hi ndlela yo tsala mayelana na vuxirho bya tona, matimba na mitirho. Tikomiti leti ti hlangana kotara yin’wana na yin’wana hilaha swi kombisiweke hakona eka kungu ra lembe leri pasisiwaka lembe na lembe. Tinhlengeletano ta komiti ti ngheneriwa hi Tithirasiti, Vulawuri bya Xikimi na switivi swin’wana, leswi nga ri ki Swirho swa Tikomiti leti, ku tisa switsundzuxo. Matafula lama nga eka tipheji ta 49 na 50 ya kombisa manghenelo ya tinhlengeletano ya Tikomiti to hambana.

8.1 Komiti ya Matirhelo

Xikongomelonkulu xa Komiti i ku pfuna Huvo ya Tithirasiti ku vona leswaku Xikimi xi tirha kahle hi ku valanga, ku hlela na ku kambisisa matirhelo hinkwawo ya bindzu ra Xikimi. Hi ndlela yaleyo, Xikimi xi pfuna Huvo ya Tithirasiti ku vona leswaku ku na ntirhisano exikarhi ka vaphakeri va vukorhokeri vo hambana hi ku fikelela swikongomelo swa matirhelo ya Xikimi. Komiti yi tlhela yi pfuna Huvo ku kula ka vuxirho bya Xikimi na ku lawula timhaka ta migingiriko na ya vutihlanganisi.

Komiti yi hlanganile hi: • 26 Nyenyenyani 2009• 21 Mudyaxihi 2009• 27 Mhawuri 2009• 20 Hukuri 2009

Swirho swa Komiti ku fikela 31 N’wendzamhala 2009 a ku ri:• Ms T Baloyi (Thirasiti)• Dr T Geldenhuys (Mutshamaxitulu na Thirasiti)• Ms S Moodley (Thirasiti)• Tatana A Van Wyk (Thirasiti)• Dr E Watson (Mufambisinkulu)

8.2 Komiti ya Ex Gratia

Vutihlamulerinkulu bya Komiti leyi i ku hlela, ku teka swiboho na ku vika mayelana na mpfumelelo wa tihakelo ta ex gratia ta swirho swa Xikimi. Komiti yi haverisiwile matimba yo pfumelela tihakelo ta ex gratia ntsena loko vuvabyi na ku hlwela therapi swi nga koxa vutomi; matshunguleloya nga antswisa nkoka wa vutomi wa mukomberi; matshungulelo ya fanerile hi xitlilinikhali naswona ya landzelela milawu ya matshungulelo ya matiko ya tinxakanxaka; naswona mukomberi u kombisa ku hluleka ku kuma vutshunguri bya muxaka wun’wana.

5

50 Bringing health within your reach

Komiti yi hlanganile hi: • 20 Sunguti 2009• 18 Nyenyenyani 2009• 12 Nyenyankulu 2009• 15 Dzivamusoko 2009• 15 Mudyaxihi 2009• 18 Khotavuxika 2009• 15 Mawuwana 2009• 13 Mhawuri 2009• 15 - 16 Ndzhati 2009• 14 - 15 Nhlangula 2009• 16 - 17 Hukuri 2009• 15 N’wendzamhala 2009

Swirho swa Komiti swi hlanganile ku fika 31 N’wendzamhala 2009 hi ndlela leyi:• Tatana M Brand (Thirasiti) • Dr A Ferreira (Thirasiti) • Dr P Mokwatlo (Xirho xa Komiti xo Tiyimela)• Ms S Moodley (Thirasiti)• Dr E Watson (Mutshamaxitulu na Mufambisinkulu)

8.3 Komiti ya Mafumelo, Makhombo na Vatirhikulorhi

Komiti yi haverisiwile matimba hi Huvo ya Tithirasiti ku vona leswaku ku na mafumelo lamanene hi ku kombisa vukamberi, makambelelo na ku pfuxetiwa ka swiyenge hinkwaswo swa sitirathejiki, swa mafumelo na malandzelelo ya bindzu ra Xikimi. Vutihlamuleri bya Komiti swi katsa ku landzelerisa Nawu wa Swikimi swa Swa Rihanyo na Swinawana; milawu ya matirhelo; na swivumbeko swa milawu yin’wana ya bindzu ra Xikimi. Komiti nakambe yi haverisiwile matimba ku vona leswaku ku na tindlela ta malawulelo ya makhombo na na ntirhisano na vangu lava khumbekaka.

Komiti yi hlanganile hi: • 19 Nyenyenyani 2009• 7 Mudyaxihi 2009• 22 Mawuwana 2009• 26 Hukuri 2009

Swirho swa Komiti swi hlanganile ku fikela 31 N’wendzamhala 2009 hi ndlela leyi:• Ms JC Brink (Thirasiti) • Ms K Kgang (Thirasiti) • Tatana V Mbethe (Mutshamaxitulu na Thirasiti)• Tatana A Schoeman (Thirasiti) • Dr E Watson (Mufambisinkulu)

8.4 Komiti ya Vulamuri

Xikongomelonkulu xa Komiti leyi i ku languta na ku kambisisa swivilelo leswi tisiweke hi Mufambisinkulu eka Komiti ya Vulamuri ku ahlula no tsundzuxa Huvo ya Tithirasiti mayelana na maahlulelo ya swivilelo hi ku angarha.

Komiti ya Vulamuri yi hlanganile hi:• 12 Nyenyenyani 2009 Ku hava swivilelo leswi amukeriweke hi Komiti hi 2009.

51

Swirho swa Komiti swi hlanganile ku fikela 31 N’wendzamhala 2009 hi ndlela leyi:• Tatana F Dingiswayo (Xirho xa Komiti xo Tiyimela) • Dr NC Matsiliza (Xirho xa Komiti xo Tiyimela) • Advocate B Mkhize (Xirho xa Komiti xo Tiyimela)

9. TIMHAKA TA KU NGA LANDZELERI

Ku kumekile timhaka leti landzelaka exikarhi ka lembe-ximali leri mayelana na ku tsandzeka ku landzelela Nawu: • Mbuyelo wa Onyx wa Xikimi a wu fikelelangi swilaveko swo tiyimela hawoxe mayelana na Xiyenge xa 33 xa Nawu kambe Huvo ya

Swikimi swa Swa Rihanyo yi tivisiwile lembe hinkwaro mayelana na matirhelo ya swa timali ta Xikimi na ya mbuyelo lowu. Rhejisitarara u pasisile kungu ra bindzu ra mbuyelo lowu leswaku wu tiyimela eka theme ya le xikarhi. Rhejisitarara u tlhele a tsarisa mbuyelo lowu eka 2010.

• Mpimo wa ku wa ka Xikimi a wu fikelelangi swipimelo swa Xinawana xa 29(3). Xikimi xi kurile hi ndlela leyi hlamarisaka hi nkarhi lowu kambisisiwaka naswona leswi swi cincile mpimo wa ku wa ka bindzu ra Xikimi. Mpimo wa ku wa ka bindzu ka 11.08% hi 31 N’wendzamhala 2009 wu le hansi ka mpimo wa 11.93% lowu pasisiweke hi Rhejisitarara hi 2007 endzhaku ka ku pasisiwa ka kungu ra bindzu leri rhumeriweke hi Xikimi eka Huvo ya Swikimi swa Swa Rihanyo. Xikimi xi tivisile hi mipimo ya rhizevhe na swivangelo swo hambana eka Huvo ya Swikimi swa Swa Rihanyo hi ku landza Xiyenge xa 29 (4) xa Nawu wa Swikimi swa Swa Rihanyo.

10. TIHAKELO TA TITHIRASITI NA MATIRHELO MAN’WANA NA MAN’WANA

Tihakelo ta Tithirasiti leti kombisaka manghenelo ya tinhlengeletano, swofamba na vutshamo, na ndzetelo ti kombisiwile eka noti ya 14 ya Switatimendze swa Swa Timali. Tihakelo swi vula mali leyi hakeriwaka Tithirasiti loko ti ta eka tinhlengeletano ta Huvo ya Tithirasiti na Tikomiti ta Huvo. Tithirasiti ti nga ha hakeriwa hikwalaho ka mali leyi tirhisiweke eka swofamba na ntirho lowu endliweke ku fikelela vutihlamuleri bya tona tani hi Tithirasiti ta Xikimi. Xikimi xi endlile mbalango wa tihakelo wo tiyimela woxe ku kuma tihakelo leti hakeriwaka Tithirasiti na ntokoto wa tithirasiti na swirho swa Komiti swo tiyimela swoxe.

Matirhelo man’wana na man’wana ya kongomisa eka tihakelo ta giroso na swikoxo leswi endliweke hi Huvo ya Tithirasiti, Mufambisinkulu na na xipano xa Huvo swi kombisiwile eka noti ya 22 ya switatimendze swa swa timali.

11. MANGHENELO YA TINHLENGELETANO TA TITHIRASITI

Xedyulu leyi landzelaka yi kombisa manghenelo ya tinhlengeletano hi Huvo ya Tithirasiti eka lembe leri kambisisiwaka:

Tinhlengeletano

ta HuvoTinhlengeletano ta

Komiti yo Odita

Tinhlengeletano ta Komiti ya Matirhelo

Tinhlengeletano ta Komiti ya Ex-gratia

Tinhlengeletano ta Komiti ya Mafumele,

makhombo na vatirhikulorhi

Thirasiti A B A B A B A B A BMs T Baloyi 7 7 4 4Mr M Brand 7 7 12 12Ms JC Brink 7 7 4 2Dr A Ferreira 7 6 12 12Dr T Geldenhuys 7 5 5 4 4 3Ms K Kgang 7 7 4 4Prof R Levin 7 5Mr V Mbethe 7 4 4 4Ms S Moodley 7 3 4 1 12 7Mr A Schoeman 7 5 4 4Mr A Van Wyk 7 7 4 4Ms V Vumendlini-Schalk 7 7 5 5

Manghenelo ya tinhlengeletano ya swirho leswi nga ri ki TithirasitiDr D P van der Nest 7 7 5 5 Dr E Watson 7 7 5 5 4 4 12 12 4 4

A - Ntsengo wa tinhlengeletano leti a ti fanele ti ngheneriwileB - Nhlayo ya tinhlengeletano leti ngheneriweke

5

52 Bringing health within your reach

12. MANGHENELO YA TINHLENGELETANO TA TIKOMITI

Xedyulu leyi landzelaka yi kombisa manghenelo ya tinhlengeletano hi swirho swa Komiti swo Tiyimela na Mufambisinkulu.

Tinhlengeletano

ta Komiti yo Odita

Tinhlengeletano ta Komiti ya

Matirhelo

Tinhlengeletano ta Komiti ya Ex-

gratia

Tinhlengeletano ta Komiti ya Mafumele,

makhombo na vatirhikulorhi

Tinhlengeletano ta komiti ya

vulamuri

Swirho swa Komitintsongo A B A B A B A B A B

Mr F Dingiswayo 1 1Ms S Hari 5 5Dr N Matshiliza 1 1Adv B Mkhize 1 1Dr P Mokwatlo 12 12Mr C Senoamadi 5 5Ms G Spelman 5 5Dr DP van der Nest 5 5Dr E Watson 5 5 4 4 12 12 4 4 1 1

A - Ntsengo wa tinhlengeletano leti a ti fanele ti ngheneriwileB - Nhlayo ya tinhlengeletano leti ngheneriweke

5

Huvo ya Tithirasiti ta GEMSKusukaeximatsinikuyaexineneni:Prof.R.Levin,Ms.K.Kgang,Tat.A.Schoeman,Ms.J.C.Brink,Dr.A.Ferreira,

Ms.S.Moodley,Dr.T.Geldenhuys,Ms.T.Baloyi,Tat.A.vanWyk,Ms.V.Vumendlini-Schalk,Tat.M.Brand

53

Xitatimende xa Vutihlamuleri bya Huvo ya Tithirasiti 6

Tithirasiti ti na vutihlamuleri byo lulamisa, ntiyiso na maandlalelo ya Switatimende swa Swa Timali swa Xikimi xa Swa Rihanyo swa Xikimi xa Swa Rihanyu xa Vatirhelamfumo. Switatimende swa Swa Timali leswi kombisiweke eka mapheji ya 57 ku fika eka 70 swi lulamisiwile hi ku landza Switandati swa Mavikelo swa Swa Timali swa Tinxakanxaka (IFRS) naswona swi katsa mavonelo na mikumbetelo ya vulawuri.

Tithirasiti ti kambela leswaku loko ku lulamisiwa Switatimende swa Timali swa Lembe na Lembe ku tirhisiwile tipholisi ta tinkota leti nga fanela, ti tirhisiwa ku fana mikarhi hinkwayo na ku seketeriwa hi maavanyiselo ya vutlhari no twala na mipimanyeto.

Tithirasiti ta enetiwa leswaku mahungu lama nga eka Switatimende swa Timali swa Lembe na Lembe ya humesela erivaleni kahle mbuyelo wa matirhelo ya lembe na xiyimo xa swa timali xa Xikimi eku heleni ka lembe. Tithirasiti ti lulamisile na mahungu man’wana lama a ma katsa xiviko xa lembe na lembe naswona ti vona leswaku xi tiyile no fambelana na Switatimende swa Swa Timali. Tithirasiti ti na vutihlamuleri byo vona leswaku tirhekhodo ta tinkota ta hlayisiwa. Tirhekhodo ta tinkota ti kombisa ntiyiso wa xiyimo xa swa timali swa Xikimi leswi pfunaka Huvo ya Tithirasiti ku vona leswaku Switatimende swa Swa Timali swa Lembe na Lembe swi fambelana na milawu leyi nga vekiwa.

Xikimi xa Swa Rihanyo xa Vatirhelamfumo xi tirhile eka mbango wa kahle lowu lawuriwaka, lowu tsariweke naswona wu pfuxetiwaka nkarhi na nkarhi. Leswi swi katsa malawulelo ya makhombo na maendlelo ya malawulelo ya le ndzeni, leswi endliweke hi xikongomelo xo kongomisa, hambiloko swi nga hetisiwangi, ntshembo wa leswaku tiasete ti hlayisekile na leswaku makhombo lama nga kongoma bindzu ya lawuleka.

Xivilelo xo ya emahlweni xi tekeriwile enhlokweni loko ku lulamisiwa Switatimende swa Swa Timali swa Lembe na Lembe. Tithirasiti ti hava xivangelo xo tshemba leswaku Xikimi xi nge vi na xivilelo xo ya emahlweni eka nkarhi lowu taka, hi ku landza mikumbetelo na switirhisiwa swa timali leswi nga kona. Switatimende swa Swa Timali swa Lembe na Lembe swi kombisa leswaku bindzu ra Xikimi ri tiyile ku fika kwihi.

Tioditara ta Le Handle ta Xikimi, SizweNtsaluba VSP ti na vutihlamuleri byo odita Switatimendze swa Swa Timali hi ku landza Switandadi swa Tinxakanxaka swo Odita naswona xiviko xa vona xi kombisiwile eka pheji ya 56.

Switatimendze swa Swa Tiamli swi pasisiwile hi Huvo ya Tithirasiti hi 29 Dzivamusoko 2010 no sayiniwa hi ku yimela tona:

..................................................Prof. R. LevinMutshamaxitulu

..................................................Ms. V. Vumendlini-SchalkMuseketeri wa Mutshamaxitulu

..................................................Dr. E. WatsonMufambisinkulu

29 Dzivamusoko 2010

54 Bringing health within your reach

Xitatimindhe xa Mafumelo Lamanene hi Huvo ya Tithirasiti

Xikimi xa Swa Rihanyo xa Vatirhelamfumo yi tiyimiserile eka timhaka ta vululami, ntiyiso, ku tshembeka na vutihlamuleri eka vutihlanganisi hinkwabyo na vanhu lava khumbekaka. Tsevu wa Tithirasiti leti tirheke ku suka hi 2007 ti thoriwile hi Holobye wa Vukorhokeri bya Tiko na Vulawuri kasi Tithirasiti ta tsevu letin’wana ti hlawuriwile hi swirho.

HUVO YA TITHIRASITI

Tithirasiti ti hlangana nkarhi na nkarhi ku kambela matirhelo ya Vafambisi. Ti langutisa na timhaka tin’wana ta nkoka no vona leswaku mimbulavulo ya timhaka ta pholisi, switiratheji na matirhelo yi na nkoka no kongoma.

Tithirasiti hinkwato ti kuma switsundzuxo na vukorhokeri bya Mufambisinkulu, naswona, laha swi kotekaka, ti nga kuma switsundzuxo swa phurofexinali eka munhu wa le tlhelo hi tihakelo ta Xikimi.

MALAWULELO YA LE NDZENI

Vafambisi va vulawuri bya le ndzeni bya Xikimi na tisisiteme leti tumbuluxiweke ku vona leswaku switatimendze swa swa timali swi na ntiyiso na ku hlayisa, ku tiyisisa na ku va na vutihlamuleri eka timhaka ta tiasete. Malawulelo lama ma simekiwile ehanhla ka tipholisi leti tumbuluxiweke na matirhelo lama tirhisiwaka hi vatirhi lava leteriweke lava kotaku ku hambanyisa mitirho.

Ku hava mhaka leyi kombiseke Huvo ya Tithirasiti leswaku malawulelo na tisisiteme ta le ndzeni a swi pfa swi nga tirhi kahle eka lembe leri kambisisiwaka.

..................................................Prof. R. LevinMutshamaxitulu

..................................................Ms. V. Vumendlini-SchalkMuseketeri wa Mutshamaxitulu

..................................................Dr. E. WatsonMufambisinkulu

29 Dzivamusoko 2010

7

55

Xiviko xa Komiti yo Odita

Hi titwa hi tsakile ku andlala xiviko xa hina xa timali xa lembe leri helaka hi 31 N‘wendzamhala 2009. Komiti yo Odita yi languteriwile ku landzelela switandati swa le henhla swa mafumelo ya vutihlamuleri, ku vona ku hlawuleka ka tindlela ta mavikelo ya swa timali, tisisiteme ta vulawuri na malawulelo ya makhombo, na ku vona leswaku xiyimo xa malawulelo ya timhaka to odita ta le ndzeni xi le henhla.

VUTIHLAMULERI BYA KOMITI YO ODITA

Komiti yi tiyisisa leswaku yi na kungu ra ximfumo ra matirhelo leri nga Chata ya Komiti yo Odita, leyi pasisiweke hi Huvo ya Tithirasiti. Komiti yi tirhisa milawu yo karhi ku landzelela Chata leyi, naswona mitirho ya yona yi lawuriwa hi Chata leyi. Chata yi pfuxetiwile no antswisiwa exikarhi ka lembe leri kambisisiwaka.

KU HLERIWA KA SWITATIMENDE SWA SWA TIMALI NA XIVIKO XA ODITARA

Komiti yi kambisisile no bula na Oditara na vulawuri mayelana na Switatimende swa Swa Timali swa Lembe na Lembe leswaku swi katsiwa eka Xiviko xa Lembe na Lembe. Swi na nkoka ku tiva leswaku Xikimi xi kumile xiviko xa oditi xo ka xi nga khwalifayiwangi eka malembe ya mune hi ku landzelelana. Komiti yo odita yi na vonele ra leswaku tisisiteme ta le ndzeni ta malawulelo ya timali ti kahle, na leswaku Switatimende swa swa Timali swi kombisa kahle migingiriko ya Xikimi eka lembe-ximali leri nga hundza.

KU LAWULA KA LE NDZENI NA MBANGU WA MAKHOMBO

Xikimi xi antswisile mahlelelo ya xona ya makhombo eka lembe-ximali leri na ku lawula makhombo lama Xikimi a xi ta hlangana na wona. Komiti yo odita yi kumile swiviko swa le ndzeni swo odita nkarhi na nkarhi leswi a swi tiyisisa leswaku tisisiteme ta malawulelo ya le ndzeni ya Xikimi ma kahle.

MAHETELELO

Komiti yo Odita yi lava ku hoyozela Mufambisinkulu, Huvo, xipano xa swa Timali na vulawuri eka ku landzelela hi mikarhi hinkwayo tindlela ta mafumelo lamanene ya Xikimi, no kuma xiviko xo odita xo ka xi nga khwalifayiwangi eka lembe leri kambisisiwaka. Komiti yi rhandza ku khensa na Huvo ya Tithirasiti eka nseketelo wa yona na swipano swo odita swa le ndzeni na le handle eka matirhelo ya swona yo hlawuleka.

..................................................Dr D.P. van der Nest

29 Dzivamusoko 2010

8

56 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

Annual Financial Statements

57

10

Annual Financial Statements

Contents

The reports and statements set out below comprise the financial statements presented to members:

Report of the Independent Auditors 58Statement of Financial Position 59Statement of Comprehensive Income 60Statement of Changes in Funds and Reserves 61Statement of Cash Flows 62Notes to the Financial Statements 63 - 72

58 Bringing health within your reach

Report of the Independent Auditors 9

20 Morris Street East, Woodmead, 2146P O Box 2939, Saxonwold, 2132

Tel. +27 86 11 76877, Fax. +27 11 234 0933 www.sizwentsaluba.co.za

To the members of the Government Employees Medical Scheme

The accompanying summary financial statements, which comprise the Summary Statement of Financial Position as at 31 December 2009 the Summary Statement of Comprehensive Income, Summary Statement of Changes in Equity and Summary Cash Flow statement for the year then ended, and related notes, are derived from the audited financial statements of the Government Employees Medical Scheme for the year ended 31 December 2009.

We expressed an unmodified audit opinion on those financial statements in our report dated 30 April 2010. Those financial statements, and the summary financial statements, do not reflect the effects of events that occurred subsequent to the date of our report on those financial statements.

The summary financial statements do not contain all the disclosures required by the International Financial Reporting Standards as applicable to Medical Schemes in South Africa. Reading the summary financial statements, therefore, is not a substitute for reading the audited financial statements of the Government Employees Medical Scheme.

Management’s Responsibility for the Summary Financial StatementsManagement is responsible for the preparation of a summary of the audited financial statements in accordance with Circular 38 of 2007 as issued by the Council for Medical Schemes.

Auditor’s ResponsibilityOur responsibility is to express an opinion on the summary financial statements based on our procedures, which were conducted in accordance with International Standard on Auditing (ISA) 810, “Engagements to Report on Summary Financial Statements.”

OpinionIn our opinion, the summary financial statements derived from the audited financial statements of the Government Employees Medical Scheme for the year ended 31 December 2009 are consistent, in all material respects, with those financial statements, in accordance with Circular 38 of 2007 issued by the Council for Medical Schemes.

SizweNtsaluba VSPPartner: Johann StraussRegistered Auditor30 April 2010

59

Statement of Financial Position as at 31 December 2009

2009 2008Notes R R

ASSETSNon-Current AssetsProperty, plant and equipment 3 1,794,042 1,622,633

Current AssetsTrade and other receivables 4 167,501,032 181,280,176Cash and cash equivalents 5 1,623,510,199 1,051,664,483

1,791,011,231 1,232,944,659Total Assets 1,792,805,273 1,234,567,292

FUNDS AND LIABILITIESMembers’ fundsAccumulated funds 986,269,453 722,979,746

LIABILITIESCurrent LiabilitiesSavings plan liability 6 67,075,704 40,078,786Trade and other payables 7 421,476,166 241,386,159Lease escalation reserve 48,244 439,356Outstanding claims provision 8 317,935,705 229,683,245

806,535,820 511,587,546Total Equity and Liabilities 1,792,805,273 1,234,567,292

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009 10

60 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

Statement of Comprehensive Income

2009 2008Notes R R

Net contribution income 9 8,719,806,997 5,471,780,794Relevant healthcare expenditure (7,946,097,880) (4,686,055,860)

Net claims incurred (7,910,667,278) (4,648,854,919) Claims incurred 10 (7,911,802,415) (4,648,880,985) Third party claim recoveries 1,135,137 26,066Net expense on risk transfer arrangements 11 (35,430,602) (37,200,941) Risk transfer arrangement fees/premiums paid (288,566,046) (195,410,751) Recoveries from risk transfer arrangements 246,884,506 142,797,696 Profit arising from risk transfer arrangements 6,250,938 15,412,114

Gross healthcare result 773,709,117 785,724,934

Less: Managed care - management services 12 (160,975,570) (93,042,670) Administration expenses 13 (384,412,406) (221,678,153) Marketing services (31,955,956) (13,197,225) Net impairment losses on trade and other receivables 15 (15,499,240) (12,197,013)

Net healthcare result 180,865,945 445,609,873

Other income 82,423,762Add: Investment income 16 80,354,481 61,834,409 Other income 2,069,281 1,099,495

Net surplus for the year 263,289,707 508,543,777

Other comprehensive income

Other comprehensive income for the year - -

Total comprehensive surplus for the year 263,289,707 508,543,777

61

10

Statement of Changes in Funds and Reserves

Accumulated funds Total equity

R R

Balance at 01 January 2008 214,435,969 214,435,969 Net surplus for the year 508,543,777 508,543,777

Balance at 01 January 2009 722,979,746 722,979,746 Net surplus for the year 263,289,707 263,289,707

Balance at 31 December 2009 986,269,453 986,269,453

62 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

Statement of Cash Flows

2009 2008Notes R R

Cash flows from operating activities

Cash receipts from members 8,910,709,226 5,527,088,154Cash paid to suppliers and employees (8,418,415,960) (4,922,725,132)

Cash generated from operations 19 492,293,266 604,363,022

Net cash from operating activities 492,293,266 604,363,022

Cash flows from investing activities

Purchase of property, plant and equipment 3 (815,564) (1,283,858)Proceeds on sale of property, plant and equipment 13,533 80,086Investment income 80,354,481 61,834,409

Net cash from investing activities 79,552,450 60,630,637

Total cash movement for the year 571,845,716 664,993,659Cash at the beginning of the year 1,051,664,483 386,670,824

Total cash at end of the year 5 1,623,510,199 1,051,664,483

63

10

1. ACCOUNTING POLICIES

The accounting policies applied by the Scheme were consistent throughout the year under review and these policies were consistent with those used in preparing annual financial statements for the prior years.

2. OUTSTANDING CLAIMS PROVISION

2009 2008Not covered by

risk transfer arrangements

R

Covered by risk transfer arrangement

R

Not covered by risk transfer arrangements

R

Covered by risk transfer arrangement

RProvision for outstanding claims - incurred but not not yet reported 301,100,000 16,835,705 218,429,403 11,253,842

Analysis of movement in outstanding claimsBalance at beginning of year 218,429,403 11,253,842 156,828,881 13,039,895Payments in respect of prior year (218,018,867) (11,253,842) (152,856,427) (13,039,895)Prior year over/(under) provision 410,536 - 3,972,454 -Adjustments for current year 300,689,464 16,835,705 214,456,949 11,253,842

Balance at end of year 301,100,000 16,835,705 218,429,403 11,253,842

Analysis of outstanding claims provisionEstimated gross claims 301,100,000 - 218,429,403 -Outstanding claims provision relating to risk transfer transfer arrangements - 16,835,705 - 11,253,842

Balance at end of year 301,100,000 16,835,705 218,429,403 11,253,842

This provision, known as provision for claims incurred but not reported (IBNR) is determined as accurately as possible on the basis of a number of factors, which includes previous experience in claim patterns, claim settlement patterns, changes in the number of members according to gender and age, trends in claim frequency, changes in the claims processing cycle, and variations in the nature and average cost incurred per claim. The provision is net of estimated recoveries from members for co-payments and for savings plan accounts. A standard operating procedure governing the calculation of the provision as approved by the Scheme is followed by the actuaries to ensure consistency in application and interpretation of results. The Scheme does not discount its provision for outstanding claims since the effect of the time value of money is not considered material.

Each notified claim is assessed on a separate, case by case basis with due regard to the claim circumstances, information available from managed care organisations and historical evidence of the size of similar claims. The provisions are based on information currently available. However, the ultimate liabilities may vary as a result of subsequent developments. The impact of many of the items affecting the ultimate cost of the loss is difficult to estimate. The provision estimation difficulties also differ by category of claims (i.e. in-hospital, out-of-hospital and medication) caused by differences in the underlying insurance contract, claim complexity, the volume of claims, the individual severity of claims, the determination of the occurrence date of a claim, and reporting lags.

Members must submit all claims for payment within four months of seeking medical treatment. The cost of outstanding claims at the reporting date is, in this way estimated with reference to the actual claims submitted within the first three months after the reporting date that relates to the period before the reporting date. The claims to be submitted in the fourth month, relating to the reporting period, are then extrapolated using the bootstrapping method, chain ladder method or the Bornhuetter-Ferguson method.

64 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

2. OUTSTANDING CLAIMS PROVISION (continued)

These methods use historical claims development information and assume that the historical claim development pattern will occur again in the future. There are reasons why this may not be the case, which, if they can be identified, have to be allowed for by modifying the methods.

Such reasons include (but not limited to): - changes in processes that effect the development / recording of claims paid and incurred;- changes in composition of members and their dependents; and- random fluctuations, including the impact of large losses.

The bootstrapping method was preferred as it gives an indication of the range of IBNR reserves at various levels of certainty. It also combines the actual past claims experience and any prior information or expectations that might be available regarding claims. This is particularly important in light of the rapid growth on GEMS in 2009. The IBNR reserve at the 50th percentile using the bootstrap method is deemed to be the best estimate of the IBNR reserve in 2009.

3. NET CONTRIBUTION INCOME

2009 2008R R

Gross contributions 8,898,964,033 5,599,264,873 Savings contributions (179,157,036) (127,484,079)

8,719,806,997 5,471,780,794

4. NET EXPENSE ON RISK TRANSFER ARRANGEMENTS

2009 2008R R

Premiums paid 288,566,046 195,410,751 Recoveries received (246,884,506) (142,797,696) Profit share (6,250,938) (15,412,114) Net expense per statement of comprehensive income 35,430,602 37,200,941

5. RELATED PARTIES

Parties with significant influence over the Scheme

The Minister for Public Service and Administration represents the Employer in GEMS, is responsible for appointing 50% of the Board of Trustees and for determining the medical subsidy policy in the public service and thus has significant influence over the Scheme, but does not control it. The Scheme engages with the Department of Public Service and Administration (DPSA) who is responsible for implementing and maintaining the medical subsidy policy. The DPSA therefore has significant influence over the Scheme, but does not control it.

Metropolitan Health Corporate (Pty) Ltd (MHC) provides financial and operational information and recommendations, through its administration agreement with the Scheme, on which policy decisions are based, and therefore it has significant influence over the Scheme, but does not control it.

Medscheme Holdings (Pty) Ltd (MHRS) and Qualsa Healthcare (Pty) Ltd provide managed care information on which benefit design decisions are based and therefore they have significant influence over the Scheme, but do not control it. Netcare 911 (Pty) Ltd and Primecure Health (Pty) Ltd have risk transfer arrangements in place with the Scheme and therefore provide financial and operational information on which policy decisions are based and thus have significant influence over the Scheme, but do not control it.

65

10

5. RELATED PARTIES (continued)

Deloitte Actuarial and Insurance Solutions and The Health Monitor Company provide actuarial and consulting services to the Scheme and therefore they have significant influence over the Scheme, but do not control it.

Key management personnel and their close family members

Key management personnel are those persons having authority and responsibility for planning, directing and controlling the activities of the Scheme. Key management personnel include the Board of Trustees, the Principal Officer and members of the Executive Committee. This disclosure deals with full time personnel that are compensated on a salary basis (Principal Officer and Executive Committee) and part time personnel that are compensated on a fee basis (Board of Trustees). Close family members includes family members of the Board of Trustees, Principal Officer and members of the Executive Committee.

Transactions with related parties

The following table provides the total amount of transactions, which have been entered into with related parties for the relevant financial year.

2009 2008R R

Key management personnel Compensation (includes remuneration and other costs) Principal Officer 3,201,624 2,395,625Executive: Finance 1,183,364 1,156,218Executive: Contracts and Operations 1,072,395 856,566Executive: Communications and Member Affairs 913,056 867,830Executive: Governance and Stakeholder Relations 836,737 782,128Executive: Healthcare Management 1,059,960 -

Contributions and claims Statement of Comprehensive Income Gross contributions received (*) Board of Trustees 290,448 257,380Principal Officer 53,040 42,792Executive Committee 100,120 91,392

Claims incurred (*) Board of Trustees 310,590 219,267Principal Officer 21,460 38,916Executive Committee 63,477 21,759

Increases in salary packages from 2008 to 2009 relate to cost of living adjustments as well as the adjustment to packages after 3 years of service.

(*) Gross contributions and claims incurred include contributions and claims incurred by members and their beneficiaries.

The terms and conditions of the related party transactions were as follows: Transaction Nature of transactions and terms and conditions thereof.Contributions received This constitutes the contributions paid by the related party as a member of the Scheme in their

individual capacity. All contributions were at the same terms as applicable to third parties.Claims incurred This constitutes amounts claimed by the related parties in their individual capacity as members

of the Scheme. All claims were paid out in terms of the rules of the Scheme as applicable to third parties.

Contribution debt This constitutes outstanding contributions payable. The amounts are due immediately. There were no contributions outstanding in respect of related parties at year-end.

66 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

5. RELATED PARTIES (continued)

Parties with significant influence over the Scheme

2009 2008R R

Statement of Comprehensive Income - Administration fees and management fees 305,878,108 179,055,295 - Risk transfer premiums 288,566,046 195,410,751 - Managed care fees 160,975,570 93,042,670 - Actuarial fees 5,424,331 2,208,985

Statement of Financial Position Trade and other receivables: - Profit share on risk transfer arrangements 7,652,030 15,920,951

Trade and other payables: - Administration fees due 28,978,000 17,674,746 - Risk transfer premiums due 6,288,964 3,565,563 - Managed care fees due 15,401,447 9,246,583 - Provision for outstanding claims (risk transfer arrangements) 16,835,705 11,253,842

Terms and conditions of the administration agreement

The administration agreement is aligned to the rules of the Scheme and in accordance with Trustee requirements. The duration of the renewed agreement is three years effective 1 January 2009 renewable annually and will expire 31 December 2011, once expired the Scheme’s normal tendering process will take effect. The Scheme has the right to terminate the agreement on 90 days notice. Administration fees are calculated on an arm’s length basis on the number of members in good standing for the month. The outstanding balance bears no interest and is due within 7 days.

Terms and conditions of the managed care agreements

The Scheme has entered into managed care agreements in order to manage the costs of delivering healthcare services to its members. The services covered by these agreements include hospital pre-authorisation, HIV management and pharmaceutical benefit management and emergency rescue services. These services are offered by Primecure Health (Pty) Ltd whose contract has been terminated for the 2010 financial year, Medscheme Holdings (Pty) Ltd, Qualsa Healthcare (Pty) Ltd and Netcare 911 (Pty) Ltd respectively. The agreements are aligned to the rules of the Scheme and in accordance with Trustee requirements. The duration of the renewed agreement is one year effective 1 January 2009 and will expire 31 December 2009, the contract can be renewed once expired through the Scheme’s normal tendering process. The Scheme has the right to terminate the agreements on 90 days notice. In respect of hospital pre-authorisation and HIV management, managed care fees are calculated based on the number of members in good standing for the month. Managed care fees for pharmaceutical benefit management were calculated on the basis of utilisation of the service for the year under review, however from the 2009 financial year onwards the fees have been calculated per member per month. The outstanding balance bears no interest and is due within 7 days.

Terms and conditions of the risk transfer arrangements

The risk transfer arrangements are in accordance with instructions given by the Trustees of the Scheme. The agreements are reviewed annually and were subsequently renewed until 31 December 2009. The Scheme has the right to terminate the agreements on 90 days notice. The fees are calculated on an arm’s length basis on market related terms and any outstanding balances are payable within 7 days.

67

10

6. FINANCIAL RISK MANAGEMENT

The Scheme’s activities expose it to a variety of financial risks, including the effects in interest rates. The Scheme’s overall risk management programme focuses on the unpredictability of financial markets and seeks to minimize potentially adverse effects on the financial performance of the investments that the Scheme holds to meet its obligation to its members.

Risk management and investment decisions are carried out by the executive committee, under the guidance of and policies approved by the Board of Trustees. The executive committee provides written principles for overall risk management, as well as written policies covering specific areas such as interest rate risk, credit risk, and the use of derivative financial instruments and investing excess liquidity. The Board of Trustees approves all these written policies.

Interest rate risk

The Scheme holds all its investments in interest bearing instruments (cash and cash equivalents), and is therefore fully exposed to changes in the market interest rates.

The average effective interest rates for the year ended 31 December 2009 were as follows:

2009 2008R R

- Current accounts 3.56% 10.06% - Call accounts 8.00% 11.04% - Fixed deposits 8.36% 11.50%

The Scheme’s exposure to interest rate risks at 31 December amounted to:Cash and cash equivalents 1,623,510,199 1,051,664,483

The table below illustrates the impact that the fluctuation in interest rates would have on investment income for the period and the cash and cash equivalent balance. An average of 0.5% interest rate variance has been used based on 2009 inter-est rate changes effected by South African Reserve Bank Monitory Policy.

Scenario Investment income% change

investment incomeCash and cash

equivalents

% change in cash and cash

equivalents

Base scenario 80,354,481 - 1,623,510,199 -

0.5% increase 86,405,270 7.5% 1,629,560,988 0.37%

0.5% decrease 74,303,692 -7.5% 1,617,459,410 -0.37% Currency risk

The Scheme operates in South Africa and its cash flows are denominated in South African Rand. The Scheme therefore does not have a direct currency risk but does have exposure to the risk insofar as technology and services are imported by healthcare providers.

Liquidity risk

Prudent liquidity risk management implies maintaining sufficient cash and marketable securities. The availability of funding through liquid holding cash positions with various financial institutions ensures that the Scheme has the ability to fund its day-to-day operations. The Scheme is relatively young and rapidly growing membership thus in the process of building sufficient reserves. The Scheme’s available funds were invested in cash products to ensure that the Scheme can meet its short term obligations.

68 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

6. FINANCIAL RISK MANAGEMENT (continued)

The table below reflects the Scheme’s liquidity requirements to meet its financial obligations.

CategoryLess than 1

monthR

Between 1 and 3 months

R

Between 3 months and 1

yearR

Over 1 yearR

TotalR

At 31 December 2009Savings accounts 67,075,704 - - - 67,075,704Amounts owing to members and providers 5,539,704 - - - 5,539,704Claims reported not yet paid 358,214,071 - - - 358,214,071Stale cheques 160,864 - - - 160,864Sundry payables and accrued expenses 56,133,857 - - - 56,133,857Unallocated deposits 1,427,672 - - - 1,427,672Outstanding claims provision 213,731,492 92,805,965 10,834,577 563,671 317,935,705

806,487,577Available cash 1,623,510,199Excess liquidity 817,022,622

At 31 December 2008Savings accounts 40,078,786 - - - 40,078,786Amounts owing to members and providers 5,944,470 - - - 5,944,470Claims reported not yet paid 200,148,196 - - - 200,148,196Risk transfer arrangements 3,565,563 - - - 3,565,563Stale cheques 2,359,202 - - - 2,359,202Sundry payables and accrued expenses 28,111,184 - - - 28,111,184Unallocated deposits 1,257,545 - - - 1,257,545Outstanding claims provision 141,894,811 63,252,344 11,382,834 1,899,414 218,429,403

499,894,349Available cash 1,051,664,483Excess liquidity 551,770,134

Credit risk

The Scheme’s credit risk is primarily attributable to accounts receivable. The amounts represented in the Statement of Financial Position are net of allowances for doubtful receivables. An allowance for impairment is made where there is an identified loss event which, based on previous experience, is evidence of a reduction in the recoverability of the cash flows. Cash transactions are limited to high credit quality financial institutions. The Scheme has a policy of limiting the amount of credit exposure to any one financial institution.

ClassFully

performingR

Past dueR

ImpairedR

TotalR

As at 31 December 2009 Contribution debtors 105,934,594 28,922,531 11,749,077 146,606,202Recoveries from members and providers 345,685 3,987,940 269,807 4,603,432As at 31 December 2008 Contribution debtors 138,509,689 9,145,886 6,887,175 154,542,750Recoveries from members and providers 129,478 2,418,115 154,678 2,702,271

69

10

6. FINANCIAL RISK MANAGEMENT (continued)

The table below provides and age analysis of the credit that is past due, but not yet impaired.

Class3-30 days

R30-60-days

R60-90 days

RTotal

RAs at 31 December 2009

Contribution debtors - 20,499,894 8,422,637 28,922,531Recoveries from members and providers - 3,345,449 642,491 3,987,940As at 31 December 2008

Contribution debtors 8,238,356 10,067,841 1,827,259 9,145,886Recoveries from members and providers 704,190 1,194,001 519,924 2,418,115

Management information reported to the Scheme includes details of provisions for impairments on receivables. The table below provides an analysis of receivables that was impaired.

2009 2008R R

Contribution debtors 11,749,077 6,887,175Recoveries from members and providers 269,807 154,678 12,018,884 7,041,853

The amounts represented in the Statement of Financial Position are net of impairment receivables, estimated by the Scheme’s management based on outcomes of recovery processes, prior experience and the current economic environment.

Fair value estimation

The face value less any estimated credit adjustments for financial assets and liabilities with a maturity of less than one year are assumed to approximate their fair values.

Fraud risk

GEMS is committed through policies and actions, in striving towards an environment that safeguards its members, service providers, staff and the Scheme’s assets against the risk of fraud.

GEMS created anti-crime awareness campaigns to members, service providers and other stakeholders, as well as mechanisms that assist in the detection of and formal prosecution of all offenders. As a result of the GEMS fraud forum adjudications, members and providers who were found to be involved in fraudulent activities had their membership or contracts suspended or terminated, and criminal procedures implemented.

Capital adequacy risk Capital adequacy risk is the risk that there may be insufficient reserves to provide for adverse variations in actual future benefit liabilities. In terms of Regulation 29(3)A, a medical Scheme registered for the first time must maintain a solvency level of no less than:

First year of operations 10.00%Second year of operations 13.50%Third year of operations 17.50%Fourth year of operations 22.00%Fifth year of operations 25.00%

The Registrar of Medical Schemes, in terms of the business plan submitted by the Scheme, in 2007 agreed that the following solvency levels will apply to the Scheme for each related year of operation:

31 December 2007 4.86%31 December 2008 6.20%31 December 2009 11.93%31 December 2010 17.89%31 December 2011 25.12%

70 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

6. FINANCIAL RISK MANAGEMENT (continued)

The Scheme monitors and manages the capital adequacy risk through the following means: • The capital adequacy risk is documented on the risk register that is regularly reviewed by the Board of Trustees. • The Scheme’s Executive management reviews the monthly management accounts where the Scheme’s financial

performance is monitored.• Monthly management accounts and the Scheme’s quarterly performance reports are submitted to the Council for Medical

Schemes.• Annual budgeting process, long term projections and planning allows the Scheme to review its capital adequacy and

solvency levels to ensure continuity of operations and sustainability. 7. EVENTS AFTER THE REPORTING PERIOD

Effective 01 January 2010 the Scheme will take over the assets and liabilities of the Medical Scheme for Correctional Services (MEDCOR). MEDCOR’s assets and liabilities were transferred to GEMS from that date, however prior MEDCOR members will follow the normal application process for GEMS membership.

The assets and liabilities of MEDCOR will be transferred after a due diligence exercise has been carried out by GEMS management and the values of the transferred assets and liabilities will be stated on the certificate which is to be submitted to the Council for Medical Schemes in terms of Section 63 (13) of the Medical Schemes Act of 1998.

8. REGULATORY NON COMPLIANCE

Late paying employer groups In terms of Rule 13.2 of GEMS’ Scheme Rules and Section 26(7) of the Medical Scheme’s Act members’ contributions are due monthly in arrears and payable by no later than the third day of each month. During the period under review, certain employer groups paid over contributions on behalf of their members after the third day of the month. Scheme Management engaged with the employer groups concerned to ascertain the reasons for the late payment of contributions and to highlight the impact of this practice on members of the Scheme. The Council for Medical Schemes is informed quarterly of any late payers and the Auditor General is informed annually. Capital adequacy ratio The Scheme’s reserve ratio for July 2009 of 6.07% fell below the 2008 Council approved target of 6.20%. In terms of Section 29(4) of the Medical Schemes Act of 1998, a medical scheme that for a period of 90 days fails to comply with sub-regulations 29(2),(3) or (3A) must notify the regulator of such failure. The reserve ratio improved above 6.20% from August and thus does not qualify as a reportable incident in terms of the Medical Schemes Act.

The Scheme’s solvency level at 31 December 2009 was 11.08% (12.18% in 2008) which compared unfavourably with the solvency level prescribed by the Registrar of Medical Schemes of 11.93%. The Council for Medical Schemes was informed of the Scheme’s solvency level as at 31 December 2009. Onyx option The Scheme’s Onyx option did not meet the self-sufficiency requirement in terms of Section 33(2)(b) of the Medical Schemes Act of 1998, The Council for Medical Schemes was however informed of the option’s performance throughout the year. The Registrar of medical schemes has approved the business plan for the option to become self-sufficient in the medium term and registered the option for 2010.

9. PROFIT OR LOSS ON DISPOSAL OF PROPERTY, PLANT AND EQUIPMENT

2009 2008

R R

Loss on disposal property, plant and equipment 1,703 14,589

The Scheme incurred a loss of R 1,703 (2008: R 14,589) on disposal of property, plant and equipment for the 2009 financial year.

71

1010

. N

ET

HE

ALT

HC

AR

E R

ES

ULT

PE

R B

EN

EFI

T O

PT

ION

SA

PP

HIR

EB

ER

YL

RU

BY

EM

ER

AL

DO

NY

XT

OTA

L20

0920

0820

0920

0820

0920

0820

0920

0820

0920

0820

0920

08R

’000

R’0

00R

’000

R’0

00R

’000

R’0

00R

’000

R’0

00R

’000

R’0

00R

’00

0R

’000

Net

con

trib

utio

n in

com

e22

2,47

413

5,08

015

8,07

810

6,36

453

7,43

538

2,39

8 6

,897

,421

4,10

8,19

5

904,

399

71

9,74

4 8

,719

,807

5

,471

,781

R

elev

ant h

ealth

care

exp

endi

ture

(108

,121

)(6

1,35

2)(1

23,5

54)

(97,

126)

(307

,566

)(2

08,8

31)

(6,3

09,9

36)

(3,5

11,9

42)

(1,0

96,9

21)

(806

,805

) (7

,946

,098

) (4

,686

,056

)

Net

cla

ims

incu

rred

(82,

319)

(38,

025)

(117

,025

)(8

1,23

4)(3

06,2

91)

(208

,573

) (6

,308

,815

) (3,

513,

938)

(1

,096

,218

)

(807

,084

) (7

,910

,668

) (4

,648

,854

)

Cla

ims

incu

rred

(82,

319)

(38,

025)

(117

,025

)(8

1,23

4)(3

06,2

91)

(208

,573

) (6

,308

,815

) (3

,513

,938

) (1

,096

,218

) (8

07,0

84)

(7,9

10,6

68)

(4,6

48,8

54)

Rec

over

ies

from

third

par

ties

--

--

--

-

-

-

-

-

-

Net

exp

ense

on

risk

tran

sfer

ar

rang

emen

ts(2

5,80

2)(2

3,32

7)(6

,529

)(1

5,89

2)(1

,275

)(2

58)

(1

,121

) (1

,996

)

(703

) 27

9

(35,

430)

(3

7,20

2)R

isk

tran

sfer

arr

ange

men

t pr

emiu

ms

paid

(107

,165

)(6

7,88

3)(1

23,0

32)

(102

,262

)(5

,386

)(2

,691

)

(48,

015)

(1

9,84

7)

(4,9

68)

(2,7

28)

(2

88,5

66)

(195

,411

)R

ecov

erie

s fro

m r

isk

tran

sfer

ar

rang

emen

ts74

,762

34,3

2511

6,85

381

,189

4,11

12,

433

46

,894

21

,843

4,

265

3,

007

24

6,88

5

142,

797

Pro

fit a

risin

g fro

m r

isk

tran

sfer

ar

rang

emen

ts6,

601

10,2

31(3

50)

5,18

1-

-

-

-

-

-

6,25

1

15,4

12G

ross

hea

lth

care

res

ult

11

4,35

373

,728

34,5

2429

,238

229,

869

173,

567

58

7,48

5

596,

253

(1

92,5

22)

(8

7,06

1)

773,

709

78

5,72

5

Man

aged

car

e : m

anag

emen

t se

rvic

es

(4,7

89)

(2,1

86)

(4,7

56)

(1,6

41)

(13,

991)

(8,8

74)

(1

24,7

52)

(69,

691)

(1

2,68

7)

(10,

651)

(1

60,9

75)

(93,

043)

Adm

inis

trat

ion

expe

nses

(1

6,69

5)(8

,885

)(9

,933

)(6

,848

)(3

2,76

6)(2

2,05

7)

(292

,195

) (1

62,8

20)

(3

0,17

0)

(22,

458)

(3

81,7

59)

(223

,068

)M

arke

ting

serv

ices

(9

61)

(523

)(5

66)

(402

)(2

,701

)(1

,137

)

(27,

493)

(8

,312

)

(2,8

89)

(1,4

35)

(3

4,61

0)

(11,

809)

91,9

0862

,134

19,2

6920

,347

180,

411

141,

499

14

3,04

5

355,

430

(2

38,2

68)

(1

21,6

05)

19

6,36

5

457,

805

Net

impa

irmen

t los

ses

on tr

ade

and

othe

r re

ceiv

able

s(7

26)

(579

)(5

14)

(438

)(1

,276

)(1

,184

)

(11,

806)

(8

,787

)

(1,2

58)

(1,2

08)

(1

5,50

0)

(12,

196)

Net

hea

lth

care

res

ult

bef

ore

in

vest

men

t in

com

e91

,182

61,5

5518

,835

19,9

0917

9,13

514

0,31

5

131,

239

34

6,64

3

(239

,526

)

(122

,813

)

180,

865

44

5,60

9

Rev

enue

and

exp

endi

ture

is a

lloca

ted

to b

enefi

t opt

ions

on

a di

rect

bas

is w

here

this

is d

eter

min

able

. Whe

re re

venu

e an

d ex

pend

iture

is n

ot d

irect

ly a

ttrib

utab

le to

a s

peci

fic b

enefi

t op

tion,

the

reve

nue

or e

xpen

se is

allo

cate

d on

the

basi

s of

the

bene

fit o

ptio

n’s

mem

bers

hip

prop

ortio

nate

to th

e S

chem

e’s

mem

bers

hip

base

. Inv

estm

ent i

ncom

e is

allo

cate

d on

th

e ba

sis

of th

e be

nefit

opt

ion’

s co

ntrib

utio

n in

com

e pr

opor

tiona

te to

that

of t

he S

chem

e.

72 Bringing health within your reach

Government Employees Medical SchemeAbridgedFinancialStatementsfortheYearended31December2009

11. AUDITED FINANCIAL STATEMENTS

The full audited Annual Financial Statements can be obtained from the Scheme’s registered office, postal address and by email as stated below:Hillcrest Office Parkc/o Lynwood and Dyer RoadHillcrestPretoria0028

Private Bag X1Hatfield0028

[email protected]

73

10

Notes

Contact details: 0860 00 4367 • [email protected] • www.gems.gov.za