GIVEN the prospect of national health insurance (NHI), the medical schemes industry faces an uncertain future. Working out what role SA's 110 schemes will play will be part of the job of the recently appointed CEO and registrar of the Council of Medical Schemes (CMS), Monwabisi Gantsho. Set up to protect the interests of beneficiaries of medical schemes and to co-ordinate the functioning of schemes to complement national health policy, the council also monitors the solvency and financial soundness of schemes. Schemes are facing increasing pressure to expand access beyond their current 8 million members, and medical costs are increasing, so Gantsho's job will be a balancing act between maintaining a healthy medical schemes industry and protecting members. He brings rich experience in the public and private healthcare sector to his new role. A medical doctor, Gantsho was most recently head of the private practice and economics research unit at the SA Medical Association (Sama). His advocacy role at Sama will serve him well in his new position - he must work with both government and private healthcare providers as the new health system is ushered in. Gantsho is also deputy chairman of the medical tourism steering committee at the department of tourism and a member of the quality improvement & accreditation sub-committee on the NHI. After graduating from the University of Natal, Gantsho worked as a medical officer at Livingstone Hospital in Port Elizabeth in the 1980s. Later, he managed a private practice in Motherwell, where he also served as a community health practitioner. He was then appointed a city councillor in Port Elizabeth for two years and served as executive chairman of Eastern Cape Medical Business Systems and the Eastern Cape Independent Practitioners' Association. Gantsho replaces Patrick Masobe, who served as registrar at the CMS for nine years. Masobe took on Discovery Health over its reinsurance contracts and faced opposition over rules that prevented schemes from risk-rating new members. The relationship between the industry and the CMS these days is more cordial, though Gantsho will have to be tough with schemes that do not comply with governance standards. The recent curatorship application involving Bonitas shows a vigilant watchdog is still needed. Gantsho brings an understanding of the challenges that face medical professionals, providers and funders. That will be valuable to the medical schemes industry, which must chart a new path in the years ahead.

Jacqui Pile: The Financial Mail,