Nasiphi Ndevu spoke to the Chief Operations Officer of the Government Employees Medical Scheme (GEMS), Dr Vuyo Gqola who brings together clinical experience, strategic leadership and a deep understanding of the complexities facing the healthcare system.
From operational excellence and financial sustainability to artificial intelligence, universal health coverage and the advancement of women in leadership, she believes the decisions made today must ultimately serve a greater purpose – improving lives and building a stronger healthcare system for generations to come. Leadership speaks to Dr Gqola about leading through change, balancing innovation with the human element of healthcare and why meaningful leadership must extend beyond personal success.
1. Your career journey spans medicine, business leadership and healthcare strategy. Looking back, what defining moments shaped your leadership philosophy, and how have they influenced the way you lead one of South Africa’s largest medical schemes today?
My leadership journey has been shaped by two complementary experiences, namely caring for individual patients and leading complex health systems. As a medical practitioner, I learned that every clinical decision affects a person’s life and well-being. As I transitioned to the medical scheme industry, I came to appreciate healthcare delivery beyond individualised care and to understand that sustainable health systems are equally important, as they determine whether healthcare remains accessible for generations to come.
Those experiences taught me that leadership is about service, humility, empathy and creating an environment where people can thrive. At GEMS, this means making decisions that balance the immediate needs of our members with the Scheme’s long-term sustainability. Every operational decision must contribute to better health outcomes, improved experiences for members and healthcare providers and the responsible stewardship of the Scheme’s funds.
On a personal level, I believe in the philosophy of ‘paying it forward’, just as others have done for me. This means empowering others and creating opportunities for them to thrive.
2. Having transitioned from Chief Healthcare Officer to Chief Operations Officer at GEMS, how has your perspective on leadership evolved, and what new priorities have emerged in driving operational excellence across the organisation?
The transition has broadened my perspective considerably. While my previous role focused primarily on evidence-based and outcomes-based healthcare delivery, my current responsibility covers the entire operational ecosystem that enables those strategies to succeed.
Operational excellence is not simply about efficiency. It is about ensuring that every interaction a member or healthcare practitioner has with GEMS is seamless, responsive and centred on their needs. My priorities include strengthening digital capabilities, improving service delivery and stakeholder engagement, enhancing operational resilience and fostering greater collaboration across the organisation. Operations should enable quality healthcare delivery and improve the member and healthcare practitioner experience, rather than simply support administration.
3. South Africa’s healthcare landscape continues to face mounting pressures, from rising healthcare costs to unequal access to quality services. In your view, what are the biggest opportunities to create a healthcare system that is both financially sustainable and patient-centred?
South Africa has an opportunity to fundamentally reshape healthcare by focusing on prevention, primary healthcare and value-based care. We cannot continue measuring success by the volume of services delivered. Instead, we must focus on improving health outcomes while making healthcare more affordable.
Technology, stronger partnerships with healthcare providers, data-driven decision-making and greater investment in preventive healthcare all present significant opportunities. We also need greater collaboration across the healthcare ecosystem, recognising that sustainable healthcare is a shared responsibility between funders, healthcare providers, policymakers and members.
4. Under your leadership, GEMS introduced innovative healthcare models such as Emerald Value, Tanzanite One and value-based reimbursement models, which significantly improved quality and access to care. What lessons have these initiatives taught you about balancing affordability, quality and innovation in healthcare delivery?
Firstly, understanding GEMS’ demographics and the healthcare needs of its beneficiaries is the most important aspect of benefit design and the development of impactful value-based care models. This includes extensive claims and clinical data analysis.
Our experience has also taught us that, as a funder, collaboration with key stakeholders in the healthcare sector and member representatives is paramount to the success of any initiative.
5. The implementation of the National Health Insurance (NHI) remains one of the most significant healthcare reforms in South Africa. From your perspective, what role can organisations such as GEMS play in supporting the successful implementation of universal health coverage while maintaining service excellence?
Every South African has the constitutional right to equitable access to healthcare, irrespective of their socio-economic status. This is the underlying principle of universal health coverage.
GEMS is a medical scheme registered under the Medical Schemes Act 131 of 1998. As a medical scheme, we have accumulated valuable experience in healthcare funding, benefit design, clinical risk management and provider contracting. These capabilities can contribute meaningfully to broader healthcare reform.
As the policy environment continues to evolve, GEMS remains committed to constructive engagement with government and other stakeholders. Our focus is on supporting solutions that strengthen the healthcare system while ensuring that our members continue to receive quality, efficient and sustainable healthcare services.
6. Operational leadership often requires making complex decisions that balance financial sustainability with the healthcare needs of members. How do you approach these decisions while remaining true to your commitment to patient care?
Healthcare leadership requires balancing compassion with responsible stewardship. Every decision begins with the question: What can deliver the greatest long-term value for our members?
Financial sustainability and patient care are not competing priorities. Without financial sustainability, healthcare becomes unaffordable. Without quality healthcare, financial efficiency loses its purpose.
We therefore rely on clinical evidence, robust actuarial data, stakeholder engagement and sound governance to guide complex decisions. Transparency and fairness remain central to our decision-making process.
7. Your qualifications span medicine, microbiology, business leadership, negotiation and global healthcare strategy. How has combining clinical expertise with executive leadership education enabled you to solve complex healthcare challenges differently?
Healthcare challenges are rarely purely clinical or purely financial. They exist at the intersection of science, economics, policy and human behaviour.
My clinical and medical background enables me to understand patient needs and healthcare delivery, while my leadership education provides the strategic and operational tools needed to build sustainable systems.
This combination encourages evidence-based decision-making while recognising that healthcare revolves around people. It enables me to approach complex problems from multiple perspectives and identify solutions that are clinically sound, financially responsible and operationally practical.
8. Technology, artificial intelligence and data analytics are transforming healthcare worldwide. Which emerging innovations do you believe will have the greatest impact on improving healthcare outcomes in South Africa, and how is GEMS preparing for this future?
Artificial intelligence, predictive analytics and digital health platforms have enormous potential to transform healthcare delivery.
These innovative technologies can help identify health risks earlier, personalise healthcare interventions, reduce administrative complexity and improve clinical decision-making. Digital solutions can also improve member engagement by making healthcare more accessible and convenient. At GEMS, we continue investing in digital transformation, data analytics and technology-enabled service delivery. However, AI and technology should always be used with caution, as they come with risks. Technology and AI should complement, rather than replace, the human element of healthcare.
9. Women continue to be under-represented in senior executive positions across many industries. As one of South Africa’s leading healthcare executives, what advice would you give to aspiring women leaders seeking to build influential careers while remaining authentic to themselves?
My advice is to embrace your authentic leadership style and never underestimate your capabilities. Leadership is not about fitting into preconceived expectations. It is about consistently delivering excellence, building credibility and leading with integrity.
I would also encourage women to seek executive coaches, build strong professional networks and remain lifelong learners. Learning is continuous.
Take the time to enrol in programmes that will enhance your skills. Learn from people who have made a positive impact on your career, but equally, learn from those who have made a negative impact. They will teach you what kind of leader you want to be, but also the kind of leader you do not want to be.
Challenges and obstacles will arise, but resilience, preparation and confidence are powerful assets. Learn from your successes and your failures. Most importantly, remember that leadership is more than personal success – it is about uplifting others and creating opportunities for others to thrive.
10. Beyond operational performance and financial indicators, what does meaningful success look like for you as Chief Operations Officer, and what legacy do you hope to leave within GEMS and the broader healthcare sector?
Success is reflected in the confidence that our members and their healthcare providers place in GEMS.
Success is also about building a culture of innovation, accountability and continuous improvement where our people feel empowered to deliver excellence.
Personally, success means going to bed at night knowing I have made a positive impact on someone’s life, whether it is an individual GEMS member, the broader GEMS membership or the GEMS team with whom I work.
If my legacy is one of making a positive impact on individual lives and the broader community, strengthening healthcare systems, improving access to healthcare and helping position GEMS as a trusted partner in advancing sustainable healthcare, I would consider that a meaningful contribution.
11. Leadership often demands resilience in times of uncertainty and rapid change. As you look ahead, what is your long-term vision for GEMS, and what kind of healthcare system do you hope future generations of South Africans will inherit because of the decisions being made today?
My vision is for GEMS to remain an important player in healthcare reform in South Africa – a Scheme that continues to evolve while remaining firmly focused on serving public service employees and their families.
More broadly, I hope we build a healthcare system that is equitable, financially sustainable and centred on people rather than processes.
One that embraces innovation, strengthens primary healthcare, rewards quality outcomes and ensures that every South African has access to quality, affordable healthcare.
The decisions we make today will shape healthcare for decades to come. Our responsibility is therefore not only to manage today’s challenges, but to build a stronger, more resilient healthcare system for future generations.
Nasiphi Ndevu is Head of Research at Frank Dialogue Holdings.