Government spending millions on Cuban doctors each year

 ·17 Apr 2024

The Gauteng Department of Health annually allocates R14.3 million to employ 11 Cuban doctors in public hospitals, as part of an agreement between South Africa and Cuba.

This was revealed by Gauteng MEC on Health and Wellness, Nomantu Nkomo-Ralehoko, in a written reply to a question posed to her in the provincial legislature.  

The Cuban doctors, earning between R1 million to R1.6 million annually, work at the following health facilities, amounting to:

  • Johannesburg Metro Health District – 4 doctors (R4,788,600);
  • Ekurhuleni Metro Health District – 3 doctors (R3,847,503);
  • Sedibeng Metro Health District – 2 doctors (R2,833,917);
  • Thelle Mogoerane Hospital – 1 doctor (R1,642,858);
  • Tembisa Hospital – 1 doctor (R1,197,150).

These doctors’ contracts range from fixed term to permanent positions.

This has raised concerns from critics, who cite South Africa’s large number of unemployed qualified medical professionals who have completed their community service as a reason to do away with the programme.

Mixed reviews

The employment of doctors from Cuba has had mixed reviews since its inception.

“It’s just bizarre that we spend all this money training local doctors then so many of them are unemployed,” said DA shadow MEC of health, Jack Bloom, who posed the question to the MEC.

Earlier this year, it was reported that nearly 700 South African medical doctors (previously 800) had not been able to find a job in the public sector since qualifying.

The health department have consistently cited that they are unable to afford all of these placements due to shrinking health budgets, rising salaries and high medical negligence claims payouts.

“I’ve always been puzzled by it because [the Cuban doctors] don’t have specialist skills that can’t be done by local doctors,” said Bloom in an interview with the SABC.

Since these reports, Health Minister Joe Phaala said that the number of unemployed doctors has gone down, largely thanks to an over R3.7 billion boost from the treasury.

“Whilst the phenomenon of rising numbers of unemployed graduates is being experienced across many sectors, in the public health sector, the employment of health professionals has been on steady increase,” said Phaala.

The trend over the past five years shows an annual increase in the employment of medical doctors from 2018, the minister said:

YearMedical InternsCommunity Service
20181 472
20191 879
20202 3151 340
20212 2711 541
20222 1552 063
20232 3651 965
20242 2102 101

Not a new phenomenon

Having Cuban doctors work in South African hospitals is nothing new.

Back in 1996, South Africa and Cuba signed a bilateral agreement, which saw the establishment of the Nelson Mandela/Fidel Castro (NMFC) Medical Collaboration Programme.

Broadly, this programme sees South Africa sending students to Cuba for medical training, and in return, Cuba sends medical doctors to work in South Africa’s public healthcare system.

“The programme was established to address the over-concentration of health personnel in urban areas and in the exclusionary private sector as well as to increase the number of qualified health professionals,” said International Relations and Cooperation minister Naledi Pandor during a parliamentary debate on Cuban doctors in South Africa.

“Our country has especially benefited from the Cuban expertise and community orientation, which helped in the area of assessing the underlying factors that lead to diseases in communities [which] has gone a long way towards improving South Africa’s primary health care,” added Pandor.

Recently, Phaala told Parliament that over the last 15 years, the government has ramped up the training of doctors both in the local universities and the Nelson Mandela Fidel Castro programme in Cuba.

The number of graduates, according to Phaahla, has almost doubled over the last 10 years, from 1,338 graduates who entered the internship programme in 2014 to 2,210 in 2024.

“The medical profession is very key in the multidisciplinary teams, and that is why we are doing everything to retain as many doctors, nurses, physiotherapists, and other members of the teams in the public health system as possible,” said Phaala.

Read: South Africa can’t afford the doctors it needs

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