Media Statement by Theuns Botha, Minister of Health
Western Cape Government announced its position on the training of doctors in Cuba in 2012 and still stands by this viewpoint.
The Western Cape decided not to participate in the National Government’s project to send doctors to Cuba for training due to the view of the Province that the training that is offered in Cuba is not appropriate to the health system in the Western Cape.
The challenges faced by young people in adapting to the Cuban educational and health system makes the programme problematic. In terms of this program students are required to relocate to Cuba, learn Spanish and orientate in a foreign environment, culture and language. This requires an additional year, in addition to the medical curriculum. Students are only able to return to South Africa on two occasions during the full training period in Cuba.
On completion of the Cuban training each student is required to undergo "orientation" into the South African health system at a South African Health Science Faculty before they can graduate and begin to practice as medical practitioners in South Africa.
During this period each student receives a monthly payment of $200. This payment, in addition to the costs of travel and in a number of cases, tuition, is for the account of the Provinces, not for the account of the National Department of Health. The outcome of the assessment is that the training is prohibitively expensive.
While the Western Cape does face challenges in recruiting doctors in rural areas, it is our view that a more feasible and practical solution is to rather engage the university faculties in the Western Cape to address this challenge.
Instead, the Western Cape has opted to support an increase of local training of medical practitioners. Discussions between the respective deans and Western Cape Government have resulted in an agreement to rather identify prospective students from rural areas and through an arrangement with these universities ensure access to the university faculties - subject to applicable selection criteria.
In line with this, Western Cape Government Health made 20 bursaries available to the Faculties of Medicine and Health Sciences in the Western Cape for rural students to enroll in the MB ChB degree programme. 13 students have been granted bursaries for the current academic year from rural areas to enroll for the MB ChB degree at Western Cape universities.
It is noteworthy that in these discussions with the faculties, the respective deans of the universities of Cape Town and Stellenbosch have raised their concerns about the appropriateness of the Cuban program. They expressed support for increasing the number of locally trained health professionals, including doctors, and also indicated a willingness to work with our department in this regard.
In addition Western Cape Government Health has initiated a process with both the Universities of Cape Town and Stellenbosch to develop strategies to significantly increase (possibly double) the intake of MB ChB students at these two universities. This will require innovative approaches from both the Department and the Universities. We are of the opinion that this offers an alternative to the expensive and costly Cuban initiative.
These candidates would be recruited from the rural towns where recruiting doctors has proved difficult. This would be a much more cost effective strategy.
The Western Cape Government Health audit indicates that there is a need for rural doctors in the following districts:
- Central Karoo: Laingsburg, Murraysburg, Prince Albert, Beaufort West
- Eden: Uniondale, Kannaland
- West Coast: Saldanha Bay
- Overberg: Cape Agulhas, Theewaterskloof, Swellendam
- Cape Winelands: Langeberg, Witzenberg, Breede Valley
It has come to my attention that the National Minister of Health has questioned the truth of my statements in this regard in the National Assembly. I find this regrettable but not surprising as it attempts to divert attention from the real issue we should be focusing on, which is how South Africa can address the shortage of doctors in our country in the most cost effective and efficient way. We believe that the national government’s Cuba programme is not the solution to this challenge.