Thursday, September 27, 2012

Cuban doctors become costly

Cuban doctors become costly
By: DENVER KISTING 27.09.2012

NAMIBIA and Cuba are negotiating a deal for medical personnel that, if
it goes through, will cost the Namibian government N$1,3 million per
person for a two-year period – close to 50% more than the current
agreement. Currently, the fee is N$647 621 per person. There are 52
Cuban medical personnel in the country as part of the current agreement.

The fees Cuba wants to charge Namibia for medical personnel from that
country "have no relation whatsoever with the prevailing market rates
applicable in the public service within southern Africa as a whole", a
document seen by The Namibian states.

Because of this, there is a fear that the local market will be
destabilised, the document warns.

Destabilising the market would push up the cost of medical care, which
is already high, it warns.

Moreover, there are concerns that the new agreement will add fuel to the
fire in the public servants' wage talks.

"Since last year, there has been labour instability within the health
sector and already, government is negotiating for wages for public
servants. This new agreement may have bearing on the wage negotiations
especially for public servants."

Currently, the Namibian government pays N$23 000 on average per Cuban
medical staff member per month. Of that amount, the Cuban medical
personnel get a monthly allowance of N$3 200 for food and pocket money.

In terms of a new draft agreement, the cost will be N$51 800 per
employee per month.

Also, the Cuban medical staff are provided with fully furnished housing,
receive N$83 000 for international travel and N$12 621 for excess
baggage and cargo when travelling back home on holiday.

Of the N$23 000 per month, N$3 200 is paid over to the Cuban embassy and
is ultimately supposed to reach Havana.

The current agreement comes to an end next April.

It has come to light that the Ministry of Health and Social Services did
not budget for the new costs once the current agreement comes to an end.
It is understood that the ministry was caught off guard when it was
presented with the new cost structure last month.

Should the government give the new deal the green light, the Medium Term
Expenditure Framework (MTEF) ceiling of the ministry would need to be

"There is a serious financial implication – not only on the budget of
the ministry, which will be forced to forgo certain services to
accommodate the provision of the agreement, including that the
ministry's MTEF ceiling shall have to be adjusted to accommodate this cost."

Another spin-off of accepting the agreement would mean that health care
could be compromised.

Government would need to "reduce the number of required doctors to fit
within available resources which may reduce the ability of Government to
provide adequate medical care and specialised services all over the

Until now, the agreement was entered into by the two countries'
government. In terms of the new agreement, the Cuban government is
represented by a private company from that country called
Comercializadora de Servicios Medicos Cubanos, SA.

Andrew Ndishishi, permanent secretary in the Ministry of Health,
yesterday said he and Minister Richard Kamwi are travelling to Cuba
possibly as early as next week for the negotiations. "We are just
starting. The minister is supposed to lead a delegation to Cuba next week."

According to Ndishishi, the Cubans have the right to propose the cost
but the minister will still negotiate on behalf of Government.

He said he was not aware of how much money the new deal would cost.

Kamwi told The Namibian that he would not enter into an agreement which
the Namibian government couldn't afford but he did not want to comment
on costs.

The country still has a shortage of doctors, he said. Also, the current
Cuban doctors only received a living allowance and not a salary.

Between 2009 and now Namibia has received 410 Cuban medical health
personnel including doctors, nurses, technicians and technologists and
Namibia has paid only their living allowances, which amounted to N$14,4

Of the above, 52 are doctors but Namibia wants 68 more Cuban doctors by
April next year to bring the total to 120. That will be at an additional
cost of N$31,2 million.

Under the new agreement Namibia will spend N$31 800 per month on a
specialist, N$25 440 on a medical engineer at degree level, N$23 320 on
specialised nurses and N$21 200 on health personnel and technicians at
diploma level.

It is believed that Namibia is negotiating for a grace period for the
current 52 Cuban doctors to continue receiving what they earn now until
April next year when the ministry will have to find an additional N$30,3
million to fund the increases.

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