Last update: Friday, April 11th, 2003

Healthcare for all
British doctors are learning from Cuba

In Britain, the Labour government talks about public-private partnership in the NHS. It pushes through PFI deals which further cut hospital beds and seeks a deal with the private sector to help make up the shortfall. Capitalism must cheapen the cost of health care and the concept of need is subordinated to profit.

Recently, there has been growing interest in the Cuban health system, with its huge advances in health care since the revolution in 1959. A new Anglo-Cuban primary health care initiative was launched this year with a study tour for English primary health care workers, including GPs, to Cuba in March, followed by a visit to Britain in October by leading Cuban public health officials. For the Cubans, it provides an opportunity to promote their social system, share expertise and investigate new avenues for medical material aid and exchange of information. For the NHS it is an opportunity to examine a health service which has provided Cuba with health statistics to compare with the best in the industrialised nations at, as The Guardian sees it, 'only a fraction of the cost incurred elsewhere'. However, while Cuba spends less per capita on health, it in fact spends more as a percentage of its GNP.

Health for all
Pre-revolutionary medical care in Cuba was almost exclusively private. Doctors did not practise in rural areas because it was not profitable. Doctors routinely accepted bribes for hospital beds. In 1959 there were only 6,000 doctors in the whole of Cuba, half of whom fled to the USA within weeks of the revolution - transferring, in the process some $1-2m from the Cuban hospital fund to personal Miami bank accounts.

The new revolutionary government set about providing access to education and health care for all. In 1984, the family doctor programme was set up and primary health care and community health promotion declared as priority targets. Today, there is a family doctor and nurse for every 120 families. Despite the hardship imposed by the 40-year US blockade, Cuba, whose economic parameters rank it amongst the oppressed nations, has the same life expectancy and infant mortality as Britain and the USA.

Cuba has also invested heavily in research. For example, the Cuban meningitis B vaccine, which now forms part of its universal childhood vaccination programme, has been exported free to Latin American countries. After years of silence, while meningitis B continues to kill and maim children in Britain, the imperialist countries have only just acknowledged the existence of the vaccine. By 1991, Cuba had more doctors working abroad in oppressed countries than did the World Health Organisation (WHO).

It has recently offered to send out 300 doctors to Africa to help tackle the AIDS crisis. In 1988, the WHO presented Fidel Castro with its Health for All award in recognition of Cuba reaching all the WHO health goals set for developing countries to achieve by 2000.

These are the gains of a socialist society, based around the needs of the people. They cannot be simply imported to Britain to create a health service 'on the cheap'. If we want to emulate Cuba's success, then we too must work towards changing our society and building socialism.

Hannah Caller

Recommended reading is a recent pamphlet by John Waller, Health for All, available from the Cuba Solidarity Campaign, 129 Seven Sisters Road, London N7 7QG, 2.

From Fight Racism! Fight Imperialism! 158 December 2000/January 2001