Cuba reorganizes family doctor program

By Marc Frank

HAVANA (Reuters) - President Raul Castro's government will close more than half of Cuba's family doctor offices and boost staffing at the rest in a major reform of its vaunted free health care system, medical sources said.

The overhaul of one of the pillars of the health system came in response to public complaints, the sources said, and is another step by Castro to improve life since he succeeded his ailing elder brother Fidel Castro as president in February.

Cubans complain that the family doctor program has been short on staff since the communist government began sending thousands of doctors to Venezuela in 2000.

In the provinces, family doctor offices will now be staffed by a doctor and nurse the entire day, instead of just in the mornings, health care sources said.

"There has been a lot of movement in recent weeks. They are painting the offices, developing a system to insure a proper lunch for staff and more equipment is arriving at the clinics as well," a nurse in central Cuba said on Tuesday. Like others interviewed, she asked not to be named because she was not authorized to speak to a foreign journalist.

There is a similar plan for Havana, a city of 2.2 million people, but it will take more time because doctors and nurses are in short supply. For now, some of the doctors offices will open in the mornings only.

Cuba has the best health care system in Latin America, according to the Pan-American Health Organization, boasting the region's highest longevity and lowest infant, child and maternal mortality rates.

But family doctor offices were left in poor condition and understaffed when Cuba was plunged into deep economic crisis by the collapse of the Soviet Union in 1991.

Fidel Castro launched programs six years ago to rebuild crumbling hospitals and expand community clinics. But he also sent tens of thousands of doctors and nurses to work in poor neighborhoods in Venezuela after his main ally President Hugo Chavez came to power.

The export of medical services to Venezuela went in return for vital supplies of oil that helped keep Cuba's economy afloat.

Some 40,000 Cuban health professionals are working abroad in 81 developing countries, more than half in Venezuela.

OVERWORKED, UNDERPAID

Raul Castro, 76, took over day-to-day control of Cuba when Fidel Castro fell ill in July 2006 and then formally succeeded him on February 24, becoming the first new leader in almost half a century.

In public debates fostered by Raul Castro last year, authorities heard frequent complaints that family doctor offices were empty or open only in the mornings. They were told medical staff were overworked and underpaid, and forced to use some of their time in other activities to make ends meet.

Under the new reforms, all medical school students will now do their sixth year residency at a family doctor office to reinforce staffing.