Medical union condemns contract for Cuban doctors to work in Portugal as “slavery”BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4253 (Published 05 August 2010) Cite this as: BMJ 2010;341:c4253
A Portuguese doctors’ union has denounced a deal between the Portuguese and Cuban governments allowing 43 Cuban doctors to work in Portuguese primary healthcare centres.
The union claims the doctors may not be properly qualified to work as general practitioners and says they are working under conditions the union considers to be “slavery.”
The doctors began arriving in August 2009 to work in areas of Portugal that find it difficult to attract doctors to work there. In many cases the existing GP is either close to retirement age or wants to take early retirement.
Cuban doctors are not qualified to work as general practitioners, João Moura Reis, regional secretary of the Independent Union of Doctors for the Portuguese Region of Alentejo told the BMJ. Dr Moura Reis said that general practice is considered a specialty in Portugal, with a four year vocational training programme.
He said he was concerned at the lack of public transparency about the recognition of the Cuban doctors’ professional qualifications. Overseas doctors must pass a medical communication test and a state examination in a Portuguese university, which tests their theoretical knowledge and practical skills, before they can be registered with the Portuguese Medical Association.
“Did these Cuban doctors carry out the medical communication test?” asked Dr Moura Reis. “Where are their specialist qualifications in general practice? Where is their proof of recognition of professional qualifications and in which university did they do it?”
Dr José Luís Gomes, a member of the Southern Portugal Regional Council of the Portuguese Medical Association, says the Portuguese medical regulator is also concerned about the Cuban doctors’ lack of specialist credentials: “Even though they are carrying out activities that correspond to the profile of a specialist in general practice, they are not specialists in general practice,” he said.
Dr Moura Reis, who has met several of the Cuban doctors, claims they are currently earning around €300-400 (£250-330; $395-525) a month, when the Portuguese minimum wage is €475. He also claimed that the Portuguese government was offering a salary equivalent to that of a Portuguese doctor, but that the Cuban government was paying the doctors, with the difference going to the Cuban Embassy and to each doctor’s personal bank account.
“This is an attack on the integrity of the worker, which is not in line with the social and labour policy of a country that considers it rightfully belongs to the first world,” said Dr Moura Reis. “Governments should not do business with other governments regarding human resources for health.” [To do so] “is considered slavery,” he added.
Manuel Pizarro, secretary of state of health, has told the Portuguese press that the Portuguese government had nothing to do with the way Cuba pays its doctors.
A report from the Portuguese newspaper Correio da Manhã (12 Jan 2010) said “The Portuguese state pays the Cuban doctors [the same] as any other Portuguese or foreign doctor on a 40 hour week,” he said. “And it also pays overtime if [applicable].”
Dr Moura Reis said he had written to the prime minister, the minister of health, and the minister of labour and social policy, denouncing the situation. “We are still awaiting a reply, but we may ultimately resort to the European courts,” he said.
Ivette Garcia González, acting business attaché at the Cuban Embassy in Lisbon told the BMJ: “The Cuban doctors that came to Portugal to work under this agreement have their own Cuban union “Sindicato de los Trabajadores de la Salud” [the Healthworkers Union], and so far, they haven’t made any complaints.”
She added: “I can confirm that the doctors receive a stipend, but, for instance, they don’t pay rent. Their families receive a part of their salary as well. If this seems insufficient, they should consult with their union.”
Cite this as: BMJ 2010;341:c4253