Health Minister Aaron Motsoaledi has turned to Cuba to get the extra doctors and specialists needed to put the ambitious plans for National Health Insurance (NHI) into play.

He signed a co-operation deal with Cuban counterpart Roberto Morales Ojeda on Friday to raise the number of South African medical students training on the island and bring more Cuban-qualified doctors to work in SA.

"Cubans are trained in the community. on how to promote health and prevent diseases," said Dr Motsoaledi. "If you look at NHI, we want to emphasise primary healthcare (preventing disease), with doctors who work in the community," he said.

"It's not an accident that Cuba has no malaria, that their HIV/AIDS incidence is virtually zero, that they have little tuberculosis, that they hardly ever see meningitis. They (virtually) eradicated them through their primary healthcare approach," he said.

SA entered into a health co-operation agreement with Cuba in 1995. Cuban doctors were recruited to work in rural areas in SA and South African students were trained in Cuba.

The minister said SA was planning to send 500 medical students to Cuba in September, but the country had the capacity to train up to 1000 a year. Only 1200 doctors graduated from SA's eight medical schools each year.

Dr Motsoaledi declined to specify the cost of training the doctors in Cuba but insisted it would be on a par with that in SA.

The Junior Doctors Association of SA has said three doctors could be trained in SA for the cost of training a doctor in Cuba.

So far 304 doctors have been trained in Cuba, where 406 are studying and 98 will graduate this year. Students finish their studies in SA, and must pass final-year exams to register with the Health Professions Council of SA.

Cuba would also provide 208 Cuban specialists. Some were destined for the district-based specialist support teams in the pilot phase of NHI. Each of SA's 52 health districts is to get a team - a paediatrician, family medicine specialist, anaesthetist, and obstetrician-gynaecologist.

The Democratic Alliance's shadow health minister Patricia Kopane said the party supported the government's plans to increase the number of doctors available for the public health system, but the initiative should not be limited to Cuba.

"It should be expanded to other countries to bring in skills, (and) we must make sure we increase the number of doctors trained at South African universities," she said.

"Doctors in all provinces complain they are over-worked, and that is one of the reasons they go on strike. We have 27000 doctors in SA, and we need to triple the number," she added.

kahnt@bdfm.co.za