Cuban doctors in Calabria, all the details (and costs) of the agreement
The agreement signed with the Csmc provides for a fee of 4,700 euros for each selected professional (but 1,200 will go to the health professionals)
Corriere della Calabria – 18 August 2022
CATANZARO The premise is the one told by governor Roberto Occhiuto in the video that announced the arrival in Calabria of a contingent (up to 497) of doctors from Cuba to restore oxygen to the regional health system. Technical question to be resolved as soon as possible. Because "the shortage of medical personnel, determined due to the blockage of turnover following the recovery plan from the health debt, the delays registered in the recruitment procedures and the low participation of candidates in the aforementioned procedures, require a new assessment of the structure of staff and an immediate intervention to strengthen the structures in the most critical areas".
Worrying numbers: there is - reports the decree outlining the agreements between the Region and the Csmc (Comercializadora de Servicios Médicos Cubanos) - there is a "significant gap between the theoretical need for personnel detected by the Companies and the service units". To the numbers of needs (which the decree quantifies at 2,407 units in the disciplines of emergency medicine and surgery, pediatrics, intensive care and resuscitation, general surgery, diseases of the cardiovascular system, gynecology and obstetrics, radiodiagnostics, orthopedics and traumatology) alongside a dynamic that worsens the overall picture.
Attempts (unsuccessful) to recruit new doctors
In the companies of the regional health system, in fact, «several attempts to recruit medical personnel, both 
both fixed-term and open-ended contracts, did not allow the recruitment of the personnel necessary to cover the needs, in particular in the disciplines related to the emergency emergency". It is the unsuccessful tenders that Occhiuto considers the premise for the pact with Cuban health care. Which will send to Calabria, through a branch to be opened in Catanzaro, "health professionals belonging to different professional specializations to be used in the emergency emergency area".
The number – Occhiuto spoke of 497 professionals who can be recruited when fully operational – is indicated in the deed as "yet to be defined since the recruitment procedures and the timetable for the arrivals of the doctors will be agreed upon and governed by subsequent deeds". Consequently, the total costs are also to be defined.
The costs of the agreement with Csmc: up to a maximum of 2.3 million per month
Instead, what can be deduced from reading the Framework Agreement is the cost for each professional selected to lend a hand to Calabrian health care. For each doctor, the Calabria Region "will pay Csmc an all-inclusive monthly fee of 3,500 euros", a fee that will be paid quarterly.
Another certainty: due to the United States embargo against Cuba «in no case will transfers in US dollars be made; nor will US-based or non-US-based banks be used; nor banks and branches with US capital; nor branches of banks in other countries headquartered in the United States. Again to stay on the cost plan, the Region will pay «to each health worker who will provide service 
at the National Health Authorities, the net monthly lump sum of 1,200 euros, to cover maintenance costs».
The Citadel will always take charge of the Italy-Cuba travel costs (two return journeys a year) and of the accommodation costs, as well as the costs of both supplementary training and the medical examination carried out by the competent doctor identified by the Calabria Region on the basis of the provisions in force on the matter in the territory of the Italian Republic". For each doctor, therefore, the Region provides a budget of 4,700 euros, net of accommodation costs. If 497 Cuban doctors were to actually be used, the outlay would be over 2.3 million euros a month (and, in theory, around 28 million a year, again assuming full staffing).
The mutual commitments of the Region and Csmc
The agreement stipulates that the contracted Cuban doctors will operate "in terms functional to the directives of the heads of the structures of the host health institutions, undertaking to carry out their activities on the basis of the standards, protocols and regulations applicable in the territory of the Italian Republic". The CSMC is committed to “ensuring that Cuban health workers have the professional skills and adequate experience
and necessary for the exercise of the healthcare activities for which they are holders of a specific specialization".
In turn, the Region undertakes to "inform Cuban health workers of the protocols of the therapeutic standards used in the Calabria Region and the companies of the Regional Health Service of assignment and give them a course of linguistic improvement, forensic medicine and organization". (redazione@corrierecal.it)
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Calabria, Rings (Fnomceo): "Cuban doctors emergency solution, we need a structural and overall response"
“The hiring, in Calabria, of 500 Cuban colleagues is an emergency measure, to plug the shortcomings of the system. Now we need a structural and comprehensive response, which, in addition to getting us through the moment, goes to fill the health inequalities within the country".
Thus the President of Fnomceo, the National Federation of Doctors' Orders, Filippo Anelli, comments on the agreement signed by the President of the Calabria Region, Roberto Occhiuto, for the recruitment of about 500 Cuban doctors to be hired on fixed-term contracts.
“In the face of this emergency - explains - the Governor has decided to use a law that allows the simplification of the recognition of qualifications, which, normally entrusted to the Ministry of Health, thus passes to the Region. Our main concern is that the quality of assistance is guaranteed: hence the invitation to link up with the Ministry, which has experience in the recognition of qualifications, and with the Orders, which combine the certification of skills with adherence to standards shared ethics”.
“Furthermore – continues Rings – before going abroad, it would be advisable to explore all the possibilities in Italy, envisaging the employment, always on an emergency and obviously voluntary basis, of specializing doctors and pensioners. We need a pact between the health professions, which allows us to overcome the crisis: let us remember that in four years, thanks to the increase in scholarships, we will have thirty thousand new fully trained specialists".
“In the end – concludes – an appeal to politics: the government to come should have the issue of health inequalities as a priority. A question that, up to now, no intervention has managed to resolve. Here too, a common reflection is needed, to understand the causes and find solutions. It is not fair that those born in the South have a much lower life expectancy and life expectancy in good health than those born in the North. It is not fair that a newborn male residing in Caserta can count on living up to 78 years, while a newborn from Pordenone can reasonably hope to exceed 86 years. It is not fair that in Calabria there is a chance of living in full health, on average, only up to the age of 50, against 70 in Bolzano. An answer, together with other structural and organizational interventions, could be the establishment of supra-regional networks of skills, so that it is the teams of professionals who move and no longer the patients".
Fnomceo Press Office
Note: In 2019 it salary medium of a Cuban it was 879 pesos, equal to less than 37 dollars per month. A Cuban doctor in 2021 has a salary equivalent to $210, similar to that of a journalist, teacher or circus animal tamer. Approximately 50,000 Cuban doctors working in 66 different countries bring up to 8.2 billion dollars a year into Cuban coffers. Most of their wages go directly to the government.
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