“A welfare state can be sustained only as long as there is money to support it”

Dr. Dawood Oaris, President of the Association of Private Clinics and Medical Director, Chisty Shifa Clinic

• “In Mauritius, 80% of the budget goes to curative care. Prevention is underfunded, and the result is inefficiency and waste.”
• “We’re heading toward a collapse in healthcare staffing”

In this wide-ranging interview with BIZWEEK, Dr. Dawood Oaris, President of the Association of Private Clinics and Medical Director of Chisty Shifa Clinic, speaks out on the critical shortages in healthcare personnel, the lack of local training, and systemic inefficiencies affecting both public and private health services in Mauritius. With over two decades of experience and a deep commitment to public welfare, Dr. Oaris advocates for urgent reforms – from implementing a family doctor scheme to ensuring universal health insurance and rethinking the country’s approach to public-private partnerships. His message is clear: unless decisive action is taken, the country’s healthcare system risks becoming unsustainable.

Rudy Veeramundar

Are private clinics currently facing a shortage of healthcare professionals?

Absolutely. There has been no capacity building in this country for medical and paramedical staff over the last 20 years. Especially after COVID-19, it has been horrible. We haven’t recruited people, and there has been no formal training.

Let me be clear: the private sector is not saying that only the government should train nursing staff. What we’re saying is that the system must provide facilities and pathways for training. Two private institutions are currently offering support, but only for a one-year healthcare assistance programme. If someone wants to pursue a diploma or a BSc Honours degree, only a few universities, such as Curtin University, offer such courses.

Previously, people were recruited off the street and trained on the job. That is no longer sufficient. That’s why we introduced the healthcare assistance scheme. I also collaborated with the HRDC to ensure trainees receive a monthly incentive.

But if qualified people are not available on the market – whether for the public or private sector – then we simply won’t have the staff to operate. I told the ministry: in five years, you will be forced to close all the hospitals because there will be no personnel to run them.

If we don’t invest in training, we may have hospitals, but without nursing staff and lab technicians, they won’t function. Eventually, we’ll be forced to shut down both hospitals and clinics. Right now, the solution seems to be hiring foreign workers. But is that really a solution? We’re paying them, and the money is being sent abroad. Instead, we should focus on training our own people. We have enough local talent. When we train locally, the money stays in the country.

We also need to value our healthcare workers. If nurses are paid the same as clerical staff, many will choose to work in supermarkets or retail instead. They receive the same minimum wage, avoid night shifts, and carry less responsibility. In doing so, we are driving people away from this vital profession.

What would be the solution to this?

One solution I’ve proposed is that all relevant institutions must work toward the national interest. I speak as a patriot. The Mauritius Institute of Health (MIH), under the Ministry of Health, receives public funds to train people. But it is not doing its job.

We have approximately 3,500 nursing staff. Every year, at least 10% – around 350 – should be trained, as some retire, others emigrate, and some fall ill and leave the profession.

I have already recommended a basic one-year training course as essential. From there, trainees can choose to continue: two years, three years, or four years for a BSc. But there should be flexibility: if someone drops out after one year, they could still work as a healthcare assistant.

The government allocates funds to universities. Their job is to train people. But right now, we are not doing that. Capacity building simply isn’t happening.

What is the situation regarding both foreign and Mauritian specialist doctors?

Let me be clear: most of our doctors are trained abroad and return to Mauritius after their internships. Locally, we have two medical colleges – Anna Medical College and SSR Medical College – but they produce a limited number of graduates.

Once doctors wish to specialise, they must go abroad, because we don’t offer specialised training in Mauritius. There was one college that did so in the past, but it no longer does. The University of Mauritius provides some courses, but most specialists are trained overseas.

In the past, specialists returned and joined the public sector for its stable salary and the ability to do private practice after two years. But now, with the new work conditions, specialists like anaesthetists, gynaecologists, and paediatricians are required to stay overnight in hospitals. The younger generation of doctors, many with families, don’t want that. They prefer daytime work with on-call duties at night. As a result, many are leaving government service for the private sector. Due to the shortage of local specialists and general practitioners, we are now hiring foreign doctors.

On the other hand, previously, doctors in public hospitals worked standard hours, then received an allowance for night shifts. Now they work on a roster basis. This breaks continuity of care. The doctor who operated on a patient may not be the one checking on them the next day. Give a decent salary for night duties and restore continuity of care.

“The population generates 10 million visits to hospitals annually. That’s unsustainable!”

What are your views on Public-Private Partnerships (PPP) in the health sector?

We have made proposals to the Ministry of Health. Over the past five years, the PPP model has been working – not perfectly, but reasonably well.

For example, we’ve conducted cataract surgeries for patients who had been on waiting lists for four to five years. We also handle dialysis services for the government, which cannot keep up with demand. When CT scan machines in public hospitals broke down, we stepped in to conduct scans and MRIs.

We have even offered to handle surgeries for patients who were meant to go overseas through the Overseas Treatment Unit (OTU). We proposed that if our quotation matches the cost of treatment abroad, then these patients can be treated locally in our clinics.

There is a contradiction in our system. The African Union recommends that 75% of healthcare budgets go to primary care. In Mauritius, 80% of the budget goes to curative care. Prevention is underfunded, and the result is inefficiency and waste.

Let me give you an example. Someone with a sore throat might visit five different healthcare centres in a day – from the community health centre to the ENT hospital – seeing multiple doctors and receiving the same treatment each time. This results in six blocks of medication on the same table. That’s a total waste.

The system must be controlled. We always hear that e-health is coming. But it’s been “coming” for 20 years! The minister says it’s imminent – it might take five more years.

What do we do in the meantime? Continue wasting money? We have a population of 1.2 million. One-quarter go to the private sector. The remaining population generates 10 million visits to hospitals annually. That’s unsustainable.

This is why we need a health card for patients.

You mean an e-health card?

No. For now, just a basic health card. Then transition to one patient, one file. Until e-health is truly implemented, we cannot keep spending so much.

Speaking of e-health, what about medical tourism?

For tourism, we target markets like Europe, China, and Russia. But for medical tourism, we look only to Africa and nearby islands. Why? We need to create a package: come to Mauritius for treatment, then recover in a hotel. Offer a combined medical-and-leisure experience. But here’s the problem – too many ministries act like kingdoms. The Ministry of Tourism doesn’t work with the Ministry of Health. Health doesn’t work with the Prime Minister’s Office… If all stakeholders joined forces, we could build a true medical hub.

Speaking of cancer: why do so many patients still go to India?

We have the equipment to diagnose cancer. For basic radiotherapy, we’re capable. But new technologies require investment. That’s why patients are sometimes sent abroad. However, the new cancer hospital is now operational and handling a growing number of procedures.

What are the top three measures you would recommend to the government for the upcoming budget, from the perspective of private clinics?

I consider myself a patriot and speak for the health system as a whole, and not only for private clinics. I keep telling the minister: you are not a minister for hospitals; you are a minister for the country. We need a holistic approach – not just hospital-centric policies.

Secondly, implement the family doctor system. We’ve been advocating this for 10 years. The plan is ready. Around 300 doctors in the Ministry of Social Security should be integrated into the Ministry of Health. Each family doctor would be responsible for a local population, handling everything from appointments to preventative care. It is very important to bring down the cost.

What are the key ideas that you conveyed to the government for the budget?

They are preparing a five-year plan. What I’ve told you, I’ve told them. Implementation is their responsibility now.

What is the percentage of patients attending private clinics?

We have reached around 27 percent of the population going to private clinic. By the end of this year, it is going to become 30 to 33 percent. There are several reasons to that: more people are insured, more can afford private care, and many prefer the privacy of clinics.

Is it also because of the level of service?

No. Public hospital service is not bad. I’ve worked there too. But private clinics offer personalised care. For example, you can choose your specialist. That makes a difference.

You have a rich career and are a successful entrepreneur. What is your dream for the health sector in Mauritius?

My dream is for everyone in Mauritius to be insured, one way or another. Whether through personal plans, government schemes, employer-sponsored coverage, or subsidies, it doesn’t matter. What matters is giving people the freedom to choose where they receive treatment.

This isn’t about copying a model like Obamacare, but about creating a system that ensures flexibility and access for all. Welfare is important, but it shouldn’t mean taking money from your pocket and throwing it away without purpose.

Proper planning and procurement are essential. Right now, there is significant waste in both medicine and equipment procurement, and this must be urgently addressed.

We have a long-standing welfare state. How long can we sustain it?

Until we become bankrupt! A welfare state can be sustained only as long as there is money to support it. Let’s take NCDs. Why treat diabetes after it appears? Why not teach healthy habits in schools – exercise, nutrition, sports? Prevention is cheaper and more effective than cure. But here, we wait for people to become diabetic before doing anything. That attitude must change.