By Benedict Mander in Caracas

Financial Times UK

Hugo Chávez looked puzzled when, on one of his recent Sunday television shows, he listened to a guest’s account of her sister’s nightmarish experience trying to find somewhere to give birth in Caracas.

While in labour, she was bandied about from hospital to hospital, repeatedly rejected because of a lack of beds and doctors. Incredulous, the Venezuelan president asked: “Who is responsible for this?”

Many Venezuelans place the blame squarely on Mr Chávez’s shoulders. They see this increasingly common phenomenon - known as “the runaround” - as symptomatic of the crumbling decay of the oil-rich country’s public hospitals after years of neglect.

The popular network of primary healthcare centres introduced into Venezuela’s shanty towns by Mr Chávez has also deteriorated to such a degree over the past couple of years that he declared it to be in a state of “emergency” last month.

This is in spite of government coffers overflowing with oil riches thanks to a leap in energy prices in recent years. It is a matter of considerable concern to the self-styled socialist leader - whose approval ratings have slipped by about 10 percentage points since earlier this year - given that he faces legislative elections next year.

Mr Chávez’s continued popular support owes a great deal to his social programmes, or “missions", in particular the Cuban-style health programme, barrio adentro, for preventative healthcare. The president has in recent weeks been at pains to trumpet its achievements, claiming the scheme has saved 226,324 lives since it was established in 2003.

“We’ve halved poverty levels [in the past decade], and I’ll bet my life that we’ll have eliminated misery and poverty altogether within the next 10 years,” said Mr Chávez last week, announcing that over 1,000 more doctors would be sent from Cuba to reinforce the 10,000 or so working in barrio adentro - about half the original number - as well as some 2,500 Venezuelan students who have completed their medical training on the Caribbean island.

There is no doubt barrio adentro needs more and better doctors. Mr Chávez admitted that some 2,000 of about 6,700 health centres, often staffed by one person, had been “abandoned".

But experts say such problems cannot be solved by simply importing more Cuban doctors, whose numbers diminished significantly in 2005 when Mr Chávez sent 4,000 to Bolivia to establish a similar system. Many have also returned home, while some are said to have used the programme to flee the Castro regime and are no longer in the country.

“The country’s health crisis won’t be solved by just fixing barrio adentro , despite all the good it does,” said Patricia Yáñez, a leftist sociologist at the Central University of Venezuela. By setting up a parallel system in barrio adentro , healthcare had become even more fragmented, costly and inefficient, she added.

Still, these problems pale into insignificance compared with the country’s chaotic public hospitals, where Venezuelans go for emergencies, maternity care and significant surgery. With barrio adentro attracting the lion’s share of government funds, these hospitals face a dire shortage of beds and specialist doctors, while basic equipment is scarce or outdated and medicines are often lacking.

Suffering from meagre pay and miserable working conditions, more doctors choose to emigrate to countries such as Spain and Australia or work in the private sector, where they can earn multiples of their $1,023 (€685, £640) monthly public-sector wage. This has had terrible consequences for maternal mortality rates, which remain unnecessarily high in Venezuela, as well as neonatal care, says Marino Gonzalez, formerly Venezuela’s representative at the World Health Organisation.

Moreover, Venezuela’s health sector remains handicapped by corruption, mismanagement and disorganisation, rendering new investments ineffectual.

“Often you find that the newly remodelled hospitals with the latest equipment are closed, while hospitals in terrible condition remain open - or that refurbishments were started but never finished,” says Rafael Castillo, a gynaecologist in Caracas.

Miguel Manzo, who runs Caracas’s Perez de Leon hospital, complains that expansions begun six years ago should be finished. “It’s already cost them three times the original budget but it’s only half-complete. The reason? Corruption, of course,” he says.

Marisol Flores, a health ministry employee who toils high up in the slums of Petare in eastern Caracas, laments the situation. “It’s good that we’ve been able to bring medicine to the poor areas, but there needs to be much more order - that’s the bad part,” she says. “It’s a great shame, because Venezuela is such a rich country and things should be so much better.”