Healthcare and education are supposed to be the redeeming graces of the regime, but this is questionable. There are a large number of doctors, but, according to most Cubans I know, many have left the country and the health system is in a ragged state—apart from those hospitals reserved for foreigners—and people often have to pay a bribe to get treated. Michael Moore, the American film director, who has recently been praising the system should take note of the real life stories beneath the statistics. I went into a couple of hospitals for locals on my latest visit. In the first, my friend told me not to say a word in case my accent was noticed, as foreigners are not allowed in these places. I was appalled by the hygiene and amazed at the antiquity of the building and some of the equipment. I was told that the vast majority of Cuban hospitals, apart from two in Havana, were built before the revolution. Which revolution, I wondered; this one seemed to date from the 1900s.

On another occasion, I saw a man in a white coat with a stethoscope around his neck hurrying along the boulevard of Vedado, in west Havana. We struck up a conversation. He was on his way to the hospital around the corner. I asked him if he would take me there. He was charming and intelligent, and had that ease of communication that many Cubans possess: he wasn't at all taken aback by an unknown woman in dark glasses asking to accompany him to work. The doctor told me that I shouldn't be too shocked; the hospital was being "refurbished." The building certainly was in a state of filth and decrepitude. This was not a place one would want to be ill in.