The new nursing floor, enacted this month, could lead to the closing of more than 20,000 hospital beds and the dismissal of 83,000 employees, according to a survey carried out by the five largest entities in the country’s hospital sector this week. The rise in drug prices and the lag in the amounts paid by the government for tests and procedures are other bottlenecks.
Law 14,434/22, enacted by President Jair Bolsonaro (PL), on August 4, sets the minimum salary for nurses, hired under the CLT (Consolidation of Labor Laws) regime, at R$ 4,750, for nursing technicians in BRL 3,325 and for nursing assistants and midwives BRL 2,375.
Responsible for more than 50% of outpatient care and hospital admissions carried out in the Unified Health System (SUS), philanthropic hospitals and Santas Casas are among the most affected. The Federal Nursing Council (Cofen) argues that the difficulty of these institutions is historical and is not only related to the increase in the salary floor of the category.
The Confederation of Holy Houses of Mercy, Hospitals and Philanthropic Entities (CMB), National Health Confederation (CNSaúde), Brazilian Federation of Hospitals (FBH), National Association of Private Hospitals (Anahp) and Brazilian Association of Diagnostic Medicine (Abramed) heard for the survey 2,511 health institutions from all regions. Among the participants, 42.9% are hospitals and, of these, 35% are non-profit. Only 12% of the institutions consulted are large.
According to the survey, the payroll, which already represented the biggest expense of hospitals, will be burdened, on average, by 60% – and in small hospitals this burden will be 64%. Given this scenario, establishments were asked what measures should be taken: 51% will have to reduce the number of beds, 77% will have to reduce the nursing staff, 65% will reduce the number of employees in other areas and 59% will cancel investments . The research points out that about 27 beds per institution will be closed, on average.
“Our situation was already dramatic and now it has become unsustainable. Without a source of funding, it is very difficult to maintain the services of the Sister Dulce Social Works”, said Maria Rita Pontes, superintendent of Osid and niece of Santa Dulce dos Pobres. “The floor is extremely fair for the category, we have a contingent of 1,300 people, but unfortunately, we have already met with part of them and explained that we cannot assume this expense.”
The law of the national nursing floor mainly aggravates the situation of the 1,824 philanthropic hospitals and Santas Casas throughout Brazil. The new floor will increase the costs of these institutions by more than R$ 6.3 billion per year, which already face great difficulty in maintaining care for the population due to the 15-year lag in the SUS table, according to the CMB.
Daniel Menezes, spokesman for Cofen, said that the segment of private health institutions had a profit of more than 20% in the last few years and will be less affected by the floor.
“In relation to Santas Casas and the philanthropic sector, we understand and are in solidarity, but it is a historical problem.” For him, the focus of hospital entities should be on charging the Legislature and the government to adjust funding.
STF
The CMB and other national entities in the health sector, including CNSaúde, Abramed, FBH, Anahp, the Brazilian Association of Vaccine Clinics (ABCVac) and the National Confederation of Municipalities (CNM) in addition to hospital federations, filed a direct action before the Federal Supreme Court (STF) claiming the declaration of unconstitutionality of the floor law.
The Union of Hospitals, Clinics and Laboratories of the State of São Paulo entered as an interested party. According to the president, Francisco Balestrin, the adoption of the floor will make much of the medical and hospital care and health plans unfeasible.
The information is from the newspaper O Estado de S. Paulo.
Source: CNN Brasil
