A relação público/privado na saúde: as expressões das organizações sociais na Paraíba

Abstract

This research aimed to analyze the expressions of managerialism and financialization of the public/private relationship in the health policy of the state of Paraíba, through the Social Organizations (OSs), and to reveal their real interests in the provision of public services, contributing to the debate on the forms of non-classical privatization of health with the identification of elements of interest to capital in the process of privatization of health in our state. To achieve the proposed objectives, we adopted as a methodology, based on critical social theory, a bibliographical review of the main categories of the study highlighted - Neoliberalism and Ultraneoliberalism, State, Counter-Reform and Public/Private Relations - in addition to the documentary analysis of audit reports made available by the agencies of state control, through the transparency portals of the Executive Branch and the State Court of Auditors (notably the electronic Official Gazettes), as well as the Public Ministries (State, Federal, Labor and Accounts), and the websites of the Organizations Social Services and respective Citizen Information Services (SIC). This process has been experienced in Brazil, having arrived in the state of Paraíba more than a decade ago. The work brings an analysis of the state reality of the adoption of a privatizing model of management in the health area, represented by the OSs, exposing the main implications of its performance in the hospital units of Paraíba in the period from 2011 to 2020. From the analysis of the data and the irregularities listed in the reports of the control bodies to which we were able to access, we found the recurrent lack of transparency about the effective control of the indicators (goals and objectives) established in the management contracts, promised by the change in the bureaucratic-managerial paradigm, with the persistence of the unavailability of clear and detailed information on institutional websites, contrary to the provisions of the guidelines expressed in the Law on Access to Information (Law No. 12,527/2011), and the principles required in Art. 37 of the CF of 1988. However, we emphasize the importance of the process of resistance and struggle, mainly by the National Front against the Privatization of Health (FNCPS) in Brazil and in the State of Paraíba, against the implementation and expansion of this neoliberal model.