The waiting time for public health care is one of the biggest problems faced by those who need to use these services. According to data from the survey Judicialization and Society: Actions for Access to Quality Public Health, presented by the National Council of Justice (CNJ) last Thursday (8/26), the lack of professionals, regulation and organization of data on waiting lines are some of the reasons that lead people to seek justice.
The study was debated during the Empirical Research Seminars applied to Judicial Policies, promoted by the CNJ. According to the supervisor of the Executive Committee of the National Health Forum, councilor Candice Jobim, the objective of the research was to point out the deficiencies and seek ways to make the provision of health services more effective.
“All the State Health Committees had access to the research and prepared, within their state, an action plan. Based on these proposals, we prepared the National Plan of the Judiciary, which will be presented on September 9, at the IV Journey of Health Law,” he stated.
Failures in the provision of public health services were highlighted by the event debaters. For the public defender of the Federal District, Ramiro Santana, along with the shortage of medicines – also registered as one of the biggest complaints in the processes -, the long waiting lines are motivated by the precarious structure of health services. “Research is an instrument that provides a panoramic picture of the situation, but everyday practice points to even deeper problems.”
The lack of specialized professionals, in turn, was identified by municipal and state health secretaries as the second greatest difficulty in complying with the actions demanded. First, there is the scarcity of sufficient or not budgeted resources, which is also related to the purchase of medicines.
The absence of specialists would be one of the reasons for the delay, on average, of up to three months to consult an orthopedist, for example, as recorded in the survey. Santana, however, stated that, in practice, this time is even longer, reaching up to two years of waiting. “The difficulties are not only with consultations with specialists, but also with the materials needed to perform the procedure.”
The lack of regulation for waiting lines in Brazilian municipalities was also criticized by the public defender. According to him, the lack of regulation indicates that these places “are not even able to provide information about their waiting lines, much less control over the waiting time and the number of people who make up the repressed demand”.
According to the survey, about 14% of the Municipal Health Departments claimed to have normative acts for scheduling appointments and 42.4% have an act for hospitalizations. When integrated with other municipalities, about 60% have normative acts to regulate consultations and 52.8% to regulate hospitalizations. The states, on the other hand, have greater control over this regulation: among the 21 state secretariats that responded to the survey, 71.4% have a regulatory act for scheduling appointments and 76.2% have an act regulating hospital admissions.
On the other hand, the defender praised the use of Technical Notes produced by the Judiciary Support Nucleus (NatJus), which has allowed magistrates to have subsidies to base their decisions on scientific evidence. “The use of NatJus in decisions has proven to be valuable, as they provide technical guidance from the point of view of health and the proven effectiveness of evidence-based medicine.”
The judge of the Federal Regional Court of the 4th Region (TRF4) João Pedro Gebran Neto recalled that the judicialization is usually focused on medicines that are not included in public health policies, but that the study showed the existing flaws in the provision of services. He highlighted the importance of the survey data being made available on an interactive panel, which allows the user to check the conditions of their state. “Besides that, we can also demonstrate that it is a failure in the provision of service.”
The judge emphasized, however, that judicialization is not a problem that affects only states and municipalities, but also the Union. “We need to have preventive measures that should be adopted by the Ministry of Health.”
He informed that the National Forum is compiling the action plan proposals presented by the State Health Committees, not only so that they can verify the proposals of other regions, but should also make proposals to the Ministry. “The proposal, obviously, is not imposing, but they are proposals that seek to give visibility to strategic planning and also guidelines for actions that can and should be developed by the Ministry of Health, with milestones, goals, objectives and, above all, deadlines.” With information from the press office of the National Council of Justice.
Review the event on CNJ’s YouTube channel