Less than a third of Ceará municipalities were included in the first stage of the Doctors for Brazil Program, launched by the Federal Government to replace Mais Médicos. Although it was created in 2019, at the beginning of President Jair Bolsonaro’s term, the project only officially got off the ground last Monday, 19, when the Ministry of Health confirmed the hiring of 529 professionals. Of these, 59 will be directed to a total of 49 cities in Ceará.
In practice, with the number of doctors announced, the program should reach only 26.63% of the state territorya percentage far below the coverage of Mais Médicos, which in 2018, before the departure of Cuban doctors from the country, reached 169 of the 184 municipalities in Ceará, corresponding to almost 92% of the total area of the State.
The Government of the Caribbean island decided to recall its professionals in November 2018, less than a month after Bolsonaro won the presidential elections. At the time, the Cuban Ministry of Public Health in the country justified having taken the decision due to “threatening and derogatory statements” by the president. In the campaign, Bolsonaro stated on several occasions that he would “expel” Cuban professionals from Brazil if he were elected.
Despite the departure of doctors from Cuba, who represented more than half of the professionals working in Mais Médicos, the program was not extinguished by the Bolsonaro government and is still in operation today. But, according to the Ministry of Health, the idea is that it will gradually cease to exist, as Doctors for Brazil expands.
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THE PEOPLE asked the federal ministry how many and which municipalities in Ceará are still served by Mais Médicos, but did not receive the information until the closing of this article. Eight calls were made and three emails were sent.
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For the president of the Ceará Association of Family and Community Medicine (ACeMFC), Roberto Maranhão, Doctors for Brazil has not yet given indications that it will be able to meet the need for medical care in Ceará.
In his assessment, the program cannot yet be considered a consolidated public health policy. “This project was really born as a campaign promise, which was supposed to be carried out at the beginning of the government, but it took this long,” he said.
According to the doctor, the Ministry of Health has not yet detailed important points about the operation of the new program.
“If you analyze the materials of publications, you will not find any concrete information, except for the division of municipalities and the remuneration of professionals. It does not say, for example, how the process of supervising these doctors will be, a fundamental point, which directly affects the care of the population”, he pointed out.
Maranhão also adds that the Government’s new bet, although it has Mais Médicos as a reference, bears little resemblance to the structuring of the first program, launched in July 2013 during Dilma Rousseff’s government.
“There was a project that dealt with the issue of residencies, medical training in Brazil, and that there was a strategy to provide professionals to the places in an emergency,” he said.
“In recent years, what we have seen is an emptying of primary care, especially in places that were previously occupied, mostly by Cuban doctors”, criticized the doctor. In addition to chairing ACeMFC, he is also part of the Coletivo Rebento, a group that brings together about 200 Ceará doctors engaged in defending the strengthening of the Unified Health System (SUS).
THE PEOPLE also questioned the Ministry of Health about the coverage of Mais Médicos Pelo Brasil in Ceará, in this first stage, and asked if there is a forecast for hiring a new wave of professionals, but has not yet received answers. As soon as the demand is answered, the article will be updated.
At the launch of Doctors for Brazil, the secretary of Primary Health Care (Saps) of the Ministry of Health, Rafael Câmara, assured that, by the end of this year, about 4,600 professionals will be working in the program. He did not say, however, what the schedule is planned for the next steps or the number of doctors who will be hired for each of the 27 units of the federation.
In this first phase, the state that received the largest number of professionals was Bahia, with 68 doctors. At the other end, Acre was awarded only one.
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Differences between programs
Remuneration and requirements are the main points that differentiate Medicos Pelo Brasil from Mais Médicos. In the new program, the salary can reach R$ 31 thousand, while previously the value was just over R$ 11 thousand, a kind of incentive paid to professionals, who were hired as scholarship holders.
Unlike Mais Médicos, the new program only accepts professionals with active registration with the Regional Council of Medicine (CRM) in Brazil. The condition prevents the hiring of foreign doctors, except for those who pass the Revalida exam.
Another change is that to join Doctors for Brazil, professionals will have to participate in mandatory training in the area of Family Medicine, in the first two years of the contract. After the end of the period, they will be entitled to work through a CLT contract.
According to the Ministry of Health, the new strategy aims to give priority to care voids — places where there is little or no medical care, especially in municipalities with high social vulnerability. In Mais Médicos, the offer was for municipalities of all profiles, including those in large urban centers.
Municipalities from Ceará included in the first stage of Médicos Pelo Brasil:
Sao Luis do Curu
Guaraciaba do Norte
*All municipalities with the number two in parentheses will receive two doctors. The others, one doctor each.
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