Nursing floor can cost R$ 10.5 billion and lead to layoffs, says confederation of municipalities

Setting a salary floor for nursing professionals can put pressure on municipal finances and lead to layoffs or cuts in funds that support healthcare services or the purchase of medicines and vaccines, says the CNM (National Confederation of Municipalities).

In a study released this Monday (12), the entity calculates that setting a floor of R$ 4,750 for nurses, with proportional values ​​for auxiliary positions, can generate an impact of R$ 10.5 billion a year for city halls, between direct and indirect costs.

In an exercise to illustrate the risk of this measure for serving the population, the CNM states that the application of the floor could mean the dismissal of 11,800 ESF (Family Health Strategy) teams, the equivalent of 32,500 professionals .

The number represents 22.7% of the 52,200 family health teams operating in Brazil. The Northeast region would be the most impacted, with a loss of 37% of its professionals.

In the Confederation’s accounts, the demobilization of these teams could leave 34.9 million Brazilians without basic health care.

“We are not dramatizing, we are showing the numbers”, said the president of CNM, Paulo Ziulkoski, in an interview with the press.

The estimates will be presented to the STF (Federal Supreme Court), which judges an action asking for the suspension of the nursing floor. The CNM acts as an interested third party (amicus curiae), representing the municipalities.

Minister Luis Roberto Barroso granted an injunction determining the suspension of the law that established a minimum remuneration for nurses and nursing assistants and technicians “until it is clarified” the financial impact of the measure for states and municipalities and for hospitals.

In judgment in the virtual plenary, the score is 5 to 3 in favor of maintaining the injunction suspending the application of the floor.

“No mayor and no citizen is against the nurses’ floor. They would all have to be paid even better. It’s just that there is no way to bear this expense, however necessary it may be”, said Ziulkoski.

According to him, not all city halls would be able to fire their employees, as the exercise of the study suggests, as some are statutory servants, with stability in their positions.

In such cases, the impact would fall on other expenses. “Many municipalities cannot lay off workers. So vaccination coverage will continue to decrease, it will take away from other areas”, warned the president of the CNM.

The cost calculated by the entity grew in relation to the previous estimate, of R$ 9.4 billion, due to an update of the numbers, informed Ziulkoski. The previous account was based on data from Rais (Annual Social Information Report) for 2020. Since then, many municipalities have granted readjustments.

The federal government has smaller estimates of the impact. In the assessments of the Ministry of Economy, the additional cost with the floor would be R$ 4.3 billion per year for municipalities and R$ 1.6 billion for states.

The president of CNM says that some calculations underestimate the effect of the measure because, according to him, they ignore indirect costs and contracts with OSs (social organizations) that work in the primary health network and will also demand readjustments in their contracts.