STF decides to suspend nursing floor with a score of 7 to 4

By 7 votes to 4, the STF (Supreme Federal Court) decided to suspend the effects of the law that determines the national level of nursing in the country. Most ministers voted in favor of the report by Luis Roberto Barroso, who responded to a request from the CNSaúde (National Confederation of Health).

The trial began in the virtual plenary last Friday (9) and ends at 23:59 this Friday (16). As a rule, ministers can still change their votes. It is also possible that there is a request for highlighting.

The decision is valid until the financial impact of the measure for states, municipalities and hospitals is clarified. For this, several bodies were summoned and have a period of 60 days to clarify the feasibility of implementing the floor of R$ 4,750 without mass layoffs and closure of beds.

Roberto Barroso, Ricardo Lewandowski, Alexandre de Moraes, Dias Toffoli, Cármen Lúcia, Gilmar Mendes and Luiz Fux voted in favor of the suspension. The divergence was opened by André Mendonça, who was followed by ministers Nunes Marques, Edson Fachin and Rosa Werber.

Approved in July and enacted in August, law 14,434/2022 set a minimum wage floor of R$4,750 for nurses. Nursing technicians must receive 70% of this amount (R$ 3,325) and nursing assistants and midwives, 50% (R$ 2,375).

If there is a highlight, the trial starts again from scratch, this time in the physical plenary. With this, there may also be changes in the vote, as the court begins a new analysis.

A highlight was the maneuver used by Minister Nunes Marques in the STF’s decision on the lifetime review, one of the most important cases of social security law to be decided by the Supreme in recent years. With the score closed, in favor of the insured and against the INSS (National Social Security Institute), Nunes Marques interrupted the trial 30 minutes before the deadline.

What happens now to the national nursing floor?

Now, the Ministry of Health, CNS (National Health Council), Conass (National Council of Health Secretaries), Conasems (National Council of Municipal Health Secretaries) and FBH (Brazilian Federation of Hospitals) must manifest.

In his vote, Barroso pondered the reasons for his decision. “On the one hand, there is the legitimate objective of the legislator to value health professionals, who, during a long period of pandemic, were required to the limit of their strength,” he said.

“On the other hand, there are the risks to the autonomy and financial health of federative entities, the impacts on employability in the sector and, therefore, on the very provision of health services.”

Since deciding on the suspension, Barroso has reiterated that his decision is aimed at creating, by consensus, a source of funding that makes it possible to comply with the law.

While the issue is not clarified, there is no floor for the category in the country. According to the Ministry of Economy, the additional cost with the floor would be BRL 4.3 billion annually for city halls and BRL 1.6 billion for states. But the CNM (National Confederation of Municipalities) says that the measure can generate an impact of R$ 10.5 billion a year for cities, between direct and indirect costs.

The president of the Senate, Rodrigo Pacheco, has articulated a way out of the impasse that may include resources from the Union. Hypotheses such as the correction of the SUS (Unified Health System) table, the exemption of the sector’s payroll and the compensation of the debt of the states with the federal government are discussed. The exemption from the payroll, however, is criticized by specialists in the public budget.