A survey carried out by Conasems (National Council of Municipal Health Departments) at the request of the Federal Supreme Court (STF) outlines an apocalyptic scenario if the new nursing floor is paid. In the entity’s accounts, the readjustment will lead 70% of Brazilian municipalities to fail to meet the cap on personnel expenses established in the Fiscal Responsibility Law (LRF).
With the non-compliance, municipalities cannot take out bank loans, which compromises the management of investments in cities.
Sanctioned in August by Jair Bolsonaro (PL), the legislation provides for a minimum remuneration of R$ 4,750 for nurses in the public and private network. However, the application of the adjustment was suspended in September and the Supreme Court asked for the manifestation of each segment of Brazilian health to have a diagnosis of the situation before defining whether to release the application of the floor.
The private network, which will also be heavily impacted, claims to have “budgetary elasticity.” Philanthropic entities, which operate mostly in the red, are projecting the closure of entire hospitals.
The document obtained by the SA Panel shows that, among the 465 municipalities surveyed, the implementation of the new floor would lead to the closing of beds and the dismissal of employees.
The municipal management of SUS has 599 thousand nursing professionals, with an annual cost of R$ 23 billion. If the floor is considered legal, it will be necessary to add R$ 15 billion to the municipal coffers. In the states, the impact exceeds R$ 12 billion.
“If a readjustment of personnel is necessary, due to the inability to increase financially, with the current amount of financial resources available, it would be possible for municipalities to guarantee the maintenance of the employment of only 60% of nursing professionals in the SUS”, says Conasems in the document Minister LuÃs Roberto Barroso.
In addition to the labor cuts, the entity says that the floor will prevent the construction of UBSs (Basic Health Units) and the end of contracts for the provision of services to the SUS by private entities.
Conasems says that in 2021 the Union financed 45% of the SUS and an internal projection indicates that this participation will reach 41% by 2024, requiring more money from states and municipalities.
Nurses criticize the delay in the solution for the floor and representatives say that the category is in disbelief with the promises of an alternative in Congress.
Julio Wiziack (interim) with Paulo Ricardo Martins and Diego Felix
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