National floor of nurses goes to sanction without having a source of resources

The Chamber of Deputies approved this Wednesday (4) the project that establishes a national floor for nurses without indicating a specific source to defray the expense, in a text criticized by the economic team and by states and municipalities for fear of the impact of this change on their finance.

The text, by Senator Fabiano Contarato (PT-ES), was approved by 449 to 12. As there was no change in relation to the Senate project, it goes to President Jair Bolsonaro (PL) for sanction or veto.

The project creates a floor of R$4,750 for nurses. Nursing technicians would receive 70% of this amount, and nursing assistants and midwives, 50%. According to the proposal, the value will be adjusted annually based on the INPC (National Consumer Price Index).

The text came from the Senate without a source pointed out to fund the floor. Sector entities, in turn, sought to raise awareness of the project’s impact. Anahp (National Association of Private Hospitals) calculates that the impact could reach R$ 5.7 billion for public sector establishments.

Another R$ 6.4 billion affects private non-profit institutions, an effect that may end up falling on the government, since part of these organizations are remunerated by the SUS (Unified Health System) for the provision of services.

The National Treasury, in turn, estimates an even greater impact, of up to R$7 billion in the case of public hospitals, and of R$8 billion in the case of philanthropic ones. According to government technicians, the additional cost falls almost entirely on the finances of states and municipalities.

Even at the beginning of the vote, the government leader in the Chamber, deputy Ricardo Barros (PP-PR), had indicated that there was nowhere to get the funds to pay for the floor. He said, however, that the government was against withdrawing the project from the agenda.

“We want to vote on the project, but we want to deliver the amount on the nurses’ paychecks. So I hope that by the end of this vote we will find a solution that makes possible the source for these resources, so that everyone leaves here with the certainty that it was indeed a victory.”

In the end, however, he admitted that he had not yet found a source for the funds and guided the vote against the project. “The bill does not meet the fiscal responsibility law and cannot be sanctioned,” she said. He stated that the president of the Chamber, Arthur Lira (PP-AL), will only send the text to the sanction after the source of funds is available.

“What was said here, I will repeat. Deputy Carmen Zanotto (Citizenship-SC) spoke on the platform that President Arthur Lira will only send this project to sanction when the sources of funds are resolved. She cited a PEC that has to be voted on two rounds in the Senate and two rounds in the Chamber that could make the constitutionality of this project viable so that we can sanction it when it is sent to the presidency of the Republic.”

To try to find the resources, Lira had created a working group that looked into the topic in search of a source of resources. On Tuesday (3), in an interview, he stated that the deputies were still discussing funding sources for the project.

In the report, Zanotto stated that the analysis of financial and budgetary impact focuses on the federal sphere and, in the terms pointed out by the working group, “is restricted to approximately R$ 50 million per year in the Union.”

“This is a very small amount compared to the annual allocations contained in the programs of Ministries such as Health and Education, which bring together several of the professionals reached by the proposal.” Zanotto’s report says that the expense can be absorbed by specific appropriations or by supplementary credits.

The working group itself, however, cites that the Ministry of Health estimated the total impact of the project at R$ 22.5 billion.

Conass (National Council of Health Secretaries) and Conasems (National Council of Municipal Health Secretaries) also analyzed the impact for public sector professionals and SUS service providers, in states and municipalities. The total impact estimate is R$ 26.5 billion.

“Given that the proposal generates financial impacts on public entities, as well as on the private sector, with and without profit, several proposals are already being processed in the two Houses that increase revenues or relieve charges; in addition to the expansion of resources to be transferred by the Fund National Health Service to reinforce transfers to federated entities”, wrote Zanotto in the opinion. “However, as they do not directly concern the setting of the salary floor, they will be dealt with in independent proposals.”

During the vote, Zanotto spoke again on the topic. “In the Federal Senate, the PEC has just been read [Proposta de Emenda à Constituição] number 11, and here in the Chamber we have several parliamentary and Senate initiatives that seek to guarantee the respective funding”, he pointed out.

“Therefore, as was assumed with Brazilian nursing, it will not be next week that this project will go to presidential sanction. And yes, as soon as we vote for the PEC in both rounds in the Senate, in both rounds here in the Chamber, we guarantee the respective funding”, he said.

In the Senate, President Rodrigo Pacheco (PSD-MG) said that there was an effort to identify a source of funding for payment of the national floor for nurses.

“Furthermore, there is an initiative, a PEC to remedy an apparent unconstitutionality defect in this nurses’ floor project.