The end of care for SUS patients at Hospital AC Camargo, a reference in oncology in São Paulo, could result in an increase in queues and a delay in cancer treatment, in the assessment of NGOs. It is feared that the training of professionals will also be harmed.
For representatives of Abrale (Brazilian Association of Lymphoma and Leukemia), Femama (Brazilian Federation of Philanthropic Institutions to Support Breast Health) and GAPC (Support Group for People with Cancer), the decision will increase pressure on a system already problematic service.
“The system is overloaded due to the pent-up demand of the pandemic. The units are not handling so many patients who stayed at home or who did not know they had cancer and now need cutting-edge care like that of AC Camargo”, says Maira Caleffi, head of the Mastology Service at Hospital Moinhos de Vento and president of Femama.
“This decision will generate impacts on cancer diagnosis and treatment, even though the patients currently treated are being referred to other units of the SUS”, adds health doctor Catherine Moura, CEO of Abrale. “Today, access to early diagnosis and therapies is an important challenge faced by patients who depend on public health and any change in the care system could increase queues in other places, delay treatment or even cause discontinuity in some cases.”
Moura says that the latest research carried out by the association, with 1,392 patients, shows that in 28% of cases the first treatment occurred after the period of 60 days established by law.
According to the survey, people with Hodgkin’s lymphoma go through several doctors in primary care, which causes delays in referral to the specialist and in the beginning of treatment, affecting the prognosis.
The patient with non-Hodgkin’s lymphoma, on the other hand, takes about a month to seek medical care and faces difficulties in carrying out diagnostic tests such as tomography, lymph node biopsy and bone marrow biopsy.
“Before the pandemic, we had improved with the 60-day law, but the whole system turned to meet Covid and we went back ten years”, adds Caleffi.
For her, the news of the termination of care by the SUS is also a concern for the training of future specialists, another area in which AC Camargo stands out. “SUS is a great school for high-quality professionals.”
Carina Motta, a social worker at GAPC, highlights the psychological effects on patients who will be transferred. “The patient creates a bond and trust in the team and, upon receiving the news that he will have to change the place of treatment, he may feel insecurity and fear until he builds a link with the new professionals who will receive him.”
She advises those who are transferred to request a copy of the medical record and of all tests already carried out to forward to the new hospital.
The representatives emphasize, however, that AC Camargo should not be blamed for the decision.
“The public power needs to review the financing and remuneration models within the scope of the SUS and improve the capacity of public management, aiming at efficiency and reducing waste to improve the allocation and application of resources”, says Moura.
Caleffi reinforces the idea. “I’m sad because it’s an inability of the Brazilian health system not to be able to retain a hospital like AC Camargo and we don’t know how many others may be in the same situation.”
The hope, for Caleffi, is that new partnership solutions are found with the SUS and that the announcement promotes a movement of change in health financing and in the path of patients, with greater attention to prevention and early diagnosis.
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