TCU recommends that Saúde request unemployed civilian hospital beds for civilians

Posted on 9/5/2021 9:04 PM / Updated 9/05/2021 10:04 PM

The technical field of the Federal Court of Accounts (TCU) has recommended that the Ministry of Health issue an order to request clinical beds and intensive care units (ICUs) from military hospitals, which are not operational, to serve the general population during the pandemic. . Covid-19 has already killed 422,000 people in Brazil. The report has been in the context of the TCU process since mid-March and is investigating potential violations of not introducing the family to the civilian public, which will be available while facing the novel coronavirus.

The document is dated May 4 and was sent to the rapporteur of Minister Benjamin Zimmler last Friday (7). “It is considered that there will be no obstacles to emergency, temporary and exceptional assistance to civilians by military health organizations, through agreements, in cases where health systems collapse in localities,” as stated in a report prepared by the General Secretariat for External Supervision of National Defense and Public Security (SecexDefesa) .

The General Secretariat also says that the Ministry of Defense and the leaders of the armed forces should be recommended to adopt the necessary measures to enter into an agreement with the Unified Health System (SUS) for family participation with the general population and “in cases where the locals have collapsed health systems.”

In the report, the technical field claims to have verified that public resources finance approximately 78% of the marine health system, 77% of the air force system, 65% of the army system, and 88% of the resources directed to the Armed Forces Hospital. , The largest hospital in the Federal District.

Despite the amount of resources, the document states that “only 27.7% of the beneficiaries of the military health systems are active duty soldiers, leaving 72.3% of the beneficiaries of the foreigners in the institutional activities of the Forças Singulares”. The agency claims that the data “undermine the argument presented that the eventual increase in demand for beds will lead to a commitment to carry out national defense activities.” These units serve the army and their families. In Brasilia, HFA also serves civil servants from the hospital and the Department of Defense.

The report notes that the data provided by the armed forces on public resource financing are “unrealistic” and inconsistent with the value indicated by the technical area of ​​the Technical Support Coordination Unit. The document also indicates that the number of intensive care beds in military health units represents 0.13% of the total active military personnel, “which would not be a quantity capable of endangering the employment of the forces, and thus endangering national security. And sovereignty.”

The technical field also confirms that although the Ministry of Defense presented to TCU “the thesis that in order to sign agreements allowing military health organizations to provide assistance to the population, it would be necessary for such a measure to be of interest to the armed forces, which, in his understanding, would not be so.” The analysis conducted indicates that the interest to be served by the business of the administration is the public interest, which is certainly not achieved by adopting an ultimately uneconomic act, represented by the allocation of resources to provide emergencies for a new ICU family with unused beds in health organizations Military. “

The Ministry of Defense said in a memorandum that it “does not comment through the press on any technical report or judgment issued by the Federal Audit Office.” He pointed out that “it is worth noting that this is the measure that guided the relationship of respect between the armed forces and other institutions of the republic.”

Idle family

With the increase in deaths due to Covid-19 at the beginning of the year, the military has been mandated to provide intensive care beds and infirmaries that do not need to occupy the general population. At the beginning of last month, for example, the Attorney General’s Office (DPU) requested that military hospitals in the Federal District give the Department of Health in DF access to the list of ICU beds and the Dispensary of Military Hospitals in DF. Before that, the same file had requested a vacancy in the ICU from the HFA, which contains more beds among the four military units in cannons, but was rejected under the pretext of restricting technical ability.

The Ministry of Defense said that no family is idle. On the 17th, for example, he said in a note that “the vast majority of military hospitals have beds that are almost occupied in all intensive care units and are looking for alternatives to prevent collapse, such as transporting patients to other areas.” The file also claims that the units are already legally responsible for serving the 1.8 million users of the military family (active duty, inactive, dependent and retired).

In addition, they claim that the military contributes monthly health forces funds. The file shows that hospital expenses are mostly covered by resources from the army itself: the fund plus participation (20%) of all procedures. According to the ministry, a “limited portion” of funding for these units comes from “resources from what the federal government allocates and does not pay to the army as individual health care, which are paid monthly to civil servants.”

HFA

Last month, the commander of logistics at the Armed Forces Hospital, General Ricardo Rodriguez Canacci, confirmed in an interview with Mail That there were no idle beds and that the unit was on the edge of a cliff at the time. “Nobody refuses to help. He said,“ The important point is that there is no bed. ”The commander also noted that even if service is not within the limit for COVID-19, the hospital cannot provide beds to the Unified Health System (SUS) in The time being, because it will need to resume surgeries that have been delayed, in a queue that is just growing, and stressed that, in the Hyogo Framework, there is no agreement with SUS.

“Who will pay me for this patient? This SUS schedule is a lower schedule than I will get from the Troops Health Fund. Then, how will I support the hospital?” He asked. However, he noted that this “has never been and will never be a reason” to deprive SUS of a place. “The reason is that there is no bed for the large number of patients.”