Recently, the new Secretary for Primary Health Care of the Ministry of Health, Nésio Fernandes, spoke about the More Doctors Programme.
According to him, then, the provision will return immediately. Furthermore, the program will offer more opportunities for Brazilian professionals. However, those vacancies that domestic doctors do not want will be filled by foreigners.
The Mais Médicos program was born in 2013, during the government of Dilma Rousseff. Therefore, its goal was to increase the number of health professionals throughout Brazil, with priority within.
This is why Mais Médicos has also received professionals from abroad. Among these countries was Cuba, which contributed many doctors in more isolated places. However, this partnership is not expected to continue as it has previously worked.
That is, given that the vacant posts will be assigned, as a priority, to Brazilian doctors enrolled in the class councils. Thus, it will be possible to fill the positions with Brazilians educated abroad, as well as foreigners.
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“The agenda for the recovery of Mais Médicos is immediate. We want to place doctors in all Brazilian municipalities quickly,” said the secretary.
How was the program management?
Secretary Nésio Fernandes also spoke about how the program worked in the previous administration.
During the government of Jair Bolsonaro, Mais Médicos became Doctors for Brazil. However, according to the secretary, the fate of the professionals was the same as that of the previous format. Thus, other locations with a lack of this service followed.
Nésio Fernandes indicates that there are already 300 municipalities without doctors during the one-year period. Additionally, 800 cities are unable to keep professionals for more than a week.
“To date, most of the vacancies for Cuban doctors who have left Brazil due to a diplomatic crisis have not been filled. There is a gap in care and it will be filled,” he said.
This management of the program was due to divergent positions of the Bolsonaro government. According to the former president, in 2018, before taking office, he would have made changes to Mais Médicos. Furthermore, he criticized the measure by questioning the ability of Cuban doctors.
Therefore, the permanence of the foreigners would be conditional on the renewal of the diploma, without any connection with the Brazilian government. That is, these professionals should obtain an employment contract with private entities.
For this reason Cuba has stopped participating in the measure, so that 8,000 doctors have returned to the country.
The Minister of Health speaks of More Doctors
With management commencing in 2023, new ministries emerge. In this sense, the current minister, Nísia Trindade, took office this week.
According to her, therefore, the More Doctors program will ask again, being one of the priorities of the file. However, the entire team has yet to define the new format for the measure.
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“The Mais Médicos program will return. The priority objective of Mais Médicos is to guarantee the supply of doctors. The goal is to strengthen family health teams. We will work as permitted by law, with national doctors. And then we study how it will come back,” she stated.
The medical courses will comply with the Mais Médicos rules
Future doctors should pay attention to some rules of their courses. In this sense, the Ministry of Education (MEC), still in the previous administration, has published an ordinance with different rules for degrees in the area.
“The ordinance revokes the moratorium and standardizes the rules for the opening of courses. We have set up a large working group with the Ministry of Health, educational institutions and health bodies. There is greater articulation and commitment of the medical degree program with the enhancement of the local and regional SUS network,” said former MEC minister, Victor Godoy.
Therefore, the document requires that the 388 medical courses must comply with all the new rules. That is, that they comply with the Mais Médicos criteria.
Furthermore, higher education institutions are obliged to use 10% of their gross income from monthly fees to the public network of the municipality where the course is located.
Additionally, 10% of course places are required to go to low-income students or local residents. Finally, more investment is still needed in the medical residency program.
These are measures that were already part of the Mais Médicos programme. However, with some changes such as the planning of the amount of 10% of the monthly fees, which should be allocated to the health needs of the locality.
The residences will also change
Going forward, university residency programs should invest in the specializations the city needs most.
However, many colleges have managed to open medical courses through an injunction, i.e. a legal instrument. In this case, there is no obligation to comply with these requirements, which leads to criticism from those who comply with the Mais Médicos rules.
This means that the faculty will be able to rely on the medical course only in places with government determination. Therefore, generally these places are the ones that need the most healthcare workers.
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“There are counterparties who determine that all institutions must provide counterparts to the SUS, which is very interesting,” former minister Victor Godoy said at the time.
It will take 12 months to adjust to the rules
Those medical courses that started due to an injunction have 12 months to comply with all the rules.
In this sense, the period is counted from the request for renewal of the course, i.e. every 3 years.
Currently, there are a total of 200 injunctions to open courses without being in the Mais Médicos rules. Despite the large number of lawsuits on the matter, the debate went to the Federal Supreme Court (STF).
Thus, Minister Gilmar Mendes has the responsibility of analyzing the constitutionality of this new law on Mais Médicos.
“The ordinance also provides better conditions for Minister Gilmar to make his decision,” former minister Victor Godoy understood.
However, it is important to remember that even with the constitutionality of courses outside the Mais Médicos rules, they will continue to exist.
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