Um Olhar geográfico sobre o processo de inserção do Hospital Universitário da UFGD no Programa Nacional de Reestruturação dos Hospitais Universitários Federais

Abstract

This work had as general objective to analyze the government policy directed to the University Hospitals (HUs), linked to the Ministry of Education, within the scope of the National Program for the Restructuring of University Hospitals (REHUF), created in 2010, by the Federal Government, with the discourse of creating material and institutional conditions so that federal university hospitals could adequately perform their functions concerning the dimensions of teaching, research and extension and the dimension of health care. Therefore, we contextualize the process of implementation and operationalization of REHUF in HUFs, seeking to understand the speeches and theories that supported it, the investments made and their materialities, in short, its unfolding and contradictions, having as an excerpt of analysis the University Hospital of the Federal University of Grande Dourados (HU-UFGD). The methodology adopted was an integrated approach, seeking to understand the process in its entirety and relating it to its particularities. In this sense, we did a historical review about hospitals in the world and HUFs in Brazil, in addition to characterizing their structures – but, fundamentally, we analyzed the historical dynamics in the treatment spent on hospitals, their conformations in the geographical space and the financing strategies implemented in the HUFs. Likewise, we made an exhaustive documentary survey regarding the insertion and dynamics of HU-UFGD in REHUF. We show that the HU-UFGD is a reference point for 33 regionally polarized municipalities, depending on the provision of medium and high complexity health services in the Dourados macro-region, southern portion of Mato Grosso do Sul. The research reveals that from the moment that the HUFs became responsible for an additional function, that is, assistance, in addition to teaching and research, they started to have financial problems and lack of health workers. In 2011, with the governmental discourse to resolve such problems, the Brazilian Hospital Services Company (EBSERH) was created, which in 2018 was already in charge of managing 80% of the HUFs. In this new context, these are now managed in a hybrid way – the rectory indicates hospital administration, and these follow the guidelines of EBSERH SEDE (Brasilia, Federal District). The territory of the rule is not compatible with the lived/appropriate territory. The city of Dourados, from UFGD and HU-UFGD, has become a qualitative hospital center of reference for Brazil. EBSERH, being the manager of REHUF, has the function of implementing the objectives of the Program, among them the deficient situation of human resources, which has not yet been resolved, even after the contests based on the Brazilian Labor Laws (CLT) were launched. It is necessary to create conditions for all workers to act with less tension in the face of this continually changing political field.