A group of protesters, including public health professionals, held an act last Thursday (2), at the main entrance of the Hospital de Base, to demand a wide investigation of allegations of corruption at the Institute of Strategic Health Management of the Federal District ( Iges-DF). Last month, the Public Ministry of the Federal District and Territories (MPDFT) launched an operation to investigate irregularities in the hiring of beds for the Intensive Care Unit (ICU) by the Institute.
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According to MPDFT investigators, in just one of the ICUs managed by Domed, a company hired by Iges-DF, three times more deaths were registered in June, July and August 2020 than in the ICUs managed by the public health network. The investigation will confirm whether there was negligence in the supply of medicines and other supplies used in this type of treatment, as a way to reduce costs. There is also suspicion of overpricing in these hires.
The case is related to the health management model in the DF, which deepened the outsourcing process and less control over resources. Created in 2019, already under the Ibaneis Rocha government, the institute, which previously managed the Hospital de Base, the capital’s main hospital, also took over the management of the Santa Maria Regional Hospital and the Emergency Care Units (UPAs) of Ceilândia, Núcleo Bandeirante, Recanto das Emas, Samambaia, São Sebastião and Sobradinho. The promise was that, in this format, with a non-profit entity governed by private law at its head, purchases of inputs, contracts and renovations would be swift. What was seen, however, was an open door to shady business.
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“What they said is that everything would be easier, such as buying material, hiring people. However, it became much easier to divert the money. That’s the question. Being easier to buy material we even doubt because, with a lot of frequency, there is a lack of supplies for care, either in the Base Hospital or in Santa Maria. Everything that was argued is not being fulfilled”, points out Rosalina Sudo, president of the DF section of the Brazilian Nursing Association (Aben-DF), and employee of the public health. She participated in the peaceful demonstration on this farm.
For nurse Osvaldo Bonetti, who heads the health sector of the Workers’ Party in DF (PT-DF) and is also a professor in the area, the outsourcing of a significant part of public health has left services under a “double command”.
“We perceive a double command within health management, from the beginning, largely because of Iges, which occupies 30% of the resources of the Health Fund of the Federal District, but, on the other hand, it does not manage even a third of the services of the public health network. There is a huge budgetary concentration within this institute”, he points out. For him, it is necessary to guarantee a single command in the provision of public health services in the DF, by the government directly, as recommended by the Federal Constitution in relation to the Unified Health System.
Debts and scandals
Currently, Iges-DF has a debt of around R$370 million and still needs more than R$600 million from the public coffers by the end of the year to guarantee its sustainability. Last week, the Federal District Court of Auditors (TCDF) suspended the payment of an allowance, from R$4,000 to R$6,000, which would be paid to the entity’s directors. The amounts were intended to pay off expenses such as a private pension plan, life insurance, cell phone, internet and health insurance. After this decision, the institute’s management cut the measure.
This week, the institute’s president, Gilberto Occhi, resigned from his post. Occhi was Minister of Health during the government of Michel Temer. In his place, General Gislei Morais, superintendent of the Instituto de Cardiologia do DF (ICDF) was appointed. The exchange takes place days after the change in the Health Secretary’s chair, with the resignation of Osnei Okumoto and the beginning of General Manoel Pafiadache’s term at the head of the ministry.
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The DF’s public health system has experienced successive crises and scandals since the beginning of the pandemic. In August of last year, the former Health Secretary of the DF, Francisco Araújo, still in office, was arrested during Operation Falso Negativo, also triggered by the Public Ministry of the DF and Territories (MPDFT). He spent more than 20 days in prison. The investigation included illegalities in the acquisition of rapid tests for the detection of covid-19 for the local public health system, with connections to the drug company Necessidade, which is being investigated by the Parliamentary Inquiry Commission (CPI) of the Pandemic, in the Federal Senate .
In March of this year, at the height of the second wave of the pandemic, hospitals in the DF experienced scenes of war, with patients being treated at reception and bodies left on the floor of the units until they were removed. At the time, it was even necessary to summon public dentists to provide assistance.
Now, in the midst of the Iges-DF crisis, opposition deputies in the Legislative Chamber (CLDF) are defending the installation of a CPI to investigate the institute. Support for the installation of the investigation has nine signatures, more than the minimum of eight required for opening, but it is the tenth on the list of CPIs filed since 2020. Based on this argument, the President of the Chamber, Rafael Prudente (MDB) , an ally of governor Ibaneis Rocha, is blocking the CPI.
In defense of the CPI, Rosalina Sudo, president of Aben-DF, speaks about ensuring transparency in the use of public resources. “The money is going down the drain, and the number of people being served by Iges is infinitely smaller than before the privatization. What we want is for it to be clarified, for the box to be opened to show the population what is in it being done with this money, as it is being used”.
“It’s not enough just to have the CPI, you have to remove this institute and the Health Department, the public administration, recover the management of this service, the seven UPAs and the two hospitals”, says Osvaldo Bonetti.
Wanted to comment on ongoing investigations, the Iges-DF did not respond until the matter was closed. The space remains open.
Source: Federal District BdF
Edition: Flávia Quirino