Senators maintained the text approved by the Chamber; measure resumes health program discontinued in the Bolsonaro government
The Senate approved this Tuesday (20.jun.2023) the provisional measure of Mais Médicos (MP 1,165, of 2023), which opens new vacancies in the program and changes rules for the revalidation of diplomas of doctors trained abroad. The House maintained the text that was approved in the Chamber of Deputies last Wednesday (June 14), without further changes. Thus, the MP goes to the president’s sanction Luiz Inacio Lula da Silva (PT).
The basic text of the MP was approved in a symbolic vote by the full Senate. However, the Progressistas presented a highlight for separate analysis of a senator’s amendment Dr. hiran (PP-RR) to prevent doctors who graduated abroad and have not yet revalidated their diploma in Brazil from participating in Mais Médicos.
According to the justification for the request for emphasis, “Brazil has never had so many doctors working”, which would make these professionals participate in the program. Here’s the full of the highlighted application (332 KB).
Already the senator Zenaide Maia (PSD-RN), MP’s rapporteur in the joint commission on the subject, criticized the highlight. She stated that the Revalida (National Exam for Revalidation of Medical Diplomas) was not withdrawn by the text.
“What we question, everyone who is watching us, is the 2nd stage of Revalida, which is being carried out by Inep [Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira], as was shown in the commission. In a single day, Inep hires a hospital without a patient, with no patients, with actors and actresses and, representing children, those dolls that look like children. A single test.,” said the senator.
In nominal voting, the highlight was rejected by 47 to 29.
In the Chamber, by agreement between the government and the opposition, the deputies approved the highlight to remove the section that allowed the extended waiver of taking the practical test of Revalida for those who proved approval in the Mais Médicos assessments in the last 4 years.
The waiver of Revalida for program physicians trained abroad will be valid only for the first 4 years. Congress shortened the original deadline provided for in the MP.
Thus, throughout this period, professionals will be able to participate in Mais Médicos without taking the test, but it will be necessary to pass periodic evaluations of the program. Those wishing to extend their participation beyond 4 years will need to revalidate their diploma after the period, including taking the practical test.
The original text of the MP edited by the Lula government waived the revalidation for the doctor’s participation period in the program in the areas of teaching, research and extension, which could be from 4 to 8 years.
The Mais Médicos program was launched by the government of Dilma Rousseff (PT), in 2013, and discontinued in the management of Jair Bolsonaro (PL), in 2019.
MP IMPACT
According to the government, the impact of the MP is BRL 712.5 million in 2023 and BRL 3 billion for the following 2 years. The new format of the program provides for the initial opening of 15,000 new vacancies for health professionals, with the hiring of 28,000 by the end of 2023.
Scholarships for program professionals will be paid directly to doctorswithout intermediaries, unlike the previous procedure, in which the country of origin received the amounts paid by the Brazilian government and passed them on to the doctors.
Another point included in the mixed commission is the possibility of using telehealth at Mais Médicos”when necessary“, according to the text. In addition, the requirement that the professional who supervises the members of the program be a doctor was resumed.
Here are the main approved changes to the original text:
- the need for the physician to be previously informed about the program’s requirements and the vacancies available to Fies (Higher Education Student Financing Fund) graduates;
- validity of the new rules for doctors participating in the program before the publication of the MP;
- validity of leave due to domestic violence and special hours for physicians with disabilities or family members with disabilities, without compensation for workload;
- full, equal and direct payment to the doctor, without intermediation;
- reservation of vacancies for physicians with disabilities and belonging to ethnic-racial groups;
- monitoring and evaluation of the effectiveness of Mais Médicos para o Brasil, with periodic publication of reports.
INDIGENOUS TERRITORIES
In the mixed committee, changes were approved for the priority of sending doctors from the program to indigenous areas. Quilombola and riverside communities should also be preferred.
The incentive for indigenous health was also included with the alteration of Adaps (Agency for the Development of Primary Health Care), which will be transformed into AGSUS (Brazilian Agency for Support to SUS Management).
The idea is for the agency to carry out primary health care policies nationally and promote the implementation of indigenous health development policies. These actions would include other levels of care in the area, in addition to the primary one.
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