In a letter despatched on Thursday evening (4) to the Division of Well being, the most important community of dialysis clinics within the nation, DaVita, requests an pressing assembly with Minister Marcelo Queiroga and informs that the care of 14,000 sufferers of the SUS ( Unified Well being System ) is susceptible to interruption.
The warning from the community, which has 91 clinics and a vascular entry heart and serves 350 hospitals within the nation, reveals a major problem that impacts the fundamental space within the continual kidney affected person. In dialysis, a machine filters and cleans the affected person’s blood, doing a job that the kidneys cannot do.
About 90% of the dialysis clinics that serve SUS are personal and obtain referrals from the federal authorities. They report that they’ve been dealing lately with outdated costs for applications, however that in latest months, with the rise within the greenback, the rise within the worth of inputs and the rise in costs, the scenario has worsened.
“The shovel of lime”, within the phrases of the nephrologist Yussif Ali Mere Júnior, president of the ABCDT (Brazilian Affiliation of Dialysis and Transplantation Facilities), got here this Thursday, with the punishment of the wage degree of nurses, by President Jair Bolsonaro (PL) .
The invoice was accepted by the Chamber of Deputies in July and units the fundamental wage for nurses at R4,750. Nursing technicians ought to obtain 70% of this quantity, and nursing assistants and midwives, 50%.
In response to ABCDT, there will likely be a rise in prices with the creation of the usual and there’s no provision for any accomplice to switch to SUS service suppliers. This prompted protests from a number of well being care employers, in addition to mayors and governors.
Presently, the dialysis clinics that present providers within the SUS obtain R$ 218.47 per session, after the adjustment in December of final yr of 12.5% within the desk. However based on the calculations of ABCDT, the price of the system is R$ 303, that’s, there’s a lag of 39%.
With the standard of care, the sector estimates that there will likely be an extra affect of BRL 68 per dialysis session, and claims that the Ministry of Well being will cowl this improve in prices. The nation has about 800 clinics serving about 150,000 sufferers with continual kidney illness.
“Whereas it is an incredible demand for nurses, this case makes the continuity of look after all SUS sufferers unparalleled,” mentioned Bruno Haddad, president of DaVita Renal Therapy. In response to him, the usual will produce a rise in the price of R $ 120 million per yr within the community.
In a letter despatched to Queiroga, Haddad says that if there isn’t any fast resolution to the fee equation, the community, which serves 15% of dialysis sufferers within the nation, won’t be able to proceed the care of SUS.
“The scenario is chaotic. The federal government has issue understanding the danger these kidney sufferers are operating. They can not spend every week with out dialysis. In the event that they keep, they die. If we cease, they die. [governos] they don’t have any place to place public sector sufferers,” mentioned Haddad.
In recent times, at the very least 40 clinics serving SUS have been closed and lots of are going through monetary difficulties, based on ABCDT. They’re all in debt, they’re alive [empréstimos] despatched. The worst is the dearth of credit score for clinics. “The machines are getting previous, they’ve began to jeopardize the affected person’s remedy, which isn’t his fault,” mentioned Ali Mere Júnior.
He provides an instance of the affect of excessive costs on some of the vital inputs within the sector, saline resolution, one of many issues going through the scarcity drawback.
“We want 2,400 bottles of serum per thirty days. Earlier than the epidemic, every bottle value R$ 4, now there’s a vendor who asks for R$ 26”, mentioned nephrologist Viviane Elizabeth de Oliveira. With disposable gloves, the identical scenario happens. Earlier than the pandemic, Oliveira paid R$17 per field. Throughout the pandemic, it went as much as R90 and right this moment it’s round R40.
The issue of this sector comes at a time when the variety of sufferers on continual dialysis in Brazil has doubled, from 65,000 to 144,000 between 2005 and 2021, based on the statistics carried out by the Brazilian Society of Nephrology.
Within the final two years, the governments of Rio de Janeiro, Santa Catarina and Mato Grosso do Sul have begun to allocate their sources to assist the federal switch and make sure the continuity of dialysis providers for SUS sufferers.
Different states, reminiscent of Paraná, Minas Gerais and the Federal District, are testing related measures. São Paulo, nevertheless, has already advised the sector that it isn’t ready to implement it.
In smaller cities, the scenario is even worse. In March, the one dialysis clinic in Conselheiro Lafaiete (MG), with 92% of SUS sufferers, requested the general public to assist them to not shut.
“We’ve reached our debt restrict, we’re taking loans from banks to honor commitments, particularly with our staff. Accounts are closing with growing money owed each month, we’re taking a look at complete chapter”, mentioned the Santo Antônio clinic in an announcement.
Clínica do Rim de Vitória de Santo Antão (PE), which serves 100% of SUS sufferers, has resorted to financial institution loans to pay payments, payroll and 13 salaries. Docs on responsibility have been lower in half and the clinic decreased the variety of related examinations for sufferers.
The Clinefran Clinic, Franco da Rocha (SP), additionally sought a financial institution mortgage, lowering medical salaries. Investments in constructing renovations or tools acquisitions haven’t been made for greater than six years.