O Hospital Universitário no Sistema Único de Saúde

Abstract

The well-known phenomenon of the judicialization of health arises after the promulgation of the Federal Constitution that instituted the right to health as a social right to be organized in a single system, guided by universal and equal access and comprehensive care. This right is regulated by Law 8,080 / 1990, the Organic Health Law, which gives organization to the system and, since then, what has been perceived is an increase in this type of demand. This upward behavior was also seen at the Onofre Lopes University Hospital, especially with regard to requests for procedures and transfers due to late attendance. However, when the university hospital occupied the passive pole of the demand, it was possible to perceive that the Judiciary gave different treatments to the entity, sometimes understanding for its full responsibility and, at other times, for the absence of passive legitimacy to be in the dispute. Thus, this study aims to research how the university hospital is legally related to the Unified Health System. To this end, it proposes to analyze the legal relationship between the teaching hospital and how it is inserted into the SUS to provide services free to users of the public health network. The research investigates the limits of the duties of the university hospital, especially because it signs a legal instrument with the SUS manager to offer its services to the population, associating the tripod with teaching, research and extension and assistance. For this purpose, it begins by analyzing the nature of the legal relationship between the university hospital and the SUS. It also assesses Brazilian health legislation, comparing the constitutional provisions on health with the laws and rules that regulate the procurement of public health services. Once the rules that govern the matter have been established, the specific instrument that materializes the participation of the HU in the SUS begins to be evaluated. In order to achieve its scope, the work still involves the analysis of teaching and health from the perspective of harmonizing these two aspects to promote development, respecting each area, given that university hospitals have in their hands the laborious mission of associating teaching with assistance. The limitation of attendance by the university hospital is evaluated both by the determined structural and personnel capacity, as well as by the evaluation of the SUS organization, which lead to an understanding of the limitation of the judicialization of health with regard to the teaching entity. Some judicial decisions handed down by the Federal Justice in lawsuits whose liability was integrated by Hospital Universitário Onofre Lopes are analyzed in order to demonstrate how this issue has been considered by the local Judiciary. In conclusion, after verifying the exposed concepts, the study assesses that the university hospital integrates the health system through a contractual instrument, which establishes the reciprocal obligations between it and the contractor, which is the federative entity that manages the SUS. Thus, your responsibility when offering your services is not unlimited. It is also evaluated that, as a result, the obligation to provide health actions is the responsibility of the federative entities, and is not opposed to the university hospital, since it integrates the system as a service provider.