0310/2018 - A governança e a relação público-privado no cotidiano das práticas em municípios de pequeno porte. Governance and the public-private relationship in the daily life of practices in smaller municipalities.
No contexto institucional do sistema de saúde ressalta-se que a relação entre os setores público e privado ocorre, sobretudo, para a execução de serviços de saúde de média complexidade, principalmente nos municípios de pequeno porte (MPP). Assim, este artigo objetiva analisar a relação entre gestores públicos e prestadores privados no processo de governança regional, quanto aos fatores envolvidos na contratualização e nos mecanismos de gestão e planejamento das ações de média complexidade. Trata-se de um estudo de caso de natureza qualitativa, realizado em uma região de saúde do Paraná por meio de entrevistas com gestores públicos e privados, realizadas no período de dezembro de 2016 a fevereiro de 2017, e análise documental de instrumentos de gestão e tabelas de contratos firmados entre os mesmos. Os resultados apontam interdependência na relação de gestores públicos e prestadores privados; assimetrias de poder; interesses e benefícios, a depender da tipificação de contrato entre o município com o prestador; destacando-se vantagens e práticas clientelistas. O incipiente processo de planejamento e de medidas regulatórias pelos municípios da região e Estado demonstram a necessidade de investir em ações que favoreçam a governança, a capacidade regulatória de governos locais e o controle social nesta região.
Palavras-chave:
Relação Público-Privado, Governança, Regionalização.
Abstract:
In the institutional context of the health system, it is important to note that the relationship between the public and private sectors occurs mainly in the execution of medium complexity health services, especially in smaller municipalities. Thus, this article aims to analyze the relationship between public managers and private providers in the regional governance process, regarding the factors involved in contracting and in the management and planning mechanisms of medium complexity actions. This is a case study of a qualitative nature, carried out in a health region of Paraná through interviews with public and private managers, carried outDecember 2016 to February 2017, and documentary analysis of management tools and tables of contracts signed between them. The results point out interdependence in the relationship between public managers and private providers; asymmetries of power; interests and benefits, depending on the type of contract between the municipality and the provider; highlighting advantages and clientelistic practices. The incipient process of planning and regulatory measures by the municipalities of the region and state demonstrate the need to invest in actions that favor governance, the regulatory capacity of local governments and social control in this region.
Governance and the public-private relationship in the daily life of practices in smaller municipalities.
Resumo (abstract):
In the institutional context of the health system, it is important to note that the relationship between the public and private sectors occurs mainly in the execution of medium complexity health services, especially in smaller municipalities. Thus, this article aims to analyze the relationship between public managers and private providers in the regional governance process, regarding the factors involved in contracting and in the management and planning mechanisms of medium complexity actions. This is a case study of a qualitative nature, carried out in a health region of Paraná through interviews with public and private managers, carried outDecember 2016 to February 2017, and documentary analysis of management tools and tables of contracts signed between them. The results point out interdependence in the relationship between public managers and private providers; asymmetries of power; interests and benefits, depending on the type of contract between the municipality and the provider; highlighting advantages and clientelistic practices. The incipient process of planning and regulatory measures by the municipalities of the region and state demonstrate the need to invest in actions that favor governance, the regulatory capacity of local governments and social control in this region.
SIlva. JFM, Carvalho, B.G, Domingos, C.M. A governança e a relação público-privado no cotidiano das práticas em municípios de pequeno porte.. Cien Saude Colet [periódico na internet] (2018/jun). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/a-governanca-e-a-relacao-publicoprivado-no-cotidiano-das-praticas-em-municipios-de-pequeno-porte/16843?id=16843
