Judicialização do direito à saúde no estado do Ceará, Brasil : cenários e desafios

Abstract

The legalization of the right to health is political and legal phenomenon that has troubled judges and public officials throughout the country by the financial impact it causes. However, its actual size is unknown, with magnified doubts concerning the reliability of available electronic records, including those of the National Council of Justice (CNJ), a scenario that has hampered the strategic planning of the Judiciary and the Executive. The objective is to characterize the legalization of the right to health in Ceará State in order to: scale the magnitude of the phenomenon, describing the profile of the subjects involved, the diseases, the requested objects and operationalization of lawsuits, verify participation of diseases tropical neglected in the phenomenon of judicialization of health and finally verify scientific production related to the topic of legalization of health as parameters works in Brazil. It is quantitative, cross-sectional study with descriptive exploratory approach, from records of lawsuits in Ceará, in own information systems judiciary that requested the supply of goods or services health to Public Administration from 1998 and 2012. In the period surveyed were encontrados1,757 lawsuits requiring health care to the Executive. 965 cases were targets of a second analysis and revealed no difference regarding gender of the authors, the median age is 57.8 years, are retired (32%) and, mostly sponsored by private attorneys (68%), and that a single lawyer is responsible for 25% of demand. The state is the entity of the federation longer required, accounting for 85% of cases. Medical specialties with the highest number of prescriptions are hematology (25%), endocrinology (8%), pulmonology (7%), oncology (7%) and cardiology (5%), these five specialties are responsible for 51% of prescriptions. The pathologies most frequently are: lymphoma, chronic obstructive pulmonary disease, myelomas and diabetes. Most goods are required Mabthera®, Spiriva®, Lantus® and other supplies for diabetes as needles and glucometer. The request for medicine is 74% of orders and prescriptions come from the public itself in 76% of cases. We saw also that almost 100% of the demands and request free legal interlocutory relief and almost 100% of these requests are granted without even hearing the public officer, which, in theory, contrary to item b.3 of resolution 31 CNJ. Thus, in terms of legalization of health, there is urgency to decide on the election, but there is also urgency and need to hear the public manager, responsible for the organization of the system. Important improve dialogue between judiciary and executive to ensure the individual right to health along with the sustainability and management of the SUS, especially in a context that even the existing channels of communication are not being used effectively. Finally, acknowledged the difficulty of working with the foundation of the judiciary, because aspects of operation, consistency, completeness and interface between systems. We must maximize the use of databases of the Judiciary beyond the mere recording of procedural acts, allowing the health sector has access to data from all the procedures with a view to consistent quality analysis of these records, as well as their patterns and trends. The information generated from this analysis must necessarily be publicized not only the legal and executive institutions, but the whole society. Thus, elements that present today as obstacles in the relationship between the judiciary and the executive, could best be overcome.