Contra-hegemonia e legitimação no controle social na saúde: Avaliando os percursos e contradições do Conselho Regional de Saúde V em Fortaleza/CE

Abstract

The study approach the participation and the exercise of social control in the public politics (PP) of health care implemented in Fortaleza in SER V which is the region with the lowest IDH rate, starting from two analytical-concepts aspects: the notion of social control as the political-theoretical phenomenon and the Regional Council of Health V as the object of em-pirical research. In the first aspect, it is analyzed the globalization of wealth with financial domain and the repercussion in the State, in the PPs and in exercise of social control, consid-ering that the health care politics bring effects of economic crises, social inequality and ex-clusion prevailing in the current society. At the second aspect, its investigated the CRS V as a privileged instance in social control and participation in the SUS system, in the period of 2008 to 2012, since that the social control system of Fortaleza have the opposite resistance to the limits imposed by the current conjuncture. It is elected as analytical categories the Brazilian democratization, citizenship and rights, State and PPs, participation and social control. The central object of investigation is to understand and to evaluate the participatory dynamics and the exercise of social control in the context of contradictory confluence of the democratic pro-cesses and of the structural adjustments due of the reformulation of the Brazilian state. The theoretical-analytic basement supports itself in authors, such as: Karl Marx, Boaventura San-tos, Istiván Mészaros, Zigmund Baumam, Pierre Bourdieu, Antonio Gramsci, Gilberto Freyre, Sérgio Buarque de Holanda, Florestan Fernandes, Glória Gohn, Luciana Tatagiba, Elenaldo Teixeira, Alba Carvalho, Lea Carvalho. The evaluative research is outlined from a qualitative and critical-analytical approach and constitute in a case study with the using of type ethno-graphic techniques, using the followings research instruments: observations, field diary rec-ords, opened/closed forms and groups with the advisors. The methodological sketch covers the characterization of the sociopolitical profile of the subject advisors that compose the sys-tem of social control of the SER V, the comprehension of the dynamic running of the CRS V from the entanglement of the plurality of their looks, the explicitation of the boundaries, di-lemmas, contradictions and possibilities of the performance recognizing the evaluative pro-cess as results of the interpretations of the evaluator and the positions of the different subjects evaluated. In conclusive terms, the study says, in a more structural way, that the social recon-figuration and neoliberal politics reveal a trend to undermine the spaces of collective repre-sentation and of social control. Nevertheless the CRS V dawn in the advisor system of health of Fortaleza with autonomy and independence from the regional government, showing be possible the viability of exercise of social control in the local SUS, presents itself more like strategic space, with potential and defiant in face of the govern actions and less as an effective place of social control and strengthening civil society. Moreover the Council firm up as legit space that format political contexts, instance receiving complaints and promoting accuntabil-ity in SER V, which contributes to press for the implementation of political health care in line with the principles and guidelines of SUS.