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Hospitais : a longa marcha da empresarialização
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RESUMO - O modelo empresarial aplicado a hospitais públicos em
Portugal é o resultado de uma lenta mas coerente evolução,
com base em preocupações comuns a diversos governos e
legisladores: o aumento da despesa e dos orçamentos dos
hospitais e a inapropriação do modelo burocrático aos hospitais.
Não é de admirar que a reforma se tenha verificado apenas
na passagem do século XX para o XXI: porque a década de
90 foi a da abertura dos hospitais à ciência e métodos de
gestão; porque a sociedade portuguesa, no seu passado,
manifestou um significativo atraso no domínio dos métodos
de gestão empresarial; finalmente, porque na mesma
década a formação dos profissionais prestadores de cuidados
iniciou um processo para superar o passado deficitário
em ciências da gestão.
Face ao nível da despesa da saúde no país, à dimensão do
parque hospitalar e à insatisfação perante alguns dos seus
resultados, é natural que se tenha gerado o consenso suficiente
e o momentum para, em plena crise económica e
financeira, se empreender uma reforma amadurecida ao
longo de anos.
O autor identifica os diferentes marcos reformadores do
sistema hospitalar português na sua longa marcha para a
empresarialização, concluindo que o êxito dos hospitais SA
estará sempre relacionado com o êxito da sua gestão, por
sua vez condicionado pelas condições internas e externas.
ABSTRACT - The enterprise model applied to public hospitals in Portugal is the result of a slow but coherent evolution, based on common concerns of different governments and legislators: the increasing hospital expenses and budgets and the inappropriate bureaucratic model regarding the very nature of hospitals. It is not surprising that the reform has occurred in the transition from the 20th to the 21st century: first, because the nineties were the decade of the openness of hospitals, to science and modern management methods; second because Portuguese society, in the past, always revealed a significant delay in the corporate management area; and last but not least, because, in that same period of time, there was a new interest on the education and training of health care providers in the field of management sciences applied to healthcare. Taking the high level of hospital expenses in Portugal into consideration, the dimension of hospital facilities and other resources and the dissatisfaction regarding some of their outcomes, it is understandable that, in the middle of an economic and financial crisis, a consensus and a «momentum» was generated to undertake a reform, thought throughout years. The author identifies the different reforming steps in the Portuguese health system in what we can call the long path towards hospital entrepreneurialization in Portugal, concluding that the performance of hospitals SA will always be related to the success of their management which is conditioned by internal and external factors.
ABSTRACT - The enterprise model applied to public hospitals in Portugal is the result of a slow but coherent evolution, based on common concerns of different governments and legislators: the increasing hospital expenses and budgets and the inappropriate bureaucratic model regarding the very nature of hospitals. It is not surprising that the reform has occurred in the transition from the 20th to the 21st century: first, because the nineties were the decade of the openness of hospitals, to science and modern management methods; second because Portuguese society, in the past, always revealed a significant delay in the corporate management area; and last but not least, because, in that same period of time, there was a new interest on the education and training of health care providers in the field of management sciences applied to healthcare. Taking the high level of hospital expenses in Portugal into consideration, the dimension of hospital facilities and other resources and the dissatisfaction regarding some of their outcomes, it is understandable that, in the middle of an economic and financial crisis, a consensus and a «momentum» was generated to undertake a reform, thought throughout years. The author identifies the different reforming steps in the Portuguese health system in what we can call the long path towards hospital entrepreneurialization in Portugal, concluding that the performance of hospitals SA will always be related to the success of their management which is conditioned by internal and external factors.
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Citação
Varanda, Jorge - Hospitais : a longa marcha da empresarialização = Hospitals : the long path towards privatization. Revista Portuguesa de Saúde Pública. ISSN 0870-9025. Volume temático, Nº 4 (2004), p. 57-63
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública