Crisis: Martagão Gesteira announces suspension of services.

Sayonara Moreno - correspondent for Agência Brasil

With debts of around R$ 25 million, the philanthropic children's hospital Martagão Gesteira, in Salvador, announced the reduction and suspension of procedures starting in August.

The announcement was made by the institution itself, which sent an official letter to the Health Departments of Bahia and Salvador, requesting their position on patient access to the public healthcare system and the involvement of the State Public Prosecutor's Office during the transfer process for children in need of care.

"It's sad, but we tried to avoid this situation. We are very sorry because the children are very needy. More than 80% of the families we serve live on less than a minimum wage. These are people without access to healthcare, with late diagnoses, and already advanced diseases. We tried in every way to avoid suspending services, but we were forced to do so. These families are the ones who will suffer the most from this," said Antônio Santos Novaes Júnior, superintendent of the Álvaro Bahia League Against Infant Mortality, which runs the Martagão Gesteira Hospital.

Customer Service

With free care provided through the Unified Health System (SUS), the non-profit institution serves approximately 700 children in the state daily. This is the case of housewife Daniela Silva, from Camaçari, in the metropolitan region of Salvador. Mother of the boy Paulo Leone Silva Santos, she spent six months at Martagão treating her son, who has the most severe form of osteogenesis imperfecta syndrome (known as brittle bone disease).

During his treatment at the hospital, Daniela received instructions on how to care for the boy at home, where he was sent. However, he died three years later (in April of this year, at the age of six) due to the severity of his illness.

"He didn't die from lack of care. It was the severity of the illness. If it depended on Martagão and what I was taught to care for him, he wouldn't have died. Martagão helps us a lot, it helps many families. It's our safe haven, because the whole of Bahia depends on this hospital," commented Daniela Silva.

Recognition

Daniela stated that, even with her son's death, she still recognizes the effectiveness and care in the treatment given to the children. "I'm in crisis, like Martagão. Imagine a mother knowing that her child could die if they don't have a certain surgery. It's very difficult. There are no resources that can help us. I feel helpless with the hospital's situation," she lamented.

The high number of patients treated at Martagão Gesteira Hospital will decrease, as announced, because next month neurological surgeries will be suspended due to a lack of surgical materials and debts owed to professionals. In addition, treatment for new cases of childhood cancer and new cases of cleft lip and palate will be suspended. Cardiac surgeries will be reduced by half.

The management of Martagão Gesteira Hospital is requesting that the funds allocated to the hospital be recalculated, as the amounts are allegedly outdated. According to Martagão, the reimbursement schedule has been adjusted by 93,66% since the implementation of the Real Plan. However, other basic costs, such as electricity, water, and cooking gas, have been adjusted by as much as 1000%.

Costs

"There are procedures for which we have received the same amount for over 20 years. For some consultations, we receive R$ 10. The SUS (Brazilian public healthcare system) fee schedule has not been adjusted for over 20 years, and our deficit is only increasing," stated the superintendent.

According to the institution, the hospital's costs reach R$ 4,2 million per month. Transfers from the state and municipal secretariats do not reach R$ 4 million, resulting in a deficit of approximately R$ 500 per month.

"We have contracts with the city and state governments. There are states and municipalities where the local SUS (Brazilian Public Health System) manager looks at the table and recognizes the shortfall and, therefore, decides to supplement that amount in the transfer. In Bahia, this type of attitude has never occurred. That's why 40% of philanthropic hospitals have already closed in the state in the last ten years," stated Antônio Novaes.

Secretaries

In a statement, the Bahia State Health Department (Sesab) reported that the Martagão Gesteira hospital receives R$ 1,350 million per month for care and treatments provided at the institution. Furthermore, the department explained that the cost of each procedure is equivalent to 70% of the Planserv (Health Assistance System for State Public Servants) fee schedule. According to Sesab, this amount is more than 40% higher than the amount listed in the SUS (Brazilian Unified Health System) fee schedule.

Also through a statement, the Municipal Health Department said that the calculation of the amount transferred "is carried out by the Contract Monitoring Committee/DGRCA, evaluating the quantitative and/or qualitative goals of the Annual Operational Plan, an integral part of the agreement [signed between the Department and the hospital]". The resources transferred monthly by the Ministry of Health average R$ 2 million.

In addition to public funding, Martagão Gesteira Hospital receives donations via bank deposit, payment of invoices, and adoption of a hospital bed, among other options. The superintendent of the league that maintains the institution clarified that more than 90% of the donations received by the hospital are for investment, such as the purchase of equipment or renovations. A small portion of the donations (2%) is allocated to the payment of supplies and professionals, which is insufficient.

Ivete Sangalo

The superintendent highlighted that last year, the Bahian singer Ivete Sangalo even held a benefit concert in Salvador, donating all the proceeds to the hospital.

"With Ivete Sangalo's show, we raised R$ 2 million for construction, expansion, and renovation. We are finishing the construction of the third Intensive Care Unit (ICU) and will begin the renovation of the third floor, which houses the oncology wards."

The Martagão Gesteira Hospital has been in existence for almost 100 years and is a reference in highly complex pediatric treatments, such as neurosurgery, cardiology, and oncology. The building, located in the Tororó neighborhood, has 220 beds and more than 20 medical specialties. According to the institution, approximately 4 consultations and 700 surgeries are performed monthly through the SUS (Brazilian Public Health System).