On Wednesday, October 1st, President Paulo Cesar Montagner, Executive Director of Unicamp's Health Department (DEAS), Luiz Carlos Zeferino, and Dean of the School of Medical Sciences (FCM), Cláudio Coy, held the third round of discussions on the proposed autonomous government agency for the University's health department. This time, representatives from the University Council (CONSU) and the Unicamp Workers' Union (STU) were also given a chance to learn about the project.
The proposal has already been presented to unit directors, department coordinators, and the faculty committee in meetings held on September 22 and 29, respectively. The next steps in the process include public hearings at the Campinas City Council and the São Paulo State Legislative Assembly (Alesp), where the final bill will be presented and voted on.
During the meeting, employee representatives questioned points such as the maintenance of employment contracts and expressed concern about the potential precariousness of the healthcare sector following the transition to autonomous government. According to the dean, these are natural concerns that need to be discussed.
One of the STU coordinators, Elisiene Lobo, said it's necessary to seek alternatives to the proposed autonomous government and questioned why the issue only came up now at the university. "The issue is only being discussed now because it came up now," said Cláudio Coy. "This possibility only arose when we were discussing the management of the Sumaré State Hospital (HES). It opened a window of opportunity that hadn't existed before," he explained.
Luiz Carlos Zeferino said the proposal could be improved with input from all sectors, but defended the project. "I am fully convinced that we will be moving from a model that is currently stagnant to one with strong growth prospects," he assessed. "And I say this because this is what has happened in all the previously formalized government agencies. And this is not an expectation. It's a fact," he added.
The model proposed for Unicamp is inspired by that adopted at the University of São Paulo School of Medicine (USP) and the Botucatu School of Medicine at São Paulo State University (UNESP). Both are linked to the State Department of Health for administrative and budgetary purposes, but continue their teaching, research, and outreach activities. "In Botucatu, the process involved three bills between 2010 and 2019. In our case, we would do everything with one law," stated Zeferino.
On September 1st, a delegation from Unicamp was received by Governor Tarcísio de Freitas at Palácio dos Bandeirantes in São Paulo, who presented his intention to transform the University's healthcare department into an autonomous agency of the State Department of Health. The governor gave the green light to begin technical studies and budget planning, taking into account a 10-year transition period. "We haven't submitted any documents to the governor," Zeferino emphasized.
Currently, the Rector's Office allocates approximately R$1,1 billion of its annual budget to healthcare. "Since 2019, healthcare has been receiving supplemental funding without any reimbursement. We have a budget deficit every year," continued Zeferino, who emphasized that the project's objective is to find financing alternatives and participate in the state's public health budget.
Under the Botucatu School of Medicine's Hospital de Clínicas (Hospital de Clínicas) model, the University maintained its designated healthcare budget for the first two years. Disbursements were gradually reduced starting in the third year and continued to decline over time—a 10-year process of defunding.
Zeferino presented to the staff the evolution of the Botucatu Hospital, before and after the municipalization process. According to him, the hospital had 461 beds before the change and now offers 664. Until 2010, the number of hospitalizations ranged between 12 and 13 per year, and today that number ranges between 25 and 27. The number of health employees increased from 1.965 in 2009 to 3.129 this year. "There were over a thousand new employees," says Zeferino.
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