Friday, October 27, 2006

O Sistema de Saúde Britânico (NHS) e os modelos de organização

Os governos Britânicos optaram há uns anos, por uma modalidade de construção e gestão dos hospitais do NHS, que deu e dá pelo nome de "Private Finance Initiative" (PFI). Segundo lemos aqui, o conceito de PFI é o seguinte:

  • "The Private Finance Initiative specifies a method, developed initially by the United Kingdomgovernment, to provide financial support for Public-Private Partnerships" (PPPs) between the public and private sectors".
  • "These projects aim to deliver all kinds of works for the public sector, together with the provision of associated operational services. In return, the private sector receives payment, above the price that the Public Sector could have achieved the work, linked to its performance in meeting agreed standards of provision".

Agora, lemos num outro sítio, que a polémica acerca deste método de financiamento de novos projectos públicos continua: "The NHS will pay private companies £53bn for private finance initiative hospitals worth only £8bn", argumenta a oposição Britânica. O governo pelo seu lado, contra-argumenta: "the comparison was misleading, as the total cost includes cleaning and buildings maintenance" e "the flagship PFI policy means the private sector bears the risk and cost of building new hospitals".

A dimensão actual e futura das PFI's é a seguinte "There are 58 NHS PFI schemes already open with another 30 under construction". Contudo, "The extra costs of £45bn are completely unjustifiable in the context of an NHS under intolerable financial pressure".

Esta frase final diz tudo sobre o actual contexto das PFI's Britânicas: "Every hospital I talk to wants the freedom to structure its borrowing projects as they wish. For all too many, PFI has turned into a straitjacket".