The Health of SP, according to Eleuses

The former deputy mayor of Rio Preto Eleuses Paiva will be the new Secretary of Health for the State as of January next year. As the mentor of the government plan of the Tarcísio de Freitas (Republicans) campaign for Health, he listed the need for actions to ease the queues for surgeries, procedures, exams and organ transplants as the main challenge of the portfolio.

The doctor also mentioned investment plans in telemedicine and stressed the need to work with awareness campaigns to strengthen vaccination coverage in the State, especially in the face of a possible new wave of Covid.

For Rio Preto and the region, Eleuses promised a review of the Hospital Policy for Small Hospitals and an increase in beds with the inauguration of the Mirassol Regional Hospital, scheduled for 2023. Actions that, according to the doctor, will be strategies to alleviate the Hospital’s demand of Base (HB).

On political issues, the former deputy mayor of Rio Preto defended a good relationship with the elected President of the Republic, PT Luiz Inácio Lula da Silva. Below is the full interview for the Diário.

Diário – What are the main challenges of the Health Department that need to be equalized today?

Eleuses Paiva – The most obvious thing when we talk about public health concerns the management of queues for surgeries, procedures and exams. It is a notorious problem and one that needs to be tackled. People need to know clearly where they are in the queue, to have predictability, access to information. And when we talk about queue management, we talk about clinical criteria, developing something similar to what happens in the transplant queue, creating prioritization criteria. And, at the same time, offer periodic follow-up for that patient who is waiting. In addition, we are going to invest a lot in digital health, betting on transforming the state of São Paulo into a reference center and bringing the health system to a new level of access, resolution and user satisfaction. Another priority will be to reinforce the vaccination coverage of the population. The Brazilian Immunization Program has always been a world reference, but we see a drop in numbers since 2015. It is imperative that we show the population that the diseases still exist and that vaccination is essential in the prevention policy.

Diário – In view of these challenges, what are the first actions that you intend to bet on?

Eleuses – When we talk about vaccination coverage, it is essential that we invest in a strong vaccination campaign, with effective communication to raise people’s awareness of the importance and safety of vaccination, including extending times and even places to apply immunizers. As I said, Brazil didn’t become a reference for nothing, but at the same time, it seems that this success in our immunization program made the population relax; and that cannot happen. And in São Paulo, when we talk about vaccines, we also talk about strengthening the Butantan Institute, a reference in the production of immunizers and which will have an infectologist in charge, Dr. Esper Kallás. As for the queues for surgeries, I reinforce what I have already mentioned: we need to invest in the management of the queues, people want to know where they really are in the queue and, in addition, offer periodic follow-up to these people. And for Digital Health, taking advantage of the models that have already been tested during the pandemic and which have shown positive results, in addition to investing in the citizen’s single medical record, enabling integration between the different existing technology and information systems and even establishing partnerships with universities to promote the training of health professionals in digital technologies.

Diário – In a campaign, the governor-elect said that he will remove the obligation of the Covid vaccine among state servants. What is your opinion?

Eleuses – As I have already mentioned, we will act strongly to expand vaccination coverage, with effective communication to raise people’s awareness of the importance and safety of vaccination. Governor Tarcísio always made it clear that he made a point of vaccinating himself against Covid, as well as his family. In addition, he chose an infectologist to head the Butantan Institute. Brazil has always been a reference in vaccination because the population has always adhered to the call and vaccination campaigns and will continue to do so. We will continue investing in people’s awareness so that they vaccinate themselves and their children. We will continue to do our part as a State, offering immunizers to the population.

Diário – How do you believe the confrontation should be in the face of a possible new wave of Covid?

Eleuses – We can observe an upward trend in cases of Covid and we need to pay attention mainly to three large groups: people of more advanced age, people with comorbidities or immunosuppressed and people who are not up to date on their vaccination schedule. We have observed that cases are milder in the group that follows the vaccination protocol, so we will ensure vaccination for the entire population. There will be no shortage of vaccine.

Diário – Rio Preto is a city well served in the areas of public and private health. But there are still some bottlenecks, especially in relation to the lack of beds in the region, which ends up “suffocating” the Base Hospital. How to solve?

Eleuses – This problem is not unique to Rio Preto. Some cities, from the most diverse regions of the State, suffer from the same problems. Therefore, this was a point of attention during the elaboration of the Government Plan and which goes against the investment in Digital Health, in telemedicine and in the revision of the Hospital Policy of the HPPs (Small Hospitals), which will be better used to supply the demands of a queue for surgeries or specialties such as oncology or even chronic kidney disease. These strategies can prevent urgent and emergency care from being overwhelmed. From then on, we will have a system that is less pressured from the top, reflecting positively on the rest of the health system.

Diary – The Mirassol Regional Hospital, started by Father Nélio Belotti and, ten years later, “embraced by the State”, is in progress. Will the work continue?

Eleuses – An express order from Governor Tarcísio that applies to all areas: no work in progress will be paralyzed, especially when we talk about Health. All hospitals that are being built will continue to receive investments to be completed as soon as possible to serve the population. Mirassol Hospital will be delivered in 2023, with full support from the State Department of Health. Our objective is to offer a better quality service and the regional hospitals, along with the Santas Casas, are essential for structuring a reference assistance network.

Diário – You coordinated the health plan of the elected governor. Among the campaign promises is the integration of Primary Health Care (PHC) with municipalities to even relieve Urgency and Emergency. How will this be put into practice?

Eleuses – A study carried out by the World Bank shows that 30% of the Union’s budget for the Unified Health System is misused. From there, we believe that one of the fundamental pillars for better use of these resources involves strengthening primary care, ordering the process and monitoring care and combating waste. Currently, the population uses the emergency rooms as the first choice in a need for health care and, consequently, fills the emergencies for situations that could be resolved in primary care. With the reorganization of this system, where the patient is monitored in primary care, a possible worsening of the clinical picture is avoided, adequate management of queues, allowing a better quality service in urgencies and emergencies.

Diário – Another promise is the digitization of health in the state, with investments in telemedicine. What is the forecast for this to be put into practice, since part of the state’s public health does not even have an electronic medical record?

Eleuses – As previously mentioned, our goal is to transform São Paulo into a reference point in the use of digital health, to raise the health system to a new level of access, resolution, management, sustainability and user satisfaction. For this, we are bringing a team with extensive experience in telemedicine and technology in the public sector, including the implementation of relevant projects in other states of the federation. It is a sector that demands significant investment, but which we see as having enormous potential to bring benefits in the short term.

Diário – Tarcísio’s government plan also provides for a remuneration review, focusing on results, service delivery, training and management. What would this proposal look like in practice?

Eleuses – When we talk about reviewing remuneration, we are talking about a career plan, valuing professionals, especially good professionals. That is why we thought of creating a people management policy that establishes criteria for a performance evaluation, which can contribute to professional development, based on updating and training in accordance with the new technologies available and enabling fair remuneration for each a. This continuous training program can be carried out even from the structure of state universities. With regard to the remuneration policy, we will work towards taking the proposed readjustment to the SUS Table to the federal level, which has not been readjusted for more than ten years. In the state of São Paulo, we will work on a strategy to realign compensation policies, based on results.

Diário – What bridges will you (Tarcísio’s government) use to dialogue with the Lula government?

Eleuses – As Minister of Infrastructure, Governor Tarcísio has always been open to dialogue with the most diverse political representatives, regardless of political position. It is the same way that we will now work as a state government in relation to the next administration of the federal government. The focus is on doing work for people.

Diário – What ways do you consider important to seek resources and investments for São Paulo?

Eleuses – Undoubtedly, as the main federation in Brazil, São Paulo has plenty of room to attract investments and, consequently, generate jobs and income, through the health sector, whether by promoting research or technological development and innovation. Work hard to transform São Paulo into a center for the national and international production of medical devices, using tax instruments to relieve production in São Paulo so that it is more competitive. Governing is the art of setting priorities and health is a priority for our Government.

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