Santa Casa Foundation of Pará and the SUS complete 35 years of activities in favor of health users in Brazil
The institution, which has been a state foundation for 35 years, serves thousands of SUS users annually, a system that also completed 35 years this month
The Santa Casa Foundation has about 3,200 employees and collaborators, more than 500 beds, being 100% dedicated to the services of the Unified Health System (SUS), with a reference in the maternal and child area. Norma Assunção, technical and assistance director of the Santa Casa Foundation of Pará, emphasizes that the SUS is a truly universal system. "It is a system that integrates and unites all social classes, has a universal character. A good example of its importance to the population of Brazil was during the coronavirus pandemic. Without the Unified Health System, we would not have been able to save so many lives."
"It is a system that contributes greatly to the health of the population, providing each person with comprehensive assistance, with multidisciplinary teams, with an individualized approach for each patient, bringing cutting-edge technologies to this population. I understand that we still need to improve this system to expedite care. But today, without the SUS, the population would be much worse off, without any assistance. We could not do without the SUS in this country. It truly contributes to this focus on public health for our population," emphasizes the director.
The management's goal is to provide modern and adequate structures for better service to the population of Pará. The institution has made significant investments in the renovation and expansion of its structures with the inauguration of services such as: the State Transplant Center of Pará (CET-PA); the new House for pregnant women, babies, and postpartum women; the new Pediatric Outpatient Clinic; the Health Education and Training Center (CETS), all fully furnished and equipped.
Foundation - The Santa Casa of Pará was transformed into a state public foundation at the end of April 1990, after a struggle by employees, university professionals, and Labor Justice alongside the deputies of the State Legislative Assembly, when then-governor Hélio Gueiros signed the founding decree. Upon being absorbed by the State Government, the hospital was renamed the Santa Casa de Misericórdia do Pará Foundation (FSCMPA).
Bruno Carmona, president of the Santa Casa Foundation, highlights that the institution follows the actions determined by Sespa. "We have several other medium and high complexity services in outpatient, surgical, and clinical settings. Serving 100% SUS patients. Observing the mission of Santa Casa, which is to care for people's health, generating knowledge. Where the professionals who work here are increasingly committed to providing high-quality services. This is notably proven by certifications at national and international levels."
"From the perspective of transparency, Santa Casa operates within legal precepts, regarding economic and financial budgeting. The agency is balanced, and the management as a whole seeks to provide transparency to all processes carried out, alongside suppliers, in the ways that our external control agencies have always approved the actions developed by Santa Casa. This balance ensures the continuity of the services provided and has helped the institution to evolve more and more, with significant investments made by the state government management," highlights the manager.
History of struggles - Over the years, there have been several changes, including in the name of the institution. First, it was called Santa Casa de Misericórdia, then, in 1890, it received the title of Civil Charity Association Santa Casa de Misericórdia do Pará. After 100 years, in 1990, it was absorbed by the State Government, and the hospital was renamed the Santa Casa de Misericórdia do Pará Foundation (FSCMPA), formalized by then-governor Hélio da Mota Gueiros, through Complementary Law 003, of April 26, 1990.
In 1982, the Santa Casa de Misericórdia do Pará was facing financial problems that resulted in several labor lawsuits. The former management of the hospital recognized that it did not have the assets to pay the overdue amounts and maintain operations. The debt was unpayable, and the problem of lack of resources was identified by the then-president of the Labor Court at the time, Dr. Roberto Santos.
The magistrate issued a ruling consolidating all executions into one. And considering the seized assets of Santa Casa, something never seen in labor justice. According to Thadeu de Jesus e Silva, a lawyer who participated in the Governing Board of the institution in the 1980s, Roberto Santos made an unprecedented decision in Brazil. "He issued a ruling as regional corregidor, consolidating all executions into one. He considered the entire enterprise seized, centralized all labor claims in the second board, under the presidency of Haroldo da Gama Alves, because that was where the oldest execution was. He removed the provider of Santa Casa and appointed a committee as the faithful depositary of Santa Casa."
José Maria Quadros Alencar, a retired judge from the TRT, reinforces the importance of the management of the Regional Labor Court during the crisis faced by Santa Casa. "The ruling by Roberto Santos that originated all this, including the verticalization of Santa Casa, he predicted that. It was suggested that the vacant land, where today the maternity hospital named Almir Gabriel operates, be verticalized. It was in the ruling, where that verticalization was exactly suggested as a way to monetize Santa Casa."
To save Santa Casa, they decided to transform it into a foundation, a challenging act. With the help of the Ministry of Health, it was possible to pay 60% of the labor debts. "After this business evolved, a group of idealists, including the late Dr. Almir Gabriel and his team, and many others, managed to transform Santa Casa into a foundation," reports Thadeu Silva.
In 1989, with Hélio Gueiros at the helm of the state government, magistrate Roberto Santos no longer held the position of president of the Court, but continued to be active in the cause of the Constitution of the Santa Casa Foundation and was a key player in the articulation for the achievement of this act. With the implementation of the Constituent Assembly of the State of Pará in 1989, the creation of the Santa Casa de Misericórdia do Pará Foundation was determined.
Mobilization - From 1985 to 1989, the struggle of Santa Casa employees united with the management of the governing board at the time, which was coordinated by physician Angelina Serra Freire, was intense. In an emotional testimony, pediatrician Celina Borges Maciel, an employee of Santa Casa, recounts the struggle and dedication in favor of the Foundation: "Dr. Roberto Santos appointed a governing board because they needed to pay these employees who were in court and that Santa Casa itself did not have financial conditions because it was a philanthropic association. It was a challenging moment for maintaining services. We had almost nothing; we depended on the Health Department, we were with the begging bowl in hand," she recalls.
"At that time, Dr. Angelina Lobo was basically responsible for the board. And then, she started a very effective work in favor of the foundation. And her action was decisive during those difficult periods. The government helping, Sespa helping, then there was part of the SUS, and we started to create some projects to receive money for the benefit of the institution. And it was when the idea of transforming Santa Casa into a foundation came up. We worked hard for that. The first plan was for a federal foundation, and we had the entire project there, in Brasília, on the desk of then-president Sarney. It was when Dr. Angelina received a notice saying that it was impossible to transform Santa Casa into a foundation because starting that decade, the municipalization of health in Brazil began, and there would be no more foundations at the federal level," points out Celina.
During the period of 1987, the mobilization of Santa Casa employees, coordinated by Angelina Lobo, who at the time was managing the hospital board, university students, teachers, and constituted authorities gained public opinion, marked several times by marches in the streets of Belém, which was decisive for the transformation into a state foundation, with the approval of the Legislative Assembly of the State of Pará (Alepa).
"We held marches, we embraced Santa Casa, we went to speak with all the politicians who could help, and then this process of transformation began. And we could only achieve it with the unanimous support of the deputies because the governor could not say no, and this was a great lobbying effort. It was a very difficult, very arduous job, but it was rewarding because in the end, we achieved the great objective of transforming Santa Casa into a public foundation and stabilizing this institution, which at that time even had thoughts of turning this place into a shopping mall or a condominium of buildings," informs Celina Maciel.
Managers of the foundation - Over these 35 years as a state public foundation, Santa Casa do Pará has had the following managers: Clodoaldo Ribeiro Beckmann, Angelina Serra Freire Lobo, Hélio Franco Macedo Júnior, Paulo Sérgio Mota Pereira, Jorge Alberto Langbeck Ohana, Antônio Anselmo Bentes, Maurício César Soares Bezerra, Maria do Carmo de Lima Mendes Lobato, Maria Eunice Begot da Silva Dantas, Ana Conceição Matos Pessoa, Rosângela Brandão Monteiro, Manoel Eduardo Amoras Gonçalves, and the current Bruno Mendes Carmona.
Relevance of the SUS - It is the largest public health system in the world. In 35 years, the system has changed the reality of access to health and continues to be the main assistance network for 76% of the Brazilian population, as published on the Ministry of Health Portal.
On September 19, the SUS completed 35 years and is consolidated as the largest public, free, and universal health system. The result of the historical movement of the 8th National Health Conference (1986), the SUS took shape in the 1988 Constitution, which defined health as a right of all and a duty of the State. In 1990, Law No. 8,080 regulated the system throughout the national territory.
Today, the entire population has the right to services - 76% depend directly on the SUS, which represents 213 million people. Per year, the SUS performs 2.8 billion services and has about 3.5 million professionals in action.
Evolution - Brazil has the largest public transplant network in the world. In 2024, the country set a historical record in the SUS, with 30,000 procedures. In addition to performing, free of charge, highly complex services such as transplants, the public network provides immunosuppressive medications, necessary for the entire life of transplant recipients.
The SUS has the largest public vaccination program in Latin America, the National Immunization Program (PNI). Today, it offers 48 immunobiologicals, including 31 vaccines, 13 serums, and 4 immunoglobulins. The actions contributed to milestones such as the eradication of poliomyelitis in 1994, to more recent results such as the recertification of the country free of measles by PAHO. In addition, Brazil was a pioneer in offering vaccines against dengue.
