Implantação do Samu depende da criação de leitos e garantia de recursos

Representantes da Prefeitura de Uberlândia, da Universidade Federal (UFU) e do Hospital de Clínicas da UFU (HCU) se reuniram nesta segunda-feira (18) no Centro Administrativo, para discutir as questões relativas à saúde na cidade e que reforçam a impossibilidadeda implantação imediata do Serviço de Atendimento Móvel de Urgência (Samu) na região.

Com prioridade na recuperação econômica do município e no atendimento aos cidadãos, a a administração municipal voltou a afirmar que o objetivo atual é cumprir com o pagamento de dívidas oriundas da antiga gestão e manter o abastecimento da rede municipal de saúde. De acordo com o prefeito Odelmo Leão, os repasses atrasados do governo estadual atingem quase R$ 12 milhões. Nesse sentido, o Município tem arcado com recursos próprios para manter o funcionamento do Hospital e Maternidade Municipal.

A situação nas Unidades de Atendimento Integrado (UAIs) é um reflexo do desafio enfrentado pela prefeitura. A falta de 500 leitos (somente para a população da cidade) tem ocasionado a espera de centenas de pacientes para o encaminhamento a hospitais. “Nós não somos contra o Samu. Mas é preciso entender que neste momento Uberlândia não tem estrutura física nem projeto econômico para sustentar essa estrutura. A discussão precisa ter envolvimento técnico, um projeto em rede bem estruturado e firmado”, afirmou Odelmo Leão.

Responsabilidade com as pessoas

Ainda de acordo com o prefeito, para implantar o projeto, é preciso ter responsabilidade com as pessoas de Uberlândia e da região. “Eu só assino algo se eu tiver condições de arcar com o compromisso.A discussão correta hoje seria a criação de novos leitos e a ajuda necessária para que o HCU-UFU finalize a obra do hospital de traumas, ampliando essa oferta. Nosso esforço é muito grande. Nosso foco deve ser em reestabelecer e dar suporte à rede antes de qualquer coisa”, completou Odelmo Leão.

Responsável pelo atendimento de três milhões de pessoas na região, o HCU-UFU está com a capacidade de leitos no limite de ocupação. Além disso, o atraso de repasses por parte do governo estadual com convênios junto à instituição chegam a R$ 12 milhões. Outra dificuldade é quanto à construção do hospital de atendimento de traumatologia da UFU, que está em ritmo lento devido às dificuldades financeiras da construtora responsável pela obra.

“A universidade tem plena consciência de sua responsabilidade na área da saúde. O HCU cumpre duas missões: de um lado a responsabilidade na assistência, de outro, o hospital escola, com inúmeras questões. O HC é o maior hospital público de Minas Gerais e atende 100% SUS, 24 horas por dia. Para mantermos a instituição funcionando é preciso muito cuidado e respeitar a estrutura que possuímos”, observou o reitor da UFU, Valder Steffen.

Segundo Steffen, o impacto da implantação imediata do Samu acarretaria muitos problemas à comunidade e ao sistema. “Caso o serviço começasse a operar hoje, sem planejamento, o resultado seria a chegada de pacientes na unidade sem a possibilidade de receber atendimento digno. O hospital está subfinanciado, os valores não são reajustados desde 2007 e temos repasses em atraso. Isso exigiu uma transferência de verba da UFU para o HC, comprometendo algumas atividades de ensino para priorizar o atendimento no hospital. Esse tipo de arranjo não é sustentável, temos que achar um caminho adequado para a saúde. Queremos participar das discussões, assim que formos chamados, e encontrar os melhores caminhos técnicos”, explicou.

Cenário da assistência

O secreário municipal de Saúde de Uberlândia, Gladstone Rodrigues, fez questão de ressaltar as atribuições do Serviço Móvel de Atendimento de Urgência. Ele salientou que oSamu é tecnicamente um transporte médico-hospitalar e necessita de uma grande oferta de leitos para ser efetivo.

“No entanto, o HC tem número de leitos reduzidos no momento, sem condições de receber mais pacientes além daqueles que já está acolhendo. É importante ficar claro que Samu é transporte e que é necessário saber a estrutura hospitalar que o receberá antes de qualquer implantação. Então reforço que há a necessidade técnica de fazer um estudo regional para entender que outros hospitais nos municípios são credenciados ao SUS e podem fazer o atendimento em rede. Temos que analisar a estrutura hospitalar da região, o que pode ficar no hospital do município e o que pode vir pra cá. Assim, evitamos que todos sejam direcionados ao HC, que já não tem capacidade de aumentar o seu atendimento neste momento”, esclareceu.

O Hospital de Clínicas da Universidade Federal de Uberlândia possui 512 leitos. Desse total, hoje 490 estão ocupados. Esta margem, considerada inferior ao recomendado, é, segundo o reitor Valder Steffen, indispensável para quando ocorrer algum evento que necessite da intervenção ou ajuda imediata na unidade.“Hoje, se aumentarmos o transporte de pacientes para nosso hospital, o sistema corre risco de entrar em colapso. É necessário conversar com todos os envolvidos para que cada um assuma sua parte, ou seja, devemos pensar em rede, saber o que pode ser atendido pelos municípios do entorno”, explicou o reitor.

Além da falta de leitos e dificuldades econômicas, outro desafio à implantação do Samu é a disponibilidade de recursos estaduais para a continuidade ao tratamento do paciente em transporte. “Todos concordamos que fará uma grande diferença a implantação do Samu desde que tenha sequência ao atendimento. Imaginem o que é atender a pessoa e o hospital não ter condições de receber. O paciente ficará onde? Na ambulância? O recurso destinado é apenas para o transporte. O tratamento dentro do hospital e o custeio não está garantido. Essa é a nossa preocupação, pois o estado não está com condições de honrar com esse compromisso”, expôs o diretor-geral do HC, Eduardo Crosara Gustin.

O HC-UFU recebe 75% de seus pacientes pela porta urgência e emergência. O diretor-geral da unidade explica que se esse índice aumentar, devido à ampliação da assitência para a região com o Samu, o perfil epidemiológico do hospital será alterado. “O HC é a referência de alta complexidade. Se não atendermos esses casos de alta e alguns de média complexidade, geraremos um problema no município e em toda região, pois não atenderemos o mínimo necessário, já que vamos destinar o recurso disponível para urgência e emergência”, apontou.

Cuidado com os pacientes

No primeiro semestre, o secretário municipal de Saúde, Gladstone Rodrigues participou de reuniões com o Consórcio Intermunicipal de Saúde da Rede de Urgência e Emergência da Macrorregião do Triângulo do Norte (Cistri) para apontar as questões envolvendo Uberlândia.Com débitos de R$ 800 mil não pagos pela gestão anterior e mais R$ 1,5 milhão relativos ao atual exercício, o secretário afirmou que o município não está em condições de assumir esse compromisso visto que há outras dívidas e assitências que precisam ser priorizados.

No entanto, deixou claro que a gestão é a favor do transporte hospitalar. “Há a necessidade de saldarmos o que precisa ser pago, normalizar o abastecimento da rede, não deixar faltar medicamento para a população, ter segurança da receita que vamos ter para a administrar a saúde para, aí sim,assumir outros compromissos. Ninguém é contra o Samu. Mas é necessário que, tecnicamente, a rede de hospitais da região seja reforçada para receber o serviço. Mais ainda, precisa ter condições de devolvê-lo ao município de origem com as devidas pactuações, garantido a medicação para a continuidade do tratamento. Isso precisa ser planejado, acordado e pactuado antes de qualquer medida imediata”, avaliou Gladstone Rodrigues.

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