I thank Professors Jairo Bisol, Luiz Pisco and Daniel Soranz for the honor of sharing the authorship of this paper, with some generous comments and lucid remarks.
We are aware that the health system of the Federal District is still far from ideal, but we believe that new directions have been aimed at building an organized and integrated network, based on primary care, in order to face the challenges of public health in the Brazilian capital.
We take these final words to highlight two points that seem relevant to us and which were not emphasized in the introductory text.
First, we highlight our significant experience in the Eastern region with health planning, carried out with the support of the National Council of State Health Secretaries (CONASS) as of 2016. With the planning, a specialized outpatient clinic was created for patients with chronic conditions, which operates within the hospital, but in the administrative structure of secondary care, in full integration with the primary care of the region. The statements of the patients under treatment and the professionals, both primary care and ambulatory focal specialists, who participated in the planning, are moving. A cooperation of the two levels of care was observed, with effective matrix-based strategies and constant communication, resulting in greater control of chronic conditions, higher resolution of family health teams, fewer hospitalizations due to sensitive conditions and exacerbations, and satisfied patients, with a perception of high quality of care. The model has already been approved by the Management Collegiate of the SES for expansion to the entire network.
We also highlight the installation of the Situation Room Portal11. Secretaria de Estado de Saúde do Distrito Federal. Sala de situação. [internet]. 2019. [acessado 2019 Fev 6]. Disponível em: http://salasit.saude.df.gov.br/
http://salasit.saude.df.gov.br/... , built as part of technical cooperation between the Health Secretariat team and Fiocruz, which gave visibility to a wide range of information concerning public health in Brasília, useful both for studies and planning and for the knowledge of the population. The Situation Room was the main responsible for the fact that, in December 2018, the SES received, for the first time, the 100% Active Transparency Award conferred by the Federal District’s Controller’s Office.
Finally, we must recognize, as did Dr. Jairo Bisol in his manifestation, the shielding from political interference that the Governor of the Federal District provided to the Secretary of Health during this management. The Governor’s vision, trust, and support have enabled us to make the necessary dialogues and confrontations to implement what we consider to be the best management decisions for SUS in the Federal District.
Family health, regionalization and decentralization, care networks, service regulation, more efficient management models based on results and indicators, and information production structures for transparency and planning purposes: these are the foundations on which we believe the health system must be built. With this solid base, the allocation of the scarce public resource reaches the maximum return for the Unified Health System users.
- 1Secretaria de Estado de Saúde do Distrito Federal. Sala de situação [internet]. 2019. [acessado 2019 Fev 6]. Disponível em: http://salasit.saude.df.gov.br/