Photo: Erasmo Salomão / ASCOM MSContribute to the financial restructuring of philanthropic entities and to the improvement of services provided by these institutions to users of the Unified Health System (SUS). These are among the objectives of the new BNDES Saúde credit line, which will benefit almost 2 thousand units in the sector. Given the relevance of philanthropic organizations as fundamental partners in the SUS complementary network, the Launch of the new credit line brought together, this Thursday (13), at the Palácio do Planalto, in Brasília, several authorities from the country, including the President of the Republic, Jair Bolsonaro, the Minister of Health, Luiz Henrique Mandetta, and the President from the National Bank for Economic and Social Development (BNDES), Joaquim Levy.
In addition to contributing to the financial strengthening of philanthropic institutions, the financing line also aims to improve the management, governance and operational efficiency of these institutions. “Patrimonial power needs to meet managerial power in philanthropic organizations,” said Mandetta, who alluded to two BNDES Health subprograms: one aimed at implementing improvements in management, governance and operational efficiency and the other for the implementation, expansion and modernization of institutions.
The importance of the sector for the public health network can be translated into numbers: in 2018, philanthropic organizations made almost 129 thousand beds available to patients in the public health network, which represents 37.6% of the total beds available in Brazil. Currently, 2,147 philanthropic hospital entities provide services to the SUS, serving 1,308 municipalities in all regions of the country. In 968 municipalities, hospital care is provided solely by these units. “We know the importance of these institutions and, therefore, we have to think about Sustainability long-term philanthropic goals. And this is exactly the objective of BNDES Saúde, with loans for 12 to 18 years, with very competitive interest rates. And to ensure Sustainability in the long term, it is not enough to have more money, it is necessary to strengthen management”, stated the president of BNDES, Joaquim Levy.
OTHER ACTIONS
The BNDES Saúde credit line complements the Ministry of Health's initiatives already underway. Now, institutions receive greater attention from the Federal Government. With the creation of the Specialized Health Care Secretariat (SAES), the department's activities will be more directed towards improvements, Investments and the development of new policies, benefiting the philanthropic sector, which will have a specific area in the Ministry.
In addition to the funding resources and other actions carried out to qualify, reinforce and expand hospital care provided by the philanthropic sector, the Ministry of Health also transfers over R$ 5 billion annually through incentives and agreements. Furthermore, to strengthen the sector, the department has already granted 1,989 non-profit philanthropic organizations the Certificate of Social Assistance Charitable Entity in the Health Area (CEBAS), which guarantees benefits, such as tax exemption, less bureaucracy in agreements, parliamentary amendments, infrastructure expansion and equipment acquisition.
CREDIT LINE
According to the Confederation of Santas Casas de Misericórdia, Hospitals and Philanthropic Entities (CMB), in 2015 alone, 218 non-profit hospitals, 11 thousand beds and 39 thousand jobs were closed. The segment also has a high level of debt, in addition to difficulties in aspects of management, governance and operational efficiency.
BNDES will contribute to improving this scenario, as philanthropic entities that obtain financing aimed at improving management, governance and operational efficiency will be able to count on resources for financial restructuring of bank and supplier debts. In this subprogram, projects must present an institutional diagnosis and action plan prepared by an independent company or institution. Disbursements will be divided in installments and conditioned on compliance with agreed milestones based on the action plan. Thus, the Bank seeks to provide a financial solution that delivers, in addition to credit, structural changes in institutions.
With an emphasis on the effectiveness of Program, Hospital Sírio Libanês has supported BNDES in the development of manuals and internal forms for the Program, as well as training the bank's technicians in analyzing action plan diagnoses.
Financing can be carried out directly, indirectly – through financial agents – or mixed – with part of the resources released by BNDES and another by the onlending bank. Your final interest rate will be calculated based on the TLP plus 1.3% (Remuneration basic BNDES) and spread risk in the case of direct operations. In indirect operations, the spread BNDES risk rate is replaced by the financial intermediation rate and Remuneration of the financial agent. The maximum term of the operation can reach 18 years in support of Investments modernization or expansion of units. In order to expand access to financing, the Program will be able to operate using SUS receivables, a practice in the segment.
EFFECTIVENESS
The expectation is that the Initiative contribute to improving the quality of service provided to the population by reducing service time and hospital mortality rates. These and other indicators will be monitored and will enable an assessment of the effectiveness of the Program.
The new BNDES Saúde incorporates improvements drawn from an assessment of the effectiveness of an old Program aimed at the sector, in force until September 2018. The analysis, which focused on financial restructuring contracts, identified that the Program could contribute more to improving the management and governance structure of entities.
Based on dialogue with representatives of the segment, the Ministry of Health and the CMB, measures were identified that can increase the effectiveness of the Program, such as carrying out an institutional diagnosis in the analysis stage, defining an action plan with performance indicators and releasing it in installments subject to monitoring, which must be intensified.
