Specialty Outpatient Clinics: agility and resolution.

In Brazil, the struggle to build an universal, accessible and quality health system can be mistaken at first for an effort to redemocratize of our country, and may be characterized by a resistance to the conservative movement regarding public policies of the last decade. In 1986, the most important health political event of the second half of the Twentieth Century occured: the VIII National Health Conference. In this event, the basis of a new public health system was established with the following official themes: health as a duty of the State and a civil right, national healthcare system reform, and the sector’s budget. Thus, the effort toward healthcare reform was responsible for creating the Unified Health System (SUS) in 1988 as a social and political process that requires a democratic environment for its establishment in the healthcare field, which has significant character of cultural change. Founded upon ideological conventions, the healthcare system is based on an expanded concept of personal, family, and community health care. Basic principles emerge from SUS: universal and equal access to services; community participation, decentralized regional and hierarchical network administration, whose healthcare actions should be developed according to the guidelines provided by Article 198 of the Brazilian Federal Constitution. These guidelines should meet principles such as universal access to health services at all levels of care, integral care (understood as consistent actions and preventive and curative services, individual and collective, required for each case at all levels of system complexity), disclosure of informations about the potential of health services and their use by the user, and equality in healthcare without prejudice or privileges of any kind. Currently, SUS is responsible for the care of 78% of the Brazilian population, with the remaining 22% cared for by the private healthcare system [1]. In this context, the São Paulo State Government regulated the partnership between the State and philanthropic entities by Complementary Law No. 846, June 4 1998. They stipulated that these entities had at least 5 years of experience in the administration of health services, with recognized quality and a commitment to the population being served. The interested entities that have met the stipulated prerequisites were classified as Social Health Organizations, and earned the right to be able to sign a Management Contract with the State Health Secretary with a new responsibility for the management and operation of hospitals and other public health organs via public appointment. In the healthcare field, this model is already consolidated