CRISIS OF CAPITAL, HEALTH POLICY AND MANAGEMENT: the required health professional profile in University Hospitals in Brazil and Portugal
crisis of capital, SUS, SNS, management, healthcare professional.
Reality shows that the determinations of the structural crisis of capital, due to its global reach, are present in countries with diverse socio-historical contexts and backgrounds. The responses to the determinations of this crisis in countries such as Brazil and Portugal, located on the periphery of capitalism, are expressed in the counter-reform of the State and healthcare—specifically through the Unified Health System (Sistema Único de Saúde - SUS) and the National Health Service (Serviço Nacional de Saúde - SNS), respectively. The manifestation of these counter-reforms materializes in the so-called "new management models," which penetrate health establishments in both countries under the precepts of the "new public management," characterized by the transfer of managerial expertise from the private sphere to the public sector. This particularity is present in University Hospitals (HUs), represented in Brazil by the Brazilian Hospital Services Company (Empresa Brasileira de Serviços Hospitalares - EBSERH) and in Portugal by Corporate Public Entities (Estabelecimentos Públicos Empresariais - E.P.E.), which demand a specific profile of healthcare professionals in these hospital units. Based on this premise, the objective of this investigation is to understand the determinations of the crisis of capital in the management and profile of healthcare professionals required by university hospitals in Brazil and Portugal. To this end, we will conduct a mixed-methods (quantitative-qualitative) study through the lens of the historical-dialectical materialist method, utilizing bibliographical and documentary research as methodological resources. Ultimately, we proceed from the assumption that the crisis of capital has intensified managerialism in public administration in both Brazil and Portugal, with university hospitals serving as expressions of this phenomenon. This, in turn, requires healthcare professionals working in these establishments to possess a professional profile anchored in instrumental rationality and the principles of business logic.