Gonçalves M, de Almeida MP. Construindo o controle social e a cidadania em uma experiência concreta: o Conselho Municipal de Saúde de Riberão Preto (São Paulo) . [Constructing social control and citizenship in a concrete experience: the Municipal Health Council of Riberão Preto ( São Paulo ).] Saúde em Debate [Health in Debate] Rio de Janeiro, Brazil) 2002 May-August 26(61):167-175.
Objectives: To analyze the experience of the Municipal Health Council (MHC) of Riberão Preto, in São Paulo , Brazil , between 1991 and 1998.
Methodology: Case study based upon semi-structured interviews and documentary analysis.
Results: Anobjective in creating the MHC was to encourage collegial management. In this process, the MHC aimed to transform individuals as social subjects, providers, and clients into individuals as political subjects, with the capacity and power to decide municipal health policy.
The MHC manifests conflict among people with different agendas and interests. Work of the MHC demonstrates that council members play a limited role in matters of financial control. The challenge of providing sufficient data for the MHC to oversee this central aspect of health care management remains unmet. Users and providers have expressed dissatisfaction with their experience in planning. The MHC often considers important issues that already have been resolved. This process deprives council members of the ability to affect decisions through debate since the MHC simply goes through the formality of legitimizing decisions made by others.
The MHC should provide a forum in which users discuss problems related to health care. Yet, health care providers frequently go around the Council and present their cases directly to those authorities whom they view as key.
Conclusions: The article identifies technical and political limits in the MHCs functioning. The MHC should promote participation, which current processes do not guarantee. To overcome its limitations, the MHC should transcend barriers of formal custom and bureaucracy.
Copyright 2007 University of New Mexico