Zucco L, Covalcanti L. Elementos para o analise da política de saúde na década de 1990: os assistentes sociais como atores na construção do espaço público. [Elements in the analysis of health policy in the decade of the 1990s: social workers as actors in the construction of the public sphere.] Saúde em Debate [Health in Debate] ( Río de Janeiro , Brazil ) 2002 September/ December; 26(62): 282-289.

Objectives: To analyze health policy within the framework of the Unified Health System (UHS) and the challenges of health policy for health care personnel, especially social workers.

Methodology: Analytical and interpretive.

Results: The article describes the fundamentals of the UHS and notes that the concept of health is passing from the biological field to the political and historical construction of citizens’ rights.

Health must be linked to other political and social policies and have stable, assured financing. Innovations must be carried out on the judicial, political, and institutional levels as well as in the relationships among the state, markets, and public and private spheres in order to guarantee universality, equity, integration, regionalization, and the delineation of hierarchies.

The Brazilian government’s neoliberal policies during the last decade have affected these principles. Such action by the government has converted the model of care from its focus on satisfying the immediate needs of the population into an aggregate of policies and programs lacking integration. Alienation and the fragmentation of work routines have contributed to a diminished sense of responsibility among health care workers and to weakened bonds between professionals and clients.

Within this scheme, social workers intervene at the point of confrontation between the rights of users and institutional regulations, in order to assure that rights are fulfilled and broadened.

Conclusions: To achieve progress in implementing the UHS requires the development of more responsive policies and a critical review of health professionals’ training.

Copyright 2007 University of New Mexico