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Descentralização na área da saúde: o caso da região do Algarve
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Abstract(s)
O Programa do XXI Governo Constitucional prevê o reforço das competências das autarquias locais, procurando uma resposta mais ágil e eficiente da parte da Administração Pública, tendo em conta o interesse dos cidadãos. Nesta sequência foi publicada a lei-quadro da transferência de competências para os órgãos municipais, concretizando os princípios da subsidiariedade, da descentralização administrativa e da autonomia do poder local. No domínio da saúde, esta transferência foi concretizada através do Decreto-Lei nº 23/2019 de 30 de janeiro. O XXII e atual Governo Constitucional determina como essencial aprofundar a descentralização e a subsidiariedade, estabelecendo uma governação de proximidade e efetivando a transferência de competências sectoriais.
Este trabalho de projeto utiliza o método de estudo de caso para compreender a realidade do processo de descentralização na área da saúde na região do Algarve. Este processo encontra-se na sua fase inicial de implementação, com a formalização dos primeiros autos de transferência no final de 2020 e produção de efeitos a partir de 01/01/2021.
A triangulação das várias fontes de evidência utilizadas neste estudo permitiu densificar as competências transferidas para os municípios na área da saúde, quer por via do enquadramento legal e normativo, quer por via da apresentação dos critérios e pressupostos definidos no decurso dos trabalhos preparatórios. Este trabalho desenvolve um manual de normas e procedimentos, como instrumento orientador e facilitador da implementação da transferência de competências nas diversas áreas, que uniformiza a operacionalização deste processo. A investigação realizada permitiu ainda identificar os pontos fortes e os pontos fracos da descentralização na saúde, na região do Algarve, bem como as oportunidades e as ameaças (análise SWOT).
Este projeto contribuiu assim para o conhecimento de uma reforma estrutural e interinstitucional e sistematização de informação com utilidade operacional para serviços e intervenientes, conjugando a teoria e a prática do processo de descentralização.
The XXI Constitutional Government Program foresees the reinforcement of local authority powers, seeking a more agile and efficient response from the Public Administration, considering the interests of citizens. Consequently, the Framework Law on the transfer of competences to municipalities was published following the principles of subsidiarity, administrative decentralisation, and local government autonomy. In the health sector, this transfer was materialised through Decree-Law No. 23/2019 of 30 January. The XXII and current Constitutional Government has determined that it is essential to deepen decentralization and subsidiarity, establishing proximity governance and effective transfer of sectoral competencies. This applied project uses the case study method to understand the reality of the decentralisation process in the health sector in the Algarve region. This process is in its initial implementation phase, with the formalisation of the first transfer deeds at the end of 2020 and taking effect from 01/01/2021. The triangulation of the various sources of evidence allowed to gather the competencies transferred to the municipalities in the health sector, through the legal and normative framework together with the presentation of the criteria and assumptions defined during the preparatory work. This project presents a manual proposal of norms and procedures, as a guiding and facilitating tool for the implementation of the transfer of competencies in the various areas, which standardizes the operationalization of this process. Moreover, it identifies the strengths and weaknesses of health decentralisation in the Algarve region, as well as the opportunities and threats (SWOT analysis). This project contributes to the knowledge of a structural and inter-institutional reform and the systematisation of information with operational usefulness for services and actors, combining theory and practice of the decentralisation process.
The XXI Constitutional Government Program foresees the reinforcement of local authority powers, seeking a more agile and efficient response from the Public Administration, considering the interests of citizens. Consequently, the Framework Law on the transfer of competences to municipalities was published following the principles of subsidiarity, administrative decentralisation, and local government autonomy. In the health sector, this transfer was materialised through Decree-Law No. 23/2019 of 30 January. The XXII and current Constitutional Government has determined that it is essential to deepen decentralization and subsidiarity, establishing proximity governance and effective transfer of sectoral competencies. This applied project uses the case study method to understand the reality of the decentralisation process in the health sector in the Algarve region. This process is in its initial implementation phase, with the formalisation of the first transfer deeds at the end of 2020 and taking effect from 01/01/2021. The triangulation of the various sources of evidence allowed to gather the competencies transferred to the municipalities in the health sector, through the legal and normative framework together with the presentation of the criteria and assumptions defined during the preparatory work. This project presents a manual proposal of norms and procedures, as a guiding and facilitating tool for the implementation of the transfer of competencies in the various areas, which standardizes the operationalization of this process. Moreover, it identifies the strengths and weaknesses of health decentralisation in the Algarve region, as well as the opportunities and threats (SWOT analysis). This project contributes to the knowledge of a structural and inter-institutional reform and the systematisation of information with operational usefulness for services and actors, combining theory and practice of the decentralisation process.
Description
Keywords
Descentralização Transferência de competências Saúde Municípios