Nos bastidores da gestão da Saúde Pública: Ensaio-discussão sobre um itinerário por lugares onde habita o poder gestionário

Abstract

Public Health Management refers to a place that directly deals with resources to promote, prevent and recover human life. This movement represents the practice of a constitutionally guaranteed right. However, by being part of their microprocesses, experiencing the actions of those who drive them (or not), both individually and collectively, I understood the need to show my experience behind the scenes of management in the government fields in which I worked. Thus, it became urgent to describe the routine established by the management power, as well as the way in which decision-making in public policies was generated. Then, I assume that the Government hesitates to provide well-being and quality of life to the people. Besides that, it has the power to institutionalize the control and administration of governance under its territory, subjecting them to interests that are not associated with social needs. In order to build a space for reflection, the hypothesis states that the institutions which represent state governance are functionally and intentionally abstract. So, they are indifferent to their real constitutional duty, encouraging regulation and the maintenance of chaos, producing fragility in the system and, as a consequence, allowing the privileges of lovers of power, promoting a vacuum in assistance and the death of people. Therefore, with the purpose of elaborating a narrative of this process, I elaborate a mix of ideas proposed by authors connected to my thoughts, so defining the contours that I consider necessary, being as reliable as possible in the reports. In this process, I highlight the framework of Richard Sennett's method and Simone Weil's field experience. Furthermore, I carry out a dialogue about the meanings of management, its impacts established in the field of health work relationships and the damages – both emotional and physical – produced in lives shaken by carelessness in health. In this way, I receive the knowledge constituted by practice, exemplifying through narrative, the act of feeling firsthand the magnitude of the amoral vigor of management. So, as a consequence, I am exposing elements that are crucial to the execution and maintenance of government’s power. Finally, recognizing the knowledge established by experiences, I pointed out the consequences in the scope of public health work, revealing its unlimited dictates which cause death in different versions. In view of the criticisms launched throughout this work about the way of managing and thinking of other ways of building this place, I regret not being able to produce possible arguments and directions. This situation does not allow me to occupy any other position than that of disbelief. I do not believe in real possibilities of changing our reality. However, it is still urgent to understand the need to find other possible ways of managing for the benefit, in fact, of collective life. It is essential that, even so, there must be enough firmness of character to maintain the purpose to focus on the health care of the user, as well as each other, throughout this process.