As práticas de participação institucionalizadas e sua interface com a cultura política: um olhar sobre o cotidiano de um conselho municipal de saúde no nordeste brasileiro

Abstract

The Federal Constitution and Act 8142/90 define community participation as important condition for the functioning of the Unified Health System (SUS). This constitutional definition arises from the fight for the country s democratization and for the universalization of social rights, including the right to health. However, this democratization process means the adoption of democratic procedures to organize the political system than an effective democratization of social relations based on democratic values of equity and social justice. In Brazil the relation between State and society has been mediated by a political culture marked by bossiness, inheritance, clientelism, and favor. With the democratization process, in the 1980 s, elements of a new politic culture called democratic arose - guided by values as autonomy, equity, solidarity and justice - which start to exist along with the old culture. The general aim of this study is to analyze the participation practices in the Municipal Health Council (CMS) of Fortaleza, from 1997 to 2005, and its relation with local political culture. We departed from the main theoretical view: participation practices developed in health councils created a new institutionalization that includes new social subjects - the customers - in the public sphere, with whom the democratization process enlarged this sphere, creating visibility to identify the confront between the traditional political culture and the democratic political culture. Research techniques were: documental analysis, participant observation and semi-structured interview. From the different evidences observed in empirical material, the data analysis identified the predominance of traditional political culture of bossiness and co-optation in relations among municipal public power and civil society s representatives; and among counselors tension arose from the negligence of democratic procedures, such as periodic elections, respect to law and to the act that rules the Municipal Health Council, and in the conduction of conflicts and political contests. Participation practices were manifested in a contradictory and dialectic way in actions marked by criticism, denouncement, claim, with few propositional actions and most of times being its deliberative power ignored by the manager. The political conduction of the Counsel was often questioned, generating crisis of hegemony, conflicts and fights for power. Based on the analysis of these conflicts and political fights among groups within the Council we could carry out a methodical reading of the confrontation between the traditional political culture and the democratic one within the Council, noticing the predominance of the first one over the second. At last the main role played by the Public Ministry to solve conflicts, to the detriment of the best argumentation. In spite of the recurrent protection of Public Ministry, a way of resistances was built, although in minority, against the traditional political culture, whose participation practices showed constitutive elements for its transformation.