Nursing floor: see why payment is still not a reality and what are the financial barriers

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Municipalities say that the transfer from the Union is insufficient and temporary, and they demand a solution. Private entities ask for exemption from the payroll as a counterpart. STF suspended floor. Nurses protest against the suspension of the law that set the minimum salary for the category, in Brasília Brenda Ortiz/g1 Ten months after Congress approved the Proposed Amendment to the Constitution (PEC) of the minimum salary for nursing, the new remuneration for the category remains full of uncertainties and it is still not a reality in most parts of the country. The theme – which impacts the lives of 1.3 million professionals – became a tug of war between the federal government, municipalities and private hospitals. And it was once again debated in Congress, in the midst of negotiations around the fiscal framework. Last Friday (12), President Lula sanctioned a law that allocates R$ 7.3 billion to states and municipalities with the objective of making payments possible as of May. The value, however, is considered insufficient by city halls, which require larger and permanent transfers. The viability of the new floor is also questioned by private hospitals, who claim that they do not have the financial conditions to carry out the increase in salaries. In September last year, the law reached the Federal Supreme Court (STF). Minister Luís Roberto Barroso granted an injunction suspending the floor until the Executive and Legislative branches made the funding sources viable. The precautionary measure remains in effect. Understand in this article the values, impacts and obstacles to the nursing floor Values ​​and impacts Public sector Private sector Impasse in the STF Long-term challenge Values ​​and impacts The law approved by Congress defines the floor of R$ 4,750 for nurses and determines that technicians category receive 70% of this amount (R$ 3,325) and assistants and midwives, 50% (R$ 2,375). A survey by LCA Consultores points out that there are currently 1.3 million nursing professionals in the country with a formal employment contract. The study calculates that R$ 13.2 billion per year would be needed to make the new remuneration viable in the public and private sectors. According to the consultancy, 69% of nursing contracts in Brazil – equivalent to 887,500 professionals – earn below the minimum proposed by law. The Northeast tops the list of regions that concentrate the largest number of professionals who are paid below the minimum wage: 84%. In sequence, appear North (74%), South (66%), Midwest (65%) and Southeast (63%). Public sector The National Confederation of Municipalities (CNM), in a note released this Friday (12), states that the law sanctioned by President Lula, which allocates R$ 7.3 billion to governors and mayors to make the nursing floor viable, it is an “illusion”. According to the CNM, the amount referring to the municipalities (R$ 3.3 billion) does not pay a third of the minimum wage for health professionals. The CNM also alleges that this is a temporary solution for an expense that will be permanent. “The value is negligible and it is only for this year. Therefore, we cannot continue to be deceived, we have to find the definitive source of funding, not least because it will be a permanent expense, which does not change anymore”, said Paulo Ziulkoski, president of CNM , to GloboNews. The Minister of Institutional Relations, Alexandre Padilha, countered the criticism: “The total value (of the floor) is R$ 10 billion per year. This amount of R$ 7.3 billion is exactly what is needed, because it counts from May” , he said. As a solution to the impasse, the municipalities defend the approval of a PEC that expands, in a definitive way, the transfers to the Participation Fund of the Municipalities (FPM). Government publishes law that releases R$ 7.3 billion for payment of nursing floor Private sector The National Health Confederation, which brings together private entities, alleges that the law sanctioned by President Lula does not solve the segment’s financing problem, since transfers are only for the public sector. A survey by LCA Consultores points out that the impact of the floor for business entities would be R$ 5.3 billion per year. In this scenario, the consultancy estimates that the measure would lead to the dismissal of 79,300 nursing professionals. As a way out, hospitals and private clinics defend the approval of a project, in progress in the Chamber of Deputies, which exempts the payroll of the segment. Deadlock at the STF In September 2022, Minister Luís Roberto Barroso, of the Federal Supreme Court (STF), granted an injunction suspending the category floor – a measure that is still in effect. At the time, Barroso claimed that the Executive and Legislative should find ways to make the floor financially viable, both for the public and private sectors. In the decision, the minister stated that “the Legislature approved the project and the Executive sanctioned it without taking care of the measures that would make its execution feasible, such as, for example, increasing the SUS reimbursement table to the affiliated network. In this case, they would have wanted to have the benefit bonus without the burden of increasing your own expenses, outsourcing the account.” According to the National Health Council, which represents private entities, the floor is not being paid and will not be implemented if no solution is addressed by the public authorities Long-term challenge The nursing floor has once again been the subject of debate within the National Congress in the midst of negotiations around the new fiscal framework. The text sent by the Executive removes the resources destined for this remuneration from the spending limit – a point that raised criticism within the Chamber of Deputies. Behind the scenes, the project’s rapporteur, deputy Cláudio Cajado ( PP-BA), discusses the possibility of putting this expense within the spending limit. The objective is to signal greater control of expenses and avoid setting a precedent for other professional categories.

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