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Brazil: Nursing in danger from government reforms

16 August 2017
Health workers demonstrate in São Paulo
The national federation of nurses in Brazil (Federação Nacional dos Enfermeiros, FNE), has worked for many years to obtain better working conditions, fair working hours and decent pay for nurses across the country, including in São Paulo. Despite the economic crisis, it continues to fight on behalf of thousands of nurses to allow them a better quality of life which would also enable them to provide better care for patients.

The Brazilian government, in its attempt to stabilise the economy, is reversing the progress made by the trade union movement by bringing in questionable reforms to the health system. The union faces three major problems from these: outsourcing, labour reform and social security reform.

With Law 13.429/2017, President Michel Temer has approved provisions for outsourcing that would allow small and large companies to outsource their workforce. Outsourced workers are paid 24% less, according to the trade union research organisation DIEESE. The law compromises workers’ rights to benefits such as the 13th month pay bonus and makes it more difficult to apply collective bargaining.

It increases the maximum length of temporary contracts from 90 to 180 days, renewable for a further 90 days. Companies could use this type of contract for their whole workforce, resulting in low pay and continuous renewal of contracts and thus making it difficult for workers to make enough contributions to gain pension rights.

The labour reform is highly in favour of employers and much of it contradicts the terms of the Labour Code. Holidays may be divided into three periods, with payment similarly divided.  The working day can be increased to 12 hours, which is four hours more than the Labour Code currently stipulates. Rest breaks can be reduced to 30 minutes.

The social security reform (PEC 287) could seriously affect the present situation concerning nurses. The labour force category of nursing currently has a 91.8% employment rate. They are mainly female (85.1%) and more than 20% of them work almost 60 hours per week – about the legal limit. They are exposed to biological, physical, ergonomic and psychological hazards in unhealthy and dangerous working environments.

Article 57 of Act 8.213/1991 affords special pension rights to workers employed in such conditions -  workers can access their pensions after 25 years of contributions via administrative or legal action. The National Nurses’ Federation FNE proposed introducing a law clarifying this right through a Senate Bill which would regulate and guarantee this right to public and private sector workers. However, PEC 287 could put a stop to this.

We understand that Brazil urgently needs to stabilise the economy for continued social development. But this should not be at the expense of millions of working people like nurses and the communities they serve, who will be adversely affected by these reforms. There are other strategies that could be more effective for domestic resource mobilisation, such as taxing the wealthy and reducing corporate tax incentives. But there has to be popular mobilisation against the anti-poor reforms and for such redistributive measures to be taken.

This is the struggle faced by the trade union movement. Thousands of nurses in the state of São Paulo provide health care in medical establishments that guarantee quality care and dignity to patients. SESP in São Paulo and FNE nationally continue to defend the rights of nurses and will not let the government dismantle the existing progressive labour legislation. They are calling on the communities of tens of millions of Brazilians their members serve to join them in this struggle to defend the nursing profession and provision of quality health services.  

by Solange Caetano; President, Union of Nurses of the State of São Paulo (Sindicato dos Enfermeiros do Estado de São Paulo, SEESP) & National Federation of Nurses (Federação Nacional dos Enfermeiros, FNE)

This article is an extract from the “Right to Health” newsletter issue 03/2017. Subscribe to the newsletter. Send us your stories.

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