Development of the Unique Health System Letter (BR0072)
the Health System Letter is an evaluation survey (response card) with brief questions about the health care the citizen received from the Unique Health System. The quality of the professionals who provide public health services can be assessed through this survey from the perspective of the citizen who uses these services. The letter also contains data on the citizen care, including the amount that the Ministry of Health spent on this service.
IRM End of Term Status Summary
Commitment 3.4. Development of the Unique Health System Letter
Commitment Text: The Health System Letter is an evaluation survey (response card) with brief questions about the health care the citizen received from the Unique Health System. The quality of the professionals who provide public health services can be assessed through this survey from the perspective of the citizen who uses these services. The letter also contains data on the citizen care, including the amount that the Ministry of Health spent on this service.
Responsible institution: Ministry of Health
Supporting institution: None
Start date: Not specified End date: 15 March 2015
The Single Health System (SUS) letter, a survey with brief questions about the quality of health care offered by the SUS, was launched in November 2011. It offered citizens more transparency about the services they receive, and gave them the opportunity to hold the government accountable for the use of public health resources. As such, the aim of the commitment was to promote better use of public assets and service delivery.
The commitment was completed in 2012 before the beginning of the action plan. There is, however, clear evidence of the systematic use of the channel during implementation of the plan, as well as progress in the internal flow of the letters. Twenty-eight million letters were sent to citizens for their feedback during the two first years of the plan, and 4% were returned for government analysis.
Did it open government?
Civic participation: Did not change
Public accountability: Did not change
According to its self-assessment, the government sent out nearly 50 million letters between 2012 and 2015. Nearly 2 million were returned. Of those, less than 0.4% included allegations of irregularities. These allegations were sent to the responsible agencies and are monitored by the auditing arm of the SUS. SUS auditors launched several investigations as a result of SUS letters. For example, a clinic in São Gonçalvo (RJ) received 28 complaints from citizens, alleging that it was charging double for services. This led to an investigation, which resulted in the de-credentialing of the clinic.[Note 92: Portal Brasil, “Carta SUS possibilita que cidadão avalie serviços de saúde e denuncie irregularidades,” 18 July 2012, http://bit.ly/2oAgsew. ] This practice was already in place before the first OGP action plan (the SUS letters were launched in 2011). Consequently, the commitment did not change the status quo. Moreover, it is important to mention that the return rate of the letters was low (4%).
The commitment was not included in Brazil’s third action plan. If the commitment is carried forward in the future, the IRM researcher advises the government to promote open data as a first step. It is also important to create participatory channels to discuss the research model and transparency mechanisms for accountability in the investigation of irregularities, or for citizens’ identification of possible fraud.