The Assistance Teaching Units (UDA) are part of a human resources training program of the Faculty of Medicine of the University of the Republic (Udelar) to cover assistance tasks in the State Health Services Administration (ASSE). They emerged in 2008 and, until now, have been jointly managed by the Faculty of Medicine and ASSE. However, the official senators of the Budget Commission integrated with the Treasury voted on Tuesday a substitute article in the bill of Accountability that the Executive had sent and that has a half-sanction, which would modify its operation.
According to the new articles, the program “will be managed and administered in its entirety” by ASSE, which “will sign an agreement with the Faculty of Medicine” to provide ASSE with the training of human resources that it requires to cover its healthcare needs, as well as to contemplate the care function of the teachers of the Faculty of Medicine, says the new text. In other words, it takes away from Udelar its governance over the program.
This is a new confrontation in the relationship between the two parties, which had already become tense at the end of 2020 due to the budget allocation. The UDA program basically finances salaries, but the items assigned each year did not include the salary difference corresponding to the increase in the consumer price index; To compensate for this lack, during the Broad Front (FA) governments, the Ministry of Economy and Finance assigned an item at the end of the year to complete the amount that was required, and the following Accountability included that last figure.
But that did not happen in 2020: the Budget law did not include the 2019 adjustment and, by not reproducing the previous mechanism, the program’s budget would be frozen until 2024. As reported in August by the Medicine branch of the Association of Teachers of the University of the Republic (ADUR-Medicine), the difference of two years without increase, which was around 20%, could lead to the disappearance of the program.
In dialogue with the dailyRafael Vignoli, a member of the Board of Directors of ADUR-Medicina, explained that ASSE “wanted to keep the governance and be able to decide unilaterally how and where the money is spent.” He added that the new wording differs from what had been negotiated in bilateral meetings between the faculty and ASSE, in which co-governance had been agreed “because it is unusual for ASSE to manage what resources the Faculty of Medicine can form.” He said that the faculty has to be there because it is the one in charge of training human resources, and that it does so thinking in the long term, not in a period of government. In this way, he said that the training of human resources is affected not only in Medicine, but in the 20 careers that the faculty dictates.
In that sense, Juan Mila, director of the Bachelor of Psychomotricity, told the daily that “the situation is dramatic for all the careers of the Faculty of Medicine that we have at UDA”, especially for Medicine, Physiotherapy, Speech Therapy, Psychomotor and Imaging. He pointed out that in the career of Imaging at the Paysandú headquarters, the teaching tasks are sustained from the UDAs and that this will be “a clear setback.” He announced that the change will affect the training of human resources in health and the assistance to people; and that, in addition, university autonomy is damaged.
There are UDAs at all levels of care and of varying complexity. In addition to the UDA projects, which carry out specific healthcare tasks and in which around 500 teachers work, the program has a component called UDA-Faculty of Medicine, which is a salary supplement received by around 1,000 medical teachers who perform healthcare tasks .
Vignoli explained that with the salary recovery that doctors at ASSE had had in recent years, the salary gap for teaching positions had widened, and that is why this supplement was created, which is 45% above the teacher salary. Although salary equality was not reached, in this way the income of teachers was close to that of doctors hired by ASSE. The importance of this component is vital because, as he said, it supports “all gynecological and pediatric clinics, the Maciel, Pasteur and Hospital de Clínicas medical clinics.”
Between the two components, there are 2,000 teaching positions that are at risk of being lost. According to Vignoli, “it is not a question of money, it is a political decision”, because the nearly 500 million pesos a year that the program requires means 4.2% of the ASSE budget, while representing “40% of the budget of School of Medicine”. “It is an immense blow that affects teaching, attendance, employment sources,” he said, adding that it will be more expensive for ASSE, because their salaries are higher than those of teachers. “This project is not a reform to win-win, it is a reform that is lose-lose: the Faculty of Medicine loses, ASSE also, and the people lose in attendance,” he said.
The Council of the Faculty of Medicine will meet this Wednesday to discuss this issue, and on Thursday ADUR-Medicine will hold an extraordinary assembly to agree on the steps to follow.