The eclipse of the State Career in the SUS: diffusion of managerial theories and the Brazilian Health Reform Program.

The historical submersion of the State Career Plan agenda within the Brazilian Unified Health System (SUS) is directly linked to the diffusion of managerial principles structured by New Public Management. This article aims to document the theoretical reasons and practical effects of the weakening of labour rights in the construction of SUS. Drawing on data related to the process of precarious labour relations and outsourcing, as well as the increasing municipalization of health management, we identify three key areas where labour management is central to the historical challenges faced by SUS: the pressure of personnel expenses on municipal budgets; the expansion of the public-private hybrid model in public administration; and the limitations in implementing a Regionalized Health Care Network. In conclusion, we argue that the ideology and practices of 'management culture' undermine the central role of labour management in the realization of SUS. Strengthening the State Career Program for workers hinges on this critique of managerialism, from which it will be possible to restore the dignity of labour in public health.