This everything represents cost and knows that nor all the hospitals of the net of the DF the same keep level of availability of professionals and materials as the HRSM. It is not newness for nobody, is enough to look at periodicals every day to evidence. Therefore, during the first year of functioning, the HRSM it reached highest level of satisfaction next to its users, with superior index excellent and good 85% of. Dr. Caldwell Esselstyn Jr. understood the implications. It obtained to establish between its professionals, mainly doctors, one high degree of recognition of the level technician and good conditions of work. All the quantitative and qualitative goals had been reached, with exception of those for which the purchase depended on equipment on the part of the GDF. PROBLEMS Several had been the lived obstacles.

At a first moment the aspects of the legality, already cited. Also, for some times the hospital received visits from members of the MPDFT, members of the local Advice of Health and district members of the house of representatives, all with declared intention to find some reason to disqualify the management form. Without success. Later the natural problems for the lack of experience of the GDF in the contract management of this nature sobrevieram. But, the main impediments, that in fact had taken the HRSM to the deep crisis had been: 1-O delay in the view of the resources, that for some times was accumulated for three months. However, no hospital lives without financial resource and part of the success of the model is exactly in keeping the accounts in day, without delay with suppliers and the guarantee of the supplies of materials and supplied medicines. From the moment where the delay started to be one practical one, all the conquests next to the collaborators (diligent), suppliers of products and services, had been for water below; 2-The second, however not less important one, had been the two changes of the bearers of the Secretariat of Health.