Do demandismo à resolutividade: a governança colaborativa do Ministério Público na tutela coletiva da saúde na comarca de Governador Valadares

Abstract

This paper analyzes the transition in the role of the Public Prosecutor’s Office in the collective protection of health rights, contrasting the traditional "litigation-oriented" model, focused on filing public civil actions, with the "resolution-oriented" model, grounded in collaborative governance and consensual settlement. The research question investigates the extent to which the extrajudicial approach proves more efficient than judicialization for resolving complex public health conflicts. The hypothetical-deductive method was employed, with a case study conducted at the 15th Public Prosecutor's Office in the Judicial District of Governador Valadares/MG, covering the period from 2012 to 2025. The comparative analysis of the models applied objective performance criteria: time to resolution, procedural and transactional costs, degree of claim satisfaction, and social impact. The empirical research contrasts the employment of the judicial pathway for the collective protection of the fundamental right to health in the Governador Valadares Judicial District with that of the consensual approach, particularly through agreements reached via the Center for Consensual Settlement of Conflicts and Legal Certainty of the Public Prosecutor's Office of Minas Gerais (COMPOR-MPMG), Conduct Adjustment Agreements (TACs), and ministerial recommendations. It is observed that administrative resolution provides a swifter, more cost-effective, and scalable response to the demands of the brazilian Unified Health System (SUS), with judicialization repositioned as a last resort (ultima ratio).