Primary Care in the Health System: debates from Sao Paulo in a historical perspective

The central aim of this paper was to historically retrieve the dimensions relating to the organization of healthcare practices in Brazil based on clues left in records. Primary healthcare had a special place within this context. To accomplish this, attention was focused on a very rich and complex period, during which alternatives within this field were proposed, especially by healthcare professionals whose working experiences were also marked by regional dimensions within the State of Sao Paulo, through their locations and institutional experiences. In this respect, looking at the past as a point of support for this understanding will be of great value, given that complete ruptures of past experiences do not occur; rather, such experiences are continually retrieved, either to go beyond certain conjectural links, or to use the experiences as points of reference for envisaging future developments in healthcare thinking and practice. The period between 1970 and 1990 was particularly covered, highlighting the Healthcare Program proposal, which was the official policy of the State of Sao Paulo for implementing primary care as a project for extending access at the first level of the system and for producing specific care. As a complement to this, the proposals of the State of Sao Paulo for Program Action and Life Protection were examined as formulations that criticized the Program and were the basis for debate on innovations in healthcare and professional practices.