According to the Director of the DENOB/ MPOG, "the workgroups were the embryo for the formation of the Units of the SIASS, but after the creation of the units the Groups were not continued, because their purpose was, indeed, discussion of the formation of the Units" (9).
When analyzing the activities of the workgroups, Pacheco comments that the Forums of the SIASS emerged as a more appropriate strategic space for identification and overcoming of blockages, and strengthening of the field of workers' health.
The Permanent Forum of Rio de Janeiro was created in 2009, and has been meeting monthly, using the participating institutions as headquarters, with an agenda of discussions of a technical and political nature related to workers' health and the SIASS.
According to the report of the First SIASS/RJ Forum (20), the principal objective was to strengthen the actions for implementation of the SIASS Units in the State of Rio de Janeiro and, more specifically, to analyze the path of construction and implementation of the SIASS in the State, taking into account the work carried out by the workgroups, the implementation of the first units, and the difficulties they found for implementing the actions of the Government Workers' Healthcare Policy, and also to set out guidelines for creation of new units.
Pacheco (19), also said that the Forums of the SIASS constitute potential spaces for overcoming the instituted concept of occupational health in the services that concentrate on workers' health in the public institutions of Rio de Janeiro, because they are an instance of participation of these workers in relation to the subject of workers' health in general.
The plenary session of the Fourth Forum approved the creation of an Interinstitutional Committee to submit demands, specifically for direct and effective participation of the MPOG in the implementation of the SIASS and the PASS (22).
After this withdrawal by the MPOG, in support and financing of the units of the SIASS, especially in relation to the collective actions for oversight and promotion of workers' health, activities began to be undertaken on an individualized basis, restricted to medical expert opinion reports and periodic medical examinations (24).
The political-institutional context of which the SIASS is a part
These new management mechanisms result in the work in the public service being managed outside the direct control of the State and its capacity to influence the workforce and process of working conditions --which reduces the impact of the actions proposed by the SIASS.
The new scenario which began as from 1998, with the approval of Constitutional Amendment 19 of that year, has a direct impact on the PASS and on the position of workers' health in the SIASS itself.
The experience of construction and implementation of the SIASS in the municipality of Rio de Janeiro, analyzed in this paper, brings forward elements that evidence the institutional agents and the various social actors mobilized in the process of institutionalization of policies of government workers' health.
Forum Permanente do SIASS RJ: Entrevista com gestores do DENOB [Internet].