Government’s New Healthcare Policy and Violence Against Medics

Government’s New Healthcare Policy and Violence Against Medics

May 2012

The new healthcare policies set by the Ministry of Health has decreased the quality of the service, while increasing the tension between the medics and the patients.

A young thoracic surgeon, Dr. Ersin Arslan (30) was murdered by a relative of his patient. His 80 year old patient had died fews days after a lung cancer operation. Dr. Arslan was stabbed to death by his patient’s revengeful relatives. The incident caused an outrage among the Turkish healthcare providers and rallies across the country were organized. The healthcare services except emergencies, were halted across the country. More than 25.000 medics participated at the protests. This was not the first violence case against physicians and healthcare personnel in the country. In 2005, one of the best known professors of thoracic surgery, Professor Goksel Kalayci, was also assassinated by one of his patient’s relative. Unfortunately, there are have been a number of similar attacks against medics during the last decade. What are the driving forces on increasing violence against medics? Could the new healthcare policies have a direct effect?

The confrontation of the public versus the physicians started during 1980′s. The peak was achieved with the current government’s new healthcare policy. The Full Day Working Act” imposed by AKP government has limited physicians to work both in public hospitals and in private clinics. Upon objections by doctors the new regulation was canceled by the High Court many times. Nevertheless, the Ministry of Health tried to realize the act repetitively. Medical chambers across the country worked hard to communicate their thoughts to the public through mass media. However, the current Minister of Health, Recep Akdag, accused the physicians of trying to steal the money from the pockets of the public. The Prime Minister Recep Tayyip Erdogan preferred to also generalize accusing all physicians of trying to take the advantage of working in a public hospital and inviting those patients to their private offices. He also called the physicians Mr. Doctors” in a mocking way and he expressed that this was the end to an era for doctors. Similar expressions from different voices from the government have decayed the appreciation to the doctors among the public. Ironically the public is actually not aware of the long-term outcomes of the new healthcare system. The public was encouraged to call ministry hotlines for any complaint they might have against medics. Interestingly, this service wa promoted by the minister himself. Ironically such complaint lines is not offered other public services in the country.

 

After the new act, the professors, who are in charge of training and education as well as providing healthcare were forced to choose either working solely at the medical faculty or having a private practice. The professors, who preferred to have a private practice after working hours were also banned from practicing at the faculty, apart from education. This also caused confrontation of physicians with the public, who are in need of healthcare services. The main problem with the current system concerns education and training since medical education requires close contact with the teachers, students and patients. There was a series of resignations from many medical universities because the difficulties of this system. Many operations were canceled. Education and ongoing scientific research was deeply affected.

The new healthcare system is also associated with a kind of privatization. The public hospitals will be run by committees and if the hospital is not profitable, it may be shut down.

The physicians, who are working privately, were also hit by the policies of the ministry. The new regulations for private medical offices required almost impossible revisions at the offices. It is worth noting that these new regulations regarding private medical offices were also canceled or halted by High Courts.

Many aspects of Turkey’s new healthcare system has turned this crucial public service into a privatization. The public hospitals will be run by committees and if the hospital is not profitable, it can be shut down. This new approach allows Public Private Partnerships (PPP). PPPs started to appear after 1990′s in countries such as Great Britain, Ireland, Spain, Portugal and The Netherlands. The first act was legalized in Great Britain, while it was legalized in 2005 in Turkey. The act simply enables the state to avoid investing in certain areas of public services and cooperate with private companies. Although the act helps the governments to avoid expenses in such services, the debt of the private company is guaranteed by the state in case of a bankrupt of the PPP company. Moreover, the government will not be able to change the policy in case of a failure since the foreign investments are protected by international agreements, such as the case in Argentina.

The Turkish Doctors Chamber wishes that Turkish physicians have an enough salaries to have a higher life quality and to provide better standards for their families. The doctors working hours should be declared according to human rights and this should be enough for themselves and their families. The healthcare system should be provided by the state as a public service and it should be free. The hospitals should be secure and safe. Moreover, Turkish doctors do not want to be despised by government officials which return becomes a rhetoric for the public.

 

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