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Markets, modernisation and national interest: three faces of patient choice policy in Turkey

Hasan Hüseyin Yıldırım, David Hughes, Türkan Yıldırım

Health & Social Care in the Community, Volume: 19, Issue: 2, Pages: 168 - 177

Swansea University Author: David Hughes

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DOI (Published version): 10.1111/j.1365-2524.2010.00956.x

Abstract

<p>This article discusses three faces of patient choice policy in a developing country, Turkey. As part of its wider health transformation programme (HTP), Turkey has created a purchaser/provider system in which a single public purchaser channels funding to a range of public and private hospit...

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Published in: Health & Social Care in the Community
Published: wiley 2010
Online Access: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2524.2010.00956.x/full
URI: https://cronfa.swan.ac.uk/Record/cronfa6778
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2011-10-01T00:00:00.0000000</datestamp><bib-version>v2</bib-version><id>6778</id><entry>2012-01-24</entry><title>Markets, modernisation and national interest: three faces of patient choice policy in Turkey</title><swanseaauthors><author><sid>f1fbd458e3c75d8b597c0ac8036f2b88</sid><firstname>David</firstname><surname>Hughes</surname><name>David Hughes</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2012-01-24</date><deptcode>FGMHL</deptcode><abstract>&lt;p&gt;This article discusses three faces of patient choice policy in a developing country, Turkey. As part of its wider health transformation programme (HTP), Turkey has created a purchaser/provider system in which a single public purchaser channels funding to a range of public and private hospitals, and patients &#x2013; in theory at least &#x2013; are given significant freedoms to choose their hospital and physician. At the same time, marketisation has been softened by an emphasis on the creation of &#x2018;human-centred&#x2019; services, resulting in a variety of initiatives to enhance patient rights and using a similar rhetoric to that employed in modernising &#x2018;third-way&#x2019; reforms in countries such as the United Kingdom. We argue that neither markets nor modernisation fully explain the specifics of Turkish choice policy, which is also driven by the strong political imperative arising from Turkey&#x2019;s proximity to the European Union and its accession ambitions. Europeanisation represents an approach to markets softened by social solidarity, and gives the Turkish reforms a very different profile from neo-liberal reforms implemented in other middle income countries. However, in practice, medical workforce shortages, the uneven distribution of resources across the nation, and the lack of systematic information on provider outcomes limit the scope of choice for much of the population. In this situation, a planned allocation of resources to support equity of provision has advantages over a system where resource flows to providers are determined by individual patient choices&lt;/p&gt;</abstract><type>Journal Article</type><journal>Health &amp; Social Care in the Community</journal><volume>19</volume><journalNumber>2</journalNumber><paginationStart>168</paginationStart><paginationEnd>177</paginationEnd><publisher>wiley</publisher><placeOfPublication/><issnPrint/><issnElectronic/><keywords/><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2010</publishedYear><publishedDate>2010-12-31</publishedDate><doi>10.1111/j.1365-2524.2010.00956.x</doi><url>http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2524.2010.00956.x/full</url><notes>&lt;p&gt;&lt;span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: TH;" lang="EN-US"&gt;Yildirim, H., Hughes, D. and Yildirim, T. &lt;/span&gt;&lt;/p&gt;</notes><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2011-10-01T00:00:00.0000000</lastEdited><Created>2012-01-24T10:32:25.7900000</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Public Health</level></path><authors><author><firstname>Hasan H&#xFC;seyin</firstname><surname>Y&#x131;ld&#x131;r&#x131;m</surname><order>1</order></author><author><firstname>David</firstname><surname>Hughes</surname><order>2</order></author><author><firstname>T&#xFC;rkan</firstname><surname>Y&#x131;ld&#x131;r&#x131;m</surname><order>3</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2011-10-01T00:00:00.0000000 v2 6778 2012-01-24 Markets, modernisation and national interest: three faces of patient choice policy in Turkey f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2012-01-24 FGMHL <p>This article discusses three faces of patient choice policy in a developing country, Turkey. As part of its wider health transformation programme (HTP), Turkey has created a purchaser/provider system in which a single public purchaser channels funding to a range of public and private hospitals, and patients – in theory at least – are given significant freedoms to choose their hospital and physician. At the same time, marketisation has been softened by an emphasis on the creation of ‘human-centred’ services, resulting in a variety of initiatives to enhance patient rights and using a similar rhetoric to that employed in modernising ‘third-way’ reforms in countries such as the United Kingdom. We argue that neither markets nor modernisation fully explain the specifics of Turkish choice policy, which is also driven by the strong political imperative arising from Turkey’s proximity to the European Union and its accession ambitions. Europeanisation represents an approach to markets softened by social solidarity, and gives the Turkish reforms a very different profile from neo-liberal reforms implemented in other middle income countries. However, in practice, medical workforce shortages, the uneven distribution of resources across the nation, and the lack of systematic information on provider outcomes limit the scope of choice for much of the population. In this situation, a planned allocation of resources to support equity of provision has advantages over a system where resource flows to providers are determined by individual patient choices</p> Journal Article Health & Social Care in the Community 19 2 168 177 wiley 31 12 2010 2010-12-31 10.1111/j.1365-2524.2010.00956.x http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2524.2010.00956.x/full <p><span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: TH;" lang="EN-US">Yildirim, H., Hughes, D. and Yildirim, T. </span></p> COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2011-10-01T00:00:00.0000000 2012-01-24T10:32:25.7900000 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Hasan Hüseyin Yıldırım 1 David Hughes 2 Türkan Yıldırım 3
title Markets, modernisation and national interest: three faces of patient choice policy in Turkey
spellingShingle Markets, modernisation and national interest: three faces of patient choice policy in Turkey
David Hughes
title_short Markets, modernisation and national interest: three faces of patient choice policy in Turkey
title_full Markets, modernisation and national interest: three faces of patient choice policy in Turkey
title_fullStr Markets, modernisation and national interest: three faces of patient choice policy in Turkey
title_full_unstemmed Markets, modernisation and national interest: three faces of patient choice policy in Turkey
title_sort Markets, modernisation and national interest: three faces of patient choice policy in Turkey
author_id_str_mv f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author David Hughes
author2 Hasan Hüseyin Yıldırım
David Hughes
Türkan Yıldırım
format Journal article
container_title Health & Social Care in the Community
container_volume 19
container_issue 2
container_start_page 168
publishDate 2010
institution Swansea University
doi_str_mv 10.1111/j.1365-2524.2010.00956.x
publisher wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
url http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2524.2010.00956.x/full
document_store_str 0
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description <p>This article discusses three faces of patient choice policy in a developing country, Turkey. As part of its wider health transformation programme (HTP), Turkey has created a purchaser/provider system in which a single public purchaser channels funding to a range of public and private hospitals, and patients – in theory at least – are given significant freedoms to choose their hospital and physician. At the same time, marketisation has been softened by an emphasis on the creation of ‘human-centred’ services, resulting in a variety of initiatives to enhance patient rights and using a similar rhetoric to that employed in modernising ‘third-way’ reforms in countries such as the United Kingdom. We argue that neither markets nor modernisation fully explain the specifics of Turkish choice policy, which is also driven by the strong political imperative arising from Turkey’s proximity to the European Union and its accession ambitions. Europeanisation represents an approach to markets softened by social solidarity, and gives the Turkish reforms a very different profile from neo-liberal reforms implemented in other middle income countries. However, in practice, medical workforce shortages, the uneven distribution of resources across the nation, and the lack of systematic information on provider outcomes limit the scope of choice for much of the population. In this situation, a planned allocation of resources to support equity of provision has advantages over a system where resource flows to providers are determined by individual patient choices</p>
published_date 2010-12-31T03:08:21Z
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score 11.013731

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