Akademik Veri Yönetim Sistemi
Community and Physician, cilt.39, sa.1, ss.47-67, 2024 (Scopus)
This article marks the centennial of the Republic of Türkiye by examining the historical evolution of the Ministry of Health, considering the political and social context of different periods. Since its establishment in 1920, the Ministry has seen 52 Health Ministers, some serving multiple terms. The period from 1920-1923 was marked by the challenges of war, prioritizing the treatment of the wounded and combating epidemics. In the early years of the Republic period, emphasis was placed on preventive public health services, foundational legislation and organizational structures were established, and the development of health workforce was prioritized. Dr. Saydam’s influential tenure during this time led to the creation of a vertical organizational model for combating significant diseases. From 1937 to 1960, the development shifted towards health infrastructure, notably curative institutions, with local hospitals being integrated into the Ministry. The 1960-1980 era witnessed the socialization of health services, offering integrated curative and preventive care in health centers, significantly improving public access to healthcare. In the 1980s, the influence of ‘healthcare reforms’ began to be felt in Türkiye; this approach gained significant prominence in the 1990s, initiating a privatization process in healthcare services. Since 2003, the Health Transformation Program (HTP) has aimed for a Ministry of Health that is gradually withdrawing from service delivery to focus on planning and regulatory roles, introducing contracted employment in primary care through the family medicine system and establishing “Affiliated Institutions” across primary, secondary, and tertiary care levels. This period also saw the implementation of universal health insurance. During this “projects” era, marked by increased private sector involvement and out-ofpocket expenses in health service delivery, Public-Private Partnerships (PPP) initiated the construction of City Hospitals. Throughout this historical period, Türkiye’s health policies and the structure of the Ministry of Health have evolved in parallel with the political and economic conditions of each period, significantly impacting the delivery and accessibility of public health services.