The legal structure of management of public hospital unions and criminal liability of managers arising from the medical organization

With the establishment of Turkish Public Hospitals Institution and Public Hospitals Unions as its subsidiaries within the context of "Transition Program in Healthcare", based on the Executive Order (EO) no.663 on the Organization and Missions of the Institutions of the Ministry of Healthcare and Affiliates dated 02.11.2011, all public hospitals have been connected to these unions; hence second and third step healthcare services are now provided through these unions. Within this context, a fundamental change in the organization of the healthcare services have taken place in Turkey and thereafter a new group of managers, all employed on contractual basis in public hospital unions emerged. As a consequence of this change, a more autonomous structuring has been adopted with respect to the legal status of the contractual-based managers by granting them more responsibility and power. Moreover, the hospital management can now exercise more autonomy in the decision making process. This study discusses the legal status, medical organizational liabilities and connectedly criminal liabilities of the hospital managers under this quite new structure. The first part of the study focuses on the legal amendments which form the basis of Public Hospital Unions within the process of privatization of healthcare services, the organizational structure of the Public Hospital Unions and the mission and responsibilities of the managers. The second part deals with the criminal liabilities of the managers of the Public Hospital Unions including the protection of the life and physical integrity in the light of the regulations under the Turkish Criminal Act no.5237. The next focus is on the "medical organizational liability" that can be attributed to the managers of the unions and negligence crimes that may come out due to the structures of the Public Hospital Unions as a subsidiary of the Ministry of Healthcare with current examples from practice and precedent. Keywords: Public Hospital Unions, Liability of Medical Organization, Hospital Managers, Guarantor, Negligence.