The attitudes and expectations of local administrations in the process of transformation of health services: The case of metropolitan municipalities

In this dissertation, it is basically aimed to handle with the public service theory and healthcare services which are among the most crucial public services in the contexts of public administration together with those decentralization efforts toward healthcare services by taking the point view of administration science. In the first chapter of the dissertation, the theory of public service and the transformation of this term are generally examined. In this chapter, firstly, those discussions on service and goods dichotomy are delivered. Then, public service conceptualization is evaluated. The historical, economical and administrative dimensions of public service are detailed. The contemporary developments affecting the public service notion are studied aligning with the theoretical openings and discussions thereunto. In the first chapter of the dissertation, besides, health and health care concepts are dealt with a special reference to the theory. Then, some other related issues as what is health care decentralization and how to be realized, types of decentralization, positive and negative effects of decentralization and dynamics regarding the decentralization matters are deployed. The possible obstacles and resistances driven to decentralization are studied aligned with the possible weaknesses and negative ways which could be among the results of so-called decentralization policy. The international examples of healthcare decentralization are scrutinized as much measure as the dissertation allows. In the second chapter, Turkish health services are dealt with as deep as possible. The historical evolution of Turkish healthcare services, those different policies emerged meantime, basic problematic areas of Turkish health care, those reasons and justifications for the rationale of reforms, those projects and plans before the decentralization inclination and the present situation of decentralization are deeply analyzed. In the third chapter of the dissertation, the expectations and attitudes of localelected politicians are investigated with the help of an area research. The data taking shape after the so-called area research are statistically analyzed and explicated. On the upshot, there lay some applicable policy proposals having the aim to help the Turkish healthcare decentralization be successful.