A study to understand the negative impacts of Health Transformation Program practices on the working conditions of the public hospital personnel by considering employment and remuneration methods

Health Transformation Program is a milestone due to the healthcare system in Turkey have brought significant structural changes and regulations in the axis of neoliberal policies. Neoliberal reforms led to the opening of health service to the market. It cannot be said that the conditions of healthcare workers will not be affected by the transformation of social and economic structure within the health system. The permanent employment of the health workforce has switched to contractual employment, and many precarious situations and different health staff have emerged. Performance-based salary has been introduced through arrangements in the salary system of healthcare workers, therefore patient-centered understanding has been lost and patients has been treated as if they are customers. In this thesis, it has been studied to determine how HTP regulations affect the working conditions, employment methods and wages of healthcare employees working in public health care hospital by using qualitative field research method. Data analysis has been made by using the documents and reports composed of the SAGLIK-SEN Strategic Research Center (SASAM) and Turkish Medical Association (TTB). The impact of the HTP on the working environment of public hospital employees in terms of employment and remuneration has been examined in the categories of inadequate employment, employment in different statuses and performance based remuneration. As a result of this study, it has been determined that HTP has negative consequences reflected to the working environment such as depersonalization of physicians, exhaustion, violence, organizational injustice, income insecurity, deterioration of work peace etc. Keywords: Health Transformation Program (HTP), health work force working conditions, employment, performance based salary