Sağlık sektöründe kamu ve özel sektörün ortaklığına dayalı kamu-özel ortaklığı (KÖO) yöntemi Türk sağlık sektöründe de uygulanmaya başlamıştır. Son yıllarda Türkiye sağlık sektörü büyük bir değişim göstermekte ve giderek artan şekilde KÖO’nı kullanmaktadır. Bu kapsamda çalışma Türkiye sağlık sektörü politikalarında yaşanan bu değişime odaklanmıştır. Çalışmada Türkiye sağlık altyapı yatırımlarında bir finansman yöntemi olarak KÖO politikasının politika haritalama yöntemi ile analiz edilmesi amaçlanmaktadır. Bu analiz yardımıyla politikanın kapsamı, aktörleri, yanında ve karşısında yer alanlar ile henüz bu politika ile ilgili bir taraf olmayanların pozisyon, etki ve güçleri, kaynakları, bu politika ile ilgili çıkarları veya karşı çıkış sebepleri, bu politikadan etkilenecek gruplar incelenmektedir. Bu çalışmanın evrenini, Türkiye sağlık sektöründe altyapı finansman yöntemi olarak KÖO politikası içinde yer alan kamu ve özel sektör temsilciler ve bu politika ile ilgili diğer kişi ve gruplar oluşturmaktadır. Bu araştırmada veri toplama aracı olarak doküman inceleme ve yarı yapılandırılmış soru formları ile yüz yüze görüşme yöntemleri kullanılmaktadır. Araştırma kapsamında MayısKasım 2009 tarihleri arasında 35 kişi ile görüşme yapılmıştır. Toplanan veriler PolicyMaker 4.0 programı ile analiz edilerek sonuçlar literatür ışığında tartışılmıştır

HEALTH SECTOR PUBLIC-PRIVATE PARTNERSHIP POLICY IN TURKEY

Public-Private Partnership (PPP) models, public and private collaboration to service facility in for increasing demands, many governments such as the United Kingdom (UK) government look for ways to benefit from the efficiency of the private sector. As a result of this, an alternative financial method, Public-Private Partnerships (PPP) method, characterized as the second phase of liberilization movement, is used in public goods and services; from hospitals to highways, infrastructure to energy, defence to airports, and schools to jails [1]. In the UK, the approach is named as Private Finance Initiative (PFI) while in international literature it is stated as the PPP method. It is the most important project financing method used in developed countries especially in the European Union (EU).

___

  • Akintoye A, Beck M, Hardcastle C. (Eds.) Public-Private Partnerships: Managing Risks and Opportunities. Oxford: Blackwell Pub., 2003.
  • Aliyu ZY. Policy Mapping for Establishing A National Emergency Health Policy for Nigeria BMC International Health and Human Rights, Research Article, 2002, 2 (5).
  • Allard G. Trabant, A. Public-Private Partnerships in Spain: Lessons and Opportunities, IE Business School Working Paper, 2007, 10–07. Available at: www.pwcglobal.com/uk/eng/about/svcs/pfp/ppp.html, Accessed May 2006.
  • An item to the Health Services Basic Law No: 5396 in 2005. (Sağlık Hizmetleri Temel Kanununa Bir Ek Madde Eklenmesi Hakkında Kanun, Kanun No: 5396, Kabul Tarihi: 03.07.2005)
  • Bettignies J-E, Ross TW. The Economics of Public-Private Partnerships, Canadian Public Policy, Analyse De Politiques, 2004,Vol. XXX, No.2.
  • Bult-Spiering M, Dewulf G. Strategic Issues in Public-Private Partnerships in International Perspective, Oxford: Blackwell Publishing, 2006.
  • Eaton D. and Akbıyıklı R. Quantifying Quality: a Report on PFI and The Delivery of Public Services, Royal Institution of Chartered Surveyors (RICS), 2005, Available at: www.rics. org/pfi Accessed June
  • Gider Ö. and Top M. Kamu Hastane Sektöründe Liberalleşme ve Türkiye’de Yansımaları, 2007, Available at:http://www.e-konomist.net/kamu-hastane-sektorunde-liberallesme-ve-turkiyede-yansimalari, Accessed May 2008.
  • Gilson L., Buse K., Murray SF. and Dickinson C. Future Directions for Health Policy Analysis: Atribute To The Work of Proffesor Gilt Walt Editorial, Health Policy and Planning, 2008, 23, 291–293.
  • Glassman A., Reich M.R., Laserson K. and Rojas F. Political Analysis of Health Reform in The Dominican Republic, Health Policy and Planning, 1999,14 (2), 115–126.
  • Grout P. A. Public and Private Sector Discount Rates in Public-Private Partnerships, CMPO Working Paper Series No. 03/059, 2002. Available at: http://www.bris.ac.uk/cmpo/workingpapers/wp59.pdf, Accessed May 2007.
  • Hall J., Private Opportunity, Public Benefit?, Fiscal Studies, 1998, 19 (2).
  • Hardcastle C. and Boothroyd K. Risk Overview in Public-Private Partnership, in A. Akintoye and M. Beck and C. Hardcastle (Eds.) Public-Private Partnerships Managing Risk and Opportunities, Blackwell Science, 2003, 31–57.
  • Hart O. and Moore J. Property Rights and the Nature of the Firm, The Journal of Political Economy, , 98 (6), 1119–1158.
  • Hemming R. Public Private Partnerships, Government Guarantees and Fiscal Risk, IMF, 2006, Washington, DC. http://www.undp.org/pppue/prog.html, Accessed August 2000.
  • Kajula P.W., Kintu F., Barugahare J. and Nema, S. Political Analaysis of Rapid Change in Uganda’s Health Financing Policy and Consequences on Service Delivery for Malaria Control, International Health Management, 2004, 19, 133–153.
  • Klijn E-H. and Teisman G.R. Institutional and Strategic Barriers to Public-Private Partnership: An Analysis of Dutch Cases, Public Money and Management, 2003, July.
  • Krajewski-Siuda K., Romaniuk P. and Gericke C.A. Political Analysis of The Conception of The Polish National Health Fund, Journal of Public Health, 2008, 16, 153–159.
  • Kvale S. InterViews: An introduction to Qualitative Research Interviewing, Sage Publications,1996.
  • Li B., Akintoye A., Edwards P.J. and Hardcastle C. Critical Success factors for PPP/PFI Projects in The UK Construction Industry, Construction Management and Economics, 2005, June (23), 459–471.
  • Li B., Akintoye A., Edwards P.J. and Hardcastle C. Perceptions of Positive and Negative factors Influencing The Attractiveness of PPP/PFI Procurement for Construction Projects in The UK: Findings from A Questionnaire Survey, Engineering, Construction and Architectural Management, 2005, 12 (2), –148.
  • Li B., Akintoye A., Edwards P.J. and Hardcastle C. The Allocation of Risk in PPP/PFI Construction Projects in The UK, International Journal of Project Management, 2005, 23, 25-35.
  • Li B. and Akintoye A. An Overview of Public-Private Partnership. Akintoye A. Beck M. and Hardcastle C. (Eds.) Public-Private Partnerships: Managing Risks and Opportunities. Oxford: Blackwell Pub., 2003.
  • Linder S.H. Coming to Terms with the Public-Private Partnership, A Grammar of Multiple Meanings, American Behavioral Scientist, 1999, 43, 35–51. Reprinted in Pauline Vaillancourt Rosenau [Eds] Public
  • Private Policy Partnerships, MIT Press, Cambridge, MA, 2000, 19–36, and in Darrin Grimsey and Mervyn
  • Lewis (Eds.) The Economics of Public Private Partnerships, International Library of Critical Writings in Economics, Volume 183, Northhampton, MA: Edward Elgar, 2005, 75-91.
  • Middleton N. Public Private Partnerships: A Natural Successor to Privatisations?, 2000. Availiable at: www.pwcglobal.com/uk/eng/about/svcs/pfp/ppp.html, Accessed May 2005.
  • Neuman W.L. Social Research Methods Qualitative and Quantitative Approaches, Ablongman, 5th Ed. 2003.
  • Peters B.G. With A Little Help From Our Friends: Public-Private Partnerships as Institutions and Instruments, in Pierre, J. [Eds], Partnerships in Urban Governance: European and American Experience, Macmillan Press, 1998, 11–33.
  • Pollock A. and Price D. Public Risk for Private Gain?: The Public Audit Imlications of Risk Transfer and Private Finance, UNISON, Positively Public, 2004.
  • Price D. and Pollock A. Debts, Deficits and Service Reductions: Wakefield Health Authority’s Legacy to Primary Care Trust, UNISON, 2002.
  • Reich M. Political Mapping of Health Policy, A Guide for Managing The Political Dimensions of Health Policy, Data For Decision Making Project, Harvard School of Public Health,1994.
  • Riess A. Is The PPP Model Applicable Across Sectors, Economic and Financial Studies, EIB Conference on Economics and Finance Luxembourg, 2005, January.
  • Rosenau P. V. The Strengths and Weaknesses of Public-Private Policy Partnerships, American Behavioral Scientist, 1999, 43 (1), 10–34.
  • Sava V. and Wenzel H. Public Health Planning: From Recommendation To Implementation, Public Health Strategies: A Tooo For Regional Development in S. G. Scintee and A. Galan (Eds.) Hans Jacobs Publication Comp., Germany, 2005.
  • Smith R. Vaccines and Medicines for The World’s Poorest: Public-Private Partnerships Seem to be Essential, BMJ, 2000, 320, 952–3, Editorials,Available in www.bmj.com, Accessed May 2006.
  • Swart D. and Reddy P. Strengthening Comprehensive Tobacco Control Policy Development in South Africa Using Political Mapping, Medical Research Council, 1998. Available in www.crdi.org, Accessed January 2009.
  • Tatar F. Privatization and Turkish Health Policy, Unpublished Doctoral Thesis, University of Nottingham,1993.
  • Tekin A.G. Kamu-Özel Sektör İşbirlikleri- Kamu-Özel Ortaklıkları/Public Private Partnerships veya PPP Modelleri. İdarecinin Sesi Dergisi. 2007, May-June, 21 [122].
  • Tekin P.Ş. Türkiye’de Sağlık Sektöründe Bir Finansman Yöntemi Olarak Kamu-Özel Ortaklığı Politikasının Politika Haritalama Yöntemi İle Analiz Edilmesi. Hacettepe Üniversitesi, Sağlık Bilimleri Enstitüsü, Sağlık Kurumları Yönetimi Anabilim Dalı, Doktora Tezi, 2010, Ankara.
  • Tekin P.S. and Celik Y. Analysing public-private partnership policy as a financing method in Turkey health sector with political mapping. 7th Biennial Conference in Organisational Behaviour in Health Care, Mind the Gap: Policy and Practice in the Reform of Health Care, p.62, University of Birmingham, Birmingham,11-14 April 2010, UK. (Oral Presentation)
  • Tengilimoğlu D., Celik O.F. and Tekin P.Ş. Kamu Özel Ortaklığı. Mustafa Bulun (Ed.). Sağlık Hizmetlerinde Güncel Kavramlar. Sage Yayınları 21, 2010, Ankara.
  • The Regulation. No: 26236, 2006. (Sağlık Hizmetlerinin, Kiralama Karşılığı Yaptırılması İle Tesislerdeki Tıbbi Hizmet Alanları Dışındaki Hizmet Ve Alanların İşletilmesi Karşılığında Yenilenmesine Dair Yönetmelik, 2006/10655, Resmi Gazete 22.Temmuz 2006, Sayı:26236.)
  • Thobani M. Private Infrastructure, Public Risk, The Newsletter of The International Project Finance Association. 1999, 1(1).
  • UNISON. What’s Good About The NHS: And Why It Matters Who Provides The Service. UNISON. Positively Public, 2002.
  • Varvasovszky Z. and McKee M. An Analysis of Alcohol Policy in Hungary: Who is in Charge? Addictio. 1998, 93 (12), 1815-1827. www.polimap.com
  • Yıldırım A. and Simsek H. Sosyal Bilimlerde Nitel Araştırma Yöntemleri. Seçkin Pub., 5th Ed., 2005, Ankara.
  • Sağlık İstatistikleri Yıllığı. 2008.