TÜRKİYE’DE BİR KAMU POLİTİKASI SORUNU OLARAK YABANCI DOKTOR İSTİHDAMI: AVUSTRALYA, BİRLEŞİK KRALLIK VE KANADA ÖRNEKLERİ

This study examines and evaluates the positive and negative factors concerning the health services human resources policy of employing foreign doctors, which has been placed lately on Turkey’s agenda. To this end, foreign doctor employment policies of Australia, United Kingdom and Canada, with the objectives of solving the doctor shortage and geographical distribution problems, are examined and evaluated with the intention of drawing lessons for Turkey from the experiences of these countries. The study begins with the brief explanation and evaluation of the current reforms in Turkey in the area of health services. While doing that, particular attention has been given to the problems of having an inadequate number of doctors, and the uneven distribution of doctors within the geographical regions of the country in question. In this section, the arguments for and against the inadequacy in numbers and uneven distribution of doctors (and other health services personel) are presented, with the eventual objective of diagnosing the real problem. In other words, the analysis in this section was geared towards determining whether the number or the geographical distribution of the doctors/other health services personel is the real problem in the case of Turkey. After determining the real problem with the help of longitudinal and comparative data, derived especially from fellow OECD countries, and numerous European countries, examples to the policy of employing foreign doctors are evaluated. To this end, examples from Australia, United Kingdom and Canada stood out as these countries confront the problem in question for a long time -partly due to the downfall of the British colonialism and the following immigration of white-collar workforce, and among them doctors, to the colonist country and its remaining colonies- therefore have a lot to offer for countries with similar public policy problems. The analysis shows that one of the most important issues that comes up from the comparative analysis of foreign doctor emplyment policies is the licensing of foreign doctors, especially in the European Union countries, as well as in Australia and Canada. The licensing issue has a time dimension attached to it. That is, licensing can be temporary/short time or permanent/long time. The licensing issue is also related to the prevention and the legal compensation of doctor-related medical mistakes from a legal point of view. A second important issue is the cultural and lingustic barriers that make it more difficult for foreign doctors to provide high-quality service to their patients. This issue is also related to another critical issue of patient satisfaction from the services of doctors, that can be affected negatively by various cultural and lingustic barriers. The patient/customer satisfaction isssue, in return, is related to issues of performance and performance-related pay for doctors and other health services personnel. A third critical issue is the signing of bilateral or multilateral legal agreements between/among countries concerning the acceptance of medical degrees earned from different countries other than the country of employment. This particular issue is also related to the academic Exchange programs, such as those within the borders of the European Union, such as the Erasmus Academic Exchange Program, of which Turkey is a part. The final section of the study provides an overall evaluation and analysis of the public policy decision of employing foreign doctors. Within this section, the alternatives to employing foreign doctors, such as increasing the number of medical students in the already existing universities, or opening new medical schools are also taken into consideration. Another important factor in this debate, that needs to be carefully analyzed is the veto reasons of the former President of the Turkish republic, Mr. Ahmet Necdet Sezer, to the law concerning foreign doctor employment. The study concludes with the overall evaluation of all these factors stated above.