January 23, 2006

The decision of the Turkish Treasury not to pay its 3.5 Billion YTL debt to public hospitals is causing havoc for the hospitals and its workers. The health care workers, many facing foreclosures and now unemployment, are preparing mass actions.

The debt had accrued due to health services provided by the public hospitals to the SSK (Social Security Institution), the Bağ-Kur (State run agency to provide social security for the private sector and the independent professionals) and Green Card holders (State provided health care system).

If the hospitals can not collect the debt owed by the Turkish State, some hospitals may have to foreclose. In some health facilities, the medicine and equipment stocks are adequate for the time being and they will continue giving service. The workers who do not get their salaries are the hardest hit from the crises. There is a preparation by the health care workers for a massive demonstration in the capital, Ankara next week.

Broken Promises

The General Secretary of the Turkish Physicians Association, Orhan Odabaşı, said the Treasury informed them that the omission of the debt payment to the hospitals from the 2006 budget was an oversight and the mistake would be fixed. But he reminded that this “technical mistake” still had not been remedied. He said, not only do the hospitals need this money to pay utility bills, but the contract workers in these hospitals were also paid from these revenues. He added, “Hospitals are facing tough times trying to collect what is owed to them. But now, the largest revenue generator, the State, has wiped out the amount coming to these institutions. We are now facing health institutions’ foreclosing.” The General Secretary said, “The cost of medicine alone has increased dramatically. However, the Health Ministry is not accepting this. On the other hand, another agency of the same State, The Planning Agency, shows in its report, the sharp increase in the pharmaceutical costs. But the State says they do not have funds to pay us.”

Foreclosures on homes

There are 216 revolving capital institutions within the framework of the Ministry of Health as of 2005. However, the situation involves 460 hospitals altogether. There are criticisms of the way the Health Ministry has managed the revolving capital which has multiplied the expenses. The Ankara Branch manager of the Türk Sağlık-Sen (Turkish Health Care Workers Union), Orhan Yılmaz said this crisis did not start with the elimination of the debt payments from the budget, rather, the crises started by implementing a “performance based evaluation” for the revolving capital health institutions. He also said that in the past, sometimes the problems facing the workers had been fixed, but they always reappeared after some time. He said, “What we used to make in 3 months, we started getting in one month. Our wages increased. Then the whole money was cut altogether. The people had prepared their lives based on this income. Many took credits or used their credit cards relying on this income. Now we are seeing foreclosures coming down on health care workers.”

This affects 120,000 workers.

Yılmaz added that more than 120,000 health workers were being affected around Turkey by this decision. He said, “There are 28,000 health care workers in Ankara (the capital) alone, and all of them are feeling the hardship. We are working to stage a demonstration in Ankara next week with the participation of the whole health care work force.” He added that the whole 27 public hospitals in the capital are feeling the crunch. But some hospitals the condition is unbearable where workers have not been paid for months. In one of these hospitals, “there are 3,000 health care workers and more than 1,000 contract workers who have not been paid. They may be laid off due to this decision. If this continues, in the very near future, other hospitals will start sacking personnel too” he said.

The manager of the Numune Hospital, the hospital mentioned above, Mahmut Koç said, they were having problems in paying wages, but they still had stocks of heating gas and other equipment to keep the hospital working.

Manager Resigns protesting hospitals debt.

On the other hand, Yalova Public State hospital manager Dr. Ertan Sarıbaş resigned giving the reason of the hospital’s debt. The workers there had been protesting for the last two weeks. Manager Ertan Sarıbaş was the 4th doctor in charge of the hospital since the hospitals of the SSK and the State institutions were merged. He said, they could not pay the bills and two days later the hospital would not have enough resources to even prepare meals. He said, the following day they would not be able to heat the hospital. Even the Red Crescent Blood Center threatened to file to foreclose our hospital, he added. The hospital has 3 million in debt but the government owes the hospital more than 5 million YTL’s.

Pharmacists are due 300 million YTL’s from the Treasury.

The government had promised the green-card holders free medicine. Now the government refuses to pay for those pharmaceuticals to the pharmacies. The General Secretary of the Pharmacists’ Association, Mehmet Domaç said there were more than 10 million green-card holders in Turkey and the government owed more than 300 million YTL’s to the pharmacies for the medicine sales under the program. These green-card holders started buying drugs from 22,000 independent pharmacies around the country under the program, but many pharmacies were not paid for more than 8 months for the medicine they sold to the green-card program patients. In Antalya, pharmacists have declared they will no longer honor the prescriptions of the green-card program. Domaç said this practice may spread to other cities if the government refuses to pay its debt.

Tutku Ayvaz / Referans

G.Y.