How do Public-Private Partnerships Affect Public Service Principles? A Case of City Hospitals in Türkiye

Abstract

Public-private partnership (PPP) policies have been on the Turkish Government's healthcare agenda for a long time. Turkiye has implemented a series of policies with various elements of neoliberal reforms over the last 20 years and the Turkish Government initiated the PPP policy in 2013 as the final step of the Health Transformation Program. This article reviews the policy process that led to extensive collaboration with the private sector in public health and also examines the effect of the policy on the principles of public service. Turkiye's policy experience has elements that reinforce the principles of continuity, variability, and equality in many ways. However, this policy was found to have weakened the long-term financial viability of healthcare and led to its fragmentation and the government eventually abandoned this policy in the construction of new hospitals. Turkiye's experience demonstrates that governments seeking to establish sustainable PPP policies for healthcare must consider the unique dynamics inherent to public service.