Publication: Ülkemizde sağlık insan gücü planlaması ve yönetimi açısından hekimlerin çalışma koşullarının yeniden düzenlenmesi
Abstract
1. ÖZET Ülkemizde Sağlık İnsan Gücü Planlaması ve Yönetimi Açısından Hekimlerin Çalışma Koşullarının Yeniden Düzenlenmesi Ülkemizde Cumhuriyet Dönemi boyunca sağlık insan gücü geliştirme politikaları kapsamında hekimlerin çalışma koşullarında birçok defalar değişiklikler yapılmış, son olarak da Sağlıkta Dönüşüm Programının bir bileşeni olarak “Tam Gün” çalışma sistemi gündeme gelmiştir. Bu nedenle hazırlanmakta olan yasal düzenlemelere hekimlerin nasıl baktıkları araştırmamızın ana konusunu oluşturmaktadır. Ülke çapında Şubat-Mayıs 2009 tarihleri arasında yürütülen kesitsel tanımlayıcı epidemiyolojik bir araştırmada TUİK in istatistik araştırmalar için belirlediği 12 bölgeden kura ile birer il seçilmiş bu illerden tabakalı örnekleme ile seçilen 1543 hekimin görüşlerine başvurulmuştur. Yasa tasarısının gerekçeleri ve yasaya karşı eleştirel görüşlerden oluşan önermelere verilen yanıtlar hekimlerin yaşı, çalışma statüsü, meslekteki süresi, çalıştığı kurum yerleşim yeri ve uzmanlık statüsüne göre karşılaştırılmıştır. Gruplar arasında istatistiksel olarak anlamlı farklar bulunmuştur. Kısmi zamanlı çalışma sisteminin olumsuzlukları genel olarak hekimler tarafından kabul görmektedir. Yasanın uygulanması ile kamu sağlık hizmetlerinin kalitesinin artacağı, bununla birlikte kamudan özele hekim göçü olması nedeniyle niceliksel olarak hizmet sunumunun etkileneceği kabul edilmektedir. Hekimler tam gün çalışan hekimlere ödenecek ücretlerin kaynağını ve miktarını açık bulmamakta, özlük haklarında bir iyileşme olacağına katılmamaktadırlar. Yarı zamanlı çalışma sisteminin eğitimi olumsuz etkilediği, yasa ile üniversitelerde bilimsel gelişimin artacağı kabul görmekle birlikte özel sektöre geçişler ve performans ağırlıklı çalışma nedeniyle eğitimin kalitesinin olumsuz etkileneceği de ifade edilmektedir. Sonuç olarak hekimler bu şekliyle yasanın uygulanması halinde çalışma koşullarında ve özlük haklarında kalıcı bir iyileşme sağlanamayacağını ifade etmektedirler. Anahtar Sözcükler: Sağlık İnsangücü Geliştirme, Sağlık İnsangücü Planlaması, Sağlık İnsangücü Politikaları, Sağlık İnsangücü Yönetimi, “Tam Gün Yasası”. 2.
Regulation of Working Conditions of Physicians as a Part of Health Manpower Planning and Management in Turkey. The working conditions of physicians in Turkey were changed a lot of times for maintaining the health manpower development. Finally, as a part of Health Transformation Program, “full time” working of physicians was added to agenda of government. The main subject of this research is the opinion of the physicians about new legal regulations for “full-time working”. This is a cross sectional, descriptive, epidemiologic research carried out in Turkey, between 2009 February-May. A city from each 12 different district of Turkey, defined by TUIK for researches, was selected with lottery sampling. 1543 physicians are selected from these groups with stratified sampling. A survey was performed to these samples. The questions of the survey were propositions derived from the preamble of law and critics against to law. In the survey results, statistical comparison was made between groups in terms of the places of health institutions, the status of part-time and full-time working, speciality, age, and working durations of physicians. Statistically significant differences were found between groups. The failure of part-time working is mostly accepted by physicians. Physicians believe that the new law will increase the quality of health services. Nevertheless, they believe that the migration of physicians from public sector and university to private sector will affect the quality and quantity of health services. They believe that the amount and source of the money for fulltime working is not clear, and they don’t believe that the working conditions will be better. They are agreeing that the part time working decreases the quality of medical education in medical schools and new law will increase the scientific workings in university. But they also believe that the migration of physicians from university to private sector and working for only performance point will decrease the quality of medical education. Full-time Working”, Health Manpower Development, Health Manpower Management, Health Manpower Planning, Health Manpower Policies.
Regulation of Working Conditions of Physicians as a Part of Health Manpower Planning and Management in Turkey. The working conditions of physicians in Turkey were changed a lot of times for maintaining the health manpower development. Finally, as a part of Health Transformation Program, “full time” working of physicians was added to agenda of government. The main subject of this research is the opinion of the physicians about new legal regulations for “full-time working”. This is a cross sectional, descriptive, epidemiologic research carried out in Turkey, between 2009 February-May. A city from each 12 different district of Turkey, defined by TUIK for researches, was selected with lottery sampling. 1543 physicians are selected from these groups with stratified sampling. A survey was performed to these samples. The questions of the survey were propositions derived from the preamble of law and critics against to law. In the survey results, statistical comparison was made between groups in terms of the places of health institutions, the status of part-time and full-time working, speciality, age, and working durations of physicians. Statistically significant differences were found between groups. The failure of part-time working is mostly accepted by physicians. Physicians believe that the new law will increase the quality of health services. Nevertheless, they believe that the migration of physicians from public sector and university to private sector will affect the quality and quantity of health services. They believe that the amount and source of the money for fulltime working is not clear, and they don’t believe that the working conditions will be better. They are agreeing that the part time working decreases the quality of medical education in medical schools and new law will increase the scientific workings in university. But they also believe that the migration of physicians from university to private sector and working for only performance point will decrease the quality of medical education. Full-time Working”, Health Manpower Development, Health Manpower Management, Health Manpower Planning, Health Manpower Policies.