Reforming or Reframing the Health? Presentation of Turkish Health Reform by AKP

This paper aims to look into the discursive frame constructed by the Justice and Development Party (AKP) and the Ministry of Health regarding the Turkish Health Transformation Program from November 2002, when the first AKP government was established, to June 2011 when AKP received the 49.95% of the votes preceded by an election campaign where the health sector reforms of AKP were strongly emphasised. The Emergency Action Plan that preceded the Health Transformation Program included the main steps that were to be mentioned in the latter was announced by the newly formed AKP government on November 2002 following the elections. This action plan included what AKP planned to achieve in their first year in office and covered the goals of reforms within the areas of public administration, education, privatisation, taxation, the stand-by agreement with the IMF, and the health system. The proposed changes that were mentioned with respect to the health system were listed as: * Abolishing the distinctions among various public hospitals * Administrative and financial autonomy for the hospitals * A general health insurance system * A family physician model together with a solid referral system * Extension of preventive medicine * Stimulation of private investments in the health sector. This paper demonstrates that the changes listed in the Emergency Action Plan, and later elaborated in the Health Transformation Program have been supported by a coherent discursive narrative by the government through which their broader discourse of “transforming old Turkey” and “bringing equality to the country” was adapted to the domain of health care. This discursive narrative was constituted around the themes of serving the people, reducing the inequalities in the health-care system and protecting the health-care receivers from the health-care providers. Health-care during the AKP governments emerged as a politically significant domain since it constituted one key discursive space where the AKP’s claims to end social inequalities and “victimizations” materialized. By analyzing the publications of the Ministry of Health, the statements of government officials in the press, and the discourses on health care reform during the 2007 and 2011 electoral campaigns, this paper argues that the Ministry of Health in particular and the AKP government in general presented a sharp division of health-care providers (mainly the doctors) and health-care receivers and step in and define themselves as actors that bring an end to the victimizations of the receivers. This argument is supported and demonstrated through the analysis of specific issues -such as the consequences of the transfer of certain public hospitals to the Ministry of Health, introduction of compulsory service for the doctors, introduction of the general health insurance etc.- in the health sector presented in the above-mentioned sources.