Turkey Health Ministry History and Evolution of Healthcare

The evolution of healthcare in Turkey is a journey from the traditional Seljuk-Ottoman medical legacy to a modern, digitally integrated system. Since the establishment of the Ministry of Health in 1920, the nation has transitioned through various organizational models, shifting from centralized war-time recovery to a comprehensive system of universal health coverage.

Foundation of the Ministry (1920–1946)

Established on May 3, 1920, following the foundation of the Grand National Assembly of Turkey, the Ministry of Health initially focused on healing war wounds and establishing a legal framework rather than registration systems. Under the leadership of Dr. Refik Saydam until 1937, the foundation for modern Turkish healthcare was laid.

In 1923, the country operated with 86 hospitals and 6,437 patient beds. This era saw the adoption of the Law on Practice of Medicine and Medical Sciences (1928) and the Law on Public Hygiene (1930), both of which remain in effect today. The strategy relied on a "vertical organization" model, characterized by single-purpose care across broad geographies.

The health policies of this period rested on four primary pillars:

Centralized planning, design, and implementation of healthcare.
Centralized preventive care paired with local curative care.
Increasing the number of health workers by making medical faculties more appealing and enforcing mandatory service for graduates.
Targeted programs to combat communicable diseases, including leprosy, trachoma, syphilis, and malaria.

To ensure accessibility, the government aimed to place a physician in every district. By 1924, diagnostic and treatment offices were opened in 150 district centers, with 20 more added by 1936. To prioritize public service, physicians providing preventive care received salary increases but were prohibited from private practice.

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National Health Plan and Program (1946–1960)

The 1946 "First 10-Year National Health Plan," announced by Dr. Behçet Uz, marked Turkey's first written health strategy. Although a change in government prevented the plan from becoming formal law, its principles deeply influenced the nation's healthcare organization.

The plan sought to centralize inpatient facilities and expand rural access by establishing 10-bed health centers for every 40 villages. These centers integrated preventive and curative services, staffed by a team including two physicians, a health officer, a midwife, a visiting nurse, and a village midwife. The number of these centers grew from 8 in 1945 to 283 by 1960.

Maternal and Child Health

Due to high infection and child mortality rates, Turkey adopted pro-natalist policies. In 1952, the Maternal and Child Health Section was created, followed by a Development Center in Ankara in 1953, supported by the World Health Organization (WHO) and UNICEF.

Infrastructure and Workforce Expansion

The 1954 "National Health Program and Health Bank Studies" further refined planning. While the National Health Plan divided Turkey into seven health regions, the National Health Program expanded this to 16 regions. To bolster the workforce, Ege University began admitting medical students in 1955, contributing to a 100% increase in physicians, nurses, and midwives over a decade.

This era also focused on pharmaceutical independence and social security. The Biological Control Laboratory was established in 1947, initiating the production of pertussis vaccines (1948) and intradermal BCG (1947). Additionally, the Workers' Insurance Administration (Social Insurance Institution) was created in 1946.

Health Policies from 1960 to 2002

The period between 1960 and 2002 was marked by a shift toward socialization and population control. Socialization in health began in 1963 and reached nationwide coverage by 1983, establishing a network of health posts and provincial hospitals.

A significant policy shift occurred with the Population Planning Law of 1965, moving the country from pro-natalist to anti-natalist policies. This authorized the Ministry of Health to provide contraceptive drugs, either for free or at subsidized rates.

By 1990, the State Planning Organization and the Ministry of Health collaborated on the "Healthcare Sector Master Planning Study," which paved the way for future reforms. Key developments included:

The introduction of the green card in the early 1990s, providing limited insurance for the poor.
The 1993 "National Health Policy," focusing on environmental health and healthcare delivery.
Theoretical frameworks for merging social security institutions into a General Health Insurance system and introducing primary care through family practice.

Health Transformation Program (2003–2013)

Launched in 2003 with technical and financial support from the World Bank, the Health Transformation Program (HTP) aimed for "Health for All." This program moved beyond theoretical planning to implement systemic changes.

The HTP focused on several critical targets:

Implementing universal health care to cover all citizens.
Merging all health facilities under a single administrative body.
Introducing family medicine and expanding preventive care.
Granting financial and administrative autonomy to hospitals.
Promoting private sector investment and digital transformation in health.

The results were significant: long waiting lists decreased, and the issue of patients being unable to leave hospitals due to unpaid bills was resolved through social insurance. Later additions to the program included the promotion of healthy lifestyles and the delivery of cross-border health services to enhance Turkey's international standing.

The impact is reflected in the data: population satisfaction with health services rose from 39.5% in 2003 to 75.9% by 2011, while the health workforce grew from 295,000 to 460,000.

Key Facts

Founded: The Ministry of Health was established on May 3, 1920.
Early Infrastructure: In 1923, Turkey had 86 hospitals and 6,437 beds.
Rural Expansion: Health centers grew from 8 in 1945 to 283 by 1960.
Policy Shift: The 1965 Population Planning Law shifted Turkey from pro-natalist to anti-natalist policies.
HTP Success: Patient satisfaction increased from 39.5% (2003) to 75.9% (2011).
Workforce Growth: The health workforce increased by 36% between 2003 and 2011.

Period	Primary Focus	Key Milestone/Policy
1920–1946	Foundation & Legislation	Law on Public Hygiene (1930)
1946–1960	Rural Expansion & Planning	First 10-Year National Health Plan
1960–2002	Socialization & Population Control	Population Planning Law (1965)
2003–2013	Systemic Transformation	Health Transformation Program (HTP)

Frequently Asked Questions

When was the Ministry of Health established in Turkey?

The Ministry of Health was established on May 3, 1920, shortly after the foundation of the Grand National Assembly of Turkey.

What was the purpose of the First 10-Year National Health Plan?

Adopted in 1946, the plan aimed to centralize inpatient facilities and expand healthcare to rural areas by establishing 10-bed health centers for every 40 villages.

How did Turkey's population policy change in the 1960s?

With the adoption of the Population Planning Law in 1965, Turkey shifted from a pro-natalist policy (encouraging births) to an anti-natalist policy, which included providing contraceptive drugs to citizens.

What were the main goals of the Health Transformation Program (HTP)?

The HTP aimed to achieve "Health for All" by implementing universal health care, introducing family medicine, merging health facilities under one body, and promoting digital transformation.

How did the HTP affect patient satisfaction?

Patient satisfaction with health services increased significantly, rising from 39.5% in 2003 to 75.9% by 2011.