Network Policy Making within the Turkish Health Sector

Network Policy Making within the Turkish Health Sector: Becoming Collaborative

BY

Julinda Hoxha

Bilkent University, Turkey

United Kingdom – North America – Japan – India – Malaysia – China

Emerald Publishing Limited

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First edition 2020

© Julinda Hoxha, 2020

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British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

ISBN: 978-1-83867-095-5 (Print)

ISBN: 978-1-83867-094-8 (Online)

ISBN: 978-1-83867-096-2 (Epub)

List of Tables and Figuresvii
List of Terms and Abbreviationsix
Acknowledgmentsxi
Forewordxiii
Chapter 1Introduction: Extending the Study of Policy Networks Beyond their Original Context1
Chapter 2Setting the Stage: An Integrated Framework for Assessing Network Collaboration Across Country Cases17
Chapter 3Tracing Origins: The Context of Network Formation in a Least Likely Policy Environment41
Chapter 4Becoming Collaborative: Policy Networks within the Turkish Health Sector in Turkey63
Chapter 5Tackling the Root Causes: Inherited Structural and Cultural Barriers to Policy Collaboration in Turkey95
Chapter 6Conclusion: Leveraging Networks to Achieve Policy Collaboration113
Appendix127
References131
Index147
Table 1. Network Structural Capacity.26
Table 2. Network Relational Capacity.33
Table 3. Network Institutional Capacity.38
Table 4. Results of Content Analysis.66
Fig. 1. General Satisfaction with Health Care Services (%), 2003–2010.58
Fig. 2. Cross-Sectoral Arrangements within the Turkish Health Sector.97
Fig. 3. Three Stages of Network Institutional Resilience.120
AKPJustice and Development Party (Adalet ve Kalkınma Partisi)
ATOAnkara Chamber of Commerce (Ankara Ticaret Odası)
BLT ModelBuild Lease Transfer Model
CHPRepublican People’s Party (Cumhuriyet Halk Partisi)
CMHCCommunity Mental Health Centers
ÇPSSGPProgram for Improving Multi-Sectoral Health Responsibility (Çok Paydaşlı Sağlık Sorumluluğunu Geliştirme Proğramı)
DEİKForeign Economic Relations Board (Dış Ekonomik İlişkiler Kurulu)
EUEuropean Union
EVSADHome Healthcare and Social Services Association (Evde Sağlık ve Sosyal Hizmetler Derneği)
GDPGross Domestic Product
GNATurkısh Grand National Assembly
HTAHealth Technology Assessment
HTPHealth Transformation Programme
ITInformation Technology
MHSAMinistry of Health and Social Affairs
MoFSPMinistry of Family and Social Policies
MoHMinistry of Health
NCCNetwork Collaborative Capacity
NGONon-Governmental Organization
NGSNetwork Governance School
NHISNational Health Information System
OECDOrganization for Economic Cooperation and Development
PPPPublic–Private Partnership
RDARegional Development Agencies
SATURKHealth Tourism Coordination Council (Sağlık Turizmi Koordinasyon Kurulu)
SHÇEKSocial Services and Child Protection Agency (Sosyal Hizmetler ve Çocuk Esirgeme Kurumu)
SMESmall and Medium Size Enterprises
SPOState Planning Organization
SRDCSoftware Research and Development Consultancy Limited
SSISocial Security Institution
SYDVSocial Assistance and Solidarity Foundations (Sosyal Yardımlaşma ve Dayanışma Vakfı)
TAPDKTobacco and Alcohol Market Regulatory Authority (Tütün ve Alkol Piyasası Düzenleme Kurumu)
TİKATurkish Cooperation and Coordination Agency (Türk İşbirliği ve Koordinasyon Başkanlığı)
TMMDATurkish Medicines and Medical Devices Agency
TMMOBTurkish Chamber of Engineers and Architects (Türk Mühendis ve Mimar Odaları Birliği)
TOBBThe Union of Chamber and Commodity Exchanges of Turkey (Türkiye Odalar ve Borsalar Birliği)
TÜİKTurkish Statistical Institute (Türkiye İstatistik Kurumu)
WBWorld Bank
WHOWorld Health Organization
YÖKThe Council of Higher Education (Yüksek Öğretim Kurulu)

To understand matters rightly we should understand their details; and as that knowledge is almost infinite, our knowledge is always superficial and imperfect.(La Rouchefoucauld, The Maxims, 1678)

We owe so much to those people, who sometimes through their help and motivation but even more so through their critique keep us moving forward in our knowledge seeking endeavors. Here, I can only mention but a few who had a direct influence on my work. First of all, I am deeply indebted to Professor Metin Heper for his unrelenting support and guidance throughout the whole process of book writing. I am also very grateful to Associate Professor Saime Özçürümez, who encouraged me to explore some of the most relevant and salient research puzzles within the field of comparative politics and convinced me of the need to do research on the topic of this book. I would also like to thank Professor Mete Yıldız, Associate Professor Zeynep Kadirbeyoğlu, and Associate Professor Çağla Ökten, who have been very helpful in highlighting some of the main limitations as well as possibilities for improvement in my research through their constructive criticism. My special thanks go to Associate Professor Anne Mette Kjær for her readiness to help while preparing the book proposal. I am also very thankful to Eliza Gheorghe, Christina Hamer, Jermaine Ma, Amanda Hayes, and Petra Cafnik Uludağ for all their comments and suggestions throughout the process of book writing. Last but not least, I deeply thank my parents Ylli and Bukurije, my husband Saimir, and my children Emin and Sara. They are the motivation that makes me work harder each day. My biggest hope is to be their source of motivation one day in the future.

Little is known about network policy making in less advanced democracies. This is particularly the case in low- and middle-income countries. In the latter countries, little effort has been made to come up with systematic and cross-national studies of policy networks. In the process, the networks in such places have generally remained only as metaphors and “theoretical” perspectives.

Turkey is a middle-income country. Despite its “structural and cultural constrains” the country has made an effort to join the club of developed economies, basically through adopting the latter’s policy models. This has been the case particularly in the health sector, public health, health tourism, and the medical industry.

The present book examines the conditions under which said policy networks have emerged and thrived in Turkey by, not unexpectedly, drawing upon the health policy sector. While recent policy studies in Turkey have employed macro-level institutional analysis, this book has adopted a micro–meso level analysis of policy processes, focusing on the investigation of the (policy) networks within the health policy sub-areas.

As the present author has pointed out elsewhere (Heper, 1993), in Turkey while both societal and political elites have been expected to play an active role toward policy making in the name of “general interest,” studies on the Turkish case have shown that societal actors have traditionally had minimal or no impact on public policy making due to the impediments such as populism, clientelism, and opportunities (Heper & Yıldırım, 2011).

More recently, the networks in Turkey have turned out to be the effective channels of societal participation. Lately, the expert involvement in the said policy making processes and the tools that provide legitimacy to those processes, have been at the heart of public policy issues.

In her book, Julinda Hoxha has skillfully traced the past and present odyssey in question.

In essence, in solitude.

Prof. Dr. Metin Heper

Bilkent University

Heper, 1993
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