Family physicians, midwives and nurses working in family health centres (FHCs) began a nationwide work stoppage on January 6 against the Family Physician Contract and Payment Regulation. The work stoppage will continue for five days until January 10. On January 8, workers in all public health institutions will join the action and turn it into a general strike.

While the total number of physicians working in public institutions is 107,000, it is estimated that the number of physicians working in FHCs is 27,000 and the number of other health labourers is around 20,000.

This is the third time in two months that family physicians and other health workers have staged a work stoppage against the government’s regulation, which they see as an attack on their conditions. Last year, they stopped work for three days on November 5-7 and for five days on December 2-6. Family physicians had previously organised a protest rally in Ankara on October 19, which was attended by thousands of people.

The new regulation, which health workers call the “oppression regulation”, imposes many administrative tasks on family physicians that are not part of their professional duties. In addition, a change in payment coefficients and increased performance quotas mean physicians will face serious salary cuts.

Starting on January 6, with the call of the Turkish Medical Association (TMA) and various health organisations, the work stoppage saw massive participation in family health centres across the country. Physicians and allied health workers stopped work at thousands of FHCs across Turkey and protested in city squares and in front of health directorates.

On Monday, the first day of the protest, health workers gathered in front of the İstanbul Provincial Health Directorate and issued a press statement under the banner “We don’t want the oppression regulation”. Sercan Ahmet Uluç, general secretary of the İstanbul Family Physicians Association, read out the press statement: “If you want to reach the standards of OECD countries, you must first decrease the patient load of physicians and increase the welfare level of health workers. But instead we are faced with a mentality that demands more work from fewer physicians.”

Osman Küçükosmanoğlu, president of the İstanbul Medical Association, said, criticising the performance criteria imposed by the new regulation, “Our health system is broken and will become even more broken with this regulation... Health is not measured by the number of patient applications. Health is measured by criteria such as infant mortality rates, vaccination rates, maternal mortality rates and access to clean water. Can you say that we are good in these areas?”

İbrahim Kara, co-chairman of the Ankara branch of the Health Workers’ Trade Union, read out the joint statement on behalf of the participants at the press conference held in front of the Ankara Provincial Health Directorate. Kara listed some of their common demands for the improvement of the working conditions of health workers as well as the improvement of the public health service:

• The physical and medical equipment of primary health care services and family health centres, which are public services, should be provided by the state.
• Sufficient time and facilities should be provided to give quality health services to our people. The number of FHCs should be increased so that the population per physician does not exceed 2,000 until a system that prioritises preventive health services and observes the team approach is built.
• We do not accept precarious and unstaffed employment in family medicine. Sufficient nurses, midwives and technicians should be assigned to FHCs according to the population structure, and vaccination and other preventive medicine practices should be supported and developed. The salary and incentive payment criteria of midwives and nurses should be regulated according to their professional responsibilities, not according to the working criteria of family physicians. The incentive fee coefficient of FHC employees, which requires a change in the law, should be increased at least twice and the ceiling fee should be increased at least three times.
• Physicians, midwives, nurses and allied health professionals working in FHCs should be paid a single salary, sufficient for a decent life, that is not reduced when they take leave, fall ill, have a baby or when a family member dies.
• Effective and dissuasive measures should be taken to prevent violence rather than regulations that increase violence in the health sector; an effective law against violence should be enacted and the safety of health workers should be ensured.

The determined work stoppage and the basic demands of the health workers are being ignored by the Ministry of Health. The current situation has been created by the government’s evisceration of the public health system in line with the interests of the ruling class and the regression of the conditions of the health workers.

The Justice and Development Party government of Recep Tayyip Erdoğan accelerated the transfer of public services to the control of big banks and private companies with the “Health Transformation Programme” launched in 2003. While the country’s population has grown by almost 30 percent since 2002, the number of public hospitals has increased by only 12 percent. Over the same period, the number of private hospitals increased by 110 percent, and the share of private hospitals in the total number of hospitals rose from 23 percent to 36 percent.

The recent scandal of 12 newborn babies being effectively sent to their deaths in private hospitals has dramatically revealed how the capitalist health system sacrifices human life for the sake of profit. Over half of neonatal intensive care beds, which appear to be very profitable, are in the private sector.

Moreover, the public health system has collapsed not only in Turkey, but also in a similar way across the world. The global health system crisis, which has been deepened and exposed notoriously with the onset of the COVID-19 pandemic, is a product of the capitalist profit system that requires prioritising war budgets and wealth transfer to the financial oligarchy over public health.

The labouring masses of people are paying the price of this process with their health and lives. As the World Socialist Web Site emphasises in its 2025 New Year Statement: “The pandemic has exposed the deadly indifference of capitalist governments to the lives of workers, as they prioritize corporate profits over public health. Over 30 million people, overwhelmingly from the working class, have now been killed globally. At least 500 million people are now suffering from the often debilitating effects of Long COVID.”

The way forward for health workers and public health in Turkey and around the world is through the struggle for socialism, i.e. the organisation of the economy according to the needs of society, not private profit.

In this struggle, the health workers will find their allies among other sections of the working class who have entered into struggle.

The strikes and actions of the municipal workers, despite the union apparatus, to defend their living conditions against the rising costs of living, the resistance of the miners in Çayırhan, the strikes of the metal workers against the president’s attempt to ban them, and the struggles that will break out against the government’s declaration of war on millions of workers with the below-inflation minimum wage increase all offer this potential.

Most importantly, the developing struggles of workers, including health workers, must be combined with an international perspective and organisation.

As the WSWS article on the first health workers’ strike emphasised, this struggle must be linked to the international class struggles of the working class: “The recent formation of rank-and-file committees of health care workers in the US, Sri Lanka and Australia demonstrates the potential for building transnational networks of struggle and solidarity independent of the unions. The International Workers’ Alliance of Rank-and-File Committees (IWA-RFC) has been formed to bring together struggling workers in all workplaces, sectors and countries on this basis.”