Developments in Private Hospitals Legislation

Following the entry into force of the Regulation on Private Hospitals (“Regulation“) published in the Official Gazette on 30 January 2025, the Regulation on Private Hospitals published in the Official Gazette on 27 March 2002 (“Previous Regulation”) has been repealed. Unlike the Previous Regulation, the Regulation includes detailed provisions regarding the operation and inspection of private hospitals as well as the protection of patients’ rights.

In this context:

• It will not be admissible to open and operate private hospitals by or in the name of (i) individuals who are convicted of crimes against property and public trust such as theft, fraud, embezzlement, bribery as stipulated under Article 28 of the Law No. 1219 on the Practice of Medicine and the Art of Healing, (ii) individuals who are convicted of crimes against sexual immunity, and (iii) those prohibited from holding public office, and to open and operate private hospitals on behalf legal entities where such individuals take place in the shareholding structure. It is also emphasized that these individuals will not be able to acquire licenses of private hospitals or take place in the shareholding structure of legal entities holding private hospital licenses. In the event of a change in the shareholding structure of private legal entities in whose name a private hospital license is issued, such change must be notified to the relevant Provincial/District Health Directorate within a month at the latest. On the other hand, there is no notification obligation for private legal entities whose shares are listed.
• In the event of a transfer of private hospital, an application must be submitted to the relevant Provincial/District Health Directorate within a month as of the date of transfer. The operation of the hospital shall continue under the responsibility of the transferor until the license and operating permit is issued in the name of the transferee. If it is not preferred for the hospital to continue operating under the responsibility of the transferor during this process, its operations can be suspended until the new license and operating permit are issued. Upon approval of the transfer, the license and operating permit will be issued in the name of the transferee within fifteen working days. It is also stipulated under the Regulation that the acquired hospital cannot be transferred again within two years of its acquisition.
• It is regulated that private hospitals shall obtain an accreditation certificate within three years from the date of the license at the latest, from Türkiye Health Services Quality and Accreditation Institute (“THSQI“) affiliated with Türkiye Health Institutes Authority. Hospitals without an accreditation certificate are required to display an information sign stating that “This hospital does not have a THSQI accreditation certificate.” in a visible area for patients. Additionally, these hospitals will be notified to the Social Security Institution by the Ministry of Health (“Ministry”) every January.
• In case any circumstances that can be concluded as “mistreatment” within the scope of violation of patient rights are identified, or in the event of continuation of any services that adversely affect the treatment of patients in a part or all of the hospital, or in case of occurrence of urgent and irreparable conditions that endanger patients’ health and safety and require immediate cease of the service, the activities of the unit where the violation occurred/relevant services will be suspended by the relevant provincial governor’s office upon the decision of the Ministry, and administrative and judicial actions will be taken against those concerned.
• Private hospitals are subject to stricter inspection procedures under the Regulation. If deficiencies identified during inspections are not remedied within the granted grace period, the hospital’s operations may be partially or fully suspended temporarily. If deficiencies are not remedied within six months of the suspension, the Ministry will suspend the hospital’s license and grant an additional grace period of six months. In case of failure of the hospital coming into operation by the end of this period, its license will be revoked by the Ministry, and no new private hospital license will be issued for five years in the name of real persons and private legal entities whose licenses have been revoked.
• It has been explicitly regulated under the Regulation that healthcare personnel will be insured as per Article 4/1(a) of the Social Security and General Health Security Law No. 5510 under contract and as private hospital staff. This means that doctors providing services through their own companies will need to switch to employment under payroll. However, the concept of “temporary employment outside staff” has been retained under the Regulation. In this context, as of 1 January 2025, doctors with active private practice, who do not work in any other healthcare institution will be allowed to work temporarily out of staff, in up to two private hospitals in the same province if they choose to close their practice.
• Private hospitals are required to have one mobile X-ray device and establish a radiology centre with an X-ray device having at least 500 mA power. Additionally, an emergency service must be available, and medical biochemistry and medical microbiology laboratories required by relevant specialties must be set, along with a staff of specialist doctors. Furthermore, at least one emergency ambulance must be held by private hospitals, either through ownership or a service contract. Private hospitals can continue to obtain external services, including services for radiology and medical laboratory tests. These services can be obtained on-site from licensed healthcare institutions or through contractors with medical device sales authorisation.
• According to the Regulation, the pre-permit certificate required prior to opening a hospital must also be obtained when converting additional buildings into hospital buildings, before initiating renovation or construction procedures. The period for obtaining the license after the issuance of the pre-permit certificate is three years, and the pre-permit certificate will be revoked in case of failure to obtain the license within this period. As was the case under the Previous Regulation, the license issued for the hospital will be revoked by the Ministry in case of failure to obtain an operating permit within six months upon obtaining the license, and to begin admitting and treating patients.
• As per the Regulation, private hospitals may be relocated or merged in line with planning principles and with the permission of the Ministry, only within the provincial boundaries where they are located. A pre-permit certificate must be obtained within two years at the latest from the date of approval of these requests, and relocation or merger procedures must be completed by obtaining a license within three years from the date of receipt of this certificate.