Menu
Menu

Medical Malpractice

Medical-toruism-2

Setting Up Health Tourism Services in Turkey

A Strategic Guide for Investors

Airplane and medical equipment, symbolizing health tourism in Turkey

I. Intorduction

Turkey’s prominence in the global medical tourism sector has grown steadily over recent years. With the country attracting approximately 338,000 foreign patients in 2020, this number surged to 624,444 in 2021 and reached 1.258 million in 2022. Projections suggest that by 2023, this figure could touch 1.8 million.

This growth is driven by two primary factors: the cost-effective healthcare services Turkey offers compared to other countries with advanced healthcare systems, and the nation’s commitment to ensuring safety through strict regulatory measures. These regulations not only enhance the trust of international patients but also set high standards for service providers in the health tourism sector.

For potential investors eyeing Turkey’s health tourism market, understanding the legal and regulatory landscape is crucial. New entrants need to meet specific criteria and acquire the necessary licenses to operate legally. This article delves deep into the legal requirements, offering a comprehensive guide for those looking to invest in health tourism in Turkey. For readers seeking a quick overview, please refer to our summary roadmap for investing in the health tourism sector in Turkey.

Turkey’s health tourism sector operates within a robust legal framework, ensuring quality and safety standards are upheld. Key legislative texts governing the industry include the Law on the Method of Execution of Medicine and Medical Sciences No. 1219 (referred to as the Medical Law) and the Law on Health Care Services No. 3359 (known as the Healthcare Law). Additionally, a series of secondary regulations and communiqués further detail the operational specifics.

To legally provide services of health tourism in Turkey, entities must obtain the necessary licenses from Turkey’s Ministry of Health. However, the licensing process is multi-layered, with potential providers needing to first secure a Group A Tourism Agency License from TURSAB (Association of Turkish Travel Agencies) before they can apply for the Medical Tourism Intermediary Agency License from the Ministry of Health. Each license has its own set of prerequisites, making it essential for new entrants to be well-versed with the requirements.

a. Group A Tourism License

As stipulated in Article 5 of the Health Regulation, intermediary agencies aiming to provide services of health tourism in Turkey must first obtain a Group A Tourism Agency License. This requirement is further elaborated in the Law on Tourism Agencies and Tourism Agency Associations No. 1618 (the Tourism Law) and its accompanying Tourism Agencies Regulation.

To secure this license:

  • Investors need to establish a capital company, ensuring that the company’s articles of association include specific clauses relevant to health tourism.
  • Once the company is set up, an application for the reservation of a tourism agency title must be submitted to the Ministry of Culture and Tourism.
  • Following approval, a separate application is made to TURSAB for the Group A Tourism License.
  • Meeting the criteria mentioned in the Regulation is essential, which includes having a suitable office space, maintaining required company documents, and employing qualified personnel.
  • The TURSAB membership fee for 2023 is 226,856.51 TL.

b. Health Tourism Certificate

After obtaining the Group A Tourism License, entities can apply for the Health Tourism Certificate from the Ministry of Health. This certification ensures that the provider meets the standards for health tourism services. The application process includes:

  • Submitting signed protocols with licensed medical facilities.
  • Demonstrating infrastructure capabilities, such as having a functional call center.
  • Employing qualified personnel as per the Ministry’s standards.
  • Post-application, an inspection from the Ministry verifies the operational readiness of the applicant, ensuring that they possess the necessary technology and equipment.

It’s worth noting that currently, over 800 licensed health tourism companies operate in Turkey, with almost 60% based in Istanbul (data available here).

III. Data Protection and Compliance in Health Tourism in Turkey

The advent of digital health records and international patients’ mobility has amplified the importance of data protection within the health tourism sector. Ensuring the privacy and security of personal health data is not just an ethical obligation but also a stringent legal requirement in Turkey. Further details on personal data processing in Turkey can be found in our earlier article, Principles for Lawful Personal Data Processing and Personal Data Protection in Turkey.

a. The Law on Personal Data Processing (LPDP)

The primary legislative framework governing data protection in Turkey is the Law on Personal Data Processing (LPDP). The LPDP classifies health data as ‘sensitive personal data,’ mandating stricter protections and processing conditions compared to other data types.

Any health tourism service provider will be inherently dealing with health data, which necessitates strict adherence to the LPDP’s guidelines. Potential breaches can have severe legal and financial repercussions.

b. Registration with the Data Controllers’ Registry (VERBIS)

VERBIS is a public database maintained by the Data Protection Board, under the Turkish Data Protection Authority (DPA). Unless exempted, all entities processing personal data in Turkey must register with VERBIS.

Given the nature of health tourism, agencies dealing with sensitive health data are required to register with VERBIS, irrespective of their size or annual financial figures. The criteria for mandatory registration include:

  • Entities with more than 50 employees annually or an annual financial statement exceeding TL 100,000,000.
  • Entities primarily processing sensitive personal data, even if they fall below the aforementioned thresholds.

It’s crucial for health tourism agencies to ensure timely registration with VERBIS, aligning their data processing activities with the stipulated guidelines.

c. Compliance with Data Processing Principles

Agencies looking to provide services of health tourism in Turkey must ensure:

  • Data is processed lawfully and fairly.
  • Processing activities are compatible with the purposes specified during data collection.
  • Data is accurate, up-to-date, and relevant to the purpose of processing.
  • Data storage periods adhere to legal or business practice requirements.

Given the sensitive nature of health data, obtaining explicit and informed consent from patients is paramount. Health tourism agencies must ensure that patients are aware of:

  • The purpose of data collection and processing.
  • The scope and nature of the data being processed.
  • Their rights concerning data access, correction, and deletion.

e. Data Breach Protocols & Third Party Agreements

In the unfortunate event of a data breach, providers of health tourism in Turkey must have protocols in place to swiftly notify affected individuals and the Data Protection Authority. Such measures are vital to mitigate potential damage and ensure compliance with regulatory mandates.

Often, health tourism agencies collaborate with hospitals, clinics, and other healthcare providers. In such scenarios, clear data sharing and processing agreements are essential. These agreements must outline the nature of data sharing, storage protocols, and mutual responsibilities concerning data protection.

IV. Strategic Roadmap for Investors

The robust growth of health tourism in Turkey underscores an attractive opportunity for investors. However, navigating the intricacies of the legal landscape and operational requirements can be challenging. This section aims to provide a roadmap for potential investors to set up health tourism services in Turkey seamlessly.

a. Initial Market Research

Before venturing into the sector of health tourism in Turkey, it’s essential to understand the market dynamics. Factors to consider include:

  • The most sought-after medical procedures by international patients.
  • Prominent medical tourism destinations within Turkey.
  • The competitive landscape and existing key players.

b. Establishing a Capital Company

To enter the sector of health tourism in Turkey, investors will need to establish a capital company. This involves:

  • Deciding on the company type (e.g., joint-stock or limited liability company).
  • Drafting the company’s articles of association, ensuring they include specific clauses related to health tourism operations.
  • Registering the company with the relevant authorities.

c. Licensing and Regulatory Compliance for Health Tourism in Turkey

As discussed in previous sections, multiple licenses are required to operate in the health tourism sector. Investors should:

  • Apply for the Group A Tourism License from TURSAB.
  • After obtaining the Tourism License, seek the Medical Tourism Intermediary Agency License from the Ministry of Health.
  • Ensure compliance with data protection laws, especially when processing sensitive health data.

d. Building Collaborative Networks

Success in health tourism relies heavily on collaborative efforts. Investors should:

  • Establish partnerships with accredited hospitals, clinics, and healthcare providers.
  • Foster relationships with travel agencies and accommodation providers to offer comprehensive health tourism packages.

e. Ensuring Quality and Safety

To build trust and ensure repeat business, it’s crucial to prioritize patient safety and service quality. Measures include:

  • Ensuring partnered medical facilities adhere to international standards.
  • Regularly training staff on best practices in health tourism.
  • Obtaining feedback from international patients to continually improve services.

f. Marketing and Brand Building

For a health tourism business to thrive, effective marketing is key. Strategies to consider:

  • Building a professional website optimized for international search engines.
  • Engaging in digital marketing, targeting potential patients in countries known for seeking health services in Turkey.
  • Attending international health tourism conferences and expos to build brand visibility.

g. Staying Updated

The health tourism landscape is dynamic, with evolving patient preferences and regulatory changes. To remain competitive, investors should:

  • Regularly update themselves on changes in the Turkish healthcare system and regulations.
  • Monitor global health tourism trends to anticipate and cater to emerging patient needs.

V. Conclusion: A Promising Investment Horizon in Health Tourism

The sector of health tourism in Turkey has rapidly evolved into a lucrative market, not just for medical professionals but also for astute investors keen on tapping into this growth trajectory. The unique blend of high-quality medical services, cultural heritage, and picturesque landscapes make Turkey an appealing destination for international patients.

For investors, while the potential for returns is significant, the journey is not without its challenges. The legal and regulatory framework is stringent, reflecting the government’s commitment to ensuring the highest standards of patient care and safety. Understanding these legal intricacies, from company formation to data protection, is crucial for smooth operations and long-term success.

The roadmap provided in this guide offers a strategic approach to navigate the complexities of setting up services of health tourism in Turkey. From initial market research to comprehensive marketing strategies, each step has been delineated to aid potential investors in making informed decisions.

In summary, with meticulous planning, adherence to regulations, and a relentless focus on patient welfare, investors can unlock a world of opportunities in Turkey’s burgeoning health tourism sector. As the industry continues to grow, now is the opportune moment for investors to make their mark and contribute to Turkey’s meteoric rise as a global health tourism hub.

plastic-surgery-malpractice-in-turkey

Plastic Surgery Malpractice in Turkey

Understanding Your Rights: Navigating Medical Malpractice Claims in Turkey

Medical Tourism and Plastic Surgery Malpractice in Turkey

The number of plastic surgery malpractice cases filed is rising, as increasing numbers of foreigners are coming to Turkey for medical tourism purposes. Turkey is widely considered a tourism center, as the country offers a wide selection of resorts and different types of tourism across different regions. Although regular tourism took a hit due to Covid-19, the medical tourism sector is still booming, mainly benefiting from competitive prices and good quality of service, which allowed Turkey to cement its position as one of the leading actors when it comes to medical tourism, especially plastic surgery.

There are numerous medical centers and clinics with high professional and luxury standards allowing the patients to select their doctors and clinics from a wide selection of choices (an official list of licensed centers is available through the Ministry of Health’s website). Although the sector is pretty well established and the quality of service is of a high standard, patients may still experience certain issues and unwanted results, especially in cosmetic surgeries where it may lead to a plastic surgery malpractice claim.

It should be noted here that most of the operations are successfully performed to the satisfaction of the patient, and instances resulting in an undesired outcome are rare. Nonetheless, there can be unfortunate negative outcomes due to either the negligence or lack of experience of the operating doctor, or a miscommunication between the doctor and the patient, which can result in serious negative financial, physical, and emotional consequences for the patient.

Medical Malpractice Claims

In cases where a patient suspects medical malpractice, including plastic surgery malpractice is committed by either the attending doctor or the supporting medical staff, it is important to understand and determine the rights and obligations of doctors as this will in return, help the patient to understand their rights arising out of a potential plastic surgery malpractice claim.

There are separate laws in place assigning the obligations and liabilities of medical professionals in Turkey and “malpractice” is recognized by the law as an offense. Accordingly, medical professionals in Turkey do in fact have legal and criminal liabilities in cases of negligence and malpractice committed against patients under their care.

Plastic Surgery Malpractice Claims

It should be noted here that a doctor’s liability and obligations arising out of the law will differ depending on the type of treatment and/or operation performed on the patient, which will change the type of relationship established between a doctor and the patient. For example, in case the medical operation is performed due to a medical necessity, the relationship between the doctor and the patient would constitute a proxy agreement. In this case, the doctor won’t be promising a certain result and can’t be held liable for the result.

However, if an aesthetic operation, or plastic surgery, is done solely for beauty reasons, the contractual relationship between the doctor and the patient changes, as it can no longer be classified as a proxy relationship. Unfortunately, the law does not clearly designate the type of relationship such an operation will entail.

However, according to the precedent of the Court of Appeals, if an aesthetic operation or plastic surgery is performed for the sole reason of making the patient look more beautiful and/or altering their physical appearance, the contractual relationship between the doctor and the patient will have to be designated as a contract of work (also referred to as a contract of construction, and not to be confused with the contract of employment) as set forth in Article 470 of the Turkish Law of Obligations. A contract for work is an agreement, where the contractor is obliged to realize a result and the customer is obliged to pay a fee for this work.

Due to the “promised result” in this abovementioned Article, doctors doing plastic surgery operations solely for beauty reasons can be responsible in case the promised result varies heavily from the outcome. Accordingly, in case of plastic surgery malpractice, the Patient will have the right to claim compensation for pecuniary and non-pecuniary damages, if it can be proven that there are material differences between the promised result by the doctor and the actual results achieved at the end of the operation, and/or if the patient suffers from temporary/permanent injuries because of the operation. This also extends to the death of a patient at the operating table, or during the post-op recovery process.

However, these are serious offenses, both in terms of private and criminal law, and therefore, any claim to this effect will need to be proven before a competent court. Accordingly, one of the most important aspects in a plastic surgery malpractice claim is to establish and prove a causal link between the faulty behavior breaching the contract for work and the undesired outcome.

Conclusion

As noted above, medical malpractice claims, especially plastic surgery malpractice cases are serious offenses, and successfully trying them in court requires expertise on the subject. It should also be noted that, as per Article 147/6 of the Turkish Code of Obligations, the statute of limitation is five years starting from the date of the related aesthetic surgery, which means that any plastic surgery malpractice claim will need to be brought before a court before this 5-year duration expires.

Since it is a sensitive matter including the health of a person, extreme care should be taken before taking any legal action, to avoid a prolonged legal process, and it is strongly recommended to consult a specialist lawyer to determine the best course of action. In case you would like to get more information on this matter, please do not hesitate to contact us through our web page.