Infrastructural problems are amongst the most important obstacles preventing the system from being settled during these recent years in which the law numbered 6331 has entered into force. The term ‘infrastructure’ is here in used to refer to various tests and analyses, chest X-rays, hygiene measurements (such as noise, dust, chemicals, etc.), technical measurements, electricity, static, etc., and periodical maintenances.
In this commentary, I would like to talk about the infrastructure services which are aimed at providing onsite service, called as mobile health services, including chest x-ray, audiometry, respiratory function test, vision testing, blood, urine analysis, and similar analyses, and in respect of which the Ministry of Health has not yet issued a regulation or which have almost been prohibited in general sense, through the circular published in April 2014.
The law numbered 4857 used to make annual chest x-ray compulsory for workplaces with more than 50 workers and in certain hazard classes. The law numbered 6331 clearly underlines one particular issue: occupational disease. Exactly for this purpose, it imposes upon the workplace doctor the obligation to renew the health reports at minimum 1-3-5 years depending on the hazard class of the work, but it does not bring the obligation to perform tests, chest x-ray, audiometry or respiratory function tests, and leaves such matters to the initiative of the doctor. However, since those who work in the same workplace generally work in the same environment, when a chest x-ray is required, all the personnel at the factory are x-rayed. The problem starts right at this point. What will the employer do, what will the worker do, how will workplace doctor manage all this? The event evolves as follows: all factory workers joint the long queue in front of a private hospital. It causes labour loss, cessation of the activities at the factory, and burden for the hospital (it is usually invoiced to Social Security Institution). Thus, mobile health screening vehicles are very essential for us.
Under aggressive competition conditions prevailing at the time of privatisation of health services under the name of health transformation, use of mobile health vehicles had become so exaggerated that they were even started to be used as mobile surgery rooms (for example, for eye surgeries). When complications started to evolve, the Ministry of Health promptly banned mobile health vehicles during April 2014. This is of course a valid and proper reason, however, mobile health screening incorporates several services and banning mobile health screening vehicles entirely is not the same as banning mobile surgery/operation vehicles. With the influence of bureaucrats, the Ministry of Health preferred entirely prohibiting the service, and not entering into this field at all (on the grounds that it would be problematic to inspect later on), instead of issuing a regulation, and laying down the principles on the subject. Although the representative of the Ministry of Health was assigned with this task last year pursuant to the decision taken at the national occupational health council, there has been no or we have heard no development for the last 1 and half years from the side of Ministry of Health. This has caused the market to be filled with numerous mobile health vehicles which are referred to as “no-name”. These vehicles are being used by non-competent persons without obtaining impermeability certificate from Turkish Atomic Energy Authority, and they emit radiation to the environment. This is still the case and there is no authority taking any action against this, and it is not known until when it will continue like this.
Since we are not a banana republic, I would like to invite bureaucrats of the Ministry of Health to take action and issue, as soon as possible, a regulation on the matter by involving the institutions working in the field. This would, in turn, give rise to mobile health screening vehicles that operate soundly and in good order since such a regulation would also bring about the right for inspection, and this may give the institutions operating in this field the opportunity to work at more sustainable prices. When we look at the issue from the viewpoint of the Ministry of Labour, we opine that blocking of the law and the business life based on such trivial issues is not appropriate at a time when such radical changes are being done in the field of occupational health and safety.
Yours respectfully. Dr. Mustafa AĞIR