Report of the İstanbul Medical Chamber, Naples, May 2019
Violence against Physicians and Health Care Employees has yet become a public health problem.
Occurrence of violence in daily social life and professional life increases day by day across the globe. WHO describes workplace violence as one of the major public health issues; whereas International Labor Organization (ILO) defines violence in the workplace (2002) as: “incidents where staff are abused, threatened or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being or health”.
Despite the fact that violence is an act of crime, it is not being penalized adequately, depending on retarded functioning of legal systems in general. As a consequence, the senses of justice and safety in the society are impaired and lose their values.
According to data obtained from Ministry of Health, the number of incidents within the period between 14th May 2012 and 1st April 2018 was recorded as 68,375 and about 30 percent of such incidents health care employees were exposed to physical violence, with 30 incidents observed on averagedaily.
The hotline initiated by Ministry of Health under the title “133 White Code” for health care employees exposed to violence couldn’t unfortunately produce a deterrent and detractive effect in practice.Applications varying between 10 and 13,500 yearly have been received since the year 2013.Such measures were only limited by the support provided solely to own personnel of Ministry of Health exposed to violence.
The violence against physicians and health care employees prevailing in our country having an extremely negative influence on almost all of the health care sector employees, is also violating their rights to life and rights to work and impeding them from exercising duly their professions.
Violence designated since 2002 as an occupational hazard and risk threating health care employees has directly led to death of more than 10 physicians and to injury of many physicians since the date Health Care Transformation Program was launched.
Due to following reasons violence against health care employees is growing as the result of Health Care Transformation Program and its practices.
- Expectations from health care service have risen
- Demand for patient applications has been solicited
- Patient referral system has been eliminated and is not being used anymore.
- Inadequacy in qualities and quantities of health care services despite the procurement of public resources in earnest
- Health care service becoming a paid service (by means of patient shares, contribution fees and difference pays) and its persistently increasing prices
- Thrusting the patient concept and satisfaction approach persistently to the forefront
- Professional undervaluing and discrediting of health care employees
- Performance and allowance systems are applied and included into the health care service as the principal occupational approach.
- Falling service and education quality due to large number of medical/health care educational institutions being launched in face of lack of adequate education/training staff
Beneath violation, occupational conditions aggravated as the result of Health Transformation Care Program has led to occupational burnout experienced by physicians and dramatically to cases of suicide of health care employees.
Within recent three years 413 health care employees have committed suicide,24 of whom are physicians, 162 are nurses and 277 are other health care employees, since 26th December 2017, according to data of Ministry of Health.
A political stance is absolutely obligatory in order to be able to stop violence.An approach raising the esteem of health care professionals in the society should be adopted and practices undervaluing health care employees should be avoided.In case of occurrence of a violence incidence against health care employees, all directors in public service should demonstrate their condemn strongly in a similar manner (zero tolerance to violence) any perpetrator committing violence against health care employees should be penalized beneath due civil prosecution,also by certain deprivation of administrative rights; and the public authority should cooperate with all constituents of the health care sector and health care occupational organizations in prevention of violation.
Protection of health care employees amounts to securing health care services and public health in the country too.
Violence is a crime in terms of public health issue.A major step in the resolution of this problem would be that the legal system mechanism in our country acts by adopting an approach of “emergency case concept”, in order to show a prompt and deterrent reaction to the issue of violence against health care employees.
For this reason, an “emergency case concept” should be adopted in linewith universal principlesof law, for the sake of “Prevention of Violence in Health Care”.