Genel Sa\u011fl\u0131k-\u0130\u015f Genel Ba\u015fkan\u0131 Dr. Derya U\u011fur birinci basamak sa\u011fl\u0131k hizmetinde ya\u015fanan sorunlar ve aile hekimlerinin \u00e7ekti\u011fi s\u0131k\u0131nt\u0131lara ili\u015fkin Cumhuriyet\u2019e a\u00e7\u0131klamalarda bulundu.<\/p>\n\n\n\n
Birinci basamak sa\u011fl\u0131k hizmetlerinin temelinde koruyucu sa\u011fl\u0131k oldu\u011funu an\u0131msatan U\u011fur, \u201cAile hekimleri bu hizmeti 2005 y\u0131l\u0131ndan bu yana, her t\u00fcrl\u00fc zorlu\u011fa, artan i\u015f y\u00fck\u00fcne ve sistemin kronikle\u015fen sorunlar\u0131na ra\u011fmen b\u00fcy\u00fck bir \u00f6zveriyle s\u00fcrd\u00fcrmektedir. Ancak bug\u00fcn gelinen noktada aile hekimli\u011fi uygulamas\u0131, sa\u011fl\u0131k hizmeti sunumundan uzakla\u015ft\u0131r\u0131larak; masa ba\u015f\u0131nda veri yeti\u015ftirme, say\u0131 tamamlama ve performans bask\u0131s\u0131 alt\u0131nda s\u00fcrd\u00fcr\u00fclen bir yap\u0131ya d\u00f6n\u00fc\u015ft\u00fcr\u00fclmek istenmektedir.<\/p>\n\n\n\n
\u201cHYP kapsam\u0131nda izlem say\u0131s\u0131n\u0131n 12\u2019den 18\u2019e \u00e7\u0131kar\u0131lmas\u0131\u201d ve buna e\u015flik eden katsay\u0131 d\u00fc\u015f\u00fc\u015fleri; aile hekimlerine a\u00e7\u0131k\u00e7a daha fazla \u00e7al\u0131\u015f, daha az kazan dayatmas\u0131 yap\u0131lmas\u0131d\u0131r. Bu yakla\u015f\u0131m hakkaniyetle, nitelikle, kamu yarar\u0131yla ba\u011fda\u015fmamaktad\u0131r. G\u00fcnde onlarca, kimi zaman y\u00fcz\u00fc a\u015fan hastaya hizmet vermeye \u00e7al\u0131\u015fan hekimlerden ayn\u0131 g\u00fcn i\u00e7erisinde y\u00fczlerce veri giri\u015fi, takip ve kay\u0131t i\u015flemi beklenmesi; sa\u011fl\u0131k hizmetini g\u00fc\u00e7lendirmek de\u011fil, aile hekimli\u011fini i\u015flevsiz hale getiren bir angaryad\u0131r\u201d dedi.<\/p>\n\n\n\n
\u201cHEK\u0130M, VER\u0130 G\u0130R\u0130\u015e PERSONEL\u0130 DE\u011e\u0130LD\u0130R\u201d
U\u011fur s\u00f6zlerini \u015f\u00f6yle s\u00fcrd\u00fcrd\u00fc: \u201cAile Sa\u011fl\u0131\u011f\u0131 Merkezlerinde t\u0131bbi sekreter yoktur, veri giri\u015f personeli yoktur, yard\u0131mc\u0131 idari personel yoktur. Buna ra\u011fmen hekimler ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131; muayene eden, izlem yapan, rapor d\u00fczenleyen, a\u015f\u0131 uygulayan, gebe-bebek-\u00e7ocuk izlemi y\u00fcr\u00fcten olmalar\u0131n\u0131n yan\u0131nda bir de sistemde veri i\u015fleyen memur gibi \u00e7al\u0131\u015ft\u0131r\u0131lmak istenmektedir. Hekimleri bilgisayar ba\u015f\u0131na mahkum eden bu anlay\u0131\u015f; yaln\u0131zca eme\u011fi s\u00f6m\u00fcrmekle kalmamakta, hekimlik mesle\u011finin itibar\u0131n\u0131 da hedef almaktad\u0131r. Hekim, veri giri\u015f personeli de\u011fildir.\u2028Aile hekimli\u011fi, ekran ba\u015f\u0131nda say\u0131 tamamlama sistemi hi\u00e7 de\u011fildir. Vatanda\u015f\u0131n nitelikli sa\u011fl\u0131k hizmetine eri\u015fimi; hekimin hastas\u0131na ay\u0131rd\u0131\u011f\u0131 s\u00fcreyle, dikkatle, temasla ve t\u0131bbi de\u011ferlendirmeyle m\u00fcmk\u00fcnd\u00fcr. Siz hekimin \u00f6n\u00fcne ekran, arkas\u0131na performans bask\u0131s\u0131, yan\u0131na ise personelsiz bir sistem b\u0131rak\u0131rsan\u0131z; ortaya \u00e7\u0131kan \u015fey sa\u011fl\u0131k hizmeti de\u011fil \u00e7\u00f6k\u00fc\u015ft\u00fcr.\u201d<\/p>\n\n\n\n
\u201cPERFORMANS ADI ALTINDA HESAP SORMAKTIR\u201d
\u00d6te yandan; n\u00fcfusun azalt\u0131laca\u011f\u0131, ASM say\u0131lar\u0131n\u0131n art\u0131r\u0131laca\u011f\u0131, fiziki ko\u015fullar\u0131n iyile\u015ftirilece\u011fi ve sistemin g\u00fc\u00e7lendirilece\u011fi y\u00f6n\u00fcndeki a\u00e7\u0131klamalar\u0131n sahada hi\u00e7bir somut kar\u015f\u0131l\u0131\u011f\u0131n\u0131n bulunmad\u0131\u011f\u0131n\u0131 belirten U\u011fur, \u201cY\u0131llard\u0131r ayn\u0131 vaatler tekrar edilmekte, ancak aile sa\u011fl\u0131\u011f\u0131 merkezlerinde \u00e7al\u0131\u015fanlar her ge\u00e7en g\u00fcn daha a\u011f\u0131r ko\u015fullar alt\u0131nda daha fazla sorumlulukla ba\u015f ba\u015fa b\u0131rak\u0131lmaktad\u0131r. Cari \u00f6demeler art\u0131k bir\u00e7ok yerde kira, personel ve temel giderleri dahi kar\u015f\u0131layamaz hale gelmi\u015ftir. ASM\u2019lerin g\u00fcvenlik, fiziki altyap\u0131, donan\u0131m ve personel ihtiya\u00e7lar\u0131 g\u00f6rmezden gelinmekte; sahadaki ger\u00e7ekler masa ba\u015f\u0131nda al\u0131nan kararlarla yok say\u0131lmaktad\u0131r. Taleplerimiz aras\u0131nda olan ikinci aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 ve t\u0131bbi sekreter deste\u011fi hala sa\u011flanmam\u0131\u015f, sistem bilin\u00e7li \u015fekilde eksik personelle y\u00fcr\u00fct\u00fclmeye \u00e7al\u0131\u015f\u0131lm\u0131\u015ft\u0131r. Bunun ad\u0131 planlama de\u011fil; sa\u011fl\u0131k emek\u00e7isini yaln\u0131z b\u0131rakmak, y\u00fck\u00fc onun s\u0131rt\u0131na y\u0131kmak ve sonra da \u201cperformans\u201d ad\u0131 alt\u0131nda hesap sormakt\u0131r.<\/p>\n\n\n\n
Aile hekimleri ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131; y\u0131llard\u0131r artan i\u015f y\u00fck\u00fcne, belirsiz uygulamalara, keyfi performans kriterlerine ve s\u00fcrekli de\u011fi\u015ftirilen sistem dayatmalar\u0131na ra\u011fmen ayakta kalmaya \u00e7al\u0131\u015fmaktad\u0131r. Ancak bilinmelidir ki sa\u011fl\u0131k emek\u00e7isi s\u0131n\u0131rs\u0131z sab\u0131r, s\u0131n\u0131rs\u0131z zaman ve s\u0131n\u0131rs\u0131z i\u015f g\u00fcc\u00fc demek de\u011fildir. Fiilen sa\u011fl\u0131kl\u0131 y\u00fcr\u00fct\u00fclmesi imkans\u0131z olan bu sistem, aile hekimli\u011fini g\u00fc\u00e7lendirmemekte; tam tersine cezaland\u0131rmakta, y\u0131pratmakta ve t\u00fcketmektedir.<\/p>\n\n\n\n
T\u00fcrkiye\u2019nin y\u00fckselen, susmayan ve e\u011filmeyen g\u00fcc\u00fc olan Genel Sa\u011fl\u0131k-\u0130\u015f, aile hekimli\u011fi \u00e7al\u0131\u015fanlar\u0131n\u0131n eme\u011fini de\u011fersizle\u015ftiren, sa\u011fl\u0131k hizmetini performans cetvellerine indirgeyen bu anlay\u0131\u015f\u0131n kar\u015f\u0131s\u0131ndad\u0131r. Sa\u011fl\u0131k emek\u00e7isinin s\u0131rt\u0131na y\u0131k\u0131lan her angaryan\u0131n, her adaletsiz d\u00fczenlemenin, her hukuka ayk\u0131r\u0131 uygulaman\u0131n kar\u015f\u0131s\u0131nda olmaya devam edece\u011fiz\u201d diye konu\u015ftu.<\/p>\n\n\n\n