Health Tourism Should Strengthen the Health System and Protect Domestic Patients

The New Paradigm of Health Tourism – Part 13

Behlül Ünver – President, World Health Tourism Platform

Türkiye has long aspired to be among the world’s leading health tourism countries. Strong hospitals, skilled physicians, advanced infrastructure, geography and tourism experience support that ambition.

As health tourism grows, however, a more important question arises: how much does the economic value it creates strengthen Türkiye’s health system?

Incoming patient numbers and revenue are no longer enough to measure success. What matters is how much returns to the system as new capacity, technology, workforce, education and investment.

Public healthcare has a different responsibility

A large majority of care in Türkiye is publicly provided. According to the Ministry of Health’s 2026 assessment, the private sector accounts for approximately 18 per cent. The public system therefore still carries the main service burden.

Public hospitals cannot approach health tourism in exactly the same way as private providers. Their primary responsibility is to safeguard their own citizens’ access to care.

The view that “we should treat our own patients first” cannot be dismissed as entirely unjustified. It is understandable when appointments, waiting times or overcrowding are problematic.

But ending the discussion there would be incomplete. Properly planned health tourism can become a new resource that strengthens domestic care.

The issue is the model, rather than unwillingness

I do not believe the public sector is unwilling to participate. Physicians, health workers and managers show substantial motivation to serve international patients, extend specialised care and create value for the country. Daily workloads and public responsibilities mean different methods are needed.

Private providers can operate flexibly through individual patient acquisition, digital marketing, intermediaries and international networks. Public institutions need not seek individual patients in the same way. A better approach is institutional models that plan patient groups, funding, treatment areas and capacity through intergovernmental and institutional agreements.

For example, government-funded programmes can be developed with foreign health ministries, social security organisations or public funds. Agreements can cover patients funded by foundations and associations. Municipalities, public bodies, large employers and others can support specialised programmes. Public capacity in advanced surgery, oncology, transplantation, rehabilitation and similar fields can serve international patients through such arrangements. In the other direction, specialised operations, clinical training and expertise can be provided abroad. Public health tourism can thereby become an export model for services, education and knowledge.

Why should major public hospitals remain outside the system?

Türkiye has built substantial public infrastructure, particularly city hospitals. Some have significant capacity in advanced oncology, transplantation, cardiovascular and robotic surgery, neurosurgery, advanced imaging, intensive care, rehabilitation and other specialised treatments.

They are also centres of education, research and expertise.

I do not believe this capacity should remain entirely outside international healthcare. The objective is to turn planned capacity into economic and strategic value while protecting domestic patients’ rights and access.

The new era has already begun

Recent measures support more active public participation. The 2025 Regulation on International Health Tourism and Tourist Health places public institutions, universities, private providers and intermediaries within the same regulatory framework.

In 2026, an agreement between the General Directorate of Public Hospitals and USHAŞ enabled public hospital health tourism processes to be conducted through intermediaries under USHAŞ coordination.

The Regulation on Cooperation in International Healthcare Services published that year also enables more systematic cooperation between authorised facilities belonging to the Ministry of Health and state universities.

These are important steps towards professional intermediary support and central coordination, rather than expecting public institutions to market independently. This model has long been needed.

A new resource for public healthcare

Healthcare represents substantial public expenditure. Through health tourism, some public capacity can also generate revenue.

This can be reinvested in devices, infrastructure, staff training, research, technology, employee motivation and new capacity.

Health tourism then becomes a financial mechanism that develops the system’s own capabilities. This is where its true public rationale should be sought.

Revenue must recognise staff contributions

A critical issue is how revenue is used and shared. Physicians, nurses, technicians, coordination teams and administrative staff undertake additional responsibilities when caring for international patients.

Within the applicable legal framework, revenue should support institutional investment and the people providing care through a transparent, measurable and fair model. Recognising their work strengthens motivation, quality and institutional capacity together.

The public sector’s advantage includes its skilled workforce. Fair value sharing must be a fundamental principle if these people are to participate willingly and sustainably.

Domestic patients’ rights must be protected

The boundary must be clear: international patients must not worsen domestic access to healthcare.

Appointment and surgery waiting times, bed utilisation, access to specialised treatment, patients per physician and satisfaction can be monitored regularly.

Dedicated capacity, time slots or organisational models can be created for international services. Health tourism can then produce new capacity, rather than make two groups compete for limited resources.

Health tourism should generate new capacity.

Public and private sectors can complement one another

Growth is a shared responsibility. Private providers offer flexibility, marketing capabilities, rapid decisions and international patient experience.

The public sector offers large infrastructure, specialised capacity, teaching hospitals, academic strength and extensive clinical experience.

These should be complementary structures. Some patients may receive private care; complex cases may be assessed in public or university hospitals. Joint patient journeys can be created. Agreements can cover specialised care, training and second opinions.

The strength of Türkiye’s brand will come from organising all this capacity effectively.

Measure success beyond patient numbers

International patient numbers and revenue matter. We should also ask how much new capacity was created, how much technology investment occurred, how many professionals received training, how many jobs were generated, which research and innovation projects were supported, and whether domestic care was affected positively or negatively.

These questions should form part of assessing real success. We might call this “net health value”: measuring the lasting capacity created alongside income.

Greater value alongside growth

Türkiye should continue growing in health tourism, with both sectors participating. The objective should extend beyond attracting more foreign patients.

We need a model that produces higher value, protects domestic care, creates capacity and supports investment in technology and people.

Perhaps the question should become: “How does every international patient coming to Türkiye make its health system stronger?”

Properly planned health tourism can help domestic patients access better hospitals, better technology and a stronger system.

Perhaps it is time to see public healthcare’s role as a strategic structure delivering high-quality care, education and knowledge between countries and institutions, fairly recognising staff contributions and returning the value it creates to the health system.