Court of Accounts Reports for 2025 have been announced. The report included remarkable findings regarding the Ministry of Health. In one of these findings, it was stated that the deficiencies in the preparation of implementation projects and tender documents obtained through service procurement caused additional costs and health facilities not being able to start operating at the planned time.
It has been determined that the contract periods for service procurement are often inadequately determined, regardless of the size and nature of the work to be done, the work cannot be started or the work period is stopped due to the incomplete allocation and zoning process on the real estate where the investment will be made, and for these reasons, many works cannot be completed within the contract period.
In the report, which is reminded that the approximate total closed area of Antalya Aksu 300-Bed State Hospital is 54 thousand square meters, and the approximate total closed area of Diyarbakır Hani District 35-Bed State Hospital is 8 thousand 750 square meters, it is stated that the contract period for the preparation of the application project and tender document for these two works, which contain significant differences in terms of quality and physical size, has been determined as 180 days.
However, the preparation time of the application projects is an important criterion in terms of showing all the details of the structure completely and accurately, and it was evaluated that keeping these periods short in order to start the work as soon as possible had a negative impact on the projects.
'THE PROJECTS ARE NOT COMPATIBLE'
It was emphasized in the report that deficiencies in the preparation of implementation projects and tender documents caused delays in construction work tenders and investments. In the report, where it was determined that the projects were not compatible with each other and the current regulations, it was stated that "The implementation projects should be prepared to cover all the details of the work; in order to prevent additional costs and delays, the allocation and zoning processes related to the real estate should be finalized before the implementation project service procurement tenders are held, the project preparation periods should be determined by taking into account the square meter, nature and technical difficulties of the work, and harmony and integration between the projects of all disciplines should be ensured before the tender."
CONFUSION IN HEALTH RECORDS
In the report, it was stated that examination records were created by family medicine units on behalf of patients hospitalized in the intensive care unit, within the same time period as the hospitalization period. Since it was understood that it was not possible for the patients in question to leave the health facility on the relevant dates and therefore they could not have been actually examined in the family medicine unit, this situation; It was stated that it created records regarding health services that were not actually provided and that the health records did not reflect the truth.
LACK OF FINAL COMPLETION CERTIFICATE
The report also included findings regarding city hospitals. It was stated that in city hospitals operated with the Public Private Partnership (PPP) Model, the final completion processes were not carried out even though the period stipulated in the contract on the actual completion dates had passed. In the examination, it was determined that, as of the end of 2025, although two years have passed since the Actual Completion Certificate was issued in 17 city hospitals, the final completion processes were not carried out and the Final Completion Certificate was not issued.
In addition, although construction activities were started in city hospitals without site delivery, it was observed that this situation was not reflected in the operating period and the necessary contract revisions were not made. In the case of Ankara Bilkent City Hospital, it was observed that the manufacturing carried out by the company before the site delivery date corresponded to a period of six months and the said period was offset from the Operation Period.
'THEY WAS NOT COLLECTED EVEN THOUGH IT WAS THE COMPANY'S LIABILITY'
It was revealed that in city hospitals, the total fixed investment amount was not revised due to works that were foreseen in the project and needs program with equal conditions at the final bid date, but whose production was abandoned by the administration or not done by the company, incomplete or unfinished, works that had to be done within a certain period of time and/or equipment that was not delivered, and no service changes were made in the services affected by these deficiencies.
Again, the goods deliveries and service performances carried out during the investment periods of city hospitals are exempt from Value Added Tax (VAT) within the scope of the temporary article 29 of the Value Added Tax Law No. 3065, and while the companies in charge must waive a part of the rental amount or period in order to benefit from this exemption, it was stated that no action was taken regarding this issue between the administration and the companies in charge.
It was also among the findings in the report that in some city hospitals, heating and cooling expenses for areas where laundry, food, laboratory, imaging and sterilization services are provided were not collected, although they were the company's liability in accordance with the tender specifications.
'THE EQUIPMENT IS MISSING AND INAPPROPRIATE'
In the findings; It was stated that the existing commercial areas used by the companies in charge of city hospitals are more than the commercial areas included in the implementation projects approved by the administration, and that it has been determined that the warehouses that should be used by the administration in some city hospitals are used by commercial area operators. Also in city hospitals; It was also stated that there were deficiencies or non-conformities in the equipment that had to be supplied by the company in charge and that there were significant delays in sterilization cycle times according to the method declaration specifications.
