ANAYASA MAHKEMES\u0130 KARARI<\/p>\n
\u00a0<\/p>\n
Esas Say\u0131s\u0131 : 2024\/90<\/p>\n
Karar Say\u0131s\u0131 : 2024\/233<\/p>\n
Karar Tarihi : 25\/12\/2024<\/p>\n
R.G.Tarih-Say\u0131 : 12\/3\/2025-32839<\/p>\n
\u00a0<\/p>\n
\u0130T\u0130RAZ YOLUNA BA\u015eVURAN: Dan\u0131\u015ftay \u0130kinci Dairesi<\/p>\n
\u0130T\u0130RAZIN KONUSU: 24\/11\/2004 tarihli ve 5258 say\u0131l\u0131 Aile Hekimli\u011fi Kanunu\u2019nun 3. maddesine 14\/7\/2023 tarihli ve 7456 say\u0131l\u0131 Kanun\u2019un 13. maddesiyle eklenen;<\/p>\n
A. On \u00fc\u00e7\u00fcnc\u00fc f\u0131kran\u0131n birinci, ikinci ve \u00fc\u00e7\u00fcnc\u00fc c\u00fcmlelerinin,<\/p>\n
B. On d\u00f6rd\u00fcnc\u00fc f\u0131kran\u0131n,<\/p>\n
Anayasa\u2019n\u0131n 2., 7., 27., 128. ve 130. maddelerine ayk\u0131r\u0131l\u0131\u011f\u0131 ileri s\u00fcr\u00fclerek iptallerine karar verilmesi talebidir.<\/p>\n
OLAY: 30\/6\/2021 tarihli ve 31527 say\u0131l\u0131 Resm\u00ee Gazete\u2019de yay\u0131mlanan Aile Hekimli\u011fi S\u00f6zle\u015fme ve \u00d6deme Y\u00f6netmeli\u011fi\u2019nin 10. maddesinin iptali talebiyle a\u00e7\u0131lan davada itiraz konusu kurallar\u0131n Anayasa\u2019ya ayk\u0131r\u0131 oldu\u011fu kan\u0131s\u0131na varan Mahkeme, iptalleri i\u00e7in ba\u015fvurmu\u015ftur.<\/p>\n
I. \u0130PTAL\u0130 \u0130STENEN KANUN H\u00dcK\u00dcMLER\u0130<\/p>\n
Kanun\u2019un itiraz konusu kurallar\u0131n da yer ald\u0131\u011f\u0131 3. maddesi \u015f\u00f6yledir:<\/p>\n
\u00a0\u201cPersonelin stat\u00fcs\u00fc, hak ve y\u00fck\u00fcml\u00fcl\u00fckleri<\/p>\n
Madde 3- Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131; Bakanl\u0131k veya di\u011fer kamu kurum veya kurulu\u015flar\u0131 personeli olan uzman tabip, tabip ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 olarak \u00e7al\u0131\u015ft\u0131r\u0131lacak sa\u011fl\u0131k personelini, kendilerinin talebi ve kurumlar\u0131n\u0131n veya Bakanl\u0131\u011f\u0131n muvafakat\u0131 \u00fczerine, 657 say\u0131l\u0131 Devlet Memurlar\u0131 Kanunu ile di\u011fer kanunlar\u0131n s\u00f6zle\u015fmeli personel \u00e7al\u0131\u015ft\u0131r\u0131lmas\u0131 hakk\u0131ndaki h\u00fck\u00fcmlerine ba\u011fl\u0131 olmaks\u0131z\u0131n, s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131rmaya veya bu nitelikteki Bakanl\u0131k personelini aile hekimli\u011fi uygulamalar\u0131 i\u00e7in g\u00f6revlendirmeye veya aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlarla s\u00f6zle\u015fme yapmaya yetkilidir.<\/p>\n
Aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 taraf\u0131ndan uygun g\u00f6r\u00fclen ve aile hekiminin de g\u00f6r\u00fc\u015f\u00fc al\u0131narak, kurumlar\u0131nca muvafakat\u0131 verilen Bakanl\u0131k veya di\u011fer kamu kurum ve kurulu\u015flar\u0131 personeli aras\u0131ndan se\u00e7ilir ve bunlar s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131r\u0131l\u0131r. Bu suretle eleman temin edilememesi halinde, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131, personelini bu hizmetler i\u00e7in g\u00f6revlendirebilir. \u0130htiya\u00e7 duyulmas\u0131 halinde, T\u00fcrkiye’de mesle\u011fini icra etmeye yetkili ve 657 say\u0131l\u0131 Devlet Memurlar\u0131 Kanununun 48 inci maddesinin (A) bendinin (4), (5) ve (7) numaral\u0131 alt bentlerindeki \u015fartlar\u0131 ta\u015f\u0131yan kamu g\u00f6revlisi olmayan uzman tabip, tabip ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131; Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n \u00f6nerisi, Maliye Bakanl\u0131\u011f\u0131n\u0131n uygun g\u00f6r\u00fc\u015f\u00fc \u00fczerine s\u00f6zle\u015fme yap\u0131larak aile hekimli\u011fi uygulamalar\u0131n\u0131 y\u00fcr\u00fctmek \u00fczere aile hekimleri ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 altm\u0131\u015f be\u015f ya\u015f\u0131na kadar \u00e7al\u0131\u015ft\u0131r\u0131labilir.<\/p>\n
S\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015fan aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 kurumlar\u0131nda ayl\u0131ks\u0131z veya \u00fccretsiz izinli say\u0131l\u0131rlar ve bunlar\u0131n kadrolar\u0131 ile ili\u015fkileri devam eder. (De\u011fi\u015fik ikinci c\u00fcmle:11\/10\/2011-KHK-663\/58 md.) Bu personelin, s\u00f6zle\u015fmeli stat\u00fcde ge\u00e7en s\u00fcreleri kazan\u0131lm\u0131\u015f hak derece ve kademelerinde veya k\u0131demlerinde de\u011ferlendirilerek her y\u0131l i\u015flem yap\u0131l\u0131r ve bunlar talepleri halinde eski g\u00f6revlerine atan\u0131rlar. S\u00f6zle\u015fmeli personel stat\u00fcs\u00fcnde \u00e7al\u0131\u015fmakta iken aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 stat\u00fcs\u00fcne ge\u00e7enlerden \u00f6nceki s\u00f6zle\u015fmeli personel stat\u00fcs\u00fcne d\u00f6nmek isteyenler, eski kurumlar\u0131ndaki bo\u015f pozisyonlara \u00f6ncelikle atan\u0131rlar ve bu madde kapsam\u0131ndaki \u00e7al\u0131\u015fmalar\u0131 hizmet s\u00fcrelerinde dikkate al\u0131n\u0131r.<\/p>\n
Kadroya ba\u011fl\u0131 olarak veya s\u00f6zle\u015fmeli personel pozisyonlar\u0131nda g\u00f6rev yapan personelden Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca aile hekimi veya aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 olarak g\u00f6revlendirilenlere, 209 say\u0131l\u0131 Sa\u011fl\u0131k ve Sosyal Yard\u0131m Bakanl\u0131\u011f\u0131na Ba\u011fl\u0131 Sa\u011fl\u0131k Kurulu\u015flar\u0131 ile Esenlendirme (Rehabilitasyon) Tesislerine Verilecek D\u00f6ner Sermaye Hakk\u0131nda Kanun uyar\u0131nca ek \u00f6deme yap\u0131lmaz. Bunlara, ayl\u0131klar\u0131na ve \u00fccretlerine ilaveten, \u00e7al\u0131\u015ft\u0131klar\u0131 g\u00fcnler dikkate al\u0131narak a\u015fa\u011f\u0131daki f\u0131krada belirlenen miktarlar\u0131n yar\u0131s\u0131n\u0131 a\u015fmamak \u00fczere tespit edilecek tutarda \u00f6deme yap\u0131l\u0131r.<\/p>\n
S\u00f6zle\u015fme yap\u0131lan aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131na, 657 say\u0131l\u0131 Kanunun 4 \u00fcnc\u00fc maddesinin (B) bendine g\u00f6re belirlenen en y\u00fcksek br\u00fct s\u00f6zle\u015fme \u00fccretinin aile hekimi i\u00e7in (6) kat\u0131n\u0131, aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 i\u00e7in (1,5) kat\u0131n\u0131 a\u015fmamak \u00fczere tespit edilecek tutar, \u00e7al\u0131\u015f\u0131lan ay sonu\u00e7lar\u0131n\u0131n ilgili sa\u011fl\u0131k idaresine bildiriminden itibaren onbe\u015f g\u00fcn i\u00e7erisinde \u00f6denir. (Ek c\u00fcmle: 4\/7\/2012-6354\/ 12 md., De\u011fi\u015fik ikinci c\u00fcmle: 20\/8\/2016-6745\/59 md.) Aile hekimlerine ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131na ihtiya\u00e7 h\u00e2linde, 657 say\u0131l\u0131 Kanunun ek 33 \u00fcnc\u00fc maddesinde belirtilen yerlerde haftal\u0131k \u00e7al\u0131\u015fma s\u00fcresi ve mesai saatleri d\u0131\u015f\u0131nda n\u00f6bet g\u00f6revi verilir. (Ek c\u00fcmle: 2\/1\/2014-6514\/52 md.) Bunlara entegre sa\u011fl\u0131k hizmeti sunulan merkezlerde art\u0131r\u0131ml\u0131 \u00fccretten yararlananlar hari\u00e7 olmak \u00fczere, 657 say\u0131l\u0131 Kanunun ek 33 \u00fcnc\u00fc maddesi \u00e7er\u00e7evesinde n\u00f6bet \u00fccreti \u00f6denir.<\/p>\n
S\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015fmaya ba\u015flayanlar\u0131n, daha \u00f6nce ba\u011fl\u0131 olduklar\u0131 sosyal g\u00fcvenlik kurulu\u015flar\u0131yla ili\u015fkileri ayn\u0131 \u015fekilde devam ettirilir. Ancak, her t\u00fcrl\u00fc prim, kesenek ve kurum kar\u015f\u0131l\u0131klar\u0131 bu f\u0131krada belirtilen \u00fccretlerden kesilerek ilgili sosyal g\u00fcvenlik kurulu\u015funa aktar\u0131l\u0131r. Bunlar \u00f6nceki durumlar\u0131 \u00e7er\u00e7evesinde tedavi yard\u0131mlar\u0131ndan yararlanmaya devam ederler.<\/p>\n
Aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n durumlar\u0131 ve aile hekimli\u011fi uzmanl\u0131k e\u011fitimi alm\u0131\u015f olup olmad\u0131klar\u0131 da dikkate al\u0131nmak suretiyle yap\u0131lacak \u00f6deme tutarlar\u0131n\u0131n tespitinde; \u00e7al\u0131\u015ft\u0131\u011f\u0131 b\u00f6lgenin sosyo-ekonomik geli\u015fmi\u015flik d\u00fczeyi, Bakanl\u0131k\u00e7a kar\u015f\u0131lanmad\u0131\u011f\u0131 takdirde aile sa\u011fl\u0131\u011f\u0131 merkezi giderleri, (\u2026), kay\u0131tl\u0131 ki\u015fi say\u0131s\u0131 ve bunlar\u0131n risk gruplar\u0131, gezici sa\u011fl\u0131k hizmetleri ile aile hekimi taraf\u0131ndan kar\u015f\u0131lanmayan gider unsurlar\u0131, belirlenen standartlar \u00e7er\u00e7evesinde sa\u011fl\u0131\u011f\u0131n geli\u015ftirilmesi, hastal\u0131klar\u0131n \u00f6nlenmesi, takibi ve kontrol\u00fcndeki ba\u015far\u0131 oran\u0131 gibi kriterler esas al\u0131n\u0131r. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca belirlenen standartlara g\u00f6re, koruyucu hekimlik hizmetlerinin eksik uygulamas\u0131 (\u2026) halinde bu \u00f6deme tutar\u0131ndan br\u00fct \u00fccretin % 20’sine kadar indirim yap\u0131l\u0131r. Sosyo-ekonomik geli\u015fmi\u015flik d\u00fczeyi \u00fccreti, aile sa\u011fl\u0131\u011f\u0131 merkezi giderleri, (\u2026) ve gezici sa\u011fl\u0131k hizmetleri \u00f6demelerinden Damga Vergisi hari\u00e7 herhangi bir kesinti yap\u0131lmaz. (Ek c\u00fcmle: 2\/1\/2014-6514\/52 md.) Aile hekimlerince talep edilen tetkik ve sarf malzemelerinin giderleri halk sa\u011fl\u0131\u011f\u0131 m\u00fcd\u00fcrl\u00fckleri taraf\u0131ndan hak sahiplerine ayr\u0131ca \u00f6denir.<\/p>\n
\u00a0(Ek f\u0131kra: 4\/7\/2012-6354\/12 md.) Aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlar\u0131n; her bir ara\u015ft\u0131rma g\u00f6revlisi\/asistan ba\u015f\u0131na azam\u00ee kay\u0131tl\u0131 ki\u015fi say\u0131s\u0131 4000 ki\u015fiyi a\u015fmamak ve her kay\u0131tl\u0131 ki\u015fi ba\u015f\u0131na (g\u00f6rev yapacak ara\u015ft\u0131rma g\u00f6revlisi\/asistan say\u0131s\u0131 da esas al\u0131nmak suretiyle) ayl\u0131k be\u015f T\u00fcrk Liras\u0131ndan fazla olmamak \u00fczere belirlenecek tutar, \u00e7al\u0131\u015f\u0131lan aya ait sonu\u00e7lar\u0131n ilgili sa\u011fl\u0131k idaresine bildiriminden itibaren onbe\u015f g\u00fcn i\u00e7inde ilgili d\u00f6ner sermaye mevzuat\u0131 h\u00fck\u00fcmlerine tabi tutulmaks\u0131z\u0131n d\u00f6ner sermaye i\u015fletmelerinde bu ama\u00e7la a\u00e7\u0131lacak olan hesaba yat\u0131r\u0131l\u0131r. Bu tutar\u0131 \u00fc\u00e7 kat\u0131na kadar art\u0131rmaya Cumhurba\u015fkan\u0131 yetkilidir. Kay\u0131tl\u0131 ki\u015fi ba\u015f\u0131na belirlenen tutar, 657 say\u0131l\u0131 Kanunun 4 \u00fcnc\u00fc maddesinin (B) bendine g\u00f6re belirlenen en y\u00fcksek br\u00fct s\u00f6zle\u015fme \u00fccretinin art\u0131\u015f\u0131 oran\u0131nda art\u0131r\u0131labilir. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 taraf\u0131ndan belirlenen standartlara g\u00f6re, koruyucu hekimlik hizmetlerinin eksik uygulanmas\u0131 h\u00e2linde \u00f6deme tutar\u0131n\u0131n % 20\u2019sine kadar indirim yap\u0131l\u0131r.<\/p>\n
\u00a0(Ek f\u0131kra: 4\/7\/2012-6354\/12 md.) Bu \u015fekilde kurumlarca olu\u015fturulacak aile sa\u011fl\u0131\u011f\u0131 merkezlerinin bu Kanun kapsam\u0131nda olu\u015facak t\u00fcm giderleri sekizinci f\u0131krada belirtilen hesaplardan \u00f6denir. Kurumlar\u0131nca aile hekimli\u011fi hizmetlerinde \u00e7al\u0131\u015ft\u0131r\u0131lan \u00f6\u011fretim \u00fcyesi, e\u011fitim g\u00f6revlisi, ara\u015ft\u0131rma g\u00f6revlisi ve asistanlara; kay\u0131tl\u0131 ki\u015fi say\u0131s\u0131 ve bunlar\u0131n risk gruplar\u0131, gezici sa\u011fl\u0131k hizmetleri, belirlenen standartlar \u00e7er\u00e7evesinde sa\u011fl\u0131\u011f\u0131n geli\u015ftirilmesi, hastal\u0131klar\u0131n \u00f6nlenmesi, takibi ve kontrol\u00fcndeki ba\u015far\u0131 oran\u0131 gibi kriterlere g\u00f6re yap\u0131lacak \u00f6demelere ili\u015fkin usul ve esaslar Maliye Bakanl\u0131\u011f\u0131n\u0131n uygun g\u00f6r\u00fc\u015f\u00fc \u00fczerine Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca \u00e7\u0131kar\u0131lacak y\u00f6netmelikle belirlenir. \u0130lgililere yap\u0131lacak toplam \u00f6deme, kadrolar\u0131na ba\u011fl\u0131 olarak yap\u0131lan \u00f6demeler de d\u00e2hil olmak \u00fczere be\u015finci f\u0131krada yer alan s\u0131n\u0131rlar\u0131 a\u015famaz. Sekizinci f\u0131kra kapsam\u0131nda olu\u015fturulan aile sa\u011fl\u0131\u011f\u0131 merkezlerinde g\u00f6rev yapan aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131na 209 say\u0131l\u0131 Kanunun 5 inci maddesi ve 4\/11\/1981 tarihli ve 2547 say\u0131l\u0131 Y\u00fcksek\u00f6\u011fretim Kanununun 58 inci maddesi h\u00fck\u00fcmleri \u00e7er\u00e7evesinde belirlenen azam\u00ee ek \u00f6deme tutar\u0131n\u0131 ge\u00e7memek \u00fczere yukar\u0131da belirtilen kriterler \u00e7er\u00e7evesinde yap\u0131lacak \u00f6deme, an\u0131lan f\u0131kra uyar\u0131nca a\u00e7\u0131lm\u0131\u015f bulunan hesaplardan \u00f6denir. (M\u00fclga c\u00fcmle: 16\/6\/2022-7411\/11 md.) (De\u011fi\u015fik c\u00fcmle: 16\/6\/2022-7411\/11 md.) Bu \u00f6demelerden yararlanan personele, \u00e7al\u0131\u015fmalar\u0131 sebebiyle 4\/1\/1961 tarihli ve 209 say\u0131l\u0131 Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131na Ba\u011fl\u0131 Sa\u011fl\u0131k Kurumlar\u0131 ile Esenlendirme (Rehabilitasyon) Tesislerine Verilecek D\u00f6ner Sermaye Hakk\u0131nda Kanunun 5 inci ve ek 3 \u00fcnc\u00fc maddeleri ile 2547 say\u0131l\u0131 Kanunun 58 inci maddesi uyar\u0131nca hizmet sunum \u015fartlar\u0131 ve kriterleri de dikkate al\u0131nmak suretiyle \u00f6deme yap\u0131l\u0131r. (Ek c\u00fcmle: 16\/6\/2022-7411\/11 md.) Bu \u00f6demeler toplam\u0131 ilgisine g\u00f6re 209 say\u0131l\u0131 Kanunun 5 inci maddesi ile 2547 say\u0131l\u0131 Kanunun 58 inci maddesinde belirlenmi\u015f olan tavanlar\u0131 ge\u00e7emez.<\/p>\n
\u00a0(Ek f\u0131kra:15\/11\/2018-7151\/26 md.) Aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren vak\u0131f \u00fcniversiteleri ile Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 aras\u0131nda bu maddenin birinci f\u0131kras\u0131 kapsam\u0131nda kurumsal s\u00f6zle\u015fme yap\u0131labilir ve sekizinci f\u0131kradaki usul ve esaslara g\u00f6re \u00fcniversite hesab\u0131na \u00f6deme yap\u0131l\u0131r.<\/p>\n
\u00a0(Ek f\u0131kra:15\/11\/2018-7151\/26 md.) Aile hekimleri ferden veya m\u00fc\u015ftereken personel \u00e7al\u0131\u015ft\u0131rabilir ve i\u015fveren olabilir.<\/p>\n
\u00a0(Ek f\u0131kra:15\/11\/2018-7151\/26 md.) Aile hekimleri ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n y\u0131ll\u0131k izinleri, y\u0131l i\u00e7inde \u00e7al\u0131\u015f\u0131lan s\u00fcre ile orant\u0131l\u0131 olmak ve ait oldu\u011fu s\u00f6zle\u015fme d\u00f6neminde kullan\u0131lmak \u00fczere otuz g\u00fcnd\u00fcr. Ayr\u0131ca be\u015f g\u00fcn kongre ve seminer izni ile y\u0131ll\u0131k izin bitiminden sonra mazeretleri nedeniyle be\u015f g\u00fcn idari izin verilebilir. Evlenme, \u00f6l\u00fcm, do\u011fum ve emzirme h\u00e2llerinde, 657 say\u0131l\u0131 Kanunun 4\/B maddesi kapsam\u0131ndaki s\u00f6zle\u015fmeli personele ili\u015fkin izin s\u00fcreleri uygulan\u0131r. Hastal\u0131k durumunda, bir mal\u00ee y\u0131lda en \u00e7ok on g\u00fcnl\u00fck d\u00f6nemler halinde toplam k\u0131rk g\u00fcne kadar hekimin uygun g\u00f6rmesiyle hastal\u0131k izni verilebilir. Bir defada on g\u00fcn\u00fc a\u015fan hastal\u0131k izni ancak sa\u011fl\u0131k kurulu raporu ile verilebilir. S\u00f6zle\u015fmeli aile hekimi iken aile hekimli\u011fi uzmanl\u0131k e\u011fitimi almakta olanlar, bu e\u011fitimleri kapsam\u0131ndaki hastane rotasyonu s\u00fcresince izinli say\u0131l\u0131r.<\/p>\n
\u00a0(Ek f\u0131kra: 14\/7\/2023-7456\/13 md.) S\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 hakk\u0131nda uygulanacak disiplin cezalar\u0131nda bu Kanun ile ilgili d\u00fczenlemeler d\u0131\u015f\u0131nda, 657 say\u0131l\u0131 Devlet Memurlar\u0131 Kanununun ilgili maddelerine g\u00f6re i\u015flem yap\u0131l\u0131r. Ayl\u0131ktan kesme cezas\u0131, ki\u015finin br\u00fct \u00fccretinin 1\/30-1\/8 aras\u0131nda kesinti yap\u0131lmas\u0131 \u015feklinde, bu Kanunun 3 \u00fcnc\u00fc maddesinin ikinci f\u0131kras\u0131n\u0131n son c\u00fcmlesi kapsam\u0131nda \u00e7al\u0131\u015fanlar i\u00e7in kademe ilerlemesinin durdurulmas\u0131 cezas\u0131 br\u00fct \u00fccretinin 1\/6-1\/4 aras\u0131nda kesinti yap\u0131lmas\u0131 \u015feklinde uygulan\u0131r. Devlet memurlu\u011fundan \u00e7\u0131karma cezas\u0131 s\u00f6zle\u015fmenin feshini gerektirir. (Ek c\u00fcmleler:21\/2\/2024-7496\/25 md.) S\u00f6zle\u015fme ile \u00e7al\u0131\u015ft\u0131r\u0131lan aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131na, halk sa\u011fl\u0131\u011f\u0131n\u0131n geli\u015ftirilmesine destek olmalar\u0131n\u0131, halk\u0131n birinci basamak sa\u011fl\u0131k hizmetlerine eri\u015fimlerini kolayla\u015ft\u0131rmalar\u0131n\u0131 ve d\u00fczenli hizmet sunmalar\u0131n\u0131 teminen \u00f6d\u00fcllendirilmeleri ve motivasyonlar\u0131n\u0131n art\u0131r\u0131lmas\u0131 amac\u0131yla destek \u00f6demesi yap\u0131l\u0131r. Bu \u00f6deme, uyarma cezas\u0131 alanlara bir ay, k\u0131nama cezas\u0131 alanlara iki ay, ayl\u0131ktan kesme ya da kademe ilerlemesinin durdurulmas\u0131 cezas\u0131 alanlara \u00fc\u00e7 ay s\u00fcresince yap\u0131lmaz. Aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131na bir s\u00f6zle\u015fme d\u00f6neminde toplam alt\u0131 ay ve \u00fczerinde \u00f6deme kesintisini gerektirir disiplin cezas\u0131 verilmesi h\u00e2linde aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n mevcut s\u00f6zle\u015fmeleri feshedilir.<\/p>\n
\u00a0(Ek f\u0131kra: 14\/7\/2023-7456\/13 md.) Sa\u011fl\u0131\u011f\u0131n geli\u015ftirilmesi, hastal\u0131klar\u0131n \u00f6nlenmesi, takibi ve kontrol\u00fc ile koruyucu sa\u011fl\u0131k hizmetlerinin standartlara uygun olarak yerine getirilmemesi gibi Bakanl\u0131k\u00e7a belirlenen performans hedeflerine ula\u015f\u0131lamamas\u0131 halinde s\u00f6zle\u015fmenin Bakanl\u0131k\u00e7a yenilenmemesine karar verilebilir.<\/p>\n
\u00a0(Ek f\u0131kra: 14\/7\/2023-7456\/13 md.) S\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015fan aile hekimi, aile di\u015f hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n eski kadro veya pozisyonlar\u0131na atanabilmeleri i\u00e7in s\u00f6zle\u015fmelerinin Devlet memurlu\u011fundan \u00e7\u0131karma cezas\u0131n\u0131 gerektiren fiilleri nedeniyle sona ermemi\u015f olmas\u0131 gerekir.<\/p>\n
\u00a0(Ek f\u0131kra: 14\/7\/2023-7456\/13 md.) Disiplin kurullar\u0131n\u0131n te\u015fkili, disiplin amirlerinin tayin ve tespiti ile disiplin h\u00fck\u00fcmlerinin uygulanmas\u0131na ili\u015fkin di\u011fer esaslar y\u00f6netmelikte d\u00fczenlenir.\u201d<\/p>\n
II. \u0130LK \u0130NCELEME<\/p>\n
1. Anayasa Mahkemesi \u0130\u00e7t\u00fcz\u00fc\u011f\u00fc h\u00fck\u00fcmleri uyar\u0131nca Kadir \u00d6ZKAYA, Hasan Tahsin G\u00d6KCAN, Basri BA\u011eCI, Engin YILDIRIM, R\u0131dvan G\u00dcLE\u00c7, Recai AKYEL, Yusuf \u015eevki HAKYEMEZ, Y\u0131ld\u0131z SEFER\u0130NO\u011eLU, Selahaddin MENTE\u015e, \u0130rfan F\u0130DAN, Kenan YA\u015eAR, Y\u0131lmaz AK\u00c7\u0130L ve \u00d6mer \u00c7INAR\u2019\u0131n kat\u0131l\u0131mlar\u0131yla 9\/5\/2024 tarihinde yap\u0131lan ilk inceleme toplant\u0131s\u0131nda \u00f6ncelikle uygulanacak kural sorunu g\u00f6r\u00fc\u015f\u00fclm\u00fc\u015ft\u00fcr.<\/p>\n
2. Anayasa\u2019n\u0131n 152. ile 30\/3\/2011 tarihli ve 6216 say\u0131l\u0131 Anayasa Mahkemesinin Kurulu\u015fu ve Yarg\u0131lama Usulleri Hakk\u0131nda Kanun\u2019un 40. maddelerine g\u00f6re bir davaya bakmakta olan mahkeme, bu dava sebebiyle uygulanacak bir kanunun veya Cumhurba\u015fkanl\u0131\u011f\u0131 kararnamesinin h\u00fck\u00fcmlerini Anayasa\u2019ya ayk\u0131r\u0131 g\u00f6rmesi h\u00e2linde veya taraflardan birinin ileri s\u00fcrd\u00fc\u011f\u00fc ayk\u0131r\u0131l\u0131k iddias\u0131n\u0131n ciddi oldu\u011fu kan\u0131s\u0131na varmas\u0131 durumunda bu h\u00fck\u00fcmlerin iptalleri i\u00e7in Anayasa Mahkemesine ba\u015fvurmaya yetkilidir. Ancak an\u0131lan maddeler uyar\u0131nca bir mahkemenin Anayasa Mahkemesine ba\u015fvurabilmesi i\u00e7in elinde y\u00f6ntemince a\u00e7\u0131lm\u0131\u015f ve mahkemenin g\u00f6revine giren bir davan\u0131n bulunmas\u0131, iptali talep edilen kural\u0131n da o davada uygulanacak olmas\u0131 gerekir. Uygulanacak kural ise bak\u0131lmakta olan davan\u0131n de\u011fi\u015fik evrelerinde ortaya \u00e7\u0131kan sorunlar\u0131n \u00e7\u00f6z\u00fcm\u00fcnde veya davay\u0131 sonu\u00e7land\u0131rmada olumlu ya da olumsuz y\u00f6nde etki yapacak nitelikte bulunan kurallard\u0131r.<\/p>\n
3. Bak\u0131lmakta olan davan\u0131n konusu Aile Hekimli\u011fi S\u00f6zle\u015fme ve \u00d6deme Y\u00f6netmeli\u011fi\u2019nin \u201cDisiplin \u0130\u015flemleri ve G\u00f6revden Uzakla\u015ft\u0131rma\u201d ba\u015fl\u0131kl\u0131 10. maddesinin iptali talebidir. An\u0131lan maddede s\u00f6zle\u015fmeli aile hekimleri ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 hakk\u0131nda uygulanacak disiplin cezalar\u0131nda 5258 say\u0131l\u0131 Kanun\u2019da yer alan d\u00fczenlemeler d\u0131\u015f\u0131nda 14\/7\/1965 tarihli ve 657 say\u0131l\u0131 Devlet Memurlar\u0131 Kanunu\u2019nun ilgili maddelerine g\u00f6re i\u015flem yap\u0131laca\u011f\u0131 belirtilerek br\u00fct maa\u015f \u00fczerinden uygulanacak ayl\u0131ktan kesme ve kademe ilerlemesinin durdurulmas\u0131 cezalar\u0131n\u0131n oranlar\u0131na yer verilmi\u015ftir. Maddede ayr\u0131ca disiplin cezas\u0131n\u0131n sonucu olarak devlet memurlu\u011fundan \u00e7\u0131karma cezas\u0131 verildi\u011finde aile hekimi veya aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n s\u00f6zle\u015fmelerinin vali taraf\u0131ndan feshedilece\u011fi h\u00fckme ba\u011flanm\u0131\u015f; s\u00f6zle\u015fmeli aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n disiplin amirine, maddede h\u00fck\u00fcm bulunmayan h\u00e2ller ile disiplin kurullar\u0131 ve disiplin soru\u015fturmalar\u0131nda uygulanacak di\u011fer mevzuata ve g\u00f6revden uzakla\u015ft\u0131rmaya ili\u015fkin h\u00fck\u00fcmlere yer verilmi\u015ftir.<\/p>\n
4. 5258 say\u0131l\u0131 Kanun\u2019un 3. maddesinin itiraz konusu on d\u00f6rd\u00fcnc\u00fc f\u0131kras\u0131nda Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca (Bakanl\u0131k) belirlenen performans hedeflerine ula\u015f\u0131lamamas\u0131n\u0131n sonucu olarak s\u00f6zle\u015fmenin yenilenmemesi d\u00fczenlenmi\u015f, performans hedeflerine ula\u015f\u0131lamamas\u0131 sonucunu do\u011furan h\u00e2ller ise \u00f6rnekleme suretiyle belirlenmi\u015ftir.<\/p>\n
5. Bak\u0131lmakta olan davan\u0131n konusunun ise an\u0131lan Y\u00f6netmelik\u2019in disiplin i\u015flemleri ve g\u00f6revden uzakla\u015ft\u0131rma ile ilgili hususlar\u0131 d\u00fczenleyen 10. maddesinin iptali talebine ili\u015fkin oldu\u011fu g\u00f6zetildi\u011finde itiraz konusu on d\u00f6rd\u00fcnc\u00fc f\u0131kran\u0131n bak\u0131lmakta olan davada uygulanacak kural niteli\u011finde olmad\u0131\u011f\u0131 anla\u015f\u0131lmaktad\u0131r. Bu itibarla s\u00f6z konusu f\u0131kraya ili\u015fkin ba\u015fvurunun Mahkemenin yetkisizli\u011fi nedeniyle reddi gerekir.<\/p>\n
6. A\u00e7\u0131klanan nedenle 24\/11\/2004 tarihli ve 5258 say\u0131l\u0131 Aile Hekimli\u011fi Kanunu\u2019nun 3. maddesine 14\/7\/2023 tarihli ve 7456 say\u0131l\u0131 Kanun\u2019un 13. maddesiyle eklenen;<\/p>\n
A. On \u00fc\u00e7\u00fcnc\u00fc f\u0131kran\u0131n birinci, ikinci ve \u00fc\u00e7\u00fcnc\u00fc c\u00fcmlelerinin esas\u0131n\u0131n incelenmesine,<\/p>\n
B. On d\u00f6rd\u00fcnc\u00fc f\u0131kran\u0131n itiraz ba\u015fvurusunda bulunan Mahkemenin bakmakta oldu\u011fu davada uygulanma imk\u00e2n\u0131 bulunmad\u0131\u011f\u0131ndan bu f\u0131kraya ili\u015fkin ba\u015fvurunun Mahkemenin yetkisizli\u011fi nedeniyle REDD\u0130NE,<\/p>\n
OYB\u0130RL\u0130\u011e\u0130YLE karar verilmi\u015ftir.<\/p>\n
III. ESASIN \u0130NCELENMES\u0130<\/p>\n
7. Ba\u015fvuru karar\u0131 ve ekleri, Raport\u00f6r Derya ATAKUL taraf\u0131ndan haz\u0131rlanan i\u015fin esas\u0131na ili\u015fkin rapor, itiraz konusu kanun h\u00fck\u00fcmleri, dayan\u0131lan ve ilgili g\u00f6r\u00fclen Anayasa kurallar\u0131 ve bunlar\u0131n gerek\u00e7eleri ile di\u011fer yasama belgeleri okunup incelendikten sonra gere\u011fi g\u00f6r\u00fc\u015f\u00fcl\u00fcp d\u00fc\u015f\u00fcn\u00fcld\u00fc:<\/p>\n
A. Anlam ve Kapsam<\/p>\n
8. 5258 say\u0131l\u0131 Kanun\u2019un 1. maddesinde an\u0131lan Kanun\u2019un ama\u00e7 ve kapsam\u0131n\u0131n Bakanl\u0131\u011f\u0131n belirleyece\u011fi illerde birinci basamak sa\u011fl\u0131k hizmetlerinin geli\u015ftirilmesi, birey ihtiya\u00e7lar\u0131 do\u011frultusunda koruyucu sa\u011fl\u0131k hizmetlerine a\u011f\u0131rl\u0131k verilmesi, ki\u015fisel sa\u011fl\u0131k kay\u0131tlar\u0131n\u0131n tutulmas\u0131 ve bu hizmetlere e\u015fit eri\u015fimin sa\u011flanmas\u0131 amac\u0131yla aile hekimli\u011fi hizmetlerinin y\u00fcr\u00fct\u00fclebilmesini teminen g\u00f6revlendirilecek veya \u00e7al\u0131\u015ft\u0131r\u0131lacak sa\u011fl\u0131k personelinin stat\u00fcs\u00fc ve mali haklar\u0131 ile hizmetin esaslar\u0131n\u0131 d\u00fczenlemek oldu\u011fu belirtilmi\u015ftir.<\/p>\n
9. An\u0131lan Kanun\u2019un 2. maddesinde aile hekimi, ki\u015fiye y\u00f6nelik koruyucu sa\u011fl\u0131k hizmetleri ile birinci basamak te\u015fhis, tedavi ve rehabilite edici sa\u011fl\u0131k hizmetlerini ya\u015f, cinsiyet ve hastal\u0131k ayr\u0131m\u0131 yapmaks\u0131z\u0131n her ki\u015fiye kapsaml\u0131 ve devaml\u0131 olarak belli bir mek\u00e2nda vermekle y\u00fck\u00fcml\u00fc, gerekti\u011fi \u00f6l\u00e7\u00fcde gezici sa\u011fl\u0131k hizmeti veren ve tam g\u00fcn esas\u0131na g\u00f6re \u00e7al\u0131\u015fan aile hekimli\u011fi uzman\u0131 veya Bakanl\u0131\u011f\u0131n \u00f6ng\u00f6rd\u00fc\u011f\u00fc e\u011fitimleri alan uzman tabip veya tabip; aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 ise aile hekimi ile birlikte hizmet veren hem\u015fire, ebe, sa\u011fl\u0131k memuru gibi sa\u011fl\u0131k eleman\u0131 olarak tan\u0131mlanm\u0131\u015ft\u0131r.<\/p>\n
10. Kanun\u2019un 3. maddesinin birinci f\u0131kras\u0131nda Bakanl\u0131k veya di\u011fer kamu kurum veya kurulu\u015flar\u0131 personeli olan uzman tabip, tabip ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 olarak \u00e7al\u0131\u015ft\u0131r\u0131lacak sa\u011fl\u0131k personelinin kendilerinin talebi ve kurumlar\u0131n\u0131n veya Bakanl\u0131\u011f\u0131n muvafakati \u00fczerine 657 say\u0131l\u0131 Kanun ile di\u011fer kanunlar\u0131n s\u00f6zle\u015fmeli personel \u00e7al\u0131\u015ft\u0131r\u0131lmas\u0131 hakk\u0131ndaki h\u00fck\u00fcmlerine ba\u011fl\u0131 olmaks\u0131z\u0131n s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131rmaya veya bu nitelikteki Bakanl\u0131k personelini aile hekimli\u011fi uygulamalar\u0131 i\u00e7in g\u00f6revlendirmeye ya da aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlarla s\u00f6zle\u015fme yapmaya Bakanl\u0131\u011f\u0131n yetkili oldu\u011fu belirtilmi\u015ftir.<\/p>\n
11. An\u0131lan maddenin ikinci f\u0131kras\u0131nda ise ihtiya\u00e7 duyulmas\u0131 h\u00e2linde, T\u00fcrkiye\u2019de mesle\u011fini icra etmeye yetkili ve s\u00f6z konusu Kanun\u2019un 48. maddesinin (A) bendinin (4), (5) ve (7) numaral\u0131 alt bentlerindeki \u015fartlar\u0131 ta\u015f\u0131yan kamu g\u00f6revlisi olmayan uzman tabip, tabip ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n da Bakanl\u0131\u011f\u0131n \u00f6nerisi, Hazine ve Maliye Bakanl\u0131\u011f\u0131n\u0131n uygun g\u00f6r\u00fc\u015f\u00fc \u00fczerine aile hekimli\u011fi uygulamalar\u0131n\u0131 y\u00fcr\u00fctmek \u00fczere s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131r\u0131labilece\u011fi h\u00fck\u00fcm alt\u0131na al\u0131nm\u0131\u015ft\u0131r.<\/p>\n
12. Maddenin \u00fc\u00e7\u00fcnc\u00fc f\u0131kras\u0131nda da s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015fan aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n kurumlar\u0131nda ayl\u0131ks\u0131z veya \u00fccretsiz izinli say\u0131laca\u011f\u0131 ve bunlar\u0131n kadrolar\u0131 ile ili\u015fkilerinin devam edece\u011fi, bu kapsamda s\u00f6z konusu personelin, s\u00f6zle\u015fmeli stat\u00fcde ge\u00e7en s\u00fcrelerinin kazan\u0131lm\u0131\u015f hak derece ve kademelerinde veya k\u0131demlerinde de\u011ferlendirilerek her y\u0131l i\u015flem yap\u0131laca\u011f\u0131 ve bunlar\u0131n talepleri h\u00e2linde eski g\u00f6revlerine atanacaklar\u0131 h\u00fckme ba\u011flanm\u0131\u015ft\u0131r. An\u0131lan f\u0131krada ayr\u0131ca s\u00f6zle\u015fmeli personel stat\u00fcs\u00fcnde \u00e7al\u0131\u015fmakta iken aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 stat\u00fcs\u00fcne ge\u00e7enlerden \u00f6nceki s\u00f6zle\u015fmeli personel stat\u00fcs\u00fcne d\u00f6nmek isteyenlerin eski kurumlar\u0131ndaki bo\u015f pozisyonlara \u00f6ncelikle atanacaklar\u0131 ve bu madde kapsam\u0131ndaki \u00e7al\u0131\u015fmalar\u0131n\u0131n hizmet s\u00fcrelerinde dikkate al\u0131naca\u011f\u0131 belirtilmi\u015ftir.<\/p>\n
13. Bu itibarla aile hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n istihdam\u0131nda \u00fc\u00e7 farkl\u0131 istihdam usul\u00fcn\u00fcn \u00f6ng\u00f6r\u00fcld\u00fc\u011f\u00fc anla\u015f\u0131lmaktad\u0131r. Buna g\u00f6re Bakanl\u0131k veya di\u011fer kamu kurum veya kurulu\u015flar\u0131 personeli olan uzman tabip, tabip ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n kendilerinin talebi ve kurumlar\u0131n\u0131n veya Bakanl\u0131\u011f\u0131n muvafakati \u00fczerine s\u00f6zle\u015fmeli olarak veya bu nitelikteki Bakanl\u0131k personelinin aile hekimli\u011fi uygulamalar\u0131 i\u00e7in g\u00f6revlendirilmeleri suretiyle istihdam edilmeleri ya da ihtiya\u00e7 duyulmas\u0131 h\u00e2linde Bakanl\u0131\u011f\u0131n \u00f6nerisi ve Hazine ve Maliye Bakanl\u0131\u011f\u0131n\u0131n uygun g\u00f6r\u00fc\u015f\u00fc al\u0131narak 657 say\u0131l\u0131 Kanun\u2019da aranan niteliklere sahip kamu g\u00f6revlisi olmayan ki\u015filerin s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131r\u0131lmalar\u0131 m\u00fcmk\u00fcnd\u00fcr.<\/p>\n
14. Ayr\u0131ca 5258 say\u0131l\u0131 Kanun’un 3. maddesinin birinci ve onuncu f\u0131kralar\u0131na g\u00f6re Bakanl\u0131\u011fa aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlar ve vak\u0131f \u00fcniversiteleriyle s\u00f6zle\u015fme yapma imk\u00e2n\u0131 tan\u0131narak aile hekimli\u011fi hizmetlerinin kurumsal s\u00f6zle\u015fme y\u00f6ntemiyle sunulmas\u0131 m\u00fcmk\u00fcn k\u0131l\u0131nm\u0131\u015f, sekizinci f\u0131kras\u0131nda bu hizmetlerinin kar\u015f\u0131l\u0131\u011f\u0131 olarak aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlara yap\u0131lacak \u00f6demeyle ilgili usul ve esaslara yer verilmi\u015ftir.<\/p>\n
15. An\u0131lan maddenin on \u00fc\u00e7\u00fcnc\u00fc f\u0131kras\u0131n\u0131n itiraz konusu birinci c\u00fcmlesinde s\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 hakk\u0131nda uygulanacak disiplin cezalar\u0131nda s\u00f6z konusu Kanun ile ilgili d\u00fczenlemeler d\u0131\u015f\u0131nda 657 say\u0131l\u0131 Kanun\u2019un ilgili maddelerine g\u00f6re i\u015flem yap\u0131laca\u011f\u0131 \u00f6ng\u00f6r\u00fclm\u00fc\u015ft\u00fcr. An\u0131lan f\u0131kran\u0131n itiraz konusu ikinci c\u00fcmlesinde de ayl\u0131ktan kesme cezas\u0131n\u0131n ki\u015finin br\u00fct \u00fccretinin 1\/30-1\/8 aras\u0131nda kesinti yap\u0131lmas\u0131, kamu g\u00f6revlisi stat\u00fcs\u00fcnden gelmeyen s\u00f6zle\u015fmeli \u00e7al\u0131\u015fanlar i\u00e7in kademe ilerlemesinin durdurulmas\u0131 cezas\u0131n\u0131n br\u00fct \u00fccretin 1\/6-1\/4 aras\u0131nda kesinti yap\u0131lmas\u0131 \u015feklinde uygulanaca\u011f\u0131 belirtilmi\u015ftir. F\u0131kran\u0131n itiraz konusu \u00fc\u00e7\u00fcnc\u00fc c\u00fcmlesinde ise devlet memurlu\u011fundan \u00e7\u0131karma cezas\u0131n\u0131n s\u00f6zle\u015fmenin feshini gerektirece\u011fi h\u00fck\u00fcm alt\u0131na al\u0131nm\u0131\u015ft\u0131r.<\/p>\n
16. \u0130tiraz konusu kurallara g\u00f6re kamu kurum veya kurulu\u015flar\u0131 personeli iken kurumlar\u0131nda ayl\u0131ks\u0131z veya \u00fccretsiz izinli say\u0131lmak suretiyle s\u00f6zle\u015fme akdedilen aile hekimleri ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 ile kamu g\u00f6revlisi olmayanlardan aile hekimi ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 olarak s\u00f6zle\u015fme akdedilenler hakk\u0131nda disiplin cezalar\u0131 bak\u0131m\u0131ndan 5258 say\u0131l\u0131 Kanun ile 657 say\u0131l\u0131 Kanun\u2019un ilgili h\u00fck\u00fcmleri uygulanacakt\u0131r. Dolay\u0131s\u0131yla kurallar\u0131n aile hekimli\u011fi uygulamalar\u0131 i\u00e7in g\u00f6revlendirilen Bakanl\u0131k personeli ile aile hekimli\u011fi hizmetlerinin Bakanl\u0131k ile kurumsal s\u00f6zle\u015fme yapan aile hekimli\u011fi dal\u0131nda uzmanl\u0131k e\u011fitimi veren devlet ve vak\u0131f \u00fcniversiteleri taraf\u0131ndan sunulmas\u0131 h\u00e2linde t\u0131pta uzmanl\u0131k mevzuat\u0131na g\u00f6re bu kurumlarda e\u011fitici olarak g\u00f6rev yapan profes\u00f6r, do\u00e7ent, doktor \u00f6\u011fretim \u00fcyesi, e\u011fitim g\u00f6revlisi ve ba\u015fasistanlar ile uzmanl\u0131k e\u011fitimi alan asistanlar hakk\u0131nda uygulanmas\u0131 s\u00f6z konusu de\u011fildir. <\/p>\n
B. \u0130tiraz\u0131n Gerek\u00e7esi<\/p>\n
17. Ba\u015fvuru karar\u0131nda \u00f6zetle; 5258 say\u0131l\u0131 Kanun kapsam\u0131nda aile hekimli\u011fi \u00e7al\u0131\u015fanlar\u0131n\u0131n 657 say\u0131l\u0131 Kanun ile di\u011fer kanunlar\u0131n s\u00f6zle\u015fmeli personel \u00e7al\u0131\u015ft\u0131r\u0131lmas\u0131 hakk\u0131ndaki h\u00fck\u00fcmlerine ba\u011fl\u0131 olmaks\u0131z\u0131n s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131r\u0131lmas\u0131 \u00f6ng\u00f6r\u00fcl\u00fcrken itiraz konusu kurallarla disiplin h\u00fck\u00fcmleri y\u00f6n\u00fcnden an\u0131lan Kanun\u2019a tabi k\u0131l\u0131nd\u0131klar\u0131 ancak bu ki\u015filerin yapt\u0131klar\u0131 i\u015fin niteli\u011fi ve \u00e7al\u0131\u015fma ko\u015fullar\u0131 bak\u0131m\u0131ndan memurlardan farkl\u0131 bir durumda olduklar\u0131, bu ki\u015filer hakk\u0131nda memurlar\u0131n tabi oldu\u011fu disiplin h\u00fck\u00fcmlerinin uygulanmas\u0131n\u0131n hakkaniyete ayk\u0131r\u0131 oldu\u011fu, ayr\u0131ca aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlardaki ara\u015ft\u0131rma g\u00f6revlisi ve asistanlar\u0131n da aile hekimli\u011fi hizmeti verebildikleri, dolay\u0131s\u0131yla kurallarla bu ki\u015filerin de disiplin h\u00fck\u00fcmleri bak\u0131m\u0131ndan s\u00f6z konusu Kanun\u2019a tabi k\u0131l\u0131nmalar\u0131n\u0131n Anayasa\u2019da bu ki\u015filer i\u00e7in \u00f6ng\u00f6r\u00fclen g\u00fcvencelerle ba\u011fda\u015fmad\u0131\u011f\u0131 belirtilerek kurallar\u0131n Anayasa\u2019n\u0131n 2., 27. ve 130. maddelerine ayk\u0131r\u0131 oldu\u011fu ileri s\u00fcr\u00fclm\u00fc\u015ft\u00fcr.<\/p>\n
C. Anayasa\u2019ya Ayk\u0131r\u0131l\u0131k Sorunu<\/p>\n
18. 6216 say\u0131l\u0131 Kanun\u2019un 43. maddesi uyar\u0131nca kurallar, ilgisi nedeniyle Anayasa\u2019n\u0131n 128. maddesi y\u00f6n\u00fcnden de incelenmi\u015ftir.<\/p>\n
19. Anayasa\u2019n\u0131n 128. maddesinin birinci ve ikinci f\u0131kralar\u0131nda \u201cDevletin, kamu iktisad\u00ee te\u015febb\u00fcsleri ve di\u011fer kamu t\u00fczelki\u015filerinin genel idare esaslar\u0131na g\u00f6re y\u00fcr\u00fctmekle y\u00fck\u00fcml\u00fc olduklar\u0131 kamu hizmetlerinin gerektirdi\u011fi asl\u00ee ve s\u00fcrekli g\u00f6revler, memurlar ve di\u011fer kamu g\u00f6revlileri eliyle g\u00f6r\u00fcl\u00fcr.\/ Memurlar\u0131n ve di\u011fer kamu g\u00f6revlilerinin nitelikleri, atanmalar\u0131, g\u00f6rev ve yetkileri, haklar\u0131 ve y\u00fck\u00fcml\u00fcl\u00fckleri, ayl\u0131k ve \u00f6denekleri ve di\u011fer \u00f6zl\u00fck i\u015fleri kanunla d\u00fczenlenir. Ancak, mal\u00ee ve sosyal haklara ili\u015fkin toplu s\u00f6zle\u015fme h\u00fck\u00fcmleri sakl\u0131d\u0131r.\u201d denilmektedir.<\/p>\n
20. An\u0131lan maddede ge\u00e7en di\u011fer kamu g\u00f6revlileri, memurlar ve i\u015f\u00e7iler d\u0131\u015f\u0131nda, kamu hizmetinin gerektirdi\u011fi asli ve s\u00fcrekli g\u00f6revlerde, kamu hukuku ili\u015fkisiyle \u00e7al\u0131\u015fanlar\u0131 kapsamaktad\u0131r (AYM, E.2005\/10, K.2008\/63, 21\/2\/2008). Anayasa Mahkemesinin \u00f6nceki kararlar\u0131nda da belirtildi\u011fi \u00fczere aile hekimli\u011fi hizmetleri, devletin genel idare esaslar\u0131na g\u00f6re y\u00fcr\u00fctmekle y\u00fck\u00fcml\u00fc oldu\u011fu kamu hizmetinin gerektirdi\u011fi asli ve s\u00fcrekli g\u00f6revlerden olup idari hizmet s\u00f6zle\u015fmesi ile aile hekimli\u011fi uygulamalar\u0131n\u0131 y\u00fcr\u00fctmek \u00fczere \u00e7al\u0131\u015ft\u0131r\u0131lanlar\u0131n da Anayasa\u2019n\u0131n 128. maddesinde ifade edilen di\u011fer kamu g\u00f6revlisi kapsam\u0131nda olduklar\u0131 a\u00e7\u0131kt\u0131r (AYM, E.2005\/10, K.2008\/63, 21\/2\/2008; E.2014\/177, K.2015\/49, 14\/5\/2015; E.2015\/17, K.2015\/20, 5\/3\/2015; E.2014\/82, K.2014\/143, 11\/9\/2014).<\/p>\n
21. Anayasa\u2019n\u0131n s\u00f6z konusu maddesinin ikinci f\u0131kras\u0131nda memurlar\u0131n ve di\u011fer kamu g\u00f6revlilerinin nitelikleri, atanmalar\u0131, g\u00f6rev ve yetkileri, haklar\u0131 ve y\u00fck\u00fcml\u00fcl\u00fckleri, ayl\u0131k ve \u00f6denekleri ve di\u011fer \u00f6zl\u00fck i\u015flerinin kanunla d\u00fczenlenece\u011fi belirtilmi\u015ftir. Memurlar ve di\u011fer kamu g\u00f6revlilerinin stat\u00fc haklar\u0131n\u0131 do\u011frudan etkileyen disiplin i\u015flemleri an\u0131lan f\u0131krada yer alan di\u011fer \u00f6zl\u00fck i\u015fleri kapsam\u0131ndad\u0131r. Buna g\u00f6re s\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n disiplin i\u015flemlerine ili\u015fkin usul ve esaslar\u0131n kanunla d\u00fczenlenmesi gerekir.<\/p>\n
22. \u0130tiraz konusu kurallarda s\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 hakk\u0131nda uygulanacak disiplin cezalar\u0131nda 5258 ve 657 say\u0131l\u0131 Kanunlar\u2019\u0131n ilgili maddelerine g\u00f6re i\u015flem yap\u0131laca\u011f\u0131 belirtilmi\u015f, ayl\u0131ktan kesme cezas\u0131 ile kamu g\u00f6revlisi stat\u00fcs\u00fcnden gelmeyen s\u00f6zle\u015fmeli \u00e7al\u0131\u015fanlar i\u00e7in kademe ilerlemesinin durdurulmas\u0131 cezas\u0131n\u0131n verilmesi h\u00e2linde br\u00fct \u00fccret \u00fczerinden yap\u0131lacak kesintinin oranlar\u0131 belirlenmi\u015f, s\u00f6zle\u015fmenin feshi, devlet memurlu\u011fundan \u00e7\u0131karma cezas\u0131n\u0131n sonucu olarak \u00f6ng\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Buna g\u00f6re disiplin cezalar\u0131 ile disiplin cezas\u0131n\u0131 gerektiren fiillere ili\u015fkin sair hususlarda 5258 say\u0131l\u0131 Kanun\u2019un yan\u0131 s\u0131ra 657 say\u0131l\u0131 Kanun\u2019un ilgili h\u00fck\u00fcmlerinin esas al\u0131naca\u011f\u0131 anla\u015f\u0131lmaktad\u0131r.<\/p>\n
23. Kamu g\u00f6revlisi stat\u00fcs\u00fcnde olan s\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n disiplin i\u015flemlerine ili\u015fkin usul ve esaslar\u0131 belirleme konusundaki takdir yetkisi kanun koyucuya aittir. Bu ki\u015filer hakk\u0131nda 5258 say\u0131l\u0131 Kanun\u2019la memurlar ile di\u011fer kamu g\u00f6revlilerinin g\u00f6rev ve sorumluluklar\u0131na, haklar\u0131na ve disiplin cezalar\u0131na ili\u015fkin temel kurallar\u0131 belirleyen 657 say\u0131l\u0131 Kanun\u2019a at\u0131fta bulunulmas\u0131 kurallar\u0131n belirsiz oldu\u011fu veya keyf\u00eeli\u011fe kar\u015f\u0131 gerekli kanuni g\u00fcvenceleri ta\u015f\u0131mad\u0131\u011f\u0131 anlam\u0131na gelmemektedir. Bu ba\u011flamda kurallarla s\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 hakk\u0131nda uygulanacak disiplin cezalar\u0131 ile bu cezalara ve fiillere y\u00f6nelik kanunlarda genel \u00e7er\u00e7evenin \u00e7izildi\u011fi sonucuna ula\u015f\u0131lm\u0131\u015ft\u0131r.<\/p>\n
24. Kald\u0131 ki 657 say\u0131l\u0131 Kanun\u2019un kamu personel rejimini d\u00fczenleyen temel kanun niteli\u011fi ta\u015f\u0131mas\u0131 nedeniyle di\u011fer kamu g\u00f6revlilerine ili\u015fkin \u00f6zel kanunlarda h\u00fck\u00fcm bulunmayan hususlarda 657 say\u0131l\u0131 Kanun\u2019a at\u0131fta bulunulmak suretiyle an\u0131lan Kanun h\u00fck\u00fcmlerinin uygulanabilece\u011fi de tabiidir. Ancak bu t\u00fcr d\u00fczenlemeler yap\u0131l\u0131rken d\u00fczenlemeye konu kamu g\u00f6revlileri hakk\u0131nda Anayasa ile ortaya konulan ilke ve ayr\u0131mlar\u0131n kanun koyucu taraf\u0131ndan dikkate al\u0131nmas\u0131 gerekmektedir (AYM, E.2017\/33, K.2019\/20, 10\/4\/2019, \u00a7 26). Kanun koyucu takdir yetkisi i\u00e7indeki bu t\u00fcr d\u00fczenlemeleri yaparken Anayasa\u2019n\u0131n 2. maddesinde yer alan hukuk devleti ilkesinin bir gere\u011fi olan \u00f6l\u00e7\u00fcl\u00fcl\u00fck ilkesiyle ba\u011fl\u0131d\u0131r.<\/p>\n
25. \u00d6te yandan Anayasa\u2019n\u0131n 129. maddesinin ikinci f\u0131kras\u0131nda memurlar ve di\u011fer kamu g\u00f6revlileri ile kamu kurumu niteli\u011findeki meslek kurulu\u015flar\u0131 ve bunlar\u0131n \u00fcst kurulu\u015flar\u0131 mensuplar\u0131na savunma hakk\u0131 tan\u0131nmad\u0131k\u00e7a disiplin cezas\u0131 verilemeyece\u011fi h\u00fck\u00fcm alt\u0131na al\u0131narak ilgilinin savunma hakk\u0131 g\u00fcvence alt\u0131na al\u0131nm\u0131\u015ft\u0131r. An\u0131lan maddenin \u00fc\u00e7\u00fcnc\u00fc f\u0131kras\u0131yla da memurlar ve di\u011fer kamu g\u00f6revlileri hakk\u0131nda verilen disiplin cezalar\u0131n\u0131n yarg\u0131 denetimi d\u0131\u015f\u0131nda tutulmas\u0131 \u00f6nlenmi\u015ftir. Dolay\u0131s\u0131yla disiplin cezas\u0131 ile disiplin cezas\u0131na esas fiillerin somut olay\u0131n \u00f6zelli\u011fine g\u00f6re kanuna dayal\u0131 olarak idare taraf\u0131ndan belirlenmesi m\u00fcmk\u00fcn ise de idarenin disiplin cezas\u0131 ile bu cezay\u0131 gerektiren fiilin somut olay\u0131n ko\u015fullar\u0131na uygun olup olmad\u0131\u011f\u0131 hususunun yarg\u0131 denetimine tabi oldu\u011fu a\u00e7\u0131kt\u0131r.<\/p>\n
26. Di\u011fer yandan 657 say\u0131l\u0131 Kanun\u2019da d\u00fczenlenen disiplin cezalar\u0131 ve bu cezalara kar\u015f\u0131l\u0131k gelen fiiller de g\u00f6zetildi\u011finde s\u00f6zle\u015fmeli aile hekimleri ve s\u00f6zle\u015fmeli di\u015f hekimleri ile aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131 hakk\u0131nda an\u0131lan Kanun\u2019un ilgili h\u00fck\u00fcmlerinin uygulanmas\u0131nda \u00f6l\u00e7\u00fcs\u00fcz bir y\u00f6n bulunmad\u0131\u011f\u0131 gibi ayl\u0131ktan kesme cezas\u0131 ile kamu g\u00f6revlisi stat\u00fcs\u00fcnden gelmeyen s\u00f6zle\u015fmeli \u00e7al\u0131\u015fanlar i\u00e7in kademe ilerlemesinin durdurulmas\u0131 cezas\u0131n\u0131n al\u0131nmas\u0131 h\u00e2linde uygulanacak ceza i\u00e7in belirlenen kesinti miktarlar\u0131n\u0131n orant\u0131s\u0131z oldu\u011fu da s\u00f6ylenemez.<\/p>\n
27. A\u00e7\u0131klanan nedenlerle kurallar, Anayasa’n\u0131n 2. ve 128. maddelerine ayk\u0131r\u0131 de\u011fildir. \u0130tiraz\u0131n reddi gerekir.<\/p>\n
Kurallar\u0131n Anayasa\u2019n\u0131n 27. ve 130. maddeleriyle ilgisi g\u00f6r\u00fclmemi\u015ftir.<\/p>\n
IV. H\u00dcK\u00dcM<\/p>\n
24\/11\/2004 tarihli ve 5258 say\u0131l\u0131 Aile Hekimli\u011fi Kanunu\u2019nun 3. maddesine 14\/7\/2023 tarihli ve 7456 say\u0131l\u0131 Kanun\u2019un 13. maddesiyle eklenen on \u00fc\u00e7\u00fcnc\u00fc f\u0131kran\u0131n birinci, ikinci ve \u00fc\u00e7\u00fcnc\u00fc c\u00fcmlelerinin Anayasa\u2019ya ayk\u0131r\u0131 olmad\u0131klar\u0131na ve itiraz\u0131n REDD\u0130NE 25\/12\/2024 tarihinde OYB\u0130RL\u0130\u011e\u0130YLE karar verildi.<\/p>\n
Ba\u015fkan<\/p>\n
Kadir \u00d6ZKAYA<\/p>\n
Ba\u015fkanvekili<\/p>\n
Hasan Tahsin G\u00d6KCAN<\/p>\n
Ba\u015fkanvekili<\/p>\n
Basri BA\u011eCI<\/p>\n
\u00dcye<\/p>\n
Engin YILDIRIM<\/p>\n
\u00dcye<\/p>\n
R\u0131dvan G\u00dcLE\u00c7<\/p>\n
\u00dcye<\/p>\n
Yusuf \u015eevki HAKYEMEZ<\/p>\n
\u00dcye<\/p>\n
Y\u0131ld\u0131z SEFER\u0130NO\u011eLU<\/p>\n
\u00dcye<\/p>\n
Selahaddin MENTE\u015e<\/p>\n
\u00dcye<\/p>\n
\u0130rfan F\u0130DAN<\/p>\n
\u00dcye<\/p>\n
Kenan YA\u015eAR<\/p>\n
\u00dcye<\/p>\n
Muhterem \u0130NCE<\/p>\n
\u00dcye<\/p>\n
Y\u0131lmaz AK\u00c7\u0130L<\/p>\n
\u00dcye<\/p>\n
\u00d6mer \u00c7INAR<\/p>\n
\u00dcye<\/p>\n
Metin KIRATLI<\/p>\n
\u200bAnayasa Mahkemesi’nin 25\/12\/2024 tarihli, 2024\/90 esas – 2024\/233 karar say\u0131l\u0131 karar\u0131\u00a0Hukuki Haber<\/p>\n
Haberin Al\u0131nt\u0131land\u0131\u011f\u0131 Kaynak: www.hukukihaber.net<\/p>","protected":false},"excerpt":{"rendered":"
ANAYASA MAHKEMES\u0130 KARARI \u00a0 Esas Say\u0131s\u0131 : 2024\/90 Karar Say\u0131s\u0131 : 2024\/233 Karar Tarihi : 25\/12\/2024 R.G.Tarih-Say\u0131 : 12\/3\/2025-32839 \u00a0 \u0130T\u0130RAZ YOLUNA BA\u015eVURAN: Dan\u0131\u015ftay \u0130kinci Dairesi \u0130T\u0130RAZIN KONUSU: 24\/11\/2004 tarihli ve 5258 say\u0131l\u0131 Aile Hekimli\u011fi Kanunu\u2019nun 3. maddesine 14\/7\/2023 tarihli ve 7456 say\u0131l\u0131 Kanun\u2019un 13. maddesiyle eklenen; A. On \u00fc\u00e7\u00fcnc\u00fc f\u0131kran\u0131n birinci, ikinci ve \u00fc\u00e7\u00fcnc\u00fc c\u00fcmlelerinin, B. On d\u00f6rd\u00fcnc\u00fc f\u0131kran\u0131n, Anayasa\u2019n\u0131n 2., 7., 27., 128. ve 130. maddelerine ayk\u0131r\u0131l\u0131\u011f\u0131 ileri s\u00fcr\u00fclerek iptallerine karar verilmesi talebidir. OLAY: 30\/6\/2021 tarihli ve 31527 say\u0131l\u0131 Resm\u00ee Gazete\u2019de yay\u0131mlanan Aile Hekimli\u011fi S\u00f6zle\u015fme ve \u00d6deme Y\u00f6netmeli\u011fi\u2019nin 10. maddesinin iptali talebiyle a\u00e7\u0131lan davada itiraz konusu kurallar\u0131n Anayasa\u2019ya ayk\u0131r\u0131 oldu\u011fu kan\u0131s\u0131na varan Mahkeme, iptalleri i\u00e7in ba\u015fvurmu\u015ftur. I. \u0130PTAL\u0130 \u0130STENEN KANUN H\u00dcK\u00dcMLER\u0130 Kanun\u2019un itiraz konusu kurallar\u0131n da yer ald\u0131\u011f\u0131 3. maddesi \u015f\u00f6yledir: \u00a0\u201cPersonelin stat\u00fcs\u00fc, hak ve y\u00fck\u00fcml\u00fcl\u00fckleri Madde 3- Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131; Bakanl\u0131k veya di\u011fer kamu kurum veya kurulu\u015flar\u0131 personeli olan uzman tabip, tabip ve aile sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fan\u0131 olarak \u00e7al\u0131\u015ft\u0131r\u0131lacak sa\u011fl\u0131k personelini, kendilerinin talebi ve kurumlar\u0131n\u0131n veya Bakanl\u0131\u011f\u0131n muvafakat\u0131 \u00fczerine, 657 say\u0131l\u0131 Devlet Memurlar\u0131 Kanunu ile di\u011fer kanunlar\u0131n s\u00f6zle\u015fmeli personel \u00e7al\u0131\u015ft\u0131r\u0131lmas\u0131 hakk\u0131ndaki h\u00fck\u00fcmlerine ba\u011fl\u0131 olmaks\u0131z\u0131n, s\u00f6zle\u015fmeli olarak \u00e7al\u0131\u015ft\u0131rmaya veya bu nitelikteki Bakanl\u0131k personelini aile hekimli\u011fi uygulamalar\u0131 i\u00e7in g\u00f6revlendirmeye veya aile hekimli\u011fi uzmanl\u0131k e\u011fitimi veren kurumlarla s\u00f6zle\u015fme yapmaya yetkilidir. Aile sa\u011fl\u0131\u011f\u0131 …<\/p>","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27],"tags":[],"class_list":["post-35471","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hukukihaber"],"acf":[],"yoast_head":"\n