Managing expectations with emotional accountability: making City Hospitals accountable during the COVID-19 pandemic in Turkey

Abstract

Purpose: This paper explores the role of the COVID-19 pandemic in the financial and parliamentary accountability mechanisms of public-private partnership (PPP) “City Hospitals” in Turkey. Diverse and changing accountability mechanisms are explored regarding budgetary, affordability and emotions during the COVID-19 pandemic. Design/methodology/approach: This is a case study of City Hospitals in Turkey. Empirical data are collected and analyzed qualitatively from publicly available government and related sources, Turkish National Audit reports (Sayistay), strategic healthcare investment plans, relevant laws, decrees and NGO reports and news articles. Findings: Existing accountability mechanisms for arranging and/or delivering value-for-money (VfM) in Turkish PPP hospitals are weak. This provided policy makers with more flexibility to manage expectations of its citizens in dealing with COVID-19 pandemic. Political decision makers, through PPPs, created political capital for themselves by engaging in emotional accountability at the expense of better financial and parliamentary accountability. Originality/value: This article contributes to the literature by articulating how roles of accountability change in crisis and introduces the concept of emotional accountability during a period of heavy infrastructure investments in City Hospitals in Turkey.