family physicians for example have no budgetary oversight over the nurses working under their supervision whilst strongly divergent views between government and professional groups are not unique to turkey consensus has had a notably minor role in steering refonn in turkey the turkish medical association remains opposed to the htp especially as payment arrangements place considerable pressure on doctors to deliver higher volumes of services although some elementary selfregulation of the medical profession is in place strong disagreements exist between the profession as represented by the turkish medical association turkish nurses association and turkish midwives association and the government on mutual roles and responsibilities while the ministry of health is taking some such steps to devolve responsibility for example by devolving the responsibility for delivering hospital services progress on shifting focus to its regulatory oversight and quality governance functions has been rather slow