In the last quarter century, there have been worldwide changes in the way public institutions operate and are organised. These changes have impacted government staffing and employment strategies, and personnel promotion and evaluation approaches. Health care policies and the governments' roles and responsibilities in health care were transformed in the process, as much as the changes in the understanding of the public and the staffing system were reflected in the field of health care (Özkal Sayan & Küçük, 2012). In addition to these changes, health reforms that occurred due to demographic changes, technological developments, increased expectations, financial pressures and improved health have been implemented or, at least, discussed in almost all countries (Bostan & Çiftçi, 2016). Within this scope, the Turkish Ministry of Health (MoH) implemented health reforms under the name of Transformation in Health Program in 2003, leading to significant changes in the health care system (Bostan & Ağaç, 2019). Ever since, a rapid transformation has