Agencies and facilitators in health tourism: who is liable when things go wrong?

Most patients from the UK do not come to a clinic in Antalya directly, but through an agency: a website with an English-speaking contact, an Instagram profile, a WhatsApp number, an all-inclusive package with airport transfers, hotel and interpreter. That is convenient – and often perfectly reputable. But it raises a question that few people ask before booking: if something goes wrong, who is actually responsible?

This guide explains the different types of facilitator, who is liable for what, what the Turkish regulation of 2025 requires of agencies and how to recognise a reputable one.

Three kinds of “agency”

The word “agency” is used for very different providers. Legally, it makes a big difference who you are dealing with:

1. The pure intermediary

The agency puts you in touch with the clinic, forwards photos and enquiries and helps arrange the date. You conclude the treatment contract directly with the clinic, which also issues the invoice. The agency receives a commission from the clinic or a fee from you.

Liability: the clinic is liable for the treatment. The intermediary is liable only for its own intermediary activity – for example if it knowingly gives you false information about the clinic.

2. The package provider

The agency sells you an overall package in its own name: surgery, clinic, hotel, transfers, interpreter. You pay the agency, the agency pays the clinic. Only the agency is named in the contract.

Liability: here the agency is your contractual partner for the whole package – under Turkish law in principle also for the services it has provided through third parties (clinic, hotel). For the treatment itself, the liability of the clinic and doctor additionally comes into play, and you can claim against them directly.

3. The clinic’s own department

Some “agencies” are in fact the international patient department of a clinic, or a company owned by the clinic. Then the clinic is effectively your counterpart.

Liability: the clinic is liable – for treatment and organisation.

How to tell which type you are dealing with

Question	Intermediary	Package provider
Who issues the invoice for the surgery?	The clinic	The agency
Who confirms the surgery date in writing?	The clinic	The agency
Who is named in the contract as the service provider?	The clinic	The agency
Who do you pay?	The clinic	The agency

Often the roles are not cleanly separated. Then the only answer is: clarify in writing before you pay.

Who is liable for what?

For the medical treatment

For treatment errors, failures to inform and organisational failures, the clinic and doctor are liable – in contract and in tort. An agency does not change that. Even if you only communicated with the agency, it was the doctor who treated you, and the doctor must work to the medical standard and inform you properly. More on this in our guide Medical malpractice in Türkiye.

For the package

Hotel, transfers, interpreter, scheduling: whoever promised these services in the contract is liable for them – the agency in the case of a package provider, the clinic or the respective provider in the case of a pure intermediary.

For the agency’s own mistakes

Regardless of the contract type, an agency can be liable for its own breaches of duty. Typical cases:

• False information: “The surgeon is a specialist in plastic surgery” – but he is not. “The clinic is authorised by the Ministry” – but it is not.
• Withholding important information: for example that the operation takes place in a different facility from the one advertised.
• Poor organisation: wrong dates, no interpreter during the consent discussion, return flight booked too early against the doctor’s advice.
• Misleading advertising: before-and-after pictures that are not from this clinic, or promises of guaranteed results.

Here the agency is liable for its own contribution – not for the treatment error as such.

If the agency chose the clinic

If the agency recommended a clinic or doctor to you without checking authorisation and qualifications, that can be a breach of duty in its own right. This applies especially if the agency advertises “vetted partner clinics”.

What the 2025 regulation requires of facilitators

With the Turkish Regulation on International Health Tourism of 2025, facilitators were made subject to comprehensive obligations for the first time. The key points:

• Authorisation: facilitators need an authorisation certificate (Yetki Belgesi), issued through the state body USHAŞ. It cannot be transferred.
• Registration: facilitators must be registered on the state platform HealthTürkiye and work with it.
• Only with authorised clinics: authorised clinics and facilitators are meant to work only with each other.
• Availability: facilitators must be reachable around the clock in at least two foreign languages.
• Information about their own services: the facilitator must inform patients and companions in detail about its services and obtain their consent.
• Itemised prices: the costs of accommodation, transport, transfers, interpreting and consultancy must be shown separately.
• Website: facilitators must have a foreign-language website; the name used there must match the authorisation.
• Evaluation: facilitators are assessed, among other things, on complaint rates and patient satisfaction.
• Responsibility by type of service: the regulation makes clear that clinic and facilitator are each responsible for the services they themselves provide – the clinic for the treatment, the facilitator for consultancy, organisation, accommodation and transfers.
• Emergency care: authorised facilities must treat emergencies without preconditions and without delay; payment is settled afterwards.
• Sanctions: in the event of breaches, the authorisation can be suspended or revoked – for example where patients are put at risk or documentation is inadequate.

For you this means: ask every agency for its authorisation – and have them send you proof. An agency without authorisation is acting in breach of the rules, and an authorised clinic should not really be working with it.

Agency in the UK, clinic in Türkiye

Many agencies are based in the UK or elsewhere in Europe. Then the law of your own country may apply to your contract with the agency – especially if the agency targets customers there. For the treatment in Türkiye, Turkish law and Turkish courts generally still apply.

This has a practical consequence: claims against the agency can under certain circumstances be pursued at home, claims against the clinic generally only in Türkiye. Whether and to what extent the agency has to answer for the clinic’s mistakes depends on what it took on contractually. Have both contracts checked separately.

Whether a clinic package with flights and hotel legally counts as a package holiday – with the corresponding protective rules – is not conclusively settled and depends on the individual case. Do not rely on it; rely on clear contractual arrangements.

Red flags with agencies

• No company name, no address, no legal notice – just a first name and a WhatsApp number.
• Payment to a private account or in cash to an employee.
• The clinic is only named after the deposit or changes shortly before the trip.
• No authorisation, or evasiveness when asked about it.
• Advice only from sales staff – no consultation with the surgeon before the operation.
• Several procedures “at a package price” without a medical assessment of whether that is sensible.
• Pressure: “only today”, “last date this month”.
• Reviews that all sound the same, or before-and-after pictures with no indication of where they come from.
• Return flight fixed in the package before the doctor has seen how you are healing.

How to protect yourself

1. Clarify the role: does the agency only make the introduction, or is it the contractual partner for the package? In writing.
2. Ask for the authorisation of both agency and clinic and check that the names match.
3. Two contracts, two invoices: ideally, conclude the treatment contract directly with the clinic and a separate contract for organisation and travel with the agency. That way it is clear who is responsible for what.
4. Establish direct contact with the clinic – the surgeon’s name, the clinic’s email, a consultation before surgery.
5. Have the prices itemised: what does the treatment cost, what does everything else cost?
6. Have an aftercare contact named – at the clinic, not just at the agency.
7. Keep everything in writing: quotes, promises, dated chat histories.

What belongs in the treatment contract is explained in our guide Your treatment contract with a Turkish clinic.

If there are problems

• Medical problems: contact the clinic and doctor directly. The agency can mediate, but it is not the medically responsible party.
• Organisational problems (hotel, transfer, date): contact the contractual partner for the package.
• False information from the agency: object in writing, secure evidence, set a deadline.
• Complaint: with authorised agencies you can contact the provincial health directorate; the complaint rate feeds into the facilitator’s evaluation.
• Legal steps: against the clinic generally in Türkiye; against an agency, depending on where it is based and the contract, possibly at home. Get advice before deadlines expire.

Read more

• Your treatment contract with a Turkish clinic: what to check
• Deposit refund? Cancelling a clinic package in Türkiye
• How to choose a reputable clinic in Türkiye