Expansion in coverage was accompanied by health spending growth well above other OECD countries, averaging 7.7% since 2002. As a share of GDP, health spending in Turkey went from 5.4% in 2002 to 6.1% in 2008. The training of new physicians as family physicians and retraining of existing GPs into the speciality have been national priorities. The introduction of a pay penalty for doctors not delivering a basic set of child and maternal health services led to remarkable improvements in the delivery of these services.