Introduction
Public Private Partnership (“PPP”) is a cooperation agreement between public and private sectors for rendering of public services that are traditionally provided by the state and funded by taxpayers, and is characterized by sharing the investments, risks, liabilities and revenue between the cooperating parties. The economic challenges associated with supplying fundamental public services are shared with the private sector in order to assure public welfare1.
PPP as a model has been implemented in Turkey by the enactment of the Law on Realization of Certain Investments and Services through Build-Operate-Transfer Model since 1994, primarily in relation to airports and ports. The vast majority of PPP projects in Turkey are today implemented in health sector. Therefore, the main target of this paper is to give a general idea on how PPP projects work in building and renewing hospitals and to demonstrate the completed, ongoing and upcoming healthcare projects. Although it differs in nature with PPP, important Highway Projects to be built based on Build Operate Transfer (“BOT”) Model are also listed for the reader.
A. PUBLIC-PRIVATE PARTNERSHIP (PPP) MODEL IN TURKEY
In General
Public-Private Partnership model is an investment and service model of setting up a long-term contract based collaboration between the public and the private sector. Under PPP model, it is intended to provide faster and better services to society. Sharing risks is an attractive feature of the model for the private sector while gaining an alternative source for financing and provision of services are what make the model thus desirable for the public side.
In recent years, PPP projects have been preferable in very broad and various fields in the world such as hospitals, highways, infrastructure, defense, energy, airports, schools, prisons and so on. It also contains in itself alternative sub-models such as Build Operate Transfer.
When it comes to Turkey, the Public-Private-Partnership model is being widely used across the country
from infrastructure to energy projects. In a view to supplement its modern infrastructure with world- class projects, Turkey takes the second highest score in the World Bank’s Private Participation in Infrastructure Database’s (PPI Database) latest update after Brazil2. In comparison with the EU, Turkey is currently more enterprising than any other EU countries.
The Turkish Government now aims to repeat the success of the PPP model in the healthcare sector though City Hospital Projects which will give the private sector a much larger role in providing healthcare services.
Turkish Legislation on PPP Applications in Health Sector
Turkey is transforming its healthcare system to make it more efficient and cost-effective by utilizing the PPP model. The participation of the private sector in the health field is growing day by day.
Previously, PPP projects were governed by the Supplemental Article 7 of the Health Services Law No. 3359 and the Regulation on the Construction of Health Facilities in Return for Lease and the Renovation of Health Facilities in return for Management of Non-Medical Services and Areas. Afterwards, some actions of annulment were made against tenders which were realized under these laws. On the one hand, there were discussions about the unconstitutionality of this Supplemental Article 7 and so was of the Regulation. Supplemental Article 7 of Law No. 3359, on the other hand, was not detailed enough in some aspects. Therefore, a new Law was required to contain all principles and procedures thoroughly to be followed in PPP projects in health sector. Eventually, the Law on “Building and Renewal of Facilities and Procurement of Services through Public Private Partnership Mode” No. 6428 has been enacted and came into force with its announcement in the Official Gazette on March 9th, 2013. Afterwards, a subregulation entered into force on 9 May 2014 determining detailed the application of the Law No. 6428.
According to the Law No. 6428, the facility to be constructed on a land in the possession of the Treasury, would give an independent and continuous right of superficies to the contractor free of charge for a maximum period of 30 years – excluding the fixed investment term. The exact term of the contract shall be decided by the administrative authority3. Other than construction of a new facility, the Law No.6428 does also cover the procurements to be realized for the renewal of the existing facilities as well as procurements for consultancy services, R&D services and/or any other services that might require high technology or great financial resource4.
The contract to be concluded between the administrative authority and the private company shall be governed by private law5. The State Tender Law No. 2886 and the Public Tender Law No. 4734 shall therefore not be applied to the projects that are subject to the Law No. 64286. The contract price shall be determined taking into consideration the investment cost, the significance and the scope of the project, whether or not the general and medical equipment shall be provided by the private party, the profit of the contractor, whether or not the operation of services with regard to the facility that is subject to the investment and the operation of the commercial service areas within the facility shall be left to the private party7. No payment of the contract price shall be done before the completion of the construction work unless any provisions with regard to partial acceptance shall be agreed by the parties to the contract8.
The contractor/s shall establish a company (“special purpose vehicle”) as a form of a Joint Stock Company (Anonim Şirket) which shall be the party to the contract to be signed by and between the administration and the contractor as the successful bidder. The field of activity of this company shall be limited only to the subject of the contract9.
The private party itself shall obtain the whole financing of the contract10 and shall provide either % 3 of the fixed investment amount or 3% of the bid price as a provisional bond; 3 % of the bid price as the fixed guarantee and 1, 5 % of the bid price for and during the operation period after the completion of the fixed investment11. At least 20 % of the medical equipment, which is a part of the fixed investment, has to be home production according to the Law No.642812.
Turkish Law shall govern the disputes which might arise from the contract and the Turkish Courts shall have the jurisdiction over the disputes. However, the parties may also agree on arbitration for the settlement of disputes provided that the applicable law to the merits of the dispute is agreed as Turkish Law by the parties and Turkish International Arbitration Law No. 4686 is chosen as the applicable law to the conduct of the arbitration procedure13.One last very important issue for the dispute settlement is that the provision which says “the seat of arbitration shall be in Turkey” has been annulled from the Law to facilitate a much more unbiased alternative dispute settlement system for PPPs.
Contractor shall be liable for damages of third parties during the contract term14.The administrative authority shall control each and every step of the operations to be realized under the contract which may be done through a “controlling and administration system” to be established by the Ministry15. At the end of the concession period, the PPP project shall be transferred back to the administrative authority in a good condition, with zero costs, well-kept and without any burdens16.
The Contractor, upon the approval of the administrative authority, may transfer all its rights and obligations under the contract to another individual or a legal entity subject to private law who must also carry the conditions set forth in the Law No. 6248 upon which all the related contracts shall also be deemed to have been transferred to the new party17.
A written notice giving a reasonable amount of time shall be served to the private party to complete the works if it has not fulfilled its obligations during the designated construction period and the lenders shall also be informed of the situation. If the private party has not performed its obligations within the allotted period, the financial backer shall be offered by the administration a change in the shareholding structure of the private company to complete the remaining works. If this is not achieved, then the contract shall be terminated by the administration18. However, if the continuance of the project is impossible because of the failure of the private party, then, without offering any of the foregoing, the administration shall have the remaining works done to someone else on behalf of the private party. Besides, during the operation process, the administration shall terminate the agreement directly if the performance of the private party is below the performance score to be determined by the administration19.
The aim of the Law No. 6428 is to provide a unified and clear legal instrument to be applied for the PPP projects in health sector. Although the ongoing PPP projects are implemented only for building and renewing hospitals, it should be noted here that there is a lack of specialized care-homes for elderly, hospice services, and specialized facilities for kids and adults suffering from down syndrome or autism, where around the clock care is essential for life quality of the persons and PPP projects in these areas shall also be on the agenda of the Government once the ongoing projects are finalized.
B. PUBLIC – PRIVATE PARTNERSHIP (PPP) PROJECTS FOR HEALTHCARE FACILITIES IN TURKEY
1. Health Facility Projects with PPP Model of Which Tender Process is Completed
1.1. Kayseri Integrated Health Campus Project
Kayseri Integrated Health Campus is a health facility project to be made with public-private partnership model in Kayseri Province (Central Anatolia) and will have 1.583 bed capacity within its General Hospital, Maternity Hospital, Physiotherapy and Rehabilitation Hospital, Psychiatry Hospital and High Security Forensic Psychiatry Hospital. This Project’s construction period shall be three years and operation period shall be twenty-five years. Successful tenderer of this Project is YDA İnşaat Sanayi Ticaret A.Ş. & INSO Sıstemı Per Le Infrastrutture Socıalı S.P.A Joint Venture. Ministry of Health Directorate of Public Private Partnership and YDA İnşaat Sanayi Ticaret A.Ş. & INSO Sıstemı Per Le Infrastrutture Socıalı S.P.A Joint Venture signed the Contract on August 10, 2011. Annual rent will be 137.730.000 TL.
1.2. Elazığ Integrated Health Campus Project
Elazığ Integrated Health Campus is a health facility project to be made with public-private partnership model in Elazığ Province and will have 1.040 bed capacity within its District Hospital, Maternity and Children Hospital, Psychiatry Hospital, High Security Forensic Psychiatry Hospital. This Project’s construction period shall be three years and operation period shall be twenty-five years. Successful tenderer of this Project is “Sıla Dan. Bilş. Eğt. İnşaat Taah. ve Sağ. Hizm. Ltd. Şti – Şentürkler Müh. İnş. Taah. Turz. San. ve Tic. A.Ş. – Medikal Park Sağ. Hizm. A.Ş. Joint Venture. Ministry of Health Directorate of Public Private Partnership and Sıla Dan. Bilş. Eğt. İnşaat Taah. ve Sağ. Hizm. Ltd. Şti – Şentürkler Müh. İnş. Taah. Turz. San. ve Tic. A.Ş. – Medikal Park Sağ. Hizm. A.Ş.”. Joint Venture signed the Contract on June 04, 2013. The annual rent will be 94.837.104 TL.
1.3. Ankara Etlik Integrated Health Campus Project:
Ankara- Etlik Integrated Health Campus is a health facility project to be made with public-private partnership model in Ankara Province on 1.400.000 m² land and will have 3.566 bed capacity within its District Hospital, Cardiovascular Diseases Hospital, Orthopaedics and Neurosciences Hospital, Oncology Hospital, Maternity Hospital, Children Hospital, Rehabilitation Hospital, Psychiatry Hospital, High Security Forensic Psychiatry Hospital. This Health Campus will also include Health Sciences University, Congress Centres, Trading Areas, High Technology Centre and Research and Development Centre. This Project’s construction period shall be three and a half years and operation period shall be twenty-five years. The final tender was made on June 30, 2011. Successful tenderer of this Project is “Astaldi SPA – Türkerler İnş. Turz. Mad. Enrj. Üretim Tic. San. A.Ş. Joint Venture”. Ministry of Health Directorate of Public Private Partnership and Astaldi SPA – Türkerler İnş. Turz. Mad. Enrj. Üretim Tic. San. A.Ş. Joint Venture signed the Contract on March 05, 2012. The annual rent will be 276.000.000 TL.
1.4. Ankara Bilkent Integrated Health Campus Project:
Ankara Bilkent Integrated Health Campus is a health facility project to be made with public-private partnership model in Ankara Province on 1.200.000 m² land and will have 3.660 bed capacity within its District Hospital, Cardiovascular Diseases Hospital, Orthopaedics and Neurosciences Hospital, Oncology Hospital, Maternity Hospital, Children Hospital, Rehabilitation Hospital, Psychiatry Hospital and High Security Forensic Psychiatry Hospital. This Health Campus will also include Health Sciences University, Congress Centres, Trading Areas, High Technology Centre and Research and Development Centre. This Project’s construction period shall be three and a half years and operating period shall be twenty-five years. Final tender was made on October 10, 2011. Successful tenderer of this Project “Ic İçtaş İnşaat San.Tic. A.Ş. – Dia Holding Fzco Joint Venture”. The annual rent will be 240.000.000 TL.
1.5. İstanbul Başakşehir İkitelli Integrated Health Campus Project:
İstanbul Başakşehir Integrated Health Campus is a health facility project to be made with public- private partnership model in İstanbul Province and will have 2.680 bed capacity within its District Hospital, Oncology Hospital, Children Hospital, Maternity Hospital, Cardiovascular Diseases Hospital, Orthopaedics and Neurosciences Hospital, Psychiatry Hospital and Physiotherapy and Rehabilitation Hospital. This Project’s construction period shall be three years and operating period shall be twenty-five years. Final tender was made on March 15, 2012. Successful tenderer of this Project is “ Emsaş İnş. Tur. Tic. ve San. A.Ş. – PBK Architects Inc. – Ascension Group Architects LP – Allen Shariff Corparation & Meinhardt Group – May Eczane – Sürat Bilişim – Forcimsa Emprasa Constructora S.A. – Consortio International Eng. Consult – Şahin Tıp Joint Venture”. The annual rent will be 258.900.000 TL.
1.6 Yozgat Education and Research Hospital Project:
Yozgat Education and Research Hospital Project is a health facility project to be made with public- private partnership model in Yozgat Province and will have 475 bed capacity. This Project’s construction period shall be two years and operating period shall be twenty-five years. Final tender was made on November 23, 2011. Successful tenderer of this Project is “Sıla Danışmanlık Bilişim Eğt.İnş.Taah.Tic. ve Sağlık Hizmetleri Ltd.Şti -Rönesans Holding A.Ş.-Rönesans Medikal Yatırımları A.Ş.-Şam Yapı San. Ve Tic. Ltd.Şti. – Şentürkler Müh. Müt.İnş.Taah.Tur.veTic.A.Ş Joint Venture”. The annual rent will be 54.750.000 TL.
1.7. Public Health Agency of Turkey & Drug and Medical Device Institution of Turkey Campus Project:
Public Health Agency of Turkey and Drug and Medical Device Institution of Turkey Campus is a high technology health facility project to be made with public-private partnership model in Ankara Province and will consist of one Customer Safety Reference Laboratory Building, two Infection Disease Reference Laboratory Buildings, two Drug and Medical Device Analysis and Control Laboratory Buildings, one Research and Reference Laboratory Building including Biosecurity Level 3 (BSL-3-P3) and Biosecurity Level 4 (BSL-4-P4) Units, one Experimental Animals Production, Test and Research Building, Public Health Agency of Turkey Administrative Building, Drug and Medical Device Institution of Turkey Administrative Building, Data Centre, Social Facility and Technical Facility. This Project’s construction period shall be three years and operation period shall be fifteen years. Final tender was made on June 14, 2013. Successful tenderer of this Project is “Yıldızlar İnş.ve Tic. A.Ş.”. Ministry of Health Directorate of Public-Private Partnership and Yıldız İnş.ve Tic. A.Ş. signed the Contract on September 12, 2013.
1.8. Mersin Integrated Health Campus Project:
Mersin Integrated Health Campus is a health facility project to be made with public-private partnership model in Mersin Province and will have 1.250 bed capacity within its District Hospital, Cardiovascular Diseases Hospital, Oncology Hospital, Maternity and Children Hospital, and Psychiatry Hospital. This Project’s construction period shall be three years and operation period shall be twenty-five years. Final tender was made on May 11, 2012. Successful tenderer of this Project is “Yda İnş. San. ve Tic. A.Ş. & Inso Sıstemı Per Le Infrastrutture Socıalı S.P.A. Joint Venture”. The annual rent will be 140.900.000 TL.
1.9. Manisa Education and Research Hospital Project:
Manisa Education and Research Hospital is a health facility project to be made with public-private partnership model in Manisa Province and will have 558 bed capacity. The construction period shall be three years and operation period shall be twenty-five years. Final tender was made on October 05, 2011. Successful tenderer of this Project is “YDA İnş. San. ve Tic. A.Ş. & Inso Sıstemı Per Le Infrastrutture Socıalı S.P.A. Joint Venture”. The annual rent will be 64.250.000 TL.
1.10. Konya Karatay Integrated Health Campus Project:
Konya Karatay Integrated Health Campus is a health facility project to be made with public-private partnership model in Konya Province and will have 840 bed capacity within its District Hospital, Maternity and Children Hospital. This Project’s construction period shall be three years and operation period shall be twenty-five years. Final tender was made on January 30, 2012. Successful tenderer of this Project is “Yda İnş. San. ve Tic. A.Ş. & Inso Sıstemı Per Le Infrastrutture Socıalı S.P.A. Joint Venture”. The annual rent will be 88.791.634 TL.
1.11. Gaziantep Integrated Health Campus Project:
Gaziantep Integrated Health Campus is a health facility project to be made with public-private partnership model in Gaziantep Province and will have 1.875 bed capacity within its District Hospital, Oncology Hospital, Maternity and Children Hospital, Cardiovascular Diseases Hospital, Psychiatry Hospital, High Security Forensic Psychiatry Hospital and Physiotherapy and Rehabilitation Hospital. This Project’s construction period shall be three years and operation period shall be twenty-five years. Final tender was done on November 01, 2012. Successful tenderer of this Project is “Samsung C&T Corporation – Kayı İnş. San. ve Tic. A.Ş. – Salini S.P.A. – Simed International B.V. – Studio Altieri Spa – HAN Teknik Müşavirlik Mühendislik Mimarlık A.Ş. Joint Venture”.
1.12. PTR, Psychiatry and High Security Forensic Psychiatry Hospitals Project:
PTR, Psychiatry and High Security Forensic Psychiatry Hospitals is a health facility project to be made with public-private partnership model in Afyon, Diyarbakır, Erzurum, İstanbul-Bakırköy, Malatya, Samsun, Trabzon and Van Provinces and will have 2.400 bed capacity in total. This Project’s construction period shall be two years and operation period shall be twenty-five years for all. Final bids were submitted on December 14, 2012. Successful tenderer of this Project is “Sıla Dan.Bilş.Eğt.İnş.Taah.Tic.ve Sağ.Hizm.Ltd.Şti.-Şentürkler Müh. İnş. Taah. Turzm. San. Ve Tic. A.Ş.- Ş.A.M Yapı San. Ve Tic Ltd.Şti-Rönesans Medikal Yatırımları A.Ş.-Rönesans Holding A.Ş. Joint Venture”.
1.13. Adana Integrated Health Campus Project:
Adana Integrated Health Campus is a health facility project to be made with public-private partnership model in Adana Province on 436.750 m2 land and will have 1.550 bed capacity within its District Hospital, Oncology Hospital, Maternity and Children Hospital, Cardiovascular Diseases Hospital, High Security Forensic Psychiatry Hospital, and Physiotherapy and Rehabilitation Hospital. This project’s construction period shall be three years and operation period shall be twenty-five years. Final tender was made on October 05, 2012. Successful tenderer of this Project is “Sıla Danışmanlık Bilişim Eğitim İnşaat Taahhüt Ticaret ve Sağlık Hizmetleri Limited Şirketi – Şentürkler Mühendislik İnşaat Taahhüt Turizm Sanayi ve Ticaret A.Ş. – Rönesans Holding A.Ş. – Rönesans Medikal Yatırımları A.Ş. – Şam Yapı Sanayi ve Ticaret Ltd. Şti. Joint Venture”. The annual rent will be 115.500.000 TL.
1.14. İzmir Bayraklı Integrated Health Campus Project:
İzmir Bayraklı Integrated Health Campus is a health facility project to be made with public-private partnership model in İzmir Province and will have 2.060 bed capacity within its General Hospital, Maternity and Children Hospital, Cardiovascular Surgery Hospital, Oncology Hospital, Physiotherapy and Rehabilitation Hospital, Psychiatry Hospital and High Security Forensic Psychiatry Hospital. This project’s construction period shall be three years and operation period shall be twenty-five years. Final tender was made on December 10, 2012. Successful tenderer of this Project is “Türkerler İnş. Tur. Madencilik Enerji Üretim Tic. ve San. A.Ş.-Gama Holding A.Ş. Joint Venture”.
1.15. Isparta City Hospital Project:
Isparta City Hospital is a health facility project to be made with public-private partnership model in Adana Province on 180.000 m2 land and will have 755 bed capacity within its General Hospital and Maternity and Children Hospital. This Project’s construction period shall be two years and operation period shall be twenty-five years. Final tender was made on February 22, 2013. The successful tenderer of this Project is “Akfen İnş. Tur. ve Tic. A.Ş.”. Ministry of Health Directorate of Public- Private Partnership and Akfen İnş. Tur. Ve Tic. A.Ş. signed the Contract on September 12, 2013.
1.16. Bursa Integrated Health Campus Project:
Bursa Integrated Health Campus is a health facility project to be made with public-private partnership model in Bursa Province and will have 1.355 bed capacity within its District Hospital, Cardiovascular Diseases Hospital, Oncology Hospital, Psychiatry Hospital, High Security Forensic Psychiatry Hospital and Physiotherapy and Rehabilitation Hospital. This Project’s construction period shall be three years and operation period shall be twenty-five years. Final tender was made on December 06, 2012. Successful tenderer of this Project is “Şentürkler Müh. Müteahhitlik İnş. Taahhüt Turizm Sanayi ve Ticaret A.Ş. – Sıla Danışmanlık Bilişim Eğitim İnş. Taahhüt Tic. ve Sağlık Hizmetleri Limited Şirketi – Medical Park Sağlık Hizmetleri A.Ş. Joint Venture”.
1.17. Kocaeli Integrated Health Campus Project:
Kocaeli Integrated Health Campus is a health facility project to be made with public-private partnership model in Kocaeli Province on 226.626 m2 land and will have 1.180 bed capacity within its District Hospital, Oncology Hospital, Maternity and Children Hospital, Cardiovascular Diseases Hospital, High Security Forensic Psychiatry Hospital and Physiotherapy and Rehabilitation Hospital. This Project’s construction period shall be three and operation period shall be twenty-five years. Final tender was made on May 15, 2013. Successful tenderer of this Project is “Gama Holding A.Ş.- Türkerler İnş. Turz. Mad. En. Ür. Tic. ve San. A.Ş. Joint Venture”.
1.18. Eskişehir Integrated Health Campus Project:
Eskişehir Integrated Health Campus is a health facility project to be made with public-private partnership model in Eskişehir Province and will have 1.081 bed capacity within its General Hospital, Oncology Hospital, Cardiovascular Diseases Hospital and High Security Forensic Psychiatry Hospital. This Project’s construction period shall be two years and operation period will be twenty-five years. Final tender was made on December 26, 2014. Successful tenderer of this Project is “Akfen İnş. Tur. Tic. A.Ş.”.
2. Health Campus Projects with PPP of Which Tender Process is Not Completed
2.1.Kütahya Health Campus Project:
Kütahya Health Campus is a health facility project to be made with public-private partnership model in Kütahya Province and will have 600 bed capacities within its Public Hospital and Physiotherapy and Rehabilitation Hospital. This Project’s construction period shall be two years, if extension is granted, shall be maximum three years and operation period shall be twenty-five years. Preliminary qualification tender has already been announced. Tender process has not been concluded yet.
2.2 Şanlıurfa Health Campus Project:
Şanlıurfa Health Campus is a health facility project to be made with public-private partnership model in Şanlıurfa Province and will have 1.700 bed capacity within its Education and Research Hospital, Maternity and Children Hospital, Cardiovascular Hospital, Oncology Hospital, Rehabilitation Hospital and Psychiatry Hospital. This Project’s construction period shall be three years, if extension is granted, shall be maximum four years and operation period shall be twenty-five years. The tender is currently at the decision phase.
2.3. Samsun Health Campus Project:
Samsun Health Campus is a health facility project to be made with public-private partnership model in Samsun and will have 900 bed capacity within its Maternity and Children Hospital, Cardiovascular Surgery and Chest Diseases Hospital and Oncology Hospital. This Project’s construction period shall be two and a half years, if extension is granted, shall be maximum three and a half years and operation period shall be twenty-five years. Preliminary qualification tender has already been announced. Tender process has not been concluded yet.
2.4. Denizli Health Campus Project:
Denizli Health Campus Project is a health facility project to be made with public-private partnership model in Denizli Province and will have 1.000 bed capacity within its General Hospital, Maternity and Children Hospital, Oncology Hospital, Cardiovascular Diseases Hospital, Psychiatry Hospital. This Project’s construction period shall be two and a half years, if extension is granted, shall be maximum three and a half years and operation period shall be twenty-five years. Preliminary qualification tender has already been announced. Tender process has not been completed yet.
2.5. Tekirdağ Health Campus Project:
Tekirdağ Health Campus is a health facility project to be made with public-private partnership model in Tekirdağ Province and will have 480 bed capacity within its General Hospital, Ambustion Hospital, Maternity and Children Hospital, Newborn Intensive Care Unit. This Project’s construction period shall be two years, if extension is granted, shall be three years and operation period shall be twenty- five years. The tender is currently at the decision phase.
2.6. Istanbul Bakırköy Integrated Health Campus Project:
İstanbul Bakırköy Integrated Health Campus is a health facility project to be made with public-private partnership model in İstanbul Province and will have 1.043 bed capacity within its Maternity and Children Hospital, Cardiovascular Diseases Hospital and Oncology Hospital. This Project’s tender is subject to the procedure of “tender to predetermined bidders”.
3. Upcoming Projects20
3.1. İzmir Yenişehir (Tepecik) City Hospital Project:
İzmir Yenişehir (Tepecik) City Hospital is a health facility project to be made with public-private partnership model in İzmir Province and will have 1.200 bed capacities. Tender preparation process is still proceeding.
3.2 Aydın Physiotherapy and Rehabilitation Hospital Project:
Aydın Physiotherapy and Rehabilitation Hospital is a health facility project to be made with public- private partnership model in Aydın Province and will have 150 bed capacities. Tender preparation process is still proceeding.
3.3. İstanbul Sancaktepe City Hospital Project:
İstanbul Sancaktepe City Hospital is a health facility project to be made with public-private partnership model in İstanbul and will have 3.800 bed capacities. This Project is still under approval process of High Planning Council.
3.4. Antalya City Hospital Project:
Antalya City Hospital is a health facility project to be made with public-private partnership model in Antalya Province and will have 1.000 bed capacities. This Project is still under approval process of High Planning Council.
3.5. Diyarbakır Kayapınar Hospital Project:
Diyarbakır Kayapınar Hospital is a health facility project to be made with public-private partnership model in Diyarbakır Province and will have 750 bed capacities. This Project is still under approval process of High Planning Council.
3.6. Diyarbakır Yenişehir City Hospital Project:
Diyarbakır Yenişehir City Hospital is a health facility project to be made with public-private partnership model in Diyarbakır Province and will have 705 bed capacities. This Project is still under approval process of High Planning Council.
3.7. Aydın City Hospital Project:
Aydın City Hospital is a health facility project to be made with public-private partnership model in Aydın Province and will have 800 bed capacities. This Project is still under approval process of High Planning Council.
3.8. Ordu City Hospital Project:
Ordu City Hospital is a health facility project to be made with public-private partnership model in Ordu Province and will have 600 bed capacities. This Project is still under approval process of High Planning Council.
3.9. Kahramanmaraş Public Hospital Project:
Kahramanmaraş Public Hospital is a health facility project to be made with public-private partnership model in Kahramanmaraş Province and will have 500 bed capacities. This Project is still under approval process of High Planning Council.
3.10. Bartın Public Hospital Project
Bartın Public Hospital is a health facility project to be made with public-private partnership model in Bartın Province and will have 500 bed capacities. This Project is still under approval process of High Planning Council.
3.11. Trabzon City Hospital Project:
Trabzon City Hospital is a health facility project to be made with public-private partnership model in Trabzon Province and will have 600 bed capacities. Pre-feasibility studies of this Project are still proceeding.
C. HIGHWAY PROJECTS WITH BUILD OPERATE TRANSFER (BOT) MODEL IN TURKEY
1. Upcoming Highway Projects with Build Operate Transfer Model of Which the Tender is Expected to be Announced in the First Quarter of 2016
1.1. Kınalı – Odayeri Part of the Northern Marmara Highway (European Side):
Total length of this highway will be 149 km. The tender of this Project is expected to be announced in the first quarter of 2016.
1.2. Kurtköy – Akyazı Part of the Northern Marmara Highway (Asian Side):
Total length of this highway will be 187 km. The tender of this Project is expected to be announced in the first quarter of 2016.
2. Upcoming Highway Projects with Build Operate Transfer Model of Which are Under the Approval Process of the Ministry of Development
2.1. Ankara – Niğde Highway Project:
Total length of this highway will be 330 km. This project is particularly important since this is the only non-highway part of the main corridor from Edirne (Greek Border) to Şanlıurfa (Syrian Border).
2.2. Ankara – Kırıkkale – Delice Highway Project:
Total length of this highway will be 119 km. Being an important part on the west-east corridor, this highway will also serve Kayseri one of the most important industrialized cities in Anatolia.
2.3. Çiğli – Aliağa – Çandarlı Highway Project:
Total length of this highway will be 76 km. This project takes its significance from serving in Çandarlı/İzmir transhipping port which will be largest in Turkey upon completion.
2.4.Kınalı – Tekirdağ – Çanakkale – Balıkesir Highway Project:
Total length of this highway will be 352 km. This Project shall be contracted under two different tenders: (1) Çanakkale Suspension Bridge (52 km) and (2) the main highway (300 km). After three bridges connecting Europe and Asia on the Bosporus, Canakkale Suspension bridge in the Dardanelles shall be the fourth connecting two continents which is expected to relieve the traffic on Istanbul’s Bosporus bridges.
3. Targeted Highway Projects with Build Operate Transfer Model within the 2023 Vision
- Yalova – İzmit Highway Project
- Antalya – Alanya Highway Project
- Ankara – Sivrihisar Highway Project
- Mersin – Silifke (Taşucu) Highway Project
- Şanlıurfa – Diyarbakır – Habur Highway Project
- Aydın – Denizli – Burdur Highway Project
- Delice – Samsun Highway Project
- Sivrihisar – İzmir Highway Project
- Afyonkarahisar – Burdur – Antalya Highway Project
- Sivrihisar – Bursa Highway Project
- Gerede – Merzifon Highway Project
- Merzifon – Gürbulak Highway Project
CONCLUSION
PPP projects are originated from the need for additional finance under the ongoing economic program. Through this method, implementation of the projects is conducted much faster, operation and construction costs would reduce and enhanced public management system is provided. Additionally, private sector’s managerial skill is transferring to public services.
PPP method is also criticized since the capacity of the state in delivering services decreases, public funding are wasted and all these result in a sort of reduction of confidence of the society against the government. PPP method is sometimes is interpreted by the society as an alternative and allure way of privatization. However, it is also argued that these prejudices are resulting from uncertainty about the outcomes of PPP projects. Currently there is not any completed PPP project which would decrease people’s concern.
The fundamental problem of the PPP applications in Turkey is that it lacks central administrative structure for the PPP projects. As mentioned above, previously PPP projects in health sector were governed by the Supplemental Article 7 of the Health Services Law No. 3359 and the Regulation on the Construction of Health Facilities in Return for Lease and the Renovation of Health Facilities in return for Management of Non-Medical Services and Areas. Since this Law were not detailed enough, the Law on “Building and Renewal of Facilities and Procurement of Services through Public Private Partnership Mode” No. 6428 has been enacted and came into force. However, it only covers the PPP projects for healthcare facilities. Therefore, this law cannot supply the lack of general regulation about PPP.
It can be suggested that, enacting a new comprehensive PPP law in order to extend the scope in terms of the applicable PPP models and sectors and establishing a central public body responsible for coordinating the PPP process, policy setting and improving the institutional capacity of the implementing organizations would resolve people’s concerns about PPP and assist to carry out the PPP projects more secure.
In conclusion, PPP model, one way or another, would provide to ensure efficiency in the delivery of public services much faster and much qualified consequences of which the society as the end user would benefit from.
1 Gönenç Gürkaynak Esq, Tunç Lokmanhekim, Turkey: Legal Framework of Public Private Partnership Projects in Turkey, http://www.mondaq.com/turkey/x/230474/Government+Contracts+Procurement+PPP/Legal+Framework+Of+Public+Private+Partnership+Projec ts+In+Turkey. (Accessed 07.11.2015).
2 http://www.invest.gov.tr/en-US/infocenter/news/Pages/100615-turkey-ranks-second-in-ppp-infrastructure-projects.aspx (Accessed 07.11.2015).
3 Law No. 6428 Article 4 (1).
4 Law No. 6428 Article 1 (1) and 4 (2,3).
5 Law No. 6428 Article 4 (1).
6 Law No. 6428 Article 11.
7 Law No. 6428 Article 5 (1).
8 Law No. 6428 Article 5 (2).
9 Law No. 6428 Article 1 (2).
10 Law No. 6428 Article 6 (1).
11 Law No. 6428 Article 3 (12).
12 Law No. 6428 Article 3 (16).
13 Law No. 6428 Article 4 (11).
14 Law No. 6428 Article 4 (2).
15 Law No. 6428 Article 4(4).
16 Law No. 6428 Article 4(3).
17 Law No. 6428 Article 4(5) .
18 Law No. 6428 Article 4(6).
19 Law No. 6428 Article 4(7) .
20 These projects are expected to be announced in the Turkish Official Gazette within three or four months.
