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Healthcare by numbers

The Turkish Ministry of Health is building some of the world’s largest hospitals to meet increasing healthcare demands as a result of a fast-growing population.

95,000Beds by 2023
£9.5bnPrivate investment
Client International lenders and development banks
ExpertiseLenders’ technical advisory, providing due diligence

Opportunity

The programme will renovate healthcare infrastructure throughout Turkey, bring together smaller hospitals under 38 integrated health campuses, and increase the quality and efficiency of the health service. The key challenge of these projects was liaising with the Ministry of Health and sponsors in a country new to PPP projects, to arrive at a contractual agreement (in particular, the service specifications and payment mechanism) that was in line with international PPP best practice for risk allocation, and therefore bankable for the international lenders.

Solution

Our infrastructure finance, investment transaction and health specialists from the UK collaborated closely with our team on the ground in Istanbul and really went the extra mile to meet every client’s expectations for face-to-face support. We worked with the Ministry, sponsors and their advisors to develop a commercial solution where the risk profile would be acceptable to the lending community. We advised sponsors on their environmental and social due diligence, which was essential to meet the standards, public disclosure and consultation requirements of lenders
such as the International Finance Corporation, the European Bank for Reconstruction & Development and the Overseas Private Investment Corporation.

Outcome

We have been instrumental in assisting sponsors and the Ministry of Health to move forward towards a commercial solution that will meet the expectations of international and Turkish lenders alike. To date, six of our 12 projects have successfully reached financial close. In 2015, building began on the Bilkent Integrated Healthcare Campus, the world’s largest greenfield healthcare scheme covering over 1.2M sq m, providing 3804 beds and parking for 7209 vehicles.

It will include over 100 operating theatres and is expected to treat around 35,000 patients per day and employ approximately 8000 staff. Early in 2016, the Etlik Integrated Healthcare Campus, also one of the world’s largest hospitals with 3577 beds across more than 1M sq m, received the green light for construction to start.

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