PPP EXPERIENCES IN TURKEY

Asuman SÖYLEMEZDirecteur Général Adjoint

SILA GROUP COMPANY

GROUP

SERVICES

OCC.SAFETY

CONSULTANCY

MANAGING

I

INVST.

REAL ESTATE

IMAGING

SILA GROUP

I- HOSPITAL CONSTRUCTIONII- HOSPITAL MANAGEMENT&OPERATIONAL SERVICESIII- HOSPITAL CONSULTANCY

I-HOSPITAL CONSTRUCTION

-SILA GROUP FINALIZED A LOT OF HOSPITAL CONSTRUCTION PROJECTS

- IN PRESENT SILA GROUP CONSTRUCTING HUGE HOSPITALS IN COLLABORATION WITH CONSORTIUM PARTNERS ALSO WITH PPP MODELSILA CONSORTIUM PARTNERS;

-RÖNESANS -MERIDIAM-ŞAM

SILA CONSORTIUM CONSTRACTION PROJECTS

PPP OF TURKEY

TOTAL 7.000 BED CAPACITY

ADANA PPP HOSPITAL PROJECT

BED CAPACTY1.550

CLOSED AREA

540.000 m2

*

ELAZIĞ PPP HOSPITAL PROJECT

BED CAPASTY

1.038

CLOSED AREA

356.000 m2

*

BURSA PPP HOSPITAL PROJECT

BED CAPACITY

1.355

CLOSED AREA

460.000 m2

*

YOZGAT PPP HOSPITAL PROJECT

BED CAPASTY

475CLOSED ARE

142.000 m2

*

PHYSIOTERAPHY & PSYCHIATRY PPP HOSPITAL PROJECT

BED CAPACITY

2.400 750.000 m2

CLOSED AREA

PHYSIOTERAPHY

900BED

CAPACITY

*FTR Fizik Tedavi Rehabilitasyon Hastanesi

PSYCHIATRY

1500 BED

CAPACITY

*PH Psikiyatri Hastanesi

*

OTHER HOSPITAL CONSTRUCTION PROJECTS

-AKAY HOSPITAL PROJECT/ ANKARA

-ÇAĞ HOSPITAL/ ANKARA-GYNECOLOGY HOSPITAL/ELAZIĞ-DENTAL HOSPITAL/ELAZIĞ-ORTHOPEDIA & PHYSIOTERAPHY HOSPITAL /ISTANBUL-MILITARY HOSPITAL/BAGHDAT-ANKARA MEDICAL CENTER/BAKU-GAZI UNIVERSITY DENTAL HOSPITAL/ANKARA-UNIVERSITY HOSPITAL/HUMUS SYRIA

……AND OTHER SIMILAR MEDICAL CENTERS & HOSPITALS

II-HOSPITAL MANAGEMENT & OPERATIONAL SERVICES

TURKEY

IRAQ

AZERBAIJAN,

GEORGIA,

CYPRUS,

NETHERLAND,

ITALY

ANKARA MEDICAL CENTER (BAKU/AZERBAIJAN)

PHYSIOTERAPHY CENTER (KEÇİÖREN )PHYSIOTERAPHY CENTER (ÜMİTKÖY )

TRAINING AND RESEARCH HOSPITAL(KEÇİÖREN ANKARA)

GAZI UNIVERSITY DENTAL HOSPITAL/ANKARA

500 BEDS GERIATRIC CARE CENTER(ISTANBUL DARULACEZE)

PHYSIOTERAPHY AND REHABILITATION HOSPITALKOZAKLI/CAPPADOCIA

III-HOSPITAL CONSULTANCYMEDOFAS CONSULTANCY CO/ SILA GROUP

PROJECT CONSULTANCY

DESIGNING CONSULTANCY

HOSPITAL CONSTRUCTION CONSULTANCY

HOSPITAL MANAGEMENT&OPERATIONAL CONSULTANCY

SILA CONSULTANCY TEAM

3-HOSPITAL CONSULTANCY

PROJECT CONSULTANCYTARGET

*RIGHT PROJECT

* RIGHT BUDGET

*RIGHT OFFER

HOSPITAL PROJECT AND ARCHITECTURE IS A FIELD OF SPECIALTY

RIGHT PRICING, PRODUCTIVITY, QUALITY SERVICE, STAFF

PATIENT COMFORT IS ONLY POSSIBLE WITH THE RIGHT PROJECT

• THERE IS A NEED FOR AN URGENT REFORM AND A BIG CHANGE IN THE HEALTH SECTOR IN TURKEY

• WORN OUT PUBLIC HOSPITALS ALWAYS NEED FINANCIAL SUPPORT FOR MAINTENANCE AND REPAIR,

• ALL HOSPITALS NEED TO HAVE A HIGH MEDICAL TECHNOLOGY

• NUMBER OF BEDS NEEDED FOR THE INCREASED POPULATION UNDER THE INTERNATIONAL NORMS

• PROBLEMS IN OFFERING A QUALIFIED SERVICE

• GOVERNMENT’S ANNUAL BUDGET LIMITS FOR THE HEALTH SECTOR

• FOR HANDLING THE PROBLEMS IN PUBLIC HIERARCHY TO CARRY OUT NECESSARY ACTIONS

• WE NEEDED MORE LUXURIOUS HEALTH BULDINGS IN ORDER TO HAVE INTERNATIONAL HEALTH TOURISM

WHY DO WE NEED PPP MODEL IN TURKEY’S

HEALTH INVESTMENTS?

IN ORDER TO SOLVE PRESENT HEALTH PROBLEMS IN TURKEY,PPP MODEL WAS CHOSEN

IN THIS WAY , IT IS AIMED TO SOLVE - FINANCIAL ,- ADMINISTRATIVE,- MANAGERIAL ,- QUALITY - AND STATISTICAL PROBLEMS.

COMPARISON BETWEEN CLASSICAL MODEL AND PPP MODEL

1-GOVERNMENT ‘S AVAILABLE INVESTMENT

OPPORTUNITIES

2-SOURCES OF THE GOVERNMENT

3-DEBT: DIRECT DEBT

4-CLASSICAL MODEL ,USED BY ALL GOVERMENT’S

5- CLASSICAL MODEL INCLUDES ONLY HOSPITALS INTHE PROJECT

1- INVESTMENT’S CREDIBILITY OF THE GOVERNMENT

2- SOURCES OF THE INVESTOR (PRIVATE)

3-DEBT: INDIRECT DEBT

4-PPP MODEL ,USED BY GOVERMENTS WITH A HIGH INTERNATIONAL CREDIBILITY

5- PPP MODEL INCLUDES A COMPLEX INVESTMENT.(HOSPITAL,SOCIAL DOMAIN,BUSINESS DOMAIN )

CLASSICAL MODEL PPP MODEL

COMPARISON BETWEEN CLASSICAL MODEL AND PPP MODEL

6- CONSTRUCTION PERIOD IS LONG

7- MANAGEMENT INVOLVES PUBLIC

8- PUBLIC INVOLVES BOTH DESIGN &CONCEPT PROJECT S

9-LOCAL ACCREDITATION AND STANDARDS

10-ALL STAFF FROM PUBLIC

11- ALL SERVICE PROVIDERS ARE PUBLIC

6-CONSTRUCTION PERIOD IS SHORT

7-MANAGEMENT INVOLVES BOTH PRIVATE & PUBLIC

8-PRIVATE&PUBLIC INVOLVE BOTH DESIGN &CONCEPT PROJECT S

9-INTERNATIONAL ACCREDITATION AND STANDARDS

10-STAFF FROM PUBLIC&PRIVATE

11- SERVICE PROVIDERS ARE PRIVATE&PUBLIC

CLASSICAL MODEL PPP MODEL

12-THE BOSS IS PUBLIC /THE PUBLIC CONTROLS

13-AVAILABILITY OF THE PUBLIC SOURCES IN TECHNOLOGY

14-MAINTENANCE AND SERVICE OFFERED BY THE PUBLIC

15- SERVICE COVERS SMALL REGIONS

16- MEDIUM AND SMALL PROJECTS IN GENERAL

12-THE BOSS IS PUBLIC & PRIVATE/THE PUBLIC CONTROLS

13- ON - GOING HIGH TECHNOLOGY

14- MAINTENANCE AND SERVICE OFFERED BY THE PRIVATE

15-SERVICE COVERS LARGE REGIONS

16-MEDIUM AND BIG PROJECTS IN GENERAL

CLASSICAL MODEL PPP MODEL

COMPARISON BETWEEN CLASSICAL MODEL AND PPP MODEL

• PPP IS ONE OF THE MOST SUITABLE MODELS FOR SOLVING ALL PROBLEMS MENTIONED IN THE CLASSICAL MODEL

• WITH PPP , TURKEY TARGETED MORE QUALIFIED SERVICE AND INTERNATIONAL STANDARDIZATION IN HOSPITALS.

• THIS MODEL STARTED IN 2009 WITH THE «HEALTH TRANSFORMATION» SLOGAN

• THE MINISTRY OF HEALTH AGREED ON CONSTRUCTING 30 HOSPITALS,

AND PUT 17 OF THEM INTO TENDER WITH PPP MODEL

AT FIRST, WITH PPP MODEL BIG PROJECTS WERE TENDERED HOWEVER, WE SAW THAT INVESTORS’ REQUIREMENTS WERE NOT SUPPLIED.

THESE REQUIREMENTS WERE:-LEGAL REVISIONS-FINANCIAL REVISIONS-ADMINISTRATIVE REVISIONS

ANOTHER PROBLEM WAS:- MINISTRY BUROCRATS DID NOT KNOW MUCH ABOUT PPP MODEL-AT THIS PERIOD , MINISTRY HAD NO PPP EXPERIENCED CONSULTANS.

- FOR ALL THESE REASONS, EVERYTHING TOOK A LONG TIME !!!!!( ABOUT 3-4 YEARS)

PROBLEMS FACED IN THE IMPLEMENTATION OF PPP MODEL

• THUS INVESTORS AND MINISTRY OBTAINED ALL DECISIONS TOGETHER. • ALL NECESSARY LEGAL,FINANCIAL,ADMINISTRATIVE REVISIONS WERE MADE.• ACCORDINGLY ALL PROJECTS REVISED.• WE IMPROVED THE RELATION BETWEEN FINANCIERS AND MINISTRY • WE IMPROVED THE GUARANTEE REQUESTED BY THE FINANCIERS AND INSURANCE

COMPANIES .

WE WASTED TOO MUCH TIME UNTIL THE NECESSARY REVISIONS . AFTER THE REVISIONS, EVERYTHING WENT FAST .

OUR BIGGEST ADVANTAGE WAS THE POLITICAL AND BUREAUCRATIC DETERMINATIONS

PROBLEMS IN APPLYING PPP MODEL

PPP MODEL

THIS IS A FAST, QUALIFIED AND INTERNATIONAL STANDARIZEDMODEL WHICH CAN BE USED IN ALL PUBLIC INVESTMENTS.

IF THIS MODEL IS UNDERSTOOD ENTIRELY , IT WILL PLAY A IMPORTANT ROLE IN THE DEVELOPMENT OF A COUNTRY .

THIS WILL BE THE MOST IMPORTANT FACTOR OF A FAST GROWTH

FOR THAT REASON, ALL DEVELOPED COUNTRIES HAVE USED THIS MODEL.

PPP PROJECTS ARE INTERNATIONAL MODELS HOWEVER ; EVERY COUNRTY NEEDS TO IMPLEMENT ITS OWN LEGAL,FINANCIAL,ADMINISTRATIVE REVISIONS FOR THIS MODEL INITIALLY

THANK YOU

Asuman SÖYLEMEZ

AFTER ALL THESE PROBLEMS OF PPP PROJECTS,WE CAN WATCH THE ACTUAL SITUATION

OF OUR PROJECTS IN THIS VIDEO