EBRD supports new €1 billion hospital near Ankara under public-private scheme

By Olga Rosca

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EBRD arranges comprehensive financing package for state-of-the-art hospital campus in Etlik neighbourhood

The European Bank for Reconstruction and Development (EBRD) has arranged a comprehensive long-term financing package for the development of a €1.12 billion high-tech hospital in the Etlik neighbourhood near Turkey's capital, Ankara.

With a loan of €125 million for its own account and €131 million syndicated to commercial banks, the EBRD is the largest lender among 11 financiers in a complex financing structure which brings together international and local commercial banks as well as international financial institutions.

The Etlik hospital campus will be designed, built, equipped and managed by the private developer Ankara Etlik Hastane Saglık Hizmetleri İşletme Yatırım (Ankara Etlik Health Investment), which was set up by Astaldi and Türkerler, an Italian and a Turkish construction company, respectively.

The campus will span 11 hospital buildings with 3,566 beds, delivering better hospital facilities for the Turkish capital and central Anatolia, a region with about 12 million people. Under a 27.5-year concession, the buildings will be leased to Turkey’s Ministry of Health. The private developer will act as facilities manager, providing building maintenance and non-clinical services, while medical services will remain the remit of the Ministry of Health.

The Etlik hospital is the largest project to be financed to date under the Turkish government’s €12 billion programme to build or expand about 60 hospitals across the country in collaboration with the private sector. Faced with the need for large investments, the government is seeking to tap private sector resources and know-how to construct and manage infrastructure facilities more quickly and efficiently.

Mehmet Müezzinoğlu, the Turkish Minister of Health, said at the signing ceremony: “We decided to undertake the biggest transformation in health care. The Ankara Etlik Integrated Health Campus will be one of the world’s largest health complexes in terms of bed numbers. Along with its modern architecture and social use areas, the campus is being built, and will operate, using environmentally friendly practices.”

James Hyslop, EBRD Director for Municipal and Environmental Infrastructure, said: “We are proud to have brought together international financial institutions and local and international commercial banks in the largest financing package for a hospital PPP project in Turkey to date. This sends a strong signal about the opportunities available on the Turkish market and about investors’ confidence for long-term engagement in the country.”

Serhat İnanç, the CEO of Ankara Etlik Health Investment and Member of the Board of Directors of Türkerler Holding, said: “This is the first time in Turkey’s history that a project finance agreement of such an amount and quality has been signed, bringing  together international financial institutions and leading commercial banks.”

Șule Kiliç, EBRD Deputy Director for Turkey, added: “This financing is not only a commitment for the development of a large high-tech hospital near the capital city, but yet another demonstration of the EBRD’s strong and continuing support for the Turkish government’s plan to significantly expand quality hospital facilities across the country under the public-private partnership model.”

Under the €878 million financial package with 18 years’ maturity, the EBRD is extending a €256 million financing facility under its A/B loan structure, with €125 million for the Bank’s own account and €131 million syndicated to Deutsche Bank, Credit Agricole Corporate and Investment Bank, Unicredit and Banca IMI, the investment banking unit of Intesa Sanpaolo.

In parallel, the International Finance Corporation is providing a €154 million loan, of which €79 million is syndicated to Credit Agricole, Unicredit and Banca IMI. The Black Sea Trade and Development Bank (BSTDB) and the German development bank DEG are also joining as parallel lenders with €60 million and €30 million, respectively.

Deutsche Bank, Credit Agricole, Unicredit and Intesa Sanpaolo are providing an additional €125 million under the cover of the Italian export credit agency SACE.

Financing partners also include the local commercial banks Ișbank, Turkiye Sınai Kalkınma Bankası (TSKB) and Akbank, which together are mobilising €253 million in parallel funding.

In addition to providing and mobilising finance, the EBRD has worked closely with the Turkish Ministry of Health over the past three years to enable greater private sector involvement in the hospital sector. Improving the quality of essential infrastructure through private sector participation is one of the EBRD’s priorities in Turkey.

The EBRD started investing in Turkey in 2009 and currently operates from offices in Istanbul, Ankara and Gaziantep.

In just six years the Bank has invested over €5.5 billion in Turkey through more than 150 projects in infrastructure, energy, agribusiness, industry and finance. It has also mobilised over €12 billion for these ventures from other sources of financing.

In 2014 Turkey became the leading recipient country of the EBRD, with new investments worth €1.4 billion.

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