Konya Hospital PPP



Project number:


Business sector:

Municipal and environmental infrastructure

Notice type:


Environmental category:


Approval date:

16 Dec 2015



PSD disclosed:

12 Nov 2015

Translated version of this PSD: Turkish

Project Description

The EBRD is providing financing a hospital infrastructure PPP project involving the design, construction, equipping, financing, and maintenance of an integrated health campus in Konya, Turkey, pursuant to a 28 years concession awarded by Turkey's Ministry of Health. Under this PPP structure, the Concessionaire will supply and maintain the hospital facilities, while the provision of medical care and services will remain the responsibility of the Ministry of Health. Total Project Costs are estimated at CA. EUR 318 million.

Project Objectives

EBRD will assist in increasing private sector participation in the hospital infrastructure sector in Turkey. In response to the need for large capacity investments in healthcare systems, governments are seeking to tap private sector resources and know-how to construct and manage infrastructure related facilities more rapidly and more efficiently, while medical service provision remains under the
responsibility of the state.

YDA Group, the Sponsor, is a key investor, operator and contractor in the infrastructure sector.

The Group has undertaken building and operating Kayseri, Konya, Manisa healthcare facilities on PPP basis and it is the preferred bidder for Sanliurfa healthcare facility. In addition, YDA operates Dalaman Airport in Turkey and Aktau Airport in Kazakhstan.

Transition Impact

The Project's transition impact stems from the following key areas:

1. Demonstration effect of new and replicable behaviours and activities: New ways of financing, procuring, operating hospital facilities management: The projects under the Programme are structured on a Design-Build-Finance-Lease-Transfer ('DBFLT') basis with strong demonstration effects for the rest of Turkey and other countries in the region, by promoting the use of PPP contracting, and demonstrating good practice in international PPP standards.

Given current market conditions, and coupled with the fact that this Programme is a major pioneering initiative of the Turkish authorities, the presence of EBRD helps provide comfort for other commercial lenders interested in co-financing the projects. As such, IFI investment during the first Phase of the Programme is expected to ease the risk perception of the debt providers and help attract sufficient commercial financing to sustain the modernisation agenda envisaged in the PPP programme.

2. Demonstration effect of better value all-in cost service than a public sector alternative: The Project is expected to deliver better value from an all-in cost service perspective when compared to the public sector alternative, providing a high value for money to the Ministry of Health. Following a review of the tender documentation and the template PPP contract, the Turkish Hospital PPP programme is seen as effective in procuring hospital infrastructure services.

Setting new business standards: As part of the PPP contract, the project is expected to achieve high standards of business conduct and good practice, including advanced medical technologies and facilities, implementing performance based compensation schemes for the facility manager, and enhance the quality of monitoring quality.

Client Information


The Client is ATM Saglik Konya Yatirim ve Isletme A.S. (the 'Company', the 'SPV'), a special purpose company established by the Sponsor to design, build, finance, lease and operate the Konya HospitalPPP in Karatay, Konya, Turkey.

Konya Hospital PPP will comprise 838 beds across several hospital divisions, namely general (420 beds) and women and children (418 beds).

YDA is responsible for designing, building, financing, leasing and operating the Konya Hospital PPP, whilst MoH will remain responsible for the provision of medical care and services.

EBRD Finance Summary

EBRD is planning to provide an A/B loan of up to EUR 147.5 million.

The EBRD financing will be in parallel with facilities from other international financing institutions and commercial banks.

Total Project Cost

EUR 318,000,000.00

Total Project Costs are estimated at circa EUR 147.5 million which comprise EUR 147.5 million EBRD A/B loan as well as financing other commercial banks and IFIs and the Sponsor's equity commitments under 75:25 debt to equity structure.

Environmental and Social Summary

The project was categorised 'B' in accordance with 2008 EBRD Environmental and Social Policy: an environmental and social analysis of the project and existing conditions assessed the project's compliance with EBRD Performance Requirements. Impacts identified can be readily addressed through mitigation measures.

The Bank's specialists and consultant reviewed a questionnaire completed by the client and undertook a site visit to clarify the issues and mitigation measures. The Client developed the following documentation in Turkish and English languages: Non-Technical Summary (NTS), Environmental and Social Impact Assessment (ESIA), Environmental and Social Management Plan (ESMP), Stakeholder Engagement Plan (SEP) and Environmental and Social Action Plan (ESAP).

The 62 hectare project site is located in Karatay district of Konya Province and was previously used as an agricultural research field. The land is owned by the Ministry of Health and no land acquisition is required. The site has a zoning permit. The project site is buffered from the surroundings by a highway, road, and empty lots.

The due diligence did not identify any significant issues. No biodiversity impacts were predicted and the geological survey indicated that there is relatively low risk of an earthquake. The project's buildings are designed according to Turkish legal requirements and good international hospital design standards.

Mitigation measures for noise, dust and vibration during the construction and operation phases have been developed in the ESMP. Traffic management was assessed during the construction and operation and the Project site can be accessed via public rail transportation and municipal bus services. An overall Management System has been developed for both the construction and operation phases. Medical waste will be sent to the regional medical waste sterilization unit. Small amounts of low level radioactive waste from testing / instruments during the operational phase, as well as infectious disease control will be strictly handled in accordance with regulations and good international practice.

There is a second degree archaeological site, as defined by the Turkish authority near the project site. A procedure on managing 'Chance finds' during project earthworks will be implemented. No significant adverse social issues were identified and the project is expected to provide important social infrastructure and improved health services to the population. During the construction phase approximately 1,500, mostly local workers are expected during the peak construction period. Onsite worker accommodations and an Occupational Health and Safety (OHS) management system will be developed in line with Turkish legislation and international standards. During operation, approximately 2,000 workers will be employed. Grievance mechanisms will be provided for workers, including subcontractors.

An ESAP has been developed and agreed with the client to address any necessary commitments to structure the project to meet the EBRD requirements. Management plans will be prepared for construction camp, traffic, emergency response, and security before the construction phase starts.

The international requirements for life, fire safety and emergency response will be implemented. Full ESAP

An SEP was developed in June-July 2015 and will be updated and implemented as the project progresses. The SEP includes a public grievance mechanism. Public meetings were held in July 2015 and another is planned for November 2015. EBRD will monitor the project's environmental and social performance by reviewing a lender supervisor reports, annual environmental and social reports, and periodical monitoring visits.

Technical Cooperation


Company Contact Information

Turkekul dogan
Vedat Dalokay Cad. No:112, Çankaya/Ankara

Business opportunities

For business opportunities or procurement, contact the client company.

For state-sector projects, visit EBRD Procurement: Tel: +44 20 7338 6794
Email: procurement@ebrd.com

General enquiries

EBRD project enquiries not related to procurement:
Tel: +44 20 7338 7168
Email: projectenquiries@ebrd.com

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