Public private partnership healthcare projects in Turkey :|strategies for successful implementation

Abstract

All over the world, the use of PPP has become popular during last 30 years due to the increase in the need of new infrastructure or renewals with the growing economies especially in developing countries and limited resources of the governments. As a result of that, PPP scheme has started to be implemented for public infrastructure in transportation, energy, health, education and water supply but mostly social infrastructures in developing countries; whereas authorities in relatively more developed countries focus on renewals and improvements. Having said that, as a developing country Turkey has been experiencing the procurement of hospitals through PPP as a new concept; whereas the developed countries have an exhaustive experience and knowledge in healthcare PPPs. Therefore, in developing countries like Turkey, there is a lack of know-how and experience in healthcare PPP implementations. There are many researches about healthcare PPPs in the literature; however, there is less studies regarding healthcare PPPs already performed in developing countries identifying real-life experiences, challenges and lessons learnt. Hence, this research is based on the determination of the key challenges experienced by the stakeholders participated in the procurement of the hospital PPPs in Turkey with suggested mitigations providing a strategic road map for a successful PPP implementation. The case study research methodology is used for investigation through ve case studies. Lack of institutional capacity and adequate risk allocation, incomplete and unclear PPP contract and poor contract management and monitoring mechanism have been observed as the main challenges; whereas strategies to address above challenges are proposed as potential remedies.