University Clinic in Almaty city
Ministry of Health and Social Development
April 2016 Astana, Kazakhstan
Information Memorandum has been prepared by the experts of the Public-Private Partnership Advisory Center LLP (hereinafter referred to as - the Center) within the framework of provision of the Ministry of Healthcare and Social Development of the Republic of Kazakhstan with consulting support of the concession project “Construction and operation of a multidisciplinary hospital with 300 beds at the Republican State Enterprise on the Right of Economic Management “Asfendiyarov Kazakh National Medic University” in Almaty city”.
The Concession Grantor and the Center issue this memorandum exclusively for use by the recipients and their advisors.
DISCLAIMER
This
This
Information Memorandum is intended for information purposes only. This Information Memorandum is designed to help the recipients with estimating whether the project is attractive, but it is not designed to ensure the basis for making decision on investing.
Distribution,
copying and alteration of any materials of the Center without prior written consent of the Center are prohibited. Additional information is provided upon request, by complementing of this Information Memorandum.
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Project name
Status
Expert Examination of the Concession Proposal
The Republic of Kazakhstan represented by the Government of the Republic of Kazakhstan and the Authorized Body in the sphere of healthcare, the Ministry of Healthcare and Social Development of the Republic of Kazakhstan (hereinafter - the Concession Grantor) is planning to sign a Concession Agreement for construction of a university hospital in Almaty city with a private party (hereinafter the Concessionaire).
SUMMARY
Sector
Construction and operation of a multidisciplinary hospital with 300 beds at the Republican State Enterprise on the Right of Economic Management “Asfendiyarov Kazakh National Medic University” in Almaty city Social Infrastructure
Branch (sector) of Healthcare economy location of the Facility Almaty city, the Republic of Kazakhstan Name of the Facility A multidisciplinary hospital with 300 beds at the Republican State Enterprise on the Right of Economic Management “Asfendiyarov Kazakh National Medic University” (New University Hospital) Capacity of the Facility Hospital - 300 beds Polyclinic - 300 outpatient visits a day Legal Status of the Property of the Concession Grantor (the State) Subject of Concession expected types of Design, Construction, Financing and Operation activities of the of the Subject of Concession Concessionaire under the Concession Project Information about There are no any encumbrances and limitations encumbrances and in view of the absence of the Subject of limitations against the Concession. existing Subject of Concession The source of the Payment for availability Concessionaire’s revenue Term of the Agreement 20 years, including the period of construction 38 months
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SUMMARY
The Subject of Concession will include:
A land plot of New University Hospital (including internal roads in the territory of this land plot) Premises of the University Hospital consisting of 3 (three) buildings An incineration plant A parking garage A car parking for 40 places In addition, the Concessionaire will provide medic equipment, which complies with the consistent specializations of the New University Hospital. At the same time, The Concession Grantor will perform the replacement of the equipment at the end of useful life, presumably in the 7th year of the operational exploitation.
PROJECT TEAM
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Population Population Size, 1th March, 2016 year Active Population Size, 2015 year Unemployment Rate, 2015 year GDP and Reserves Nominal GDP, 2015 year Per Capita Nominal GDP, 2015 year Real GDP Growth Rate , 2015 year Gold and Exchange Currency Reserves, March 2016 year Assets of National Fund, March 2016 Other Economic Ratios State Budget Deficit to GDP ratio in 2015 year Public Debt to GDP ratio in 2015 year Balance of Trade (Positive Balance) in 2015 year
2,7 mln sq.km Astana Presidential Republic 17,7 mln people 9,0 mln people 5,0% 183,8 bln USD 10,48 thsnd USD 1,2% 28,5 bln USD 64,3 bln USD (2,2%) 16,2% 12,6 bln USD
KAZAKHSTAN
General Information Square Capital Form of Government
The Republic of Kazakhstan, being an export-oriented country with rich natural resources, is the largest economy in Central Asia and one of the fastest growing among the CIS countries.
Kazakhstan has a rich resource base: > 30 billion barrels of proven oil reserves (12 in the world) > 1.5 trillion m3 of proven reserves of natural gas (19 in the world) > 0.6 million tonnes of recoverable uranium (2nd place in the world)
Kazakhstan is the largest economy in Central Asia and one of the fastest growing among the CIS countries for many years Kazakhstan has shown consistently high rates of real GDP growth, averaging 7.0% per year (1998-2015.) With a low level of government borrowing. The main source of growth was the favorable prices for energy and metals.
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KAZAKHSTAN
The size of Kazakhstan's GDP the second largest among the CIS countries. CAGR in real GDP in the same period of the 1998-2015 biennium. It amounted to 7.0%.
According
to the Kazakh Statistics Committee for 2015 the volume of industrial production in value terms decreased 14.6 trillion tenge, which is 21% lower than for
Kazakhstan's GDP higher than in some countries of the European Union
Россия Russia Турция Turkey Польша Poland Казахстан Kazakhstan Чехия Czech Румыния Romania Венгрия Hungary Украина Ukraine Slovakia Словакия Azerbaijan Азербайджан
183
0
500
1.000
1.500
bln USD
2014 The volatility of real GDP of Kazakhstan is connected with changes in the volume of mineral resources production and demand foreign markets. In 2015, mining and milling of natural resources accounted for 14% of the GDP according to the Statistics Committee. Manufacturing and real estate accounted for 20% of GDP. The volume of manufacturing industry reached 4.2 trillion tenge in 2014 (40% of the total industry volume). The main articles of the manufacturing industry are the iron and steel industry, food and beverage products, as well as engineering. Compared with 2014 in 2015, the volume of manufacturing industry increased in nominal terms by 5%.
With high oil prices, the Government of the Republic of Kazakhstan managed to maintain a relatively low budget deficit and public debt, increase the assets of the National Fund of the Republic of Kazakhstan while actively investing in sector programs and infrastructure development. In addition, tax maneuvers are undertaken to increase the attractiveness of investing in non-primary sector.
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the Republic. In the city there is well-developed infrastructure operating and expanding the underground (since 2011), operates an international airport. GRP of Almaty more than 2 times higher than the average level of the Republic of Kazakhstan.
ALMATY KEY INDICATORS (2015) Share of Kazakhstan’s GDP
%
21.3
people
751 022
%
5.9
Population growth rate
per 100 people
11.14
Birth rate
per 100 people
18.31
Population average age
year
34.3
Life expectancy at birth
year
73.7
Employed population Unemployed rate
ALMATY
Almaty - the largest city in Kazakhstan. Until 1997 - the capital of
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LOCATION
Construction of the University Clinic is planned in the city of Almaty. Territory " of the "Aksai University Hospital of the Republican State Enterprise on the right of economic management "Kazakh National Medical University Asfendiyarov“ was curtained for this purpose. The plot is a total area of 4.2 hectares. The site is located in the city of Almaty. It has all the infrastructure (water supply, heating, electricity and sanitation).
In
view of the evolving infrastructure of the city and site location (in the city), disabled and inactive groups, universal access for all sectors of the population, can be a major criterion for evaluating the object. To implement the project on the specified land plot received more than 60% of the permits provided by law, but because of high seismicity, the site may not be attractive for the construction. On the plot is possible to put a clinic with 300 beds.
Distance to the city center 12 km
ASTANA
ALMATY
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According to the draft financial scheme, the Concessionaire will receive the following types of income:
PAYMENT
Creation of an advanced hospital and polyclinic based on the concession is planned under the Project. For this purpose, an investor for construction of the facility, implementation of its technical operation, equipment supply, service maintenance of equipment prior to its replacement is invited. Replacement of the equipment and its further service maintenance under the Project will be vested to the Concession Grantor. The Concessionaire’s obligations will also include preparation of project estimate documentation and passing the state expert examination according therewith, preparation of the territory of the construction. KazNMU will render healthcare services based on New University Hospital.
AVAILABILITY PAYMENT Fee for the Concession Agreement is the payment for the operational readiness of the object of the concession and is an obligation of the Grantor in respect of the Concessionaire shall be taken on the first period of operation of the concession object. INCOME FROM THE PROVISION OF ADDITIONAL SERVICES Additional revenues of the Concessionaire are formed on the basis of income from the disposal of medical waste (Class B, C), as well as income from the lease of commercial premises pharmacy in respect of third parties.
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PAYMENT
Table 1 Compliance of cost reimbursement sources with the laws of the Republic of Kazakhstan and groups of costs under the Project The cost reimbursement sources with the laws of the Republic of Kazakhstan Compensation of investment costs
Compensation of operational costs
Management Fee
Group of Costs under the Project ■ ■ ■ ■ ■ ■
■ ■
payment of the body of the senior debt and its interests during the construction Costs for bank charges during the construction Costs for bank charges during the construction Operational project costs, calculated in accordance with the regulations of the sphere of healthcare, subject to inflation Return of the Concessionaire’s own funds (including subordinating loan, own equity) Reimbursement of payment interest due to the senior debts Payment of mixed income to the own equity Adjustment for currency risk
The Availability Payment consists of the investment costs compensation, operating costs compensation and management fee management fee operating costs compensation investment costs compensation
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037
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Shall be calculated according to the regulations in the sphere of healthcare.
Additional Concessionaire’s services, which shall not be covered by the Availability Payment • •
CONCESSIONAIRE’S SERVICES
Services on construction of the hospital, supply and maintenance of the equipment: • Construction of the hospital • Hospital facilities • Development of the adjacent territory • Service maintenance of medical equipment (during the period before first replacement of equipment) Operational services: • Performing current repair of the building, technical equipment, lifts • Maintenance of medical gas supply systems Other services: • Communication services (including the Internet) • Ensuring security • Rendering disinfection services • Rendering laundry services • Organization of free parking Public-utility services: • Maintenance of water supply, heating, air ventilation and conditioning, and IT systems • General cleaning services, sanitation • Cleaning of the adjacent territory • removal of domestic waste and refuse, utilization of medical waste (waste classes A, B, C, D)
work of a commercial drugstore destroying medical waste (of B, C classes) of other medicalpreventing institutions
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INSTITUTIONAL SCHEME
OPERATIONAL STAGE Main participants of the Concession Project at the operational stage of the Subject of Concession are the Concession Grantor, the Concessionaire, the Operator of Healthcare Services, and the Ministry of Finance. Main function of the Concessionaire under the Concession Agreement at the operation stage of the Subject of Concession will be Technical Operation of the Subject of Concession. Operational exploitation of the Subject of Concession (rendering healthcare services to the population) will be performed by the Operator of Healthcare Services, namely S.D. Asfendiyarov KazNMU. The Concessionaire will be vested the Subject of Concession for possessing and using in order to perform Technical Operation under the Concession Agreement. In accordance with the laws of the Republic of Kazakhstan any improvements, made at the Subject of Concession by the Concessionaire under the Technical Operation of the Subject of Concession, according to the Concession Agreement will be transferred to the governmental property, in the procedure, set forth by the laws the Republic of Kazakhstan.
Within the framework of Technical Operation, the Concessionaire may not dispose the Subject of Concession, which transferred to him for the purposes of Technical Operation under the Concession Agreement, and may not pledge it or otherwise use it as a security. Signing the Cooperation Agreement No.1 For the purposes of effective management of New University Hospital, the Operator of Healthcare Services and the Concessionaire will sign the Cooperation Agreement No. 1. The main goal of the Cooperation Agreement No.1 shall be determination of terms of cooperation between the Concessionaire and the Operator of Healthcare Services in regard of mutual management and operation of New University Hospital, namely, including, but not limited to: ď€
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defining the sphere of activities of the Operator of Healthcare Services and the Concessionaire.
The structure of inpatient department profiles of the multidisciplinary hospital has been coordinated with the Department of Healthcare of Almaty city and MHCSD RK. The demand for healthcare services of New University Hospital is confirmed by marketing research, performed during the development of a concession offer of the Project and complies with the needs of the population of Almaty city in rendering healthcare services. New University Hospital will provide specialized and highly specialized medic aid to the residents of Almaty region and of the Republic of Kazakhstan. Profile
Quantity
Therapeutic
40
Cardiological Neurologic
30
Endocrinological
30
Rheumatological
25
Ophthalmological
20
Traumatologic
30
Surgery
30
Interventional cardiology
15
Gynaecological
20
Rehabilitation of adults
30
TOTAL
30
300
UNIVERSITY CLINIC STRUCTURE
STRUCTURE OF HOSPITAL BEDS
STRUCTURE OF THE POLYCLINIC Visiting highly specialized doctors as given below is planned: Out-Patient Daily Department’s Services Ophthalmologic Treatment Otolaryngological Treatment Proctologic Treatment Gynecological Treatment
Therapy Surgery
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VI.2016 VIII.2016 VIII.2016 I.2017 II.2017 IV.2017 X.2017 II.2018 III.2018
PROJECT SCHEDULE
Project Feasibility Study Project Feasibility Study Examination Approval by Government Tender Documentation Development Tender Announcement Pre-Qualification Request for Proposals Appointment of Preferred Bidder Sign PPP Contract
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CONTACTS 18
16 floor, 16 Dostyk avenue, Astana, Kazakhstan +7 (7172) 79-04-50 (вн. 110) +7 (7172) 79-04-50 (вн. 110) ppp.kense@gmail.com http://www.pppac.kz
HEAD OF PROJECT
MANAGER OF PROJECT
Laura VALIEVA l.valiyeva@pppac.kz + 7 701 513 95 98
Sergey KHEGAY s.khegay@pppac.kz + 7 701 165 80 34
Key concentrations ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Bankability and supports from the state ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________
INVESTOR’S FEEDBACK
Main points
Commercial issues ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________
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INVESTOR’S FEEDBACK 20
Institutional scheme ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Schedule and tender procedures ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Lender/investor issues ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________