The controversy that won’t go away

Almost 25 years since it was first envisioned as a small research hospital affiliated to San Raffaele in Rome, Mater Dei Hospital has been and continues to be a source of controversy to this day.

The latest development seems to point towards why, too. It concerns the belated discovery that an inferior quality of concrete was used – apparently in breach of contract conditions – in the construction of the Accident and Emergency Department, resulting in the need to revise a plan to build two new EU-funded wards on top of that structure.

The section in question was built in 1996, and the contract signed a few years earlier. Yet it is only now that this issue has come to light… though it was not the first time that the problem itself had been identified. Former Finance Minister Tonio Fenech admitted to having been aware of the issue since 2005, and cited it as the reason why the hospital’s helipad could not be built in the same place.

It appears strange, then, that none of the other ministers who variously oversaw this project at different stages – and who were all part of the same government alongside Mr Fenech – was aware of the concrete issue when they learnt about it from the media. Louis Galea and Joe Cassar both expressed surprise; and it was the latter who had applied for the funds to build the new wards.

Even before this consideration, the issue is also symptomatic of an endemic problem with the way public projects are carried out in general. The overall problem was broadly identified in the 2013 John Dalli report into Mater Dei, and echoed the Johns Hopkins report: lack of financial accountability, with little or no control on how contracts are awarded, personnel managed and purchasing effected.

But its political significance runs deeper than that. Oddly enough the same Mater Dei project had indirectly caused Dalli’s earlier resignation as Health Minister in 2004: another report (which later turned out to be a forgery) had implied corruption in the tendering process, resulting in a criminal investigation.

Mater Dei has, in brief, been at the pulsating heart of Malta’s political divide over the span of five elections. If it wasn’t complaints about the wastage of taxpayer money, it was shortcomings in service, waiting lists, beds in corridors, industrial disputes, lack of medicines and more.

To date, however, all such criticism concerned overspending and mismanagement. At construction stage former Prime Minister Eddie Fenech Adami admitted to having ‘nightmares’ over costs which were spiralling out of control. Yet after the hospital was finally opened in 2008, it turned out to be too small to fully take over from the ailing St Luke’s, resulting in overcrowding issues. This in turn called into question the political, rather than the administrative, handling of the project over the years.

With the hospital changing shape and purpose with every new administration, it proved impossible to remain coherent with a health policy that was arguably malfunctioning anyway. Mater Dei should ideally have been opened in conjunction with a revised national health policy aimed at preserving the sustainability of the system. Instead, for political reasons, the opposite happened: it was foisted onto the nation as a cure for all Malta’s health problems, and promoted by Maltese celebrities on national television.

The result has been chaotic, to say the least. But at no point did anyone ever question the quality of construction or equipment. Throughout its many problematic incarnations, Mater Dei was always a “state of the art” hospital. No one ever doubted that the reason we spent so much on it is that we insisted – prudently or imprudently – on the very best.

So to discover now that what we got in the end was somewhat less than what we paid for is a bitter pill to add to all the other headaches associated with this hospital. Clearly the matter needs to be investigated with urgency, and an inquiry board, headed by retired judge Philip Sciberras, has already been named. Its unofficial terms of reference are to establish ‘technical, commercial and political liability’.

On paper this should be straightforward enough. The issue revolves around contractual obligations. If the contracts were drawn up in such a way as to allow contractors to carry out shabby work, responsibility should be shouldered by the politicians and officials who allowed this to happen.

If the contracts were drawn up correctly, responsibility should be shouldered by the periti who certified the works and by contractors who should pay for any works which need to be done, or reimburse the monies they earned to the government.

But this will not address the underlying issue, which is that the political dimension of this project has made it difficult to establish a clear chain of political responsibility. Mater Dei has been juggled between ministries like a hot potato under both Labour and Nationalist administrations. On the concrete issue alone, there are already three conflicting versions by three of the ministers concerned.

The time has come to place all the cards on the table. It is inconceivable that the taxpayer forks out €600 million for a project, and is then denied explanations even when the results turn out to be substandard.