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MaltaToday 17 May 2023 MIDWEEK

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NEWS 9 maltatoday | WEDNESDAY • 17 MAY 2023 indicated that, despite this com- mitment, negotiations continued between the Minister of Tourism and Steward without his involve- ment." (Page 42, 4.22) 9. Mizzi failed to tell Cabinet of higher risk borne by govern- ment in €100m agreement "In submissions to this Of- fice, the Minister for Health [Fearne] recalled that the Min- ister for Tourism [Mizzi] had informed Cabinet that Steward had obtained a loan from BOV to finance the construction of the Barts Medical School and that the Bank sought a guarantee of the loan from the government. The Minister for Health asserted that Cabinet was not aware of the implications of the agreement that was to be entered into – oth- er than the role of guarantor that the government was to assume for the sums indicated – for the Minister for Tourism failed to highlight the broadening of the risk borne by the government, now liable to pay the concession- aire €100 million and the sum of the lenders' debt in the case of court-declared nullity of the concession agreements." (page 46, 4.4) 10. Government's exposure stood at €200 million "The Minister for Health [Fearne] informed the NAO that it was unaware of the de- velopments leading to the gov- ernment's assuming of the €100 million liability in case that the concession was legally declared null. Elaborating on the impli- cations of this development, the Minister for Health argued that its ability to seek redress for de- faults arising from failures of Steward to honour its obligations was practically curtailed, fearing that such action by the ministry could result in a court-declared nullity of the concession, there- by triggering the payment of the €100 million liability and the lenders' debt. The Minister for Health estimated the govern- ment's total exposure at €200 million." (Page 47, 4.41) Reporting by Kurt Sansone, Karl Azzopardi & Nicole Meilak words IN 2020, MaltaToday broke the story on the secret €100 million 'prize' for Steward Healthcare should its contract be rescinded by a court of law. It was negotiated as a kind of super-de- fault by the disgraced minister for PPPs Konrad Mizzi – sacked from Labour af- ter Robert Abela became PM – under the blessing of prime minister Joseph Muscat, who gave birth to the original Vitals PPP. The NAO's third Steward report, pub- lished 15 May 2023, confirms in no uncer- tain terms the closed-circle management of this PPP under Muscat and Mizzi, with the near exclusion of the health ministry. Pri- vatising three state hospitals to an Amer- ican sale-leaseback merchant seemed im- perative to save Labour's pet project, sold first to the nation as a way of letting the pri- vate market deal with the costs of health- care while it finances itself through medical tourism. That vision failed. Both men seemed to have set so much store by this hospitals privatisation deal, so much so that the 2015 tendering process devised by Projects Malta (under Mizzi's stewardship) has since been confirmed in court to have been fraudulently instrumen- talised for the benefit of the chosen ones: unknown investors Vitals. Later, the concession was conveniently sold – possibly under duress due to both Vitals' failures and the pressure from the Muscat administration – to former Vitals CEO Armin Ernst's American masters, Steward. Konrad Mizzi, who refused to cooperate with the NAO in establishing his involve- ment in the entire PPP, now uses Facebook to issue his denials. The stuff liars do, of course. But here is what we learn from this third NAO report: 1. As early as September 2017, three months before the official handover, the OPM and Steward were in touch over the handover of the concession. Vitals were unable to deliver on the milestones they had been contractually bound, and the guy who knew most about this problem was its own CEO… Armin Ernst. 2. The health ministry was kept out of the loop. Talks were held in New York and London – no records kept – between Stew- ard, and OPM and Mizzi's tourism minis- try. No government lawyers, just an audit firm and private legal firm close to Mizzi. 3. As Mizzi's permanent secretary told the NAO, "[Steward] was probably aware of this situation and had inside information as to the difficulties in the implementation of the concession and in the securing of fi- nancing." 4. It was Vitals' CEO Armin Ernst who made the play in these negotiations thanks to his "anomalous yet central role" – up until January 2017 he was CEO of Vitals, and then was placed on leave of absence for breaching his contractual obliga- tions, while still paid a salary. In August he resigned; a month later he asked Vi- tals to waive his employment contract's non-compete clause. Why? Because he was being made president of Steward's new international branch. Vitals refused, but of course Ernst did not care, because he was working for Steward in a clear con- flict of interest. He even tried to crowbar his way into the credit facility Vitals was trying to secure from Deutsche Bank. When Vitals protested, Ernst "submitted correspondence to the bank wherein he defamed the VGH and the director VGH. According to the director VGH, the de- famatory statements made led Deutsche Bank to engage its anti-money laundering department, which in turn triggered an evaluation by its risk committee." The big pay-off After taking over the concession, in 2018 Steward and the OPM and Mizzi locked horns to enter negotiations, with Mizzi and Muscat, to make the concession "banka- ble". It was here, as revealed by MaltaToday in 2020, that Steward gained a "most evident exploitation" with the €100 million liability from government, as well as any lenders' debt, in case of court-declared nullity of the concession agreements, "irrespective of the party attributed the default, a situation precipitated by the Minister for Tourism and engineered through his misleading of Cabinet." So much for big brains, Konrad Mizzi made it profitable for Steward to be kicked out – and this after then Opposition leader Adrian Delia had filed the case for rescis- sion of the Steward deal. Can you imagine? Mizzi and Muscat so- cialised the risk of a court case filed against a private company… it was a bailout (just like that Café Premier for-reasons-un- known sweetener). Compounding matters, the NAO says, was that Cabinet's authorisation was not sought by Mizzi when government acted as guarantor in several financing agreements for Steward with Bank of Valletta – because it was in this financing agreement that the €100 million default clause was included. And what did Malta gain from this con- tract? 1. Steward failed to invest the required capital investment in the hospitals it took over (it never cared, that's how the Stew- ard/Medical Properties Trust hospital sale-leaseback works – don't invest if it makes no profit, make sure the tenant pays the rent so that they pay back the share- holders' dividends); the hospitals were left derelict; 2. Government – the taxpayer, us – kept paying for the labour inside Steward's hos- pitals for a total of €456 million: €52m to Vitals, and €214m to Steward; plus another €188 million for salaries of resources. 3. We would have still paid this money for State health resrouces in the three hos- pitals, but the NAO said the value for mon- ey here was "fundamentally undermined" by the fact that taxpayers were financing the 1,536 workers transferred to Steward (from the formerly-State hospitals) at a val- ue higher than the reimbursement secured, €32 million. Government was also paying these workers higher salaries above real annual increases, "aggravating the discrep- ancy between the real cost to government of resources made available to the conces- sionaire and the amounts recovered in re- lation thereto." Get the drift? All the risk for the priva- teers in this deal concocted by Joseph Mus- cat for the mystery investors from Vitals, all friends and crocodiles known to Pakistani middleman Shaukat Ali, and Steward, was borne by us, the taxpayer. We paid high costs for a sub-par medical service that was not worth the ink on paper – all risks socialised, all gains and profits 'privatised' for shareholders and Steward's top brass. COMMENTARY Steward horror show reveals the inherent theft inside privatisation deals MATTHEW VELLA Privatising three state hospitals to an American sale-leaseback merchant seemed imperative to save Labour's pet project, sold first to the nation as a way of letting the private market deal with the costs of healthcare while it finances itself through medical tourism. That vision failed.

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