Auditor General Charles Deguara has published his third and final report on the Vitals and Steward hospitals deal.

Here are some of the key findings from the report.

1. Grave concern about Konrad Mizzi's conduct

Ex-minister Konrad Mizzi’s failure to cooperate with the National Audit Office investigation into the deal was judged to be of the “gravest concern”.

The NAO report says Mizzi’s failure to cooperate with the audit was inexcusable, compounded no less by the centrality of his role in the hospitals deal.

This “shirking of accountability” by Mizzi hampered the Auditor General from understanding the initial developments that led to the contracts for the running of the St Luke’s, Karin Grech and Gozo hospitals being transferred from Vitals Global Healthcare to Steward.

Mizzi was politically responsible for that concession at the time.

Former minister Konrad Mizzi refused to cooperate with the Auditor General.

“The NAO holds a bleak view of the tourism minister’s conduct in this respect, for ministers of government and public officials who have acted in the interests of the government should find no difficulty in accounting for their decisions and actions.

The action on the part of the tourism minister in not cooperating with the NAO was deemed deplorable,” the Auditor General’s report says.

2. Conflicting accounts on Steward takeover

Conflicting accounts were given to the Auditor General on the early interactions between Steward Healthcare and the government during the 2017 takeover period.

The confusion was compounded by key players' reluctance to divulge details. 

Former Prime Minister Joseph Muscat gave the NAO "limited disclosures" while replies given by his right-hand man, OPM chief of staff Keith Schembri, were described as "curt" in the report. 

Konrad Mizzi went one further and failed to engage with the Auditor General at all, curtailing the NAO's efforts to understand the lead-up to the takeover deal.

3. A false sense of urgency

A “false sense of urgency” was created by the government during the takeover period, the NAO said, with Steward given “limited timeframes” to complete their buyout of Vitals, the original concessionaires.

The government was found to have created a 'false sense of urgency' during Steward's takeover of the deal.

Steward has made this issue a key argument in its appeal against a court judgment that annulled the concession on the basis of fraud. 

This false sense of urgency heightened the Auditor General’s concerns about whether the government’s interests were duly served and "prompts a keen focus” on the conduct of those involved in the change of control of the concession," the NAO said. 

4. Health Minister sidelined in a deal concerning hospitals

The Auditor General noted what it described as "unfortunate parallels" between the government's incoherence in the way it granted the original concession to Vitals, to the way it then handled the transfer of the contract to Steward. 

Health Minister Chris Fearne was left out of key discussions and decisions on the hospitals.

One of the key failures repeatedly highlighted by the Auditor General was the way Health Minister Chris Fearne was essentially left out of negotiations, with Tourism Minister Konrad Mizzi taking the lead instead.

5. Malta Enterprise's no comment

Malta Enterprise was singled out for its “systemic failure” to cooperate with the Auditor General’s probe.

The government entity, whose current CEO is Joseph Muscat’s former aide Kurt Farrugia, played a central role in coordinating certain aspects of the concession. Farrugia was not its CEO at that time and only assumed that post years later, in 2019. 

Despite queries submitted by the Auditor General, Malta Enterprise failed to respond to any of the requests made.

Malta Enterprise CEO Kurt Farrugia was a close aide to Joseph Muscat. The agency ignored NAO questions.

In its only correspondence with the Auditor General for a previous report several years ago, Malta Enterprise claimed that it was precluded from providing the requested information as this would be in breach of the confidentiality provisions established in the Malta Enterprise Act and the Business Promotion Act.

Correspondence sent to it over the more recent report “was not acknowledged”.

6. Konrad Mizzi misled cabinet on €100 million deal

The Auditor General accuses Konrad Mizzi in no uncertain terms of “misleading cabinet”.

As the minister piloting the deal, Mizzi was the man responsible for presenting a side deal that obliged government to pay Steward €100 million and cover its debts if the contract to run St Luke's, Karin Grech and Gozo General hospitals was cancelled. 

But the NAO concluded he did not do that, and instead "engineered" the side deal through his misleading of cabinet. 

Mizzi, the NAO said, downplayed some facts and left out others, obscuring the deal's true implications. Cabinet approved the agreement in August 2019.  

It was only once Robert Abela took over as prime minister and the government gave a clear instruction to terminate the concession "that the Government became aware of the broader implications of that consented to by Cabinet during its meeting of 27 August 2019," the NAO notes. 

"How the Minister for Tourism envisaged that entry into this agreement would  be of benefit to Government remains entirely perplexing," the NAO noted. 

Mizzi vehemently denied the NAO conclusion, writing on Facebook that cabinet was fully informed of the deal and its implications. 

"NAO’s conclusion is therefore pure conjecture, irresponsible and blatantly false," he wrote. 

A court annulled the hospitals contract on fraud grounds in February.

What will happen of that €100 million arrangement remains to be seen: judge Francesco Depasquale struck that down along with all other contracts in the concession on fraud grounds, but Steward has appealed that verdict and also asked for its case to be referred to the European Court of Justice.