A union’s directive could paralyse the entire health system within weeks, the active ageing minister warned yesterday, as one in 10 beds at Mater Dei and Boffa hospitals remain occupied by elderly patients waiting to be transferred to care homes.

“This is not an industrial action anymore. It has become violence on the elderly,” said Jo Etienne Abela.

“We are being held with a gun to our head, unable to give people the service they deserve because of the union’s threatening directives.”

The Malta Union of Midwives and Nurses has issued a directive to its members that does not allow state care homes to admit new residents. This follows the suspension of a nurse after an elderly resident disappeared from St Vincent de Paul and was later found dead.

Active Ageing Minister Jo Etienne Abela speaks to Mark Laurence Zammit. Video: Karl Andrew Micallef

In his first interview since the disappearance and death of Carmelo Fino, Abela criticised MUMN president Paul Pace over the “harmful” directive.

But Pace stood firm, calling the minister a liar and saying he was attempting to cover up a system failure and frame weak workers to shirk responsibility for the incident.

“He should have thought about the consequences of his actions before he tried to frame one of our nurses. If his actions have led to this problem in the system, he must now face the music,” Pace said.

The bed-blocking directive has left St Vincent de Paul with 178 empty beds, the minister said, while beds at Mater Dei are increasingly becoming occupied by elderly persons who have been cured and are perpetually waiting to be transferred to a home.

The minister said Mater Dei was quickly running out of beds and there were fears that the annual influx of patients caused by the cold weather could paralyse the health system in the coming weeks.

Nurses’ union president Paul PaceNurses’ union president Paul Pace

Senior hospital sources confirmed that one in every 10 beds across Mater Dei and Sir Paul Boffa hospitals was occupied by someone who should not and does not need to be there. This was more than 70 beds in Mater Dei alone.

“They’re elderly persons who are cured of their illness now. All they need is to be transferred to a long-term facility like St Vincent de Paul,” a spokesperson said.

“But they have to stay in hospital because they’re not independent enough to go back home and the directive prevents us from admitting them to a care home.”

Minister Abela said more than 1,200 elderly persons in the community were waiting to be transferred to St Vincent de Paul and other government care homes, and more than 100 of them were considered as urgent cases, needing highly dependent care.

Before the directive, the waiting list for such cases was virtually inexistent, he said.

Abela said the situation is at an impasse because MUMN was refusing to meet and discuss a way forward.

But Pace lashed back: “I will not meet with him until he gets Rhys Xuereb [the suspended nurse] his job back. After he does that, I am willing to sit down and start discussing,” Pace lashed out.

Xuereb along with four carers and two security personnel last August after an inquiry found they did not fulfil their duties well the night Fino disappeared.

The 83-year-old dementia patient walked out of the facility unnoticed and was found dead and decomposing two weeks later.

Abela then ordered an independent inquiry led by retired judge Geoffrey Valenzia.

But Pace insists the inquiry was a fake and a sham. They judge, he holds, did not call the nurse for questioning and failed to take into account the shortage of nurses, the fact Xuereb was only a reliever nurse that night and that Fino was in an open ward instead of in a closed one with other dementia patients like himself.

But the minister defended the inquiry’s integrity, insisting he acted according to his obligations and moral convictions.

“Carmelo, his family and the people of this country trusted us with taking care of him. But he got lost and died in the most abhorrent way – without food, without water, and burnt in the sun,” he said.

“My moral obligation was to order an inquiry so that we make sure nothing like this happens again.”

The nurse landed in hot water after the inquiry found that in an email he sent to his superior, he misguided him about Fino’s whereabouts.

That night, Fino left the facility at 3am but the inquiry said that when the morning shift staff found him missing, the nurse – who was on night shift – told his superior that he had last seen Fino sleeping in his bed at 5.30am. This led the authorities to look at CCTV footage from then onwards.

When they did not see Fino leaving the facility at any point after that time, they figured he must still be wandering around the premises, so they spent the entire morning searching for the old man within the facility.

It was not until the afternoon that another patient in his ward told staff and the authorities that Fino was already out of his bed at 3am.

By the time authorities began the search for Fino outside the facility, the man had already been out in the streets for 15 hours.

But Pace insists the nurse is innocent.

“Rhys was a reliever that night. He didn’t know the patients. Maybe he thought he had really seen him in bed and mistook him for someone else,” Pace said.

“Also, Fino was in an open ward. In open wards, patients can walk in and out at any time, and the nurses cannot stop them. I, for one, wouldn’t have stopped the man if I were working there that night. The problem was that Fino was not placed in a closed ward, where he would have been safe.”

Pace said that officials within the Gozo ministry weren’t suspended when they were recently charged with involuntary homicide, and the prison director was not suspended after being charged with threatening someone with a gun.

Why was Xuereb suspended then, he asked.

Abela insisted the inquiry was fair and transparent and found that it was not the system that failed but a few individuals who did not follow the hospital’s standard operating procedures that night.

The minister said he had been asking Pace to sit down and discuss a way forward but that Pace refused to meet.

Meanwhile, Abela said the ministry has found 77 new nurses that would soon be employed to help mitigate shortages.

Furthermore, the government had rented 40 beds in private care homes and would rent another 40 next week, to cushion the impact of the directive.

“But each bed we rent in a private care home costs around €25,000 yearly. It makes no sense to spend that much money when we have our own, empty beds in St Vincent de Paul,” he said.

“I would like to echo Toni Zarb’s cry here – Issa daqshekk (Enough is enough). This cannot go on.”

He also claimed that in their last meeting with the MUMN in October, Pace lashed out at the minister for “making a fuss about an 83-year-old man”.

Abela said the statement scandalised him because he never expected Pace to speak in such a way about an elderly man.

Pace denies ever uttering that statement, arguing that what he told the minister was that this was not a one-off case. It had happened in the past that patients walked out and remained missing or were found dead. And workers were never suspended the way Xuereb was.

Abela said the issue has also affected his family.

“My children have been bullied at school – told that their father orchestrates frame-ups on other people,” he said.

“For weeks I accepted that because that’s part of political life. But now it is hugely affecting the elderly and the vulnerable. This is too much now – we need to sit down and discuss.”

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