The Story of San Raffaele Hospital and Mater Dei Hospital

1990: The idea of building a new hospital to serve as a centre of excellence complementing St Luke’s took root.
8 December 1990: The Foundation for Medical Sciences and Services (FMSS) was established by the Government of Malta by a deed of foundation as “an autonomous body corporate of a non-commercial nature” with the following aims:
· The furtherance and promotion of medical and related studies and scholarship, through research, publications and teaching;
· The provision of health care services through hospital, day care and other facilities; and
· Collaboration with other similar entities, especially on a regional and international basis.
The following sat on the first FMSS board: Dr Louis Galea (president), Prof. John Rizzo Naudi (appointed vice-president on 27 June 1992), Dr Antoine Mifsud Bonnici (appointed 27 June 1992), Dr George Hyzler (appointed vice-president 3 October 1991, retired 27 June 1992), Sig. Mario Cal, Prof. Frederick Fenech, Rev. Peter Serracino Inglott, Rev Charles Vella (appointed vice-president on 3 October 1991), Edwin Vella, Maurice Zarb Adami.
Following the 1996 October general election Prof. John Rizzo Naudi, Prof. Frederick Fenech, Edwin Vella and Maurice Zarb Adami offered their resignations.
On this date too, the Government of Malta signed a Collaboration Agreement with the Fondazione San Raffaele del Monte Tabor – Istituto Scientifico Ospedale San Raffaele. This agreement sought collaboration in the “sectors of health care and medical sciences.”
On this date too, an agreement was signed between FMSS and the Government of Malta for the management of the Zammit Clapp Hospital.
27 February 1991: FMSS (represented by its president Dr Louis Galea) and the Fondazione Centro San Romanello del Monte Tabor (represented by Rev. Prof. Luigi M Verze) together with the Centro Assistenxa Ospedaliera S Romanello (represented by Mario Cal and Dott. Raffaella Voltolini) and the Associazione Italiana per la solidarieta tra i popoli (represented by Ing. Enrico Pianetta) set up the Monte Tabor Foundation – Malta (MTFM), an Italo-Maltese Centre for the promotion of scientific research and health, educational and training services. The deed of foundation set up MTFM as an autonomous, charitable non-profit making organisation.
MTFM was established as an autonomous body corporate of a non commercial nature with its seat in Malta and the following aims:
· The furtherance and promotion of a philosophy and practice of medicine and health care inspired by the evangelical message ‘heal the sick’ and by humanitarian and sound ethical standards…
· Setting itself up as a centre of reference in the Mediterranean region for the study and treatment of ailments especially those relating to metabolism and degenerative diseases…
· Setting itself up as an educational and training centre for health care personnel.
On the signing of the deed MTFM was endowed with the sum of Lm120,000 borne equally between the two parties.
February 1992: The Nationalist Party wins a second term of office. Dr Fenech Adami is re-appointed Prime Minister and Dr Louis Galea is re-appointed Minister for Social Policy and Dr J. Rizzo Naudi as Parliamentary Secretary for Health. In 1995, following a cabinet reshuffle, Dr Louis Deguara replaced Dr Rizzo Naudi as Parliamentary Secretary for Health.
June 1992: The day to day running of the Foundation was originally entrusted to the Director General, Philip Rizzo who was officially appointed by the board in June 1992. Mr Rizzo remained in office until 6 December, 1994.
During his term of office Mr Rizzo occupied other posts namely that of chairman of the St Luke’s Refurbishment Committee and Director of Planning at university.
In August 1994, the president of the board of FMSS intimated that the fact that Mr Rizzo occupied the above mentioned posts was complicating matters and rendering control difficult.
Subsequent to Mr Rizzo’s resignation some of his decisions, of which the FMSS board was not aware of, came to light. These related mainly to acceptance and/or authorisation of expenditure on the San Raffaele Hospital and St Luke’s refurbishment projects. Rizzo denied the claims that featured in Deo Scerri’s report in The Times of 31 December 1996.
15 July 1992: A Letter of Intent was signed between FMSS and MTFM specifying the building of a hospital to complement St Luke’s as per business plan dated August 1991 presented by FMSS.
Investment on FMSS part: Provision of land, construction of structure, construction of building, provision of all equipment including medical and sanitary equipment.
MTFM’s part: To obtain the ‘know how’ of the Scientific Institute San Raffaele and the other Italian founding entities so as to be responsible for the design and construction supervision as well as the operation of the hospital.
The Government of Malta was to pay MTFM (via FMSS) a charge calculated on the basis of
1. Rent of hospital; all operating expenditure including costs, administration expenses.
2. Government guaranteed payment on the basis of an occupational level of not less than 80 per cent of total beds available.
August 1992: In view of the entity of San Raffaele project, FMSS engaged the services of Eng. E Farrugia to act as project director. Mr Farrugia occupied the post until February 1994.
9 July 1993: FMSS and MTFM signed a Frame Agreement confirming the letter of intent of 15 July 1992. This covers the Government of Malta’s desire to “construct a scientific institute to undertake research and … provide specialist medical treatment to complement public health care facilities … available in Malta. Such an institute shall be known as the San Raffaele Hospital and MTFM desires to “participate in the project and to operate the hospital.”
The agreement signified the Maltese Government’s desire that the hospital be operated according to the orientation and culture inspired by the philosophy of the Parco Scientfico Biomedico San Raffaele, an “association of hospitals and scientific institutions sharing the same evangelical philosophy: Ite, docete, senate”.
The letter of intent as confirmed by the agreement covered the “total design of the hospital, the statutory supervision of the construction of the hospital, the operation of the same hospital and the allocation of beds to the Government of Malta.”
The agreement sets out the framework of the contractual relationship between FMSS and the Government of Malta on one part and the MTFM and the Italian co-founders on the other part.
The agreement however does not only set out the framework but also provides the basis upon which the contractual relationship was to be built.
According to the Frame Agreement, FMSS shall be responsible: To define health care requirements which the hospital should meet; to procure land on which hospital will be built; to assist the government in organising the international construction tender; to manage the administration and accounting relating to the construction agreement.
The MTFM on its part was engaged by FMSS to be responsible for: Design, planning, application for permits, preparation of tender documents; technical and economic evaluation of tenders.
The San Raffaele Hospital (Malta) project was entrusted to MTFM who sub-contracted part of their rights and obligations (design and construction supervision) under the “frame agreement” to ORTESA Spa, a related company of the Italian co-founders of MTFM. Work on the designs started during 1993.
The Frame Agreement lists four contracts to be entered into, which are considered to be an integral and substantive part of the agreement and consequently the guarantor’s obligations apply to all these agreements, unless other arrangements are made.
1. Design contract: An original annex to the Frame Agreement and is clearly binding on FMSS, MTFM and the Guarantors.
2. Construction supervision agreement: Eventually called Construction Supervision Contract. This had to be negotiated and agreed to by 31 December 1993, but the date was later extended to 28 February 1994. No criteria were set out in the frame agreement in connection with the contents of this agreement which was eventually signed on 2 June 1994.
3. Operation Agreement which was to be agreed by 31 December 1995 on the basis of principles set out in the letter of intent annexed to the Frame Agreement.
This agreement had not been signed but the latest information indicates that Rev. Prof. Verze had agreed in writing to extend the date for negotiations to 31 December 1996.
4. Allocation of beds agreement was to be negotiated and agreed by 31 December 1996 on the basis of the principles set out in the letter of intent.
18 August 1993: Project Management Agreement between FMSS and Project Management Office Malta University Services Ltd for the latter to carry out detailed supervision of the construction of the hospital.
Although MUS Ltd appeared on the contract with FMSS, PMO is made up of a joint venture between MUS Ltd, University of Malta and the Director of Works.
The remuneration of PMO which comprises fees and expenses is calculated at five per cent of the total cost of the project. For the purposes of this agreement, the estimated project management fee was considered at Lm1.75 million which was to be paid in 48 equal monthly installments.
On completion of the project, PMO’s definite remuneration was to be calculated at five per cent on actual total cost in terms of the final project certificate. Payments paid to PMO will then be subtracted to arrive at the net balance payable.
As per Deo Xerri’s report, FMSS considered that PMO was understaffed and did not have enough manpower to ensure a proper detailed supervision of the project.
2 June 1994: Construction Supervision Contract signed. It forms an integral part of the Frame Agreement and is therefore binding between the parties to the agreement but is binding also on the other signatories thereto.
MTFM’s obligations under this contract is to carry out general supervision of the construction of the hospital, it being understood that the detailed supervision will be carried out by the Project Management Office, Malta University Services Ltd, who were appointed project managers for the hospital project.
In effect, MTFM’s duties consist of the provision of the following qualified specialists: Hospital construction manager; Hospital services manager (civil works); Hospital services manager (mechanical, electrical, medical equipment); Hospital medical manager.
MTFM cannot assign benefits, obligations or subcontracts without the written consent of FMSS. It was, however, agreed in this contract that MTFM shall make use of Maltese architects and civil engineers (England &England were appointed) for certain services.
15 July 1994: Roads Contract between FMSS and IRB signed. The contract for the excavations, geotechnical survey and external roads for San Raffaele Hospital is between, on the one part, FMSS as client and on the other part a joint venture made up of Impresem Spa, Rainbow Mix Concrete Ltd and G & P Borg (IRB).
15 March 1995: FMSS leased and occupied one floor of office space at Gattard House in Blata l-Bajda. FMS left Gattard House offices on 15 April 2000.
FMSS has also leased another floor at Gattard House to be used by its agency SWDP.
12 September 1995: Construction Agreement between FMSS and SKANSKA International Building Ltd, Blokrete Ltd, Devlands Ltd and Cassar, Grech, Ebejer & Partners.
Skanska was selected following a decision of the Adjudicating Committee set up by the Prime Minister in the later part of 1994. The committee was composed of nine members, including four Italians appointed on the committee to represent MTFM. FMSS did not have its own representatives on this committee.
It should be noted that one of the Monte Tabor representatives, Dott Vincenzo Mariscotti, was involved in corruption allegations in Italy. Dott. Mariscotti informed the committee that due to the allegations he would not be attending the committee meetings. It is not clear, however, whether Dot. Mariscotti actually resigned from this committee.
The conditions of the construction contract are based on the (standard) conditions of contract for work of civil engineering construction, published by the Fondation Internationale des Ingenieurs (FIDIC).
The contract for the construction (civil works) of the San Raffaele Hospital for the price, which includes VAT, of Lm31.75 million. This price which is based on Bills of Quantity appended to the contract, includes a negotiated discount of 7.5 per cent and comprises deductions from and additions to the original Bills of Quantity. The total costs of the hospital excluding the drainage system would cost Lm51 million.
The idea was to build a centre of excellence to complement the 50-year old St Luke’s general acute hospital which was to undergo an extensive programme of refurbishment. The 480-bed, state-of-the-art specialised hospital was to operate in the fields of diabetology, cardiology and degenerative diseases and other chronic illnesses prevalent in Malta and other Mediterranean countries. The new hospital was also to have a strong research and teaching aspect.
CMC (Coiperaiva Muratori e Cementisti) appealed the government’s decision that awarded the tender to Skanska.
10 October 1995: Skanska started construction work on the San Raffaele Hospital Project.
6 January 1996: FMSS approved the assignment of another design contract of MTFM referred to as ‘On site design contract’ (OSDC) for a fee of Lm50,000. This agreement was for the service of on-site CAD operator, secretarial service and a link with Milan.
February 1996: Emmanuel Attard is employed as Chief Executive of FMSS.
March 1996 Skanska maintained that 50 per cent of Ortesa’s mechanical drawings required adjustment; clerical specifications submitted were totally different from tender specifications; whereas the electrical drawings of the stairwell had to be produced by Skanska.
PMO on its part, maintained that although discrepancies in Ortesa design were more than normally expected in a project this size, Skanska’s delay was not totally attributable to design problems. PMO, however, pointed out that unless the design problems were sorted out in the near future, Skanska’s claims in this respect could become stronger.
Skanska had in fact made a 12-week delay claim up to January 1996 because of design problems. PMO instead awarded a two-week delay to Skanska in this respect.
In October 1996, however, Skanska submitted another claim of Lm2 million in relation to an envisaged 42 week delay (which also includes the 12 weeks mentioned above).
27 June 1996: The surrounding roads contract was completed by IRB on the date when the completion certificate was issued, nearly two years after the completion date stipulated in the contract.
IRB instituted court proceedings against FMSS stating that the work undertaken could not be carried out properly due to lack of proper design and radical changes in original plans. Contractor claimed damages estimated at Lm500,000.
On its part FMSS wrote to IRB on 18 November 1996 requesting payment of penalties for late completion estimated at Lm636,000. A further sum of Lm128,024 was also claimed due to lack of progress in terms of Clause 25 of the General Conditions of Contract for the Execution of Work in Malta which conditions form an integral part of the contract.
As a result of the above claim, FMSS offset the balance of Lm96,978 due in respect of interim certificate no. 16 against the total values of damages claimed, leaving a net balance in favour of FMSS of Lm667,047. FMSS was also requesting payment under the Performance Bond.
July 1996: The board of FMSS received an offer from Skanska to finalise the Ortesa drawings for a fee of Lm250,000. The responsibility of the design was to remain with Ortesa, however the delay responsibility (originating from design shortcomings) would be transferred to Skanska. Subsequent to a meeting with the PMO, the above offer was turned down by FMSS.
23 August 1996: In view of the serious problems with Ortesa, the board of FMSS decided to suspend all payments to MTFM.
September 1996: FMSS received a letter from Prof. R. England wherein he threatened to withdraw his legal representation because his company was not being paid the fees agreed to in the contract with MTFM. In order not to disrupt this project further, FMSS considered paying these fees directly to England & England out of its own funds.
The monthly progress reports contemplated on the construction supervision contract were never presented to FMSS.
The significant design problems were highlighted to Rev. Prof. Verze in a meeting with the Prime Minister and FMSS and PMO representatives. Don Verze visited the site for the last time.
10 October 1996: The drainage consultancy agreement was signed between FMSS and England & England according to which the latter were appointed as consultants on the drainage extension from the hospital to the Gzira pumping station.
26 October: The Labour Party wins the general elections.
October 1996: The new Labour government immediately commissions reports in order to be in a position to take decisions about the hospital. From the reports the following was concluded:
a. A new medical brief had to be prepared.
b. The concept of the hospital had to change from that of a specialised hospital of 450 beds to an acute general hospital of 800 to 1,000 beds. This hospital had to replace St Luke’s Hospital.
c. The contract of Ortesa Spa had to be terminated and a new tender was to be issued.
d. Skanska Malta JV had to continue the works on the existing footprint of the hospital from the designs of the original plans (those of the San Raffaele Hospital). Minister Michael Farrugia, in reply to PQ 11438 says that this was a cabinet decision and the additional cost is estimated at Lm2 million.
6 December 1996: A new (provisional) FMSS board is appointed. Mario Cacciottolo was appointed president, Joe Barbara and Alfred Vella were appointed as board members. This board was dissolved on 15 July 1997.
March 1997: FMSS commissions MSD Consultancy to quantify claims against MTF. According to this report the value of potential claims against MTF as at March 1997 was Lm9,120,046.
11 April 1997: The FMSS was instructed to request the Monte Tabor Foundation’s local representatives not to report on site and the locks of the FMS offices used by the MTF were changed.
23 April 1997: Dr Giovanni Bonello, on behalf of the MTF, alleged the unilateral termination of various agreements by FMSS and wrote that termination must be properly grounded and clearly expressed. He also alleged that the eviction of MTF from their offices was tantamount to an act of spoliation.
30 April 1997: Dr Richard Camilleri, on behalf of the FMSS, alleged that the accusation of spoliation was unfounded and that it was the MTF which unilaterally terminated the contracts in question, and which had already been practically abandoned.
The FMSS had sufficient grounds to proceed with termination of all relevant contracts in accordance with their terms and therefore, in the existing circumstances, the government accepted termination by MTF. The FMSS reserved the right in respect of any damages suffered or which may be suffered as a result of MTF’s actions or omissions.
21 July 1997: A new FMSS board was appointed with Alfred Sladden as president (resigned 19 February 1999), Joe Bugeja as vice-president, Joseph Buttigieg; Joseph Portelli, John Cachia (resigned 19 February 1999), John Bonnici, Vince Cassar (resigned 19 February 1999), Saviour Gauci, Joseph Saliba (resigned 19 February 1999) and David Spiteri Gingell.
8 January 1998: The MTF president, Rev. Luigi Verze informed the FMS that a meeting of the MTF was held in Milan on 14 November 1997. He also requested the FMS to nominate their member on the MTF.
Moreover the president of MTF reminded FMSS that a sum of Lm365,764 was still pending.
16 February 1998: In reply to PQ 12301 made by Jesmond Mugliett, Minister Michael Farrugia said that the total construction cost of the New Hospital Project is Lm100 million.
March 1998: The constitution of the Foundation for Medical Sciences and Services was amended and the foundation split into two separate organisations. The Foundation for Medical Services (FMS) which retained responsibility for the health sector services and the Foundation for Social Welfare Services (FSWS) which took over Social Welfare Services.
July 1998: Norman & Dawbarn were chosen as the new designers for the new hospital.
Minister Michael Farrugia would later confirm, in a reply to PQ 14624 that the tender offer of Norman & Dawbarn was not the cheapest bid.
5 September 1998: The Nationalist Party is returned to power.

 September 1998: The new hospital project is re-evaluated. According to a reply to PQ 749 by Minister Deguara, the new administration found a situation where:
The structure was built on the Ortesa designs for a 480-bed hospital – with an additional floor and an additional wing to Block D.
The mechanical and electrical services were suspended as from 7 February 1997 to 31 December 1998.
The new wing of Block D and car park were to be completed by February 1999.
A medical brief for a 980-bed hospital.
The hospital concept had been changed from one of research and training to a general acute hospital.
The new administration decided to re-dimension the new hospital to a 650-bed hospital with a possible extension to 825 beds. The new hospital was to cater for Malta’s acute medical needs into the next century whilst incorporating secondary and tertiary services including all major specialities. All the clinical functions were to have a strong research and teaching component.
The completion of the first section of Mater Dei Hospital was due in 2003 and to be fully completed in 2005.
It is decided to terminate the contract of designers Norman & Dawbarn.
11 November 1998: FMS terminates the Design Consultancy Contract with Norman & Dawbarn.
Due to previous experience on the project, the government concludes that it is far more advantageous to have one contracted entity to design and build the project. One has to note that this option was also considered during the Labour administration although it was not taken on board.
The contract with Norman & Dawbarn places no onus on the client to give a reason for the termination of the contract.
19 February 1999: A new FMS board is appointed for two years: Dr Joseph L Pace (president), Rene H Formosa (vice president – resigned 2 June 2000), Dr Ray Busuttil, Dr Ray Xerri, Albert Attard, Dr Natasha Muscat Azzopardi, David Spiteri Gingell (resigned 1 October 2000), Emmanuel Micallef (appointed 10 May 2000), Saviour Sciberras (appointed 10 May 2000), Paul Camilleri (appointed 25 October 2000).
6 December 1999: FMS starts negotiations with Skanska on the Design and Build Contract, with a draft proposal prepared by FMSA.
29 February 2000: Skanska Malta JV and the Foundation for Medical Services enter into an agreement for the building, finishing and commissioning of the new hospital in Tal-Qroqq. The contract is a Design and Build Contract.
Apart from FMS representatives, the FMS negotiating team also includes a prominent worker, a prominent lawyer from a local law firm and a foreign consultant belonging to an international firm specialising on contract advisory services.
The advantages of a Design and Build contract include the following:
Speed: It allows for a fast method of construction as construction time is reduced because design and building proceed in parallel. Early start on site is possible, long before tenders have been invited, for some of the work packages.
Complexity: An efficient single contractual arrangement integrating design and construction expertise within one accountable organisation. Design and construction skills are integrated at an early stage which will allow a better coordination of the design, procurement and construction works.
Quality: The client requires certain standards to be shown or described. Skanska is responsible for quality of work and materials on site and its expertise is fully utilised throughout all stages of the project including the design stage.
Flexibility: the client can modify or develop design requirements during construction, Management contractor can adjust programme and cost to meet the client’s requirements.
Competition: The management contractor has been appointed because of management expertise. However, competition can be retained for the works packages which will be subject to competitive tendering.
Responsibility: The client has access to all of the management contractor’s records due to “open book” system of working.
Controls applied to contractor: All of the Management Contractor’s systems of working are subject to discussions and approval, by the client’s control ones its employment of expatriate staff.
Sectional completion: The hospital will be completed in parts, which will allow the client the possibility of early possession and a flexible method of migration from St Luke’s Hospital. Failure by the management contractor to complete on time will be closely monitored and penalties will be applied where necessary.
Comparisons between Design & Build Contract and the pre-1998 administration negotiations:
Cost: the costs reported by Norman & Dawbarn were subject to confirmation only after considerable design development which was still to be carried out while the Lm10 million figure mentioned by Anshen Dyer Consultants can only be a very rough estimate as no professionally prepared estimate has been presented. In comparison with this, the estimated target cost of Lm83 million of the project was calculated on pre-construction documents giving scheme design details of all medical and engineering systems within this project.
Design: The Skanska and Norman & Dawbarn contracts cannot be compared on a “like for like” basis. Skanska’s Lm4.8 million incorporates a larger scope of work than N&D’s Lm3.9 million design.
Management fee: Skanska’s management fee as per 2000 per Design & Build contract = 7.5 per cent of Lm75 million = Lm5.6 million capped at Lm5 million. Skanska’s management fee as per 1998 negotiations: nine per cent of Lm10 million = Lm9 million.
Accountability: The Design & Build contract gives the advantage of contractor responsibility. When FMS had Ortesa as designers and Skanska as building contractors, significant designer-contractor problems emerged. With the 1998 Norman & Dawbarn appointment as designers, the problems would have persisted and this would have encouraged further delays.
Maltese control: The FMS team has been enhanced with professional staff as from 1990s. Before that it had a weak organisational structure.
Expropriation: The surrounding land areas of the MDH project are held from being built on in case of any future expansion. This would solve the problem of cramming buildings into each other if expansion is necessary.
Saving on penalties: Due to awarding the Design & Build contract to Skanska, the Maltese government saved circa Lm7 million that was due because of changes in designs.
Approval of expenses: All MDH project expenses have to be approved by the client (FMS).
An open book system allows FMS access to all related documents including wages and allowances of contractor’s employees.
18 February 2001: New FMS board is appointed: Dr Joseph L Pace president (resigned 28 May 2003), Albert Attard vice president (resigned 11 April 2003), Dr Natasha Muscat Azzopardi (resigned 28 May 2003), Paul Camilleri, Dr Ray Busuttil (resigned 28 May 203), Dr Ray Xerri (resigned 28 May 2003), Emanuel Micallef (resigned 31 December 2002), Saviour Sciberras, Prof Joseph Bannister (appointed 21 January 2002 and resigned 28 May 2003).
12 April 2003: The Nationalist Party is returned to power, Dr Eddie Fenech Adami is sworn in as Prime Minister and Dr Louis Deguara is appointed as Health Minister.
28 May 2003: New FMS board is appointed: Rene Formosa president, Paul Camilleri vice president, Prof. Albert Fenech, Alfred Rizzo, Saviour Sciberras, Jesmond Sharples (board members).
April 2004: Lawrence Gonzi is sworn in as Prime Minister. Following a Cabinet reshuffle, Dr Louis Deguara is appointed Health, the Elderly and Community Care Minister. Helen d’Amato is appointed Parliamentary Secretary.
April 2004: FMS Finance consultant Jackie Camilleri completes the Mater Dei Hospital Gap Analysis Target Value vs Projected Final Cost.
3 May 2004: FMS presents the same report to the Health Ministry.
12 August 2004: Rene Formosa resigns as FMS President. The Health Minister appoints Perit Paul Camilleri as acting president.
30 September 2004: The government decides to stop, with immediate effect, all negotiations regarding the Target Cost and the completion date of the project with Skanska after it received the company’s latest counter-proposals. The government remains open to further offers by Skanska.
Following the Prime Minister’s announcement that Target Cost and Completion of project were suspended, it is announced that Skanska submitted further proposals which were yet again rejected by government, describing them as a sign of good will but not yet good enough.
3 October 2004: Lawyer Dr Richard Camilleri, a government appointed member of the MDH Negotiation Team vs Skanska “sets the record straight” in The Times to allegations that his firm was chosen because he is the Prime Minister’s cousin.
Camilleri argues that “Like everyone else in Malta, I have countless close relatives, one of them being former minister Evarist Bartolo, who is my brother-in-law. This has never caused any problems and I have acted for government entities even under the 1996-1998 Labour administration.”

The Story of Mater Dei Hospital Malta

1990: The idea of building a new hospital to serve as a centre of excellence complementing St Luke’s took root.
8 December 1990: The Foundation for Medical Sciences and Services (FMSS) was established by the Government of Malta by a deed of foundation as “an autonomous body corporate of a non-commercial nature” with the following aims:
· The furtherance and promotion of medical and related studies and scholarship, through research, publications and teaching;
· The provision of health care services through hospital, day care and other facilities; and
· Collaboration with other similar entities, especially on a regional and international basis.
The following sat on the first FMSS board: Dr Louis Galea (president), Prof. John Rizzo Naudi (appointed vice-president on 27 June 1992), Dr Antoine Mifsud Bonnici (appointed 27 June 1992), Dr George Hyzler (appointed vice-president 3 October 1991, retired 27 June 1992), Sig. Mario Cal, Prof. Frederick Fenech, Rev. Peter Serracino Inglott, Rev Charles Vella (appointed vice-president on 3 October 1991), Edwin Vella, Maurice Zarb Adami.
Following the 1996 October general election Prof. John Rizzo Naudi, Prof. Frederick Fenech, Edwin Vella and Maurice Zarb Adami offered their resignations.
On this date too, the Government of Malta signed a Collaboration Agreement with the Fondazione San Raffaele del Monte Tabor – Istituto Scientifico Ospedale San Raffaele. This agreement sought collaboration in the “sectors of health care and medical sciences.”
On this date too, an agreement was signed between FMSS and the Government of Malta for the management of the Zammit Clapp Hospital.
27 February 1991: FMSS (represented by its president Dr Louis Galea) and the Fondazione Centro San Romanello del Monte Tabor (represented by Rev. Prof. Luigi M Verze) together with the Centro Assistenxa Ospedaliera S Romanello (represented by Mario Cal and Dott. Raffaella Voltolini) and the Associazione Italiana per la solidarieta tra i popoli (represented by Ing. Enrico Pianetta) set up the Monte Tabor Foundation – Malta (MTFM), an Italo-Maltese Centre for the promotion of scientific research and health, educational and training services. The deed of foundation set up MTFM as an autonomous, charitable non-profit making organisation.
MTFM was established as an autonomous body corporate of a non commercial nature with its seat in Malta and the following aims:
· The furtherance and promotion of a philosophy and practice of medicine and health care inspired by the evangelical message ‘heal the sick’ and by humanitarian and sound ethical standards…
· Setting itself up as a centre of reference in the Mediterranean region for the study and treatment of ailments especially those relating to metabolism and degenerative diseases…
· Setting itself up as an educational and training centre for health care personnel.
On the signing of the deed MTFM was endowed with the sum of Lm120,000 borne equally between the two parties.
February 1992: The Nationalist Party wins a second term of office. Dr Fenech Adami is re-appointed Prime Minister and Dr Louis Galea is re-appointed Minister for Social Policy and Dr J. Rizzo Naudi as Parliamentary Secretary for Health. In 1995, following a cabinet reshuffle, Dr Louis Deguara replaced Dr Rizzo Naudi as Parliamentary Secretary for Health.
June 1992: The day to day running of the Foundation was originally entrusted to the Director General, Philip Rizzo who was officially appointed by the board in June 1992. Mr Rizzo remained in office until 6 December, 1994.
During his term of office Mr Rizzo occupied other posts namely that of chairman of the St Luke’s Refurbishment Committee and Director of Planning at university.
In August 1994, the president of the board of FMSS intimated that the fact that Mr Rizzo occupied the above mentioned posts was complicating matters and rendering control difficult.
Subsequent to Mr Rizzo’s resignation some of his decisions, of which the FMSS board was not aware of, came to light. These related mainly to acceptance and/or authorisation of expenditure on the San Raffaele Hospital and St Luke’s refurbishment projects. Rizzo denied the claims that featured in Deo Scerri’s report in The Times of 31 December 1996.
15 July 1992: A Letter of Intent was signed between FMSS and MTFM specifying the building of a hospital to complement St Luke’s as per business plan dated August 1991 presented by FMSS.
Investment on FMSS part: Provision of land, construction of structure, construction of building, provision of all equipment including medical and sanitary equipment.
MTFM’s part: To obtain the ‘know how’ of the Scientific Institute San Raffaele and the other Italian founding entities so as to be responsible for the design and construction supervision as well as the operation of the hospital.
The Government of Malta was to pay MTFM (via FMSS) a charge calculated on the basis of
1. Rent of hospital; all operating expenditure including costs, administration expenses.
2. Government guaranteed payment on the basis of an occupational level of not less than 80 per cent of total beds available.
August 1992: In view of the entity of San Raffaele project, FMSS engaged the services of Eng. E Farrugia to act as project director. Mr Farrugia occupied the post until February 1994.
9 July 1993: FMSS and MTFM signed a Frame Agreement confirming the letter of intent of 15 July 1992. This covers the Government of Malta’s desire to “construct a scientific institute to undertake research and … provide specialist medical treatment to complement public health care facilities … available in Malta. Such an institute shall be known as the San Raffaele Hospital and MTFM desires to “participate in the project and to operate the hospital.”
The agreement signified the Maltese Government’s desire that the hospital be operated according to the orientation and culture inspired by the philosophy of the Parco Scientfico Biomedico San Raffaele, an “association of hospitals and scientific institutions sharing the same evangelical philosophy: Ite, docete, senate”.
The letter of intent as confirmed by the agreement covered the “total design of the hospital, the statutory supervision of the construction of the hospital, the operation of the same hospital and the allocation of beds to the Government of Malta.”
The agreement sets out the framework of the contractual relationship between FMSS and the Government of Malta on one part and the MTFM and the Italian co-founders on the other part.
The agreement however does not only set out the framework but also provides the basis upon which the contractual relationship was to be built.
According to the Frame Agreement, FMSS shall be responsible: To define health care requirements which the hospital should meet; to procure land on which hospital will be built; to assist the government in organising the international construction tender; to manage the administration and accounting relating to the construction agreement.
The MTFM on its part was engaged by FMSS to be responsible for: Design, planning, application for permits, preparation of tender documents; technical and economic evaluation of tenders.
The San Raffaele Hospital (Malta) project was entrusted to MTFM who sub-contracted part of their rights and obligations (design and construction supervision) under the “frame agreement” to ORTESA Spa, a related company of the Italian co-founders of MTFM. Work on the designs started during 1993.
The Frame Agreement lists four contracts to be entered into, which are considered to be an integral and substantive part of the agreement and consequently the guarantor’s obligations apply to all these agreements, unless other arrangements are made.
1. Design contract: An original annex to the Frame Agreement and is clearly binding on FMSS, MTFM and the Guarantors.
2. Construction supervision agreement: Eventually called Construction Supervision Contract. This had to be negotiated and agreed to by 31 December 1993, but the date was later extended to 28 February 1994. No criteria were set out in the frame agreement in connection with the contents of this agreement which was eventually signed on 2 June 1994.
3. Operation Agreement which was to be agreed by 31 December 1995 on the basis of principles set out in the letter of intent annexed to the Frame Agreement.
This agreement had not been signed but the latest information indicates that Rev. Prof. Verze had agreed in writing to extend the date for negotiations to 31 December 1996.
4. Allocation of beds agreement was to be negotiated and agreed by 31 December 1996 on the basis of the principles set out in the letter of intent.
18 August 1993: Project Management Agreement between FMSS and Project Management Office Malta University Services Ltd for the latter to carry out detailed supervision of the construction of the hospital.
Although MUS Ltd appeared on the contract with FMSS, PMO is made up of a joint venture between MUS Ltd, University of Malta and the Director of Works.
The remuneration of PMO which comprises fees and expenses is calculated at five per cent of the total cost of the project. For the purposes of this agreement, the estimated project management fee was considered at Lm1.75 million which was to be paid in 48 equal monthly installments.
On completion of the project, PMO’s definite remuneration was to be calculated at five per cent on actual total cost in terms of the final project certificate. Payments paid to PMO will then be subtracted to arrive at the net balance payable.
As per Deo Xerri’s report, FMSS considered that PMO was understaffed and did not have enough manpower to ensure a proper detailed supervision of the project.
2 June 1994: Construction Supervision Contract signed. It forms an integral part of the Frame Agreement and is therefore binding between the parties to the agreement but is binding also on the other signatories thereto.
MTFM’s obligations under this contract is to carry out general supervision of the construction of the hospital, it being understood that the detailed supervision will be carried out by the Project Management Office, Malta University Services Ltd, who were appointed project managers for the hospital project.
In effect, MTFM’s duties consist of the provision of the following qualified specialists: Hospital construction manager; Hospital services manager (civil works); Hospital services manager (mechanical, electrical, medical equipment); Hospital medical manager.
MTFM cannot assign benefits, obligations or subcontracts without the written consent of FMSS. It was, however, agreed in this contract that MTFM shall make use of Maltese architects and civil engineers (England &England were appointed) for certain services.
15 July 1994: Roads Contract between FMSS and IRB signed. The contract for the excavations, geotechnical survey and external roads for San Raffaele Hospital is between, on the one part, FMSS as client and on the other part a joint venture made up of Impresem Spa, Rainbow Mix Concrete Ltd and G & P Borg (IRB).
15 March 1995: FMSS leased and occupied one floor of office space at Gattard House in Blata l-Bajda. FMS left Gattard House offices on 15 April 2000.
FMSS has also leased another floor at Gattard House to be used by its agency SWDP.
12 September 1995: Construction Agreement between FMSS and SKANSKA International Building Ltd, Blokrete Ltd, Devlands Ltd and Cassar, Grech, Ebejer & Partners.
Skanska was selected following a decision of the Adjudicating Committee set up by the Prime Minister in the later part of 1994. The committee was composed of nine members, including four Italians appointed on the committee to represent MTFM. FMSS did not have its own representatives on this committee.
It should be noted that one of the Monte Tabor representatives, Dott Vincenzo Mariscotti, was involved in corruption allegations in Italy. Dott. Mariscotti informed the committee that due to the allegations he would not be attending the committee meetings. It is not clear, however, whether Dot. Mariscotti actually resigned from this committee.
The conditions of the construction contract are based on the (standard) conditions of contract for work of civil engineering construction, published by the Fondation Internationale des Ingenieurs (FIDIC).
The contract for the construction (civil works) of the San Raffaele Hospital for the price, which includes VAT, of Lm31.75 million. This price which is based on Bills of Quantity appended to the contract, includes a negotiated discount of 7.5 per cent and comprises deductions from and additions to the original Bills of Quantity. The total costs of the hospital excluding the drainage system would cost Lm51 million.
The idea was to build a centre of excellence to complement the 50-year old St Luke’s general acute hospital which was to undergo an extensive programme of refurbishment. The 480-bed, state-of-the-art specialised hospital was to operate in the fields of diabetology, cardiology and degenerative diseases and other chronic illnesses prevalent in Malta and other Mediterranean countries. The new hospital was also to have a strong research and teaching aspect.
CMC (Coiperaiva Muratori e Cementisti) appealed the government’s decision that awarded the tender to Skanska.
10 October 1995: Skanska started construction work on the San Raffaele Hospital Project.
6 January 1996: FMSS approved the assignment of another design contract of MTFM referred to as ‘On site design contract’ (OSDC) for a fee of Lm50,000. This agreement was for the service of on-site CAD operator, secretarial service and a link with Milan.
February 1996: Emmanuel Attard is employed as Chief Executive of FMSS.
March 1996 Skanska maintained that 50 per cent of Ortesa’s mechanical drawings required adjustment; clerical specifications submitted were totally different from tender specifications; whereas the electrical drawings of the stairwell had to be produced by Skanska.
PMO on its part, maintained that although discrepancies in Ortesa design were more than normally expected in a project this size, Skanska’s delay was not totally attributable to design problems. PMO, however, pointed out that unless the design problems were sorted out in the near future, Skanska’s claims in this respect could become stronger.
Skanska had in fact made a 12-week delay claim up to January 1996 because of design problems. PMO instead awarded a two-week delay to Skanska in this respect.
In October 1996, however, Skanska submitted another claim of Lm2 million in relation to an envisaged 42 week delay (which also includes the 12 weeks mentioned above).
27 June 1996: The surrounding roads contract was completed by IRB on the date when the completion certificate was issued, nearly two years after the completion date stipulated in the contract.
IRB instituted court proceedings against FMSS stating that the work undertaken could not be carried out properly due to lack of proper design and radical changes in original plans. Contractor claimed damages estimated at Lm500,000.
On its part FMSS wrote to IRB on 18 November 1996 requesting payment of penalties for late completion estimated at Lm636,000. A further sum of Lm128,024 was also claimed due to lack of progress in terms of Clause 25 of the General Conditions of Contract for the Execution of Work in Malta which conditions form an integral part of the contract.
As a result of the above claim, FMSS offset the balance of Lm96,978 due in respect of interim certificate no. 16 against the total values of damages claimed, leaving a net balance in favour of FMSS of Lm667,047. FMSS was also requesting payment under the Performance Bond.
July 1996: The board of FMSS received an offer from Skanska to finalise the Ortesa drawings for a fee of Lm250,000. The responsibility of the design was to remain with Ortesa, however the delay responsibility (originating from design shortcomings) would be transferred to Skanska. Subsequent to a meeting with the PMO, the above offer was turned down by FMSS.
23 August 1996: In view of the serious problems with Ortesa, the board of FMSS decided to suspend all payments to MTFM.
September 1996: FMSS received a letter from Prof. R. England wherein he threatened to withdraw his legal representation because his company was not being paid the fees agreed to in the contract with MTFM. In order not to disrupt this project further, FMSS considered paying these fees directly to England & England out of its own funds.
The monthly progress reports contemplated on the construction supervision contract were never presented to FMSS.
The significant design problems were highlighted to Rev. Prof. Verze in a meeting with the Prime Minister and FMSS and PMO representatives. Don Verze visited the site for the last time.
10 October 1996: The drainage consultancy agreement was signed between FMSS and England & England according to which the latter were appointed as consultants on the drainage extension from the hospital to the Gzira pumping station.
26 October: The Labour Party wins the general elections.
October 1996: The new Labour government immediately commissions reports in order to be in a position to take decisions about the hospital. From the reports the following was concluded:
a. A new medical brief had to be prepared.
b. The concept of the hospital had to change from that of a specialised hospital of 450 beds to an acute general hospital of 800 to 1,000 beds. This hospital had to replace St Luke’s Hospital.
c. The contract of Ortesa Spa had to be terminated and a new tender was to be issued.
d. Skanska Malta JV had to continue the works on the existing footprint of the hospital from the designs of the original plans (those of the San Raffaele Hospital). Minister Michael Farrugia, in reply to PQ 11438 says that this was a cabinet decision and the additional cost is estimated at Lm2 million.
6 December 1996: A new (provisional) FMSS board is appointed. Mario Cacciottolo was appointed president, Joe Barbara and Alfred Vella were appointed as board members. This board was dissolved on 15 July 1997.
March 1997: FMSS commissions MSD Consultancy to quantify claims against MTF. According to this report the value of potential claims against MTF as at March 1997 was Lm9,120,046.
11 April 1997: The FMSS was instructed to request the Monte Tabor Foundation’s local representatives not to report on site and the locks of the FMS offices used by the MTF were changed.
23 April 1997: Dr Giovanni Bonello, on behalf of the MTF, alleged the unilateral termination of various agreements by FMSS and wrote that termination must be properly grounded and clearly expressed. He also alleged that the eviction of MTF from their offices was tantamount to an act of spoliation.
30 April 1997: Dr Richard Camilleri, on behalf of the FMSS, alleged that the accusation of spoliation was unfounded and that it was the MTF which unilaterally terminated the contracts in question, and which had already been practically abandoned.
The FMSS had sufficient grounds to proceed with termination of all relevant contracts in accordance with their terms and therefore, in the existing circumstances, the government accepted termination by MTF. The FMSS reserved the right in respect of any damages suffered or which may be suffered as a result of MTF’s actions or omissions.
21 July 1997: A new FMSS board was appointed with Alfred Sladden as president (resigned 19 February 1999), Joe Bugeja as vice-president, Joseph Buttigieg; Joseph Portelli, John Cachia (resigned 19 February 1999), John Bonnici, Vince Cassar (resigned 19 February 1999), Saviour Gauci, Joseph Saliba (resigned 19 February 1999) and David Spiteri Gingell.
8 January 1998: The MTF president, Rev. Luigi Verze informed the FMS that a meeting of the MTF was held in Milan on 14 November 1997. He also requested the FMS to nominate their member on the MTF.
Moreover the president of MTF reminded FMSS that a sum of Lm365,764 was still pending.
16 February 1998: In reply to PQ 12301 made by Jesmond Mugliett, Minister Michael Farrugia said that the total construction cost of the New Hospital Project is Lm100 million.
March 1998: The constitution of the Foundation for Medical Sciences and Services was amended and the foundation split into two separate organisations. The Foundation for Medical Services (FMS) which retained responsibility for the health sector services and the Foundation for Social Welfare Services (FSWS) which took over Social Welfare Services.
July 1998: Norman & Dawbarn were chosen as the new designers for the new hospital.
Minister Michael Farrugia would later confirm, in a reply to PQ 14624 that the tender offer of Norman & Dawbarn was not the cheapest bid.
5 September 1998: The Nationalist Party is returned to power.

 September 1998: The new hospital project is re-evaluated. According to a reply to PQ 749 by Minister Deguara, the new administration found a situation where:
The structure was built on the Ortesa designs for a 480-bed hospital – with an additional floor and an additional wing to Block D.
The mechanical and electrical services were suspended as from 7 February 1997 to 31 December 1998.
The new wing of Block D and car park were to be completed by February 1999.
A medical brief for a 980-bed hospital.
The hospital concept had been changed from one of research and training to a general acute hospital.
The new administration decided to re-dimension the new hospital to a 650-bed hospital with a possible extension to 825 beds. The new hospital was to cater for Malta’s acute medical needs into the next century whilst incorporating secondary and tertiary services including all major specialities. All the clinical functions were to have a strong research and teaching component.
The completion of the first section of Mater Dei Hospital was due in 2003 and to be fully completed in 2005.
It is decided to terminate the contract of designers Norman & Dawbarn.
11 November 1998: FMS terminates the Design Consultancy Contract with Norman & Dawbarn.
Due to previous experience on the project, the government concludes that it is far more advantageous to have one contracted entity to design and build the project. One has to note that this option was also considered during the Labour administration although it was not taken on board.
The contract with Norman & Dawbarn places no onus on the client to give a reason for the termination of the contract.
19 February 1999: A new FMS board is appointed for two years: Dr Joseph L Pace (president), Rene H Formosa (vice president – resigned 2 June 2000), Dr Ray Busuttil, Dr Ray Xerri, Albert Attard, Dr Natasha Muscat Azzopardi, David Spiteri Gingell (resigned 1 October 2000), Emmanuel Micallef (appointed 10 May 2000), Saviour Sciberras (appointed 10 May 2000), Paul Camilleri (appointed 25 October 2000).
6 December 1999: FMS starts negotiations with Skanska on the Design and Build Contract, with a draft proposal prepared by FMSA.
29 February 2000: Skanska Malta JV and the Foundation for Medical Services enter into an agreement for the building, finishing and commissioning of the new hospital in Tal-Qroqq. The contract is a Design and Build Contract.
Apart from FMS representatives, the FMS negotiating team also includes a prominent worker, a prominent lawyer from a local law firm and a foreign consultant belonging to an international firm specialising on contract advisory services.
The advantages of a Design and Build contract include the following:
Speed: It allows for a fast method of construction as construction time is reduced because design and building proceed in parallel. Early start on site is possible, long before tenders have been invited, for some of the work packages.
Complexity: An efficient single contractual arrangement integrating design and construction expertise within one accountable organisation. Design and construction skills are integrated at an early stage which will allow a better coordination of the design, procurement and construction works.
Quality: The client requires certain standards to be shown or described. Skanska is responsible for quality of work and materials on site and its expertise is fully utilised throughout all stages of the project including the design stage.
Flexibility: the client can modify or develop design requirements during construction, Management contractor can adjust programme and cost to meet the client’s requirements.
Competition: The management contractor has been appointed because of management expertise. However, competition can be retained for the works packages which will be subject to competitive tendering.
Responsibility: The client has access to all of the management contractor’s records due to “open book” system of working.
Controls applied to contractor: All of the Management Contractor’s systems of working are subject to discussions and approval, by the client’s control ones its employment of expatriate staff.
Sectional completion: The hospital will be completed in parts, which will allow the client the possibility of early possession and a flexible method of migration from St Luke’s Hospital. Failure by the management contractor to complete on time will be closely monitored and penalties will be applied where necessary.
Comparisons between Design & Build Contract and the pre-1998 administration negotiations:
Cost: the costs reported by Norman & Dawbarn were subject to confirmation only after considerable design development which was still to be carried out while the Lm10 million figure mentioned by Anshen Dyer Consultants can only be a very rough estimate as no professionally prepared estimate has been presented. In comparison with this, the estimated target cost of Lm83 million of the project was calculated on pre-construction documents giving scheme design details of all medical and engineering systems within this project.
Design: The Skanska and Norman & Dawbarn contracts cannot be compared on a “like for like” basis. Skanska’s Lm4.8 million incorporates a larger scope of work than N&D’s Lm3.9 million design.
Management fee: Skanska’s management fee as per 2000 per Design & Build contract = 7.5 per cent of Lm75 million = Lm5.6 million capped at Lm5 million. Skanska’s management fee as per 1998 negotiations: nine per cent of Lm10 million = Lm9 million.
Accountability: The Design & Build contract gives the advantage of contractor responsibility. When FMS had Ortesa as designers and Skanska as building contractors, significant designer-contractor problems emerged. With the 1998 Norman & Dawbarn appointment as designers, the problems would have persisted and this would have encouraged further delays.
Maltese control: The FMS team has been enhanced with professional staff as from 1990s. Before that it had a weak organisational structure.
Expropriation: The surrounding land areas of the MDH project are held from being built on in case of any future expansion. This would solve the problem of cramming buildings into each other if expansion is necessary.
Saving on penalties: Due to awarding the Design & Build contract to Skanska, the Maltese government saved circa Lm7 million that was due because of changes in designs.
Approval of expenses: All MDH project expenses have to be approved by the client (FMS).
An open book system allows FMS access to all related documents including wages and allowances of contractor’s employees.
18 February 2001: New FMS board is appointed: Dr Joseph L Pace president (resigned 28 May 2003), Albert Attard vice president (resigned 11 April 2003), Dr Natasha Muscat Azzopardi (resigned 28 May 2003), Paul Camilleri, Dr Ray Busuttil (resigned 28 May 203), Dr Ray Xerri (resigned 28 May 2003), Emanuel Micallef (resigned 31 December 2002), Saviour Sciberras, Prof Joseph Bannister (appointed 21 January 2002 and resigned 28 May 2003).
12 April 2003: The Nationalist Party is returned to power, Dr Eddie Fenech Adami is sworn in as Prime Minister and Dr Louis Deguara is appointed as Health Minister.
28 May 2003: New FMS board is appointed: Rene Formosa president, Paul Camilleri vice president, Prof. Albert Fenech, Alfred Rizzo, Saviour Sciberras, Jesmond Sharples (board members).
April 2004: Lawrence Gonzi is sworn in as Prime Minister. Following a Cabinet reshuffle, Dr Louis Deguara is appointed Health, the Elderly and Community Care Minister. Helen d’Amato is appointed Parliamentary Secretary.
April 2004: FMS Finance consultant Jackie Camilleri completes the Mater Dei Hospital Gap Analysis Target Value vs Projected Final Cost.
3 May 2004: FMS presents the same report to the Health Ministry.
12 August 2004: Rene Formosa resigns as FMS President. The Health Minister appoints Perit Paul Camilleri as acting president.
30 September 2004: The government decides to stop, with immediate effect, all negotiations regarding the Target Cost and the completion date of the project with Skanska after it received the company’s latest counter-proposals. The government remains open to further offers by Skanska.
Following the Prime Minister’s announcement that Target Cost and Completion of project were suspended, it is announced that Skanska submitted further proposals which were yet again rejected by government, describing them as a sign of good will but not yet good enough.
3 October 2004: Lawyer Dr Richard Camilleri, a government appointed member of the MDH Negotiation Team vs Skanska “sets the record straight” in The Times to allegations that his firm was chosen because he is the Prime Minister’s cousin.
Camilleri argues that “Like everyone else in Malta, I have countless close relatives, one of them being former minister Evarist Bartolo, who is my brother-in-law. This has never caused any problems and I have acted for government entities even under the 1996-1998 Labour administration.”

Malta voted as the Best Climate in the World by www.internationalliving.com

A quintet of sunny islands makes up the Republic of Malta, with its mild winters and hot summers. Malta, Gozo, and Comino are all inhabited--though with a mere handful of families, Comino only just qualifies. The remaining islands, Cominotto and Filfla, are for boat-trippers and seabirds.

These Maltese islands take the top spot in the Climate category of our 2007 Quality of Life Index. As you know, once a year, every January, we consider nearly every nation on earth in a grueling set of nine categories. This year, our survey looks at 193 countries. And Malta has the best climate in the world.

Fair weather, averaging 5.2 hours of sunshine a day--even in December. Right into November, daytime temperatures often nudge 70 degrees Fahrenheit. Spring comes early, around late February. Frost and snow are mostly unknown. There is winter rainfall, but it tends to come in heavy bursts for short periods. And, while the islands boast few sandy beaches, there are compensations: Summertime brings a round of colorful village festivals complete with fireworks. Diving and sailing are excellent. You can play golf, go horseback riding, and attend trotting races. The second-oldest theater in Europe is the Manoel Theatre, in the capital of Malta, Valletta. In the cooler months, October through May, you can see opera, theater, music, and ballet there.

Don't be embarrassed if you can't pinpoint Malta on a map. It's not on everyone's radar, and mostly unheard of by Americans. Malta is anchored almost in the centre of the Mediterranean Sea, 60 miles from the Italian island of Sicily, which is linked to Malta by regular 90-minute ferry service. There is a modern airport at Luqa (on Malta) with flights to numerous other European countries. Rome is but one hour away by plane.

The next closest neighbours are in North Africa, which lies less than 200 miles away. Travel west, and you arrive in Tunisia; go south from Malta, and you reach Libya.

In other words, despite the Republic of Malta's island status, you won't live here like a castaway.

The government is a politically stable parliamentary democracy, so you do not have to lie awake at night worrying about army coups and crazy colonels with big ideas. A president is the titular head of state, and executive power lies in the hands of the prime minister and the cabinet, whose ministers are appointed from elected members of Parliament. Headed by an attorney general, the judiciary is independent.

Furthermore, this little island became a member of the E.U in 2004.

Apart from the near-perfect climate, on both Malta and Gozo the living is easy and affordable. Crime hardly exists, the locals are hospitable, permanent foreign residents can take advantage of a 15% tax rate, and nobody pays property taxes. The health care is excellent. And you'll encounter no language difficulties...everybody speaks English.

Laura Sheridan
Editor, IL's Quality of Life Index

P.S. The Maltese drive on the left, like the British, but a little more recklessly.

the article can be found here