Parliamentary Secretary for Active Ageing Justyne Caruana told this newsroom that no internal investigation into the case of deceased Leonard Thomas Lancaster was possible "and legal advice was even sought about this".

The widow and relatives of the deceased patient at St Vincent de Paul Residence have claimed in a Constitutional Application that the man was a victim of gross negligence by nursing staff and had several fundamental human rights breached.

"We could not hold an internal investigation into the Lancaster case. We found out about it through the media and we never received complaints or any notifications. How can I act on a situation that occurred eight months after the alleged circumstance took place? Once they chose to open a constitutional case, I must submit myself to the authority of the court. The case must now take its due course. It doesn't make sense to run an internal inquiry while a court case is ongoing, and apart from this there is the time gap. Had the relatives complained at the time, I would have ordered an internal investigation there and then."

Asked about the action the Ministry would take should neglect be found, she said "all required action in accordance with the Court judgement. But remember, remedies through the constitutional court might not be the remedy those who opened the case would want".

Further pressed to state whether or not the persons involved would be fired if the allegations are true, she said that "We have yet to identify them. Remember we never received a complaint, to the contrary, we have a letter complimenting the service provided by the relatives".

Rooms for elderlycouples

Discussing other recent cases in the media, the conversation turned to the recent revelations of an elderly couple, who have had an application pending to be closer to each other for over a year. Dr Caruana said that she could not comment on any specific case; however, she spoke on the issue in general.

"Over the years, no policy or service for couples was created. There was a very limited service for couples both in St Vincent De Paul and in other homes and there was surely a lack of foresight in this regard. We are conscious of this and every project we undertake in the future will include rooms for couple. Having spent their entire lives together, and then separating them at a later stage is wrong.

"We found this problem at the beginning of our legislature. In fact, the long-term care beds in Gozo now include rooms for the elderly as so do the newly completed project at SVP of SJ3 Ward." She also mentioned situations where, for example, the husband qualified for a home but the wife did not, "and I believe this is one of those cases".

"If I were to please the Opposition, I would take a place in a home and give it to someone who would take the place of a more urgent case; however I have to look at the bigger picture".

She stressed that she will move according to the multi-disciplinary team's decision as they determine the gravity of the case. "Everyone who wants to enter a home feels their case is a strong one: however, I will decide according to the multidisciplinary team's criteria.  Even if we were to buy all the private sector beds, we still wouldn't have enough".

2,000 pending applications for homes for the elderly

"I understand each case is urgent and important. Due to lack of planning in the past, today we find ourselves in a situation where we have2000 pending applications, with the oldest application dating back to 1996. These applications have been pending for a number of years and I have been criticised for a waiting list I did not create. There are, on average, five to seven new applications every day".

While discussing Gozo, the Parliamentary Secretary stressed that Gozo has an ageing population; however it lacks the services to address this issue. "Dementia is on the rise and we now have a strategy. Part of this strategy is to address the needs of Gozo." She mentioned an interesting project, a day centre for persons with dementia.

"The idea is to provide a place where people with dementia will be looked after. At the same time we will be helping their families and ease the pressure they are under. By offering this service, their families will be able to continue with their day-to-day lives. Many of these people stop working in order to care for their family members suffering from dementia, thus the repercussions are much larger than one can imagine, as well as the stress and burnout family members' experience."

Public-private partnerships in relation to homes for the elderly were introduced in Gozo a few weeks ago, she said. "We bought 10 beds. Now, if one asks whether 10 beds will solve the problem, my response would be that with 10 beds we helped solve problems at the Gozo General Hospital, and we actually did.

"The system in Gozo allows for the elderly to stay in hospital until they can be transferred to the geriatric ward. On paper, there wasn't much of a waiting list, but in reality, like in Mater Dei, there was a congestion of people trying to be admitted to the wards, which they were packed.

"With these 10 beds we are in a position to lessen the burden in the female ward. Ten beds in Gozo is a lot. Considering Mater Dei has around 800 beds, a major ward in Gozo has around 40 beds. When speaking about ten beds we are talking about a quarter of a ward. The aim is to keep expanding. We are also talking to the private sector and there are private investors showing interest in opening homes for the elderly."

Only highly-dependent elderly patients to be allowed in St Vincent De Paul

"Eleven per cent of St Vincent De Paul's patients are completely independent. Those 11 per cent are there, but from now only heavily-dependent residents will be admitted to St Vincent De Paul. There were some who, after this fact was made public, realised that they were taking up space of someone who needed to be there and chose to move into a home. St Vincent De Paul is a long-term care facility where patients receive acute care. We have since seen a few requests from those 11 per cent to move into homes. However, since the re-branding, it is guaranteed that no one with low or medium dependency will be accepted at SVP".

Number of respite beds in Malta tripled

"The elderly are now on the agenda more so than before. In the past we never used to hear about waiting lists for example. Today we are speaking about these issues as the reality is that we have a much higher number of elderly people.

"We are service providers, and community services are essential. Home help for example sees care assistants give basic assistance at home." Dr Caruana mentioned meals on wheels, which has a long waiting list, and a tender is currently being evaluated "that will address all on this list that has built up over the years".

She mentioned respite services, stating that the government can now provide a nationwide service with the number of respite beds in Malta having tripled, with two beds being offered in Gozo on a PPP basis. "Some might question the fact that it is only two beds in Gozo; however, compared with the current services provided, this is a good number.

"In Malta, we originally began with seven beds which rose to 21 last October. These respite beds are only for a short period of time so there is quite a turnover, and are normally used by patients for three weeks. This is different from long-term beds."

Dr Caruana then spoke about Comcare, where services for nurses, carers, physiotherapists, social workers etc., provide community care. Until last year, Comcare in Gozo only had a nurse and someone to help patients wash, she added.

"Now, Gozo will be comparable with Malta so there won't be any double standards. While Comcare is one service, there were differences in what was offered in Malta and in Gozo. This will now turn into a uniformed service.

"We have begun contacting those on the waiting list for elderly homes to see if we can assist them through these services. Using a sample of 800, out of the 2,000 people on the waiting lists, 200 of them can use these services. It is quite a significant number."

Proposal for delivering medicines to homes is at an advanced stage

Turning to the proposal of delivering medicines to homes, she assured that it is currently at an advanced stage. Although the scheme falls under the Ministry for Health, she said that her secretariat is in communication with the Ministry over this issue since the persons that will use this service are people who fall under her Secretariat's responsibility.

Talking about people with a disability, she referred to the 1969 law requiring companies with 20+ persons to hire a person with disability, or contribute to a fund.

"Over the years there were companies that followed this law, but these were few in number. We tackled it in the budget by trying to incentivise employers to employ persons with disability while recognising those who had honoured the law over the years with tax credits and exemptions.

"Those companies that will not employ people with a disability will have to give a contribution. It is a way of encouraging the employment of people with a disability. At the end of the day, they must contribute and shoulder part of the responsibility."

"Malta is one of the lowest ranked countries in the EU with regard to employed people with a disability," she said, adding that through EU funds, a national database will be created to have a real and actual picture of people with a disability in Malta. "Through this database we will know each case, their needs, care plans and so on. This will help us have a clear picture of what is going on in the disability sector as well as help with the research stage of policies."