The former Director of Nursing and Midwifery at Mater Dei Hospital is still recovering from the psychological trauma of being removed from her post, suddenly and with no explanation, two months after the general election in 2013.

The Ombudsman’s Commissioner for Health lambasted the decision, calling for Mrs Attard’s reinstatement, but the authorities seem to have taken little notice of the Commissioner’s report, and the former director is now seeking justice through the courts.

“The humiliation and psychological trauma I went through was agonising – I wouldn’t wish it on my worst enemy,” Mrs Attard said in an interview with The Malta Independent on Sunday. “I was told that I was not even wanted on Mater Dei’s pavement by former Health Minister Godfrey Farrugia.

“I was made to doubt my capabilities and lose all belief in myself. For months on end I cried. I cried when I went out with my family, I cried at home and just stared in disbelief, continually. Even my four-year-old started asking why I was crying,” she said.

The unforeseen decision

Mrs Attard graduated with an MSc Nursing degree in 2007 and held the post of assistant lecturer in the Department of Nursing at the University of Malta. She was undergoing her PhD course when, in 2009, she applied for the post of Director of Nursing and Midwifery at Mater Dei Hospital, an application supported by the university.

She was appointed Director of Nursing and Midwifery in 2009 and her contract was extended for another three years in 2012 after she was successful in a public call for applications. But on 16 May 2013, two months after the present government was elected and only one year through her second three-year contract, Mrs Attard was called in for a meeting with Mater Dei’s CEO Joe Caruana.

There she met Claudio Tonna, then Head of the Health Secretariat, who informed her that she could no longer occupy her role because of complaints, some of which had even reached the Office of the Prime Minister.

“I asked what the complaints were, so I could answer them, but he said that the content of the complaints did not matter, because the decision had already been taken,” Mrs Attard explained. “I thought I was having a stroke – I couldn’t even move or talk with the shock.”

The decision was unanticipated, particularly because Mrs Attard’s performance as Director had been exceptional and she had received a 10 per cent performance bonus two years in succession. Her last performance review, which covered the period between November 2011 and November 2012, stated “Ms Attard takes up this responsibility full and works and drives in the direction that the hospital decides. She has nurtured a good team around her and is a highly competent individual.”

Why did this occur?

The transfer could have well been a result of the reshuffle within nursing management which had happened under Mrs Attard’s directorship. According to Mrs Attard’s Affidavit, after she questioned her transfer, Mr Tonna had said “Just thank the Lord that I’m not sending you to Mount Carmel or Gozo, or in a car doing nothing, like they had done to me in the 1970s.”

“Of course, I told him then and I will say it now: if that was the case, it was wrong. What was wrong then is wrong now, but two wrongs never make a right,” the former director said.

Mrs Attard explained that during her meeting with Mr Tonna, his telephone started ringing and she could see that it was the name Isabelle Aquilina. She immediately realised that she was possibly the nurse who wanted to replace her, and Mr Tonna admitted that she would be taking over her job. “I pointed out that Ms Aquilina had no experience in management, to which he replied: “That is none of your business”. He then continued to show me a file full of transfers that needed to be implemented, and he said I was not able to do it,” she said. “So it’s clear that they wanted a yes-man.”

Colleagues expressed fury to Prime Minister

Mrs Attard’s colleagues were stunned by the government’s decision and some even went so far as writing to the Prime Minister, asking him to revoke the decision. Mater Dei’s CEO and the other nine members of the hospital’s board of directors also disapproved of the decision and tried to persuade the Ministry to reverse it.

In their letters, her colleagues wrote that she was the best thing to happen to the nursing department.

The former Director set up a meeting with Prime Minister Joseph Muscat, but he failed to turn up, sending his personal assistant Sandro Craus instead, who insisted that the OPM was unaware of the transfer. Mr Craus promised Mrs Attard he would meet her again but, despite several attempts to contact him, this never happened.

“It’s funny because, prior to the election, Dr Muscat had said to me “Aħna nies bħalek irridu biex naħdmu u nimxu 'il quddiem” (“We need more people like you to be successful”), she says. Everyone I spoke to said that it was not his decision. To this day, I don’t know who took it.”

Told to leave through the backdoor after second let-down

In a meeting, Dr Godfrey Farrugia – at the time the Minister of Health – told Mrs Attard that he strongly believed in her capabilities but could not send her back. He agreed to appoint her as Director Nursing at Boffa Hospital, but at a secondary meeting, he informed her that he could not uphold that decision, again because the management of Boffa Hospital disagreed.

“I couldn’t believe this was happening again. They were making me out to be some kind of monster. I collapsed – right there in the Minister’s office. When he saw this, he asked me to use the back door to leave. But my husband [who had accompanied Mrs Attard] informed him that we would walk out the same way as we had walked in, he was too fed up with being given the run-around,” she said.

“I never expressed my personal beliefs at work”

“Like everyone, I have my political beliefs, but I never pushed them in anyone’s face. The entire team worked together for the benefit of the patient and for the nurses, irrelevant of our political beliefs,” she says.

Mrs Attard believes that the unions also had certain influence. “I always strived to improve the conditions of nurses. However I could not agree with certain industrial action to the detriment of the patient. The patient always comes first,” she said.

“I would not say I was disliked, but of course in the position of Director one has to take certain decisions – ones which might not go down well with everyone. New blood was being promoted and certain people had to be moved around – familiarity breeds contempt. However, I was never a pen-pusher, I made a distinction between what was fair and unfair,” she said.

At the time of the transfer, Mrs Attard was working closely with the CEO on a five-year strategy aimed at improving quality and accountability within the nursing and midwifery department at Mater Dei Hospital.

“Money won’t make up for all the heartache”

The Ombudsman’s report was clear – the removal of Mrs Attard from her post was unjust and a source of humiliation and suffering. But following the publication of the report, the authorities seemed to care little.

“No one ever spoke to me about it. All I got was an email from the Human Resources Department, telling me that they wanted to give me €2,000 as ‘emotional compensation’. I returned the money, as this was not about the money. Money would not compensate for all the heartache and hardship I went through, all the difficulties my marriage and family went through. I have already battled with cancer once, and that stress could have easily caused a relapse. What compensation is there for that?”

To add insult to injury, a year after Ms Isabelle Aquilina replaced Mrs Attard, Ms Aquilina herself was replaced – again without a public call for applications. “At that point I believed I could have been sent back, but when I wasn’t I broke down all over again – I then lost all hope.”

Mrs Attard has now filed a civil case in court but she says that the authorities once again seem to have been indifferent to it all. “They broke a contract. What people who comment do not seem to realise is that I responded to a call for applications specifically for the position of Director Nursing and Midwifery Mater Dei and my contract stipulated this. This was not like a contract with government where it is stipulated that you can be transferred due to exigencies of service.”

Mrs Attard said that in the past two years, a number of people who had been through a similar ordeal had approached her, but many of them were afraid to speak up, because of possible repercussions.

She said that although she can understand that every government needs to employ people it can trust, one should not be transferred if he/she is doing a good job. “Such decisions can’t be taken on a whim, or on a personal promise – particularly in the health sector, where the patient is involved,” she says. “So many repercussions occur when people in high places, who should be giving guidance and vision, are changed. People get mixed up, they become insecure. All this has an effect on the work output.

“Initially, I wanted to go back to my role as Director. I love Mater Dei and the people I represented as Director. I also loved making a difference to patient care which is why I applied for the job in the first place. But given all that has happened, it would just be too uncomfortable to go back now. I do, however, want justice. I would like the court to decide if I was right. 

“Time has passed and I’ve had people telling me to let it go, but I can’t. There is not a day that goes by when I do not think of everything that has happened to me. It’s not out of revenge, but rather about hoping to one day be able to obtain closure.”