The public inquiry into the death of Jean Paul Sofia was one of the subjects to grip the nation during 2023, as the public united behind a grieving mother in her quest for justice.

Jean Paul Sofia died on 3 December 2022 when he went to deliver tools to a partially constructed factory in the Corradino Industrial Estate.  He entered the building, and seven minutes later it collapsed, with the 20-year-old to not be seen alive again.

Sofia’s mother Isabelle Bonnici fronted calls for a public inquiry – calls which were rebuked by the government which chose instead to wait for the conclusions of a magisterial inquiry into the case.  The government, after voting against an Opposition motion calling for the setting up of a public inquiry, eventually relented hours before a national protest drew thousands onto the Prime Minister’s doorstep in Castille Square.

It was second public inquiry of its kind in Malta after that which looked into the assassination of Daphne Caruana Galizia. This was a court process which ran between August and November and saw 69 witnesses testify, some of them more than once, and over 1,000 pages in transcripts and another 1,800 pages in documents put on record.

The process, led by retired judge Joseph Zammit McKeon who was joined by court expert Mario Cassar and Auditor General Charles Deguara, gave an unprecedented look into one of Malta’s most controversial industries and laid bare its many shortcomings.

Authorities tripping over each other, lack of resources, minimal enforcement capabilities, legal oversights, an alleged lack of political will, and an industry relying on self-regulation: every court sitting offered a new twist that left people shaking their heads and wondering just how things were allowed to be so wrong.

While the public inquiry board expressed that it would be seeking an extension until 28 March 2024 in order for its final report to be published, The Malta Independent on Sunday has combed through the witness testimonies in an analysis on a public inquiry which was the product of a civil movement.

A legal oversight

Most shocking in the search for responsibility was the stark realisation that – put simply – nobody was responsible for enforcing that the construction at the site where Sofia died was being done safely.

The partially built factory which collapsed, leaving Sofia buried under the rubble, was a stand-alone building, with no third-party property touching it.  It soon became apparent that this simple fact meant that, by law, there was no entity responsible for it.

The realisation came quite early on when the former chairperson of the Building & Construction Authority (BCA) Maria Schembri Grima, who in between the Sofia tragedy and the setting up of the inquiry had resigned following an unrelated incident, failed to provide an answer on who people can turn to if they have concerns on a building which has no neighbours.

“If it’s a structural issue, then one goes to the Chamber of Architects,” Schembri Grima told the board. 

“If it’s a problem of construction…” a pause ...  Zammit McKeon even felt the need to ask whether she was ok.  Schembri Grima replied in the affirmative, but ultimately there was no answer: the architect referred to the board’s suggestion that there should be an entity to enforce standards in such buildings – seemingly admitting that, at present, there is nobody to enforce those standards beyond those who are constructing the project.

“You need to see what remit the BCA had in this case.  The BCA is there first and foremost to safeguard third parties – so that neighbours are safe,” the architect said.

She said that the responsibility for a building on a site like that where Sofia collapsed is with the duty holders – and that is the same for following the procedures and documents submitted as part of the commencement notice.

“When there are no third parties, there is no method statement,” Schembri Grima clarified to the board as they tried to understand the matter.

“But you have the right to step in,” Zammit McKeon suggested.

“The BCA doesn’t get involved in sites where there are no third parties,” Schembri Grima replied.

“So when there are no third parties, BCA out,” Zammit McKeon stated.  “Yes,” was the reply.

It was an interpretation that some didn’t agree with: Michael Ferry, who was the CEO of the BCA’s predecessor, the Building Regulation Office, said that the authority had to be responsible for stand-alone buildings – but it was a statement which prompted the BCA to publish an official statement to declare that it was in fact not responsible for the site.

Further clarity as to how exactly this happened came in the very last sitting of the inquiry, with the testimony of lawyer Kurt Scerri from the University of Malta’s Faculty of Laws.

He explained how Malta’s construction regulations in the past centred largely around two main laws: the Avoidance of Damage to Third Parties Act (ADPTA), introduced in 2013 and amended in 2019 after a spate of – thankfully non-fatal – construction collapses, and the Environmental Management Construction Site Regulations (EMCSR), introduced in 2007.

The latter regulations were initially the responsibility of the Planning Authority, but the enforcement aspect was later transferred to the BRO.  The present issue however stems from the fact that when the BCA was created, it did not formally absorb the functions of the BRO – which was the entity it replaced.

“So informally, on 3 December (2022), who was responsible for the operation of the law?” Zammit McKeon asked.

“There was nobody responsible, because the BRO, as a government department, had not been absorbed by the BCA,” Scerri replied.  The witness confirmed his statement, even after being reminded of its implications.

Put simply there was a lacuna – or rather, a legal loophole – in the way the ECSMR was enforced.

State Advocate Chris Soler assured the board that the loophole would be filled. “But my son isn’t coming back, is he, Dr Soler?” Sofia’s father was heard telling the State Advocate – a sentiment reminding what the cost of the legal loophole was.

A system which is ‘bad from beginning to end’

The notion that the construction industry was not afforded the necessary enforcement attention was one of those things which was always known, in a way, but never spoken of in such a manner that would confirm it black-on-white.

That changed with the public inquiry as one government authority after another confirmed a bleak picture: there simply are not enough boots on the ground in order to keep up with the whole industry.

Various testimonies revealed that the BCA – responsible for enforcing method statements across the country – had 11 enforcement officers as of June 2022; the OHSA – responsible for enforcing the health and safety of every single workplace in the country – had 13 enforcement officers; and JobsPlus – responsible for making sure employers are in line with the law – had 12 enforcement officers, not all of whom were qualified to actually carry out workplace inspections.

Efforts to increase that complement to the desired level have proven futile for a myriad of reasons.

OHSA chairman David Xuereb told the inquiry that a business plan had sought an extra €2 million spread across three years to increase the enforcement staff from 13 to 45 people and the increase in administrative staff as well – money which never came – but added that even so it was difficult to find qualified people to take up the roles in the first place.

Outgoing OHSA CEO Mark Gauci said that qualifications weren’t an issue, but the issue was finding people with the desire to actually work in enforcement.

"They do not have..." Gauci cautiously began in order to describe the problem; "I'll say it for you... they do not want to get into other people's business [jilhaq salib haddiehor]," Zammit McKeon interjected.

Gauci nodded: "You need to have guts," he added.

The BCA’s first CEO Karl Azzopardi told the board that it had requested a budget of €18 million in order to have around 300 employees within the authority, but only got half of that. 

This meant that by the time of his departure there were only 11 inspectors.  This number has since increased to 21, Azzopardi’s successor Jesmond Muscat told the board.

Lands Authority chairman John Vassallo said that it is “humanly impossible” for the government to keep track of what happens on government-owned land, as the site of the factory collapse was.

INDIS Malta chairman Jean Pierre Attard said that that Malta would need “between 200 and 300 enforcement officers” to check all construction sites. “You can only mitigate risk. Never exclude it,” he told the board.

But it’s not just a matter of regulation on the ground: others testified that the country’s legal framework was not up to scratch either.

Chamber of Architects President Andre Pizzuto told the board in no uncertain terms that the system as a whole was “bad from beginning to end” and one which is mired in bureaucracy that “drives you to desperation” and needlessly split between many and various authorities.

“What is the Malta Competition Authority doing regulating lifts? What is the Malta Tourism Authority doing issuing fire regulations? Why is asbestos regulated by BCA?” he questioned.

Asked about the recently-introduced role of Site Technical Officer, an engineer or architect nominated by the contractor to ensure regulations and method statements are meticulously followed, the witness was refreshingly direct. “The STO is a stupid concept, to put it bluntly. The quicker they disappear, the better.”

He said that the sector needs to fall under the wing of one super-authority which regulates the industry by itself and serves as a central point of reference for what standards and codes should be followed.

An industry reluctantly regulating itself

A lack of regulation in effect creates a space for self-regulation, and that is exactly what stakeholders told the board has happened in the construction sector.

Pizzuto himself said that such was the Chamber’s frustration at the inaction from the authorities was that its council had to set standards for its members itself by introducing a code of practice, “instead of waiting for the BCA to decide, which might take 30 years.”

Malta Developers’ Association president Michael Stivala detailed what judge Zammit McKeon described as “a self-regulated industry.”

Stivala noted that the MDA had attempted to create a register in order to keep stock of all operators within the industry. From this exercise, the MDA found that around 65% of all contractors were not insured, and that a number of operators don’t even have a VAT number.

When asked about the MDA’s members’ training, Stivala stated that the association has its own academy and is ready to train its members’ employees.

After these questions, Judge Zammit McKeon asked the witness: “Do you realise that from what you’ve said, the industry is regulating itself?” Stivala responded in the affirmative.

What emerged from this line of questioning to various witnesses is that none of these stakeholders representing different professions in the sector want self-regulation.

Stivala said that the MDA had been lobbying for regulations to license contractors for over eight years, Pizzuto said that it wants a more centralised authority and wants more deterrents in the case of wrongdoers, and the Chamber of SMEs’ Abigail Agius Mamo, who represents the vast majority of smaller contractors, told the board of the need for minimum standards which are enforced by the BCA.

“I think we need to recognise that in sectors like construction where there is a certain danger, we cannot rely on self-regulation,” she said – summing it up.

But within this context, the board also heard from Martin Debono, a technical advisor to the Building Industry Consultative Council (BICC), who said that there was no political will to publish building codes, noting that these were ready before 2020.

“The BCA… after the election they were shelved,” Debono told the board, adding that the BCA CEO Jesmond Muscat had told him that they did not wish to burden developers more.  On its part, the BCA denied the claim that the codes had been ready for use for four years but had been shelved.

Regardless, it took the death of Miriam Pace and then of Jean Paul Sofia for concrete action to start to regulate the sector to be taken.

Some pain will never go away

In the midst of all this though, we are reminded about the human cost that shortcomings like those detailed throughout the public inquiry bring.

Jean Paul Sofia’s mother Isabelle Bonnici fought long and hard for a public inquiry to be opened, and then had to sit through the emotional pain of listening how the system went wrong and no doubt contributed to the death of her only son.

She was the first witness to address the public inquiry, and she detailed how the last message she shared with her son was an "I love you" after he had left for work – work he would never return from.

She shared how when she arrived in Kordin she was initially told by someone that Jean Paul had been led away safely from the building collapse, and subsequently went to Mater Dei Hospital only to be told by the confused nurses that he wasn't there.

Bonnici said that she went back to the collapse site, but couldn't bear to get close.  She spoke of the thoughts going through her head: "Maybe Jean Paul was in the basement at the time and he's alive?  Maybe he's shouting for help? Maybe he's shouting for his mother? Is he in pain?"

"He was my only son.  He had a life, a girlfriend, a future," she said, her voice raw with emotion.

"My son's death made me feel like I had to do something," Bonnici said.  "I don't want any parent to go through the eternal pain I am going through now," she continued.

“I will not see my son marry,” she told the board, her voice again breaking with emotion.

“I hope that his death will lead to meaningful change,” Bonnici said. 

Her hope is no doubt shared by the whole country.