Leaked documents have revealed that a €1 million bribery fund was allegedly linked to Steward Health Care's efforts to secure significant financial increases during negotiations with the Maltese government.

A Times of Malta report published on Sunday revealed that the fund may have been central to allegations of kickbacks involving Steward, Accutor, and former Maltese officials, including ex-Prime Minister Joseph Muscat, former Energy Minister Konrad Mizzi, and former Chief of Staff Keith Schembri, from nearly 300,000 internal Steward documents obtained by the Organised Crime and Corruption Reporting Project (OCCRP).

The three men face charges of corruption after a magisterial inquiry into the three hospitals’ concession was concluded.

The internal records indicate that the fund was established in 2019 through an agreement between Steward Malta director Armin Ernst and Swiss firm Accutor’s owner, Wasay Bhatti.

The alleged fund was to be terminated if financial increases being negotiated by Muscat’s government failed to materialise, the report said.

The report said that payments into the fund were tied to securing a 9% annual budget increase, which had the potential to double Steward’s revenue over a seven-year period.

The alleged scheme coincided with Mizzi signing a memorandum of understanding (MoU) in August 2019, which committed the government to a 9% yearly budget increase and improved terms for Steward’s controversial hospitals concession, the report said.

This MoU outlined financial commitments, including €1.4 million annually for leasing the Barts Medical School, “free” use of drugs and medical consumables worth €5 million per year for a five-year period given to Steward, and a transition period for payments to stabilize.

It continued that health ministry officials reportedly raised concerns that the proposed increases would significantly inflate public spending without providing additional healthcare benefits.

As part of the deal, Steward agreed to pay Accutor €100,000 per month for consultancy services aimed at securing government concessions. In addition, Accutor was promised 30% of Steward’s profits from the three hospitals covered by the concession, Gozo General, Karin Grech and St Luke’s hospitals.

The report said that investigators believe the fund was intended to facilitate a broader plan requiring cabinet approval, including the transfer of Barts Medical School to a US real estate entity.

The fund's activities came at a stalemate after Muscat’s resignation in late 2019, delaying the finalisation of Steward’s financial package.

Despite Ernst contemplating ending the arrangement due to political uncertainty in January of 2020, Bhatti urged its continuation, citing its importance to their healthcare operations. Around the same time, Muscat joined Accutor as a consultant, receiving €15,000 monthly.

Investigators believe the consulting arrangement was pivotal in facilitating Steward's requests for improved financial terms, the report said.

Muscat reportedly attended a Steward meeting with the government in early 2020 to reignite stalled negotiations but maintained that his involvement was limited to facilitating introductions.

Payments into the fund stopped two months later, and discussions about the financial package ultimately fell apart in 2021 due to opposition from then-Health Minister Chris Fearne and other officials.