Whistleblower had flagged abuse of medications inside Mount Carmel

A care worker who was sacked from a private nursing firm after blowing the whistle on nurses whom he claimed were crushing sleeping pills into the tea of prison inmates at Mount Carmel's Forensic Unit, was awarded €5,000 after winning an unfair dismissal case.

Both the care worker, Patrick Agius, and his partner Ann Bugeja, a staff nurse, were transferred from their posts by their private employer and had their wages reduced after reporting the alleged malpractice.

The two employees had told the health authorities back in April 2011 that they witnessed nurses administering medications not prescribed by Mt Carmel doctors, by crushing them into the tea of an inmate who frequently paged nurses during their night shift.

The inmate was a convicted murderer whose insomnia at night often means he pages nurses every other hour for a cup of tea, and this effectively prevents nurses from sleeping on the job when they should be monitoring the CCTV inside the cells.

The nurses' lawyer Robert Abela wrote to the health minister about the documented allegations back in October, asking him to intervene in the matter after having first reported it to CEO Edward Borg in May.

Since then, Bugeja and Agius had to resign their part-time posts from the private care provider Health Care Services Ltd, a company engaged by the health division to provide nursing services at various stations.

Both Bugeja and Agius were given transfers to other postings after flagging the abuse taking place. In the case of Bugeja, she was effectively penalised by being paid one euro less per hour. The couple are pursuing complaints against their former employer Gaetano Bonnici with the department of industrial and employment relations.

Agius said he first witnessed the abuse when he saw a nurse on night-duty at the forensic unit crushing tablets so that she could add them to the tea of an inmate.

"This particular inmate spends the entire day asleep, so at night he cannot really sleep. Every hour or so, he pages the nurse in the nursing station for a cup of tea. The norm is that care workers emerge from their own separate room, collect the inmate's cup from his cell, return to the nursing station for the tea, and take it back to the inmate."

But Agius says he was taken aback when he noticed little mounds of crushed medication - possibly sedatives although Agius cannot be certain about the drugs that were administered - being prepared beforehand, so that they could be added to the inmate's tea. "I knew that the inmate did not have any prescribed medications, because I had been working there since 2009. One evening the nurse asked me to bring the inmate's cup to her so that she could add the medication to it. But I just pretended I forgot to bring the cup back. I wanted no part in this."

When Agius started refusing to take the tea to the inmate, his fellow nurses started taunting him by using his own mug to crush the tablets in front of him. "I was hurt. As a care worker I took pride in knowing how each inmate takes their tea and coffee. I felt I cared for them. These nurses found my resistance to be a laughing matter."

Agius reported the incident to his partner Mary Ann Bugeja, a registered nurse, who like him worked a night-shift at the forensic unit as part of their part-time job with Health Services Group.

Bugeja says she first witnessed the nurse in question taking out anti-psychotic drugs from the medication cupboard. She pointed out to her that Mount Carmel administration had then discontinued the so called 'stat' treatment: a regular dispensation of tablets to inmates that took place in the evenings at around 7:30pm.

"So when I asked her what she needed all those medications for, she didn't take notice of me and took the drugs to the guard room and placed them on the desk in front of the CCTV monitor... this practice must have gone on even when I wasn't on duty, because I was once contacted by the nursing officer Alistair Chetcuti, who asked me why so many medication bottles had been left out by the monitor. He instructed me to tell night nurses to be careful that all medications are not left unattended by the CCTV monitor."

According to Bugeja, the medications included the anti-psychotic Largactil, the sedatives Phenergan and Atarax, and other pain relief medications such as Panadol, Ponstan, Voltaren and Zantac.

Bugeja said she later instructed all nurses that insomniac inmates should only be treated after first contacting the duty medical officer for permission to administer medication, and not by adding crushed tablets to their tea.

But the practice continued, with Bugeja chancing upon the crushed substances placed on a white paper on another evening, when she entered the nursing station at 3:30am during a handover.

"I confronted the nurse about the crushed tablets and told her I would not accept such practices that endanger the wellbeing of the inmates. She retaliated by saying that many colleagues of mine were talking behind my back and that she was 'ready to start a war' with me...

"So I decided to collect all the substances and give them to the deputy nursing officer and Major Frank Borg, the senior correctional officer at the forensic unit."

Bugeja also filed an incident report with Mt Carmel Hospital on 29 April 2011 after witnessing what had been going on throughout the whole month. The same report was later copied to chief executive Edward Borg and health minister Joe Cassar.

But this only created more problems for her: after being confronted by her employer Gaetano Bonnici, she was transferred to a nursing station at the Malta Freeport and also paid one euro less than her standard €9 hourly rate.

In a letter she received on 6 May, Bonnici writes that since it had transpired that the team of nurses at the forensic unit could not function together, "it was decided that for the smooth running of the unit" she would be transferred to the Freeport clinic.

Soon after, Patrick Agius filed another report with the managing nursing officer at Mt Carmel, claiming the nurses were still administering the tablets without a prescription. Agius says his employer called him and ordered him to start working a morning shift. "I couldn't do this because I already have a full-time job, so I was effectively being made to resign."

To add insult to injury, Bugeja has to pursue a complaint with the department of industrial and employment relations against her formal employer, saying that her advertised hourly rate of €9 includes her pro-rata leave and other bonuses.

"My hourly wage was split into a basic wage of €4.43 and the rest, €4.57 is an allowance that covers all my vocational leave and bonus," Bugeja said. "And this means I cannot take any form of leave, because it is integrated into my hourly leave. How can anyone lead a decent life under such conditions?"