From: Alice Elizabeth Taylor
PPP by Stealth: Hospitals for Sale

[Click here to read this article in Albanian language]

It seems the Albanian government could be negotiating a new Public Private Partnership that they are intent on keeping out of the public eye.

Through a complex web of Memorandums of Understandings, offshore companies, and hidden investors, they could be planning to sell off public hospitals to a private entity that lost millions of taxpayers’ money and resulted in allegations of government kickbacks, fraud, and a criminal inquiry in Malta. The fact that negotiations have taken place and plans have been drawn up was communicated to Exit by one ex-government employee and another senior official still in office.

The story starts in 2015 when Ram Tumuluri, a Indian-born Canadian citizen with a track record of insolvency, debt, and fraud, started boasting that he was working with the government of Albania on a 400-bed hospital and the government of Montenegro for a 300-bed hospital. No one thought much of it at the time, until journalists in Malta started questioning a deal he was involved with as an investor in Vitals Global Healthcare (VGH).

Who are Vitals Global Healthcare?

VGH were a healthcare company based in Malta that, without any prior experience in anything, won a 99-year concession to run three Maltese hospitals in a contract worth a staggering EUR 7 billion.

The government tried to sell the idea of the PPP by saying it didn’t have enough money to upgrade the hospitals themselves. VGH were to take care of all the investments and then lease back hospital beds and services to the government a few years later.

VGH were then given EUR 51 million of Maltese taxpayers’ money with the last installment being announced by the government the day before they announced VGH would be sold to American company, Steward Healthcare.

Despite being bailed out by taxpayers to the tune of tens of millions, VGH did not deliver on a single promise, such as providing additional beds in state hospitals, refurbishing various premises, or even paying salaries from their own pockets.

Maltese investigative portal The Shift News then found that a key company in the VGH group faced bankruptcy charges in the British Virgin Islands. Interestingly, as The Shift was publishing stories related to this, they received a number of cyber attacks, preventing traffic from accessing the site and the stories for hours at a time.

So where did all the money go?

Not only did all of the money given to VGH disappear into thin air, but they had accumulated a debt of EUR 55 million and left suppliers unpaid and in the lurch. The Maltese government failed to answer any questions on where taxpayers money had gone, and how a company taking over the state hospitals had managed to go bankrupt in just 18 months.

The owners of VGH were hidden behind a complex web of offshore companies in BVI and Malta, designed to avoid detection and stop any scrutiny. These companies were all set up just one day before VGH signed the deal with the Maltese government, a full five months before a call for any proposals for hospital concessions were made.

Those involved in the deal were revealed through an investigation with The Shift News and were found to include a number of Pakistani citizens, individuals who bought Maltese citizenship, Shaukat Ali Abdul Ghafoor who is still negotiating with other governments in Eastern Europe using the Malta bid to win new contracts even though the consortium failed to deliver in Malta, and Ram Tumuluri who has a less than stellar reputation.

Enter Steward Healthcare

VGH- penniless and in debt, but in possession of a deal worth over EUR 7 billion, was sold to Steward Healthcare for the grand sum of EUR 1. Whilst Maltese taxpayers lost millions, the ‘hidden investors’ behind VGH received a fortune.

Investors involved in VGH had set up a number of companies in Jersey for the purpose of receiving payoffs and “commissions” from the sale of the concession. The companies were closed shortly after, indicating that the commissions included in the sales contract were paid.

It was also discovered that one of the companies involved in the complex web of owners and shareholders, Bluestone Ltd still had shares meaning they profited from both the sale, and the acquisition of VGH.

When this came to light, Maltese courts decided that the government ministers who signed the MoU as well as those who negotiated the deal would be subjected to a criminal magisterial inquiry. The case is ongoing.

Who Are Steward?

Steward Healthcare are the largest for profit healthcare network in the US. No strangers to controversy, they are in hot water in the US for labour law violations in Massachusetts and for failing to provide audited financial statements, as required by law for two years. After being fined by the government, they still refused to submit the statements as well as the fines levied against them. They then sued the state of Massachusetts to try and keep their financial information secret.

It was also discovered that the company reported an operating loss of $270 million in 2018, and $322 million in 2017 whilst all other hospitals in the area operated at large profit. Furthermore, federal funding that they received from the government did not appear to trickle down into paying salaries, improving hospitals, and conditions for patients and staff.

Sound familiar?

How is Albania involved in this?

Operating with the full knowledge they were ripping off Maltese citizens and that sooner or later, they would be ousted, it was important that any deals in the Balkans would go through without scrutiny from the public and the media. The name VGH was sullied and after The Shift News published their investigations into the deal, and Steward, the Albanian government would need a back door if plans were to go ahead.

Tumuluri paid a visit to Albania along with other VGH/Steward investor Shaukat Ali Abdul Gafoor.

On 26 of August 2016, the government of Montenegro signed a Memorandum of Understanding with Vitals Global Healthcare (VGH) and just eight months later on 3 April 2017, the Montenegrin Ministry of Health signed a MoU with the Albanian Ministry of Health, to “promote cooperation in the field of health and medical sciences, inspired by the principles of equal and mutual benefit.”

The MoU, seen by, also agreed to the “promoting of contacts between institutes, hospitals, and organisations operating in the field of health in both countries”.

This would also include “other forms of cooperation in the field of health”, “management of health facilities”- broad language, for a reason.

The agreement was valid for two years and is automatically renewable for the same period of time.

As ownership changed from VGH to Steward in Malta in 2018, the Montenegrin government signed another agreement, this time with Steward, containing many of the same provisions as the previous MoU.

In 2019, following a freedom of information request made by Exit, the government in fact denied any agreements with Vitals Global Healthcare, but said nothing about Steward.

With the MoU in place between the Montenegrin government and Vitals/Steward, followed by the MoU in place between the Montenegrin and Albanian Ministries of Health, Steward were now free to negotiate deals in Albania, via Montenegro without being detected.


In the next article, we will reveal more about the Albanian PPP as well as VGH and Steward’s dodgy dealings in Malta and Montenegro.

This article was developed with the support of

In collaboration with The Shift News